Conclusions

Evidence reviewed in this chapter qualifies widely held beliefs about patterns of advantage and disadvantage in food allocation within households. We find little support for the notion that the youngest children tend to get less than a fair share of household food supplies: estimates of their food consumption have often been biased downwards by the omission of breastmilk from food-consumption data.

Rates of child malnutrition measured by caloric intake and anthropometry for boys and girls are quite similar in most countries. In household surveys, where both boys and girls fail to meet their nutritional needs, the usually small differences are as likely to favour females as males. These data do not only counter the notion that girls suffer hunger more than boys, almost everywhere: they contradict it even for India - the source of many of the studies that claim to document discrimination against girls in intra-household food allocation and from which broad geographic generalizations have been drawn. Although the sweeping generalization that Indian girls are discriminated against in the intra-household allocation of food is not supported by the data, there is strong evidence of such discrimination among Indians of high socio-economic status. The simple fact that the Hyderabad standard, which is normed from the anthropometric measurements of the Indian elite, incorporates gender bias would serve as adequate evidence of discrimination, even in the absence of village studies showing more discrimination against females in wealthier households.

We find that the generalization that adult women receive less than an equitable share of household food also requires qualification. For countries where women's intake data can be categorized by reproductive status, the diets of non-pregnant, non-lactating women are more adequate than those of men (though in most of these countries men and women are both undernourished). However, there is also compelling evidence of nutritional disadvantage for pregnant and lactating women in these same countries. Thus, even in populations in which women's status in general is low, we cannot assume that a simple pattern of gender discrimination in intrahousehold food allocation explains the poor diets of pregnant and lactating women.

The association of the most severe undernutrition with pregnancy and lactation implies that it really is in their roles as mothers that women experience the greatest nutritional stress. The particularly inadequate diets of women at these times compromises both their own and their children's health. This pattern calls for targeted interventions seeking to improve women's nutrition during pregnancy and breast-feeding. Most efforts to deal with hunger among women are oriented towards the nutritional stresses of reproduction; this orientation appears quite appropriate. A better understanding of the reasons for the declining adequacy of women's diets during pregnancy and lactation, however, may be necessary in order to develop interventions that will succeed in countering it. But, even with the available information, we conclude that these interventions need to do more than improve women's general status. The more favourable intakes of reproductive-aged women who are neither pregnant nor lactating argues against generalized discrimination and indicates that the nutritional needs during pregnancy - but particularly while breast-feeding - are either not well understood by women and their households or (for other reasons, including poverty) not addressed. The effect of other possible contributing factors, such as consumption of foods that are not sufficiently nutrient dense, might be countered by greater awareness of increased need as well.

Given that data on women's energy expenditures are generally unavailable, we must draw attention to the possibility that women's caloric needs are underestimated by common methodologies. The energy needs of women whose domestic and/or paid work is particularly arduous are especially likely to be underestimated. Interventions that target these women and improve understanding of their increased needs may also be appropriate.

If better information on actual energy expenditures in developing countries revealed higher energy needs for women (but not for men) than are commonly assumed, the adequacy of women's diets relative to need would be lower than indicated by the data presented in this chapter, while men's would stay the same. Non-pregnant, non-lactating women might continue to enjoy a relative advantage over men (but a smaller one), a picture of equitable food distribution might emerge, or men's diets might prove to be more adequate relative to need than women's - depending on the magnitude of the adjustment. Finally, the detailed age data on children's malnutrition also pinpoint the critical importance of weaning problems. Data permitting documentation of the weaning practices in different populations in comparable form are now available for the first time from the series of Demographic and Health Surveys (currently in Round III). Further investigation of weaning practices actually used in different populations, and the consequences of these practices for children's health and development, should be a high priority.

Notes

1. There is little room for doubt that nutritional differences are largely responsible for the smaller body sizes of Indians compared with Americans. However, this comparison provides no information about women's food deprivation relative to men's within the same society. In fact, while, on average, Indian women weigh about 75 per cent as much as American women, the comparable figure for males is only 65 per cent (James and Schofield 1990). Indians are less well fed than Americans, but this particular comparison provides no support for the belief in a female disadvantage within India.

