Gender relations of power constitute the root causes of gender inequality and are among the most influential social indicators of health (Phillips, 2011). They operate across a wide spectrum of human life and influence how people relate to each other and organize their everyday life and work. The structure that governs gender systems is manifested through beliefs, norms, organization, and everyday practices. They play a crucial role in determining the degree of control humans have over their lives and health, whether their needs are acknowledged or not. Gender disparities affect the distribution of resources, power, authority, and control, which in turn influence the well-being of many girls and women across the globe.

Women are seen as standing at the crossroad between care activities and productive activities (Razvi & Roth, 2004). Women’s association with childcare is crucial because, despite the consumption of nutritious food, a child can suffer from malnutrition due to poor health and inappropriate caregiving practices (Smith & Haddad, 2000). While purchasing power is important for food availability within the household, non-food indicators such as feeding practices, weaning, and maintenance of domestic hygiene remain exclusively within a woman’s domain (Haddad et al., 1995). The crucial role of women in the child’s nutritional well-being emanates from their traditional and natural reproductive roles and, in some cases, in terms of their contributions as income earners. Within all the socio-economic elements, gender has one of the biggest penetration in the entitlement structure of food and nutrition. It factors itself into almost all layers of discrimination in the environment (Choudhary, 2015).

Gender (as part of the social structure) can influence the nutritional status of the child in two ways: first, by encouraging direct discrimination between the male and female child in terms of resource allocation. In the Indian context, especially in rural India, boys are prioritized, and more money is spent on their clothing, healthcare, and food. These practices directly influenced the child mortality rate (Das Gupta, 1987). Such practices can lead to differences in the nutritional status of the child, in which girls are found to be more malnourished than boys. India has the largest share of missing women (Sen, 1995).

Despite the good documentation of the cultural preference for male children in India (Kishor, 1995; Griffiths, Mathews, & Hinde, 2002), there is a considerable debate in the scholarly works and literature regarding whether sex differentials affect the nutritional outcomes or not. Some studies do not support gender as a crucial influencing factor as far as child nutrition is concerned. A set of literature on intra-household food distribution has displayed slight evidence of inequity against female children in feeding (Haddad et al., 1996). Mishra et al., (1999) studied the data from a national survey of India and found that male children and female children are about equally likely to be stunted and underweight. Basu (1992) investigated field data from India and drew from a strong review of literature on food allocation in households in South Asia, known for its widespread gender inequality, and found no evidence related to gender discrimination in feeding among males and females children. Marcoux’s (2002) review of child nutrition surveys from developing economies found no strong correlation between gender discrimination and undernutrition.

I argue that even in the absence of direct discrimination between male and female children in terms of distribution of food and resources within the household, there still exists a gendered dimension of child malnutrition. This brings us to the second kind of influence, which emanates from certain practices, which, over time, influence the nutritional status of the male or female child. Here, the gender of the caregiver and their capacity to perform childcare practices becomes more important than the gender of the child. Taking care of a child is usually considered the responsibility of the mother, and therefore the factors which affect the life chances of the mother and through her the well-being of the child (even if the child is not subjected to any direct discrimination) are crucial. Gender is one such important factor that influences the child’s nutritional well-being by influencing the mother’s health, knowledge about childcare practices, and the capacity to make decisions. Central to the dynamics of care practices in India is the ideology of gendered familialism (which assume a uniform practice of care by women within the family), which reiterates care as a familial and female responsibility and works to devalue