2. Since sample sizes are not given, this can be identified only as a possibility.

3. Chen et al. (1981) refer to the physical activity adjustment as "the most crude and difficult adjustment" which they make. They used labour force participation data from the 1974 census and WHO/FAO guidelines to calculate a 26 per cent average incremental requirement for men aged 15-44 years; the increments for adolescents and men over 45 were slight. Adjustments for female work using the same set of recommendations yielded a 6 per cent increase for adult women, in part because of lack of quantitative information on the energy demands of household and home-based work.

4. The higher mortality of females in India may be a thing of the past; the more usual pattern of a female advantage in life expectancy seems to be emerging (Dyson 1989).

5. Brown et al. (1992) provide data on proportions of children still breast-fed and on amounts of breastmilk consumed by children by detailed age; they also cite previous analysis of the composition of breastmilk in the same poorly nourished population. These elements combine to define the caloric value of breastmilk consumption by detailed age of children in rural Bangladesh.

Works cited

Brown, Kenneth H., Robert E. Black, Stan Becker, Shamsun Nahar, and John Sawyer. 1982. "Consumption of Food and Nutrients by Weanlings in Rural Bangladesh." American Journal of Clinical Nutrition 36 (November): 878 889.

Bryceson, Deborah Fahy. 1989. "Nutrition and the Commoditization of Food in Sub-Saharan Africa." Social Science and Medicine 28, No. 5: 425 440.

Carlson, B., and T. Wardlaw. 1990. "A Global, Regional and Country Assessment of Child Malnutrition." UNICEF Staff Working Papers 7. New York, NY: UNICEF.

Chen, Lincoln C., Emdadul Huq, and Stan D'Souza. 1981. "Sex Bias in the Family Allocation of Food and Health Care in Rural Bangladesh." Population and Development Review 7, No. 1: 55-70.

Das Gupta, Monica. 1987. "Selective Discrimination against Female Children in Rural Punjab, India." Population and Development Review 13, No. 1: 77-100.

_____. 1995. "Life Course Perspectives on Women's Autonomy and Health Outcomes." American Anthropologist 97, No. 3: 481-491.

den Hartog, A. P. 1973. "Unequal Distribution of Food Within the Household (A Somewhat Neglected Aspect of Food Behaviour)." FAO Nutrition Newsletter 10, No. 4: 8-15.

Dyson, Tim. 1989. "A Further Note on Trends in the Sex Differential in Mortality in India." Paper for informal session on sex differentials in mortality, IUSSP Conference, New Delhi, 1989.

Garcia, M., and P. Pinstrup-Andersen. 1987. The Pilot Food Price Subsidy Scheme in the Philippines: Its Impact on Income, Food Consumption, and Nutritional Status. Washington, D.C.: International Food Policy Research Institute.

Grant, James P. 1985. The State of the World's Children 1985. New York: Oxford University Press for UNICEF.

Gross, Daniel R., and Barbara A. Underwood. 1971. "Technological Change and Caloric Costs: Sisal Agriculture in Northeastern Brazil." American Anthropologist 73, No. 3:725 740.

Grummer-Strawn, Laurence M. 1991. "Trends in Breast-feeding Behavior in Fifteen Developing Countries." Presented at the 119th Annual Meeting of the American Public Health Association, Atlanta, Georgia, November 1991.

Haaga, J. G., and J. B. Mason. 1987. "Food Distribution Within the Family." Food Policy 12, No. 2: 146-160.

Hamilton, Sahni, Barry Popkin, and Deborah Spicer. 1984. Women and Nutrition in Third World Countries. Praeger Special Studies. New York: Bergin & Garvey.

Harriss, Barbara. 1986. "The Intrafamily Distribution of Hunger in South Asia." Paper for WIDER Project on Hunger and Poverty; Seminar on Food Strategies, Helsinki, 1986.

Hossain, Mosharaff. 1987. The Assault that Failed: A Profile of Absolute Poverty in Six Villages of Bangladesh. Geneva: United Nations Research Institute for Social Development.

James, W. P. T., and E. C. Schofield. 1990. Human Energy Requirements: A Manual for Planners and Nutritionists. New York: Oxford University Press.

Kanbur, S. M. R. 1991. "Malnutrition and Poverty in Latin America." In: J. Drèze and A. Sen, eds. The Political Economy of Hunger, Volume III. Oxford: Clarendon Press, pp. 119154.

Katona-Apte, Judit. 1975. "The Relevance of Nourishment to the Reproductive Cycle of the Female in India." In: Dana Raphael, ed. Being Female: Reproduction, Power, and Change. The Hague: Mouton, pp. 43-48.

Kynch, Jocelyn, and Amartya Sen. 1983. "Indian Women: Well-Being and Survival." Cambridge Journal of Economics 7: 363-380.

Malik, N. S., and S. J. Malik. 1992. Reporting on the World Nutrition Situation: A Case Study of Pakistan (1976-1991). Report prepared for the ACC/SCN of the United Nations. Islamabad, Pakistan: Economics Department, Quaid-e-Azam University and Washington, DC: IFPRI.

McGuire, J. S., and B. M. Popkin. 1990. Beating the Zero-Sum Game: Women and Nutrition in the Third World. Administrative Committee on Coordination/Subcommittee on Nutrition, Discussion Paper 6. Geneva: ACC/SCN Secretariat.

Miller, Barbara D. 1997. "Social Class, Gender and Intrahousehold Food Allocations to Children in South Asia." Social Science and Medicine 44, No. 11: 16851695.

Millman, S. R. 1986. "Trends in Breast-feeding in a Dozen Developing Countries." International Family Planning Perspectives 12, No. 3: 91-95.

_____. 1987. Breast-feeding Trends in Eighteen Developing Countries. Research Triangle Park, NC: Family Health International.

_____. 1990. "Update on Breast-feeding Trends." In: R. S. Chen, ed. The Hunger Report 1990. Providence, Rhode Island: Alan Shawn Feinstein World Hunger Program, pp. 71-72.

NNMB. 1980. Report for the Year 1979. Hyderabad, India: National Institute of Nutrition.

_____. 1981. Report for the Year 1980. Hyderabad, India: National Institute of Nutrition.

_____. 1982. Report on Urban Population. Hyderabad, India: National Institute of Nutrition.

_____. 1989. Interim Report of Repeat Survey (Phase I)1988-89. National Nutrition Monitoring Bureau.

Pitt, Mark M., M. R. Rosenzweig, and Md Nazmul Hassan. 1990. "Productivity, Health and Inequality in the Intra-household Distribution of Food in Low Income Countries." American Economic Review (December): 1139-1156.

Rogers, Beatrice Lorge. 1983. The Internal Dynamics of Households: A Critical Factor in Development Policy. A report to the United States Agency for International Development. Medford, MA: Tufts University School of Nutrition.

Sen, Amartya K. 1988. "Family and Food: Sex Bias in Poverty." In: T. N. Srinivasan and Pranab K. Bardhan, eds. Rural Poverty in South Asia. New York: Columbia University Press, pp. 453-472.

_____1989. "Women's Survival as a Development Problem." Bulletin of the American Academy of Arts and Sciences 43, No. 2: 14-29.

Senauer, Benjamin. 1990. "The Impact of the Value of Women's Time on Food and Nutrition." In: Irene Tinker, ed. Persistent Inequalities: Women and World Development. Oxford: Oxford University Press, pp. 150-161.

Sharma, R. K., S. O. Rutstein, M. Labbok, G. Ramos, and S. Effendi. 1990. "Trends and Differentials in Breast-feeding: Findings from WFS and DHS Surveys." Population Association of America Annual Meeting, Toronto, 1990.

Stinson, S. 1985. "Sex Differences in Environmental Sensitivity During Growth and Development." Yearbook of Physical Anthropology 28: 123-147.

Svedberg, Peter. 1990. "Undernutrition in Sub-Saharan Africa: Is There a Gender Bias?" Journal of Development Studies 26, No. 3: 469-486.

Trussell, James, Laurence Grummer-Strawn, Germán Rodriguez, and Mark Van-Landingham. 1990. "Trends and Differentials in Breast-feeding Behavior: Evidence from the WFS and DHS." Population Association of America Annual Meeting, Toronto, 1990.

Van Esterik, Penny. 1984. Intra-Family Food Distribution: Its Relevance for Maternal and Child Nutrition. Cornell University, Cornell Nutritional Surveillance Program Working Paper Series No. 31. Ithaca: Cornell University Press.

Watkins, Susan Cotts, and Jane Menken. 1985. "Famines in Historical Perspective." Population and Development Review 11: 647 675.

World Bank. 1992. World Development Report 1992. Washington, D.C.: World Bank.

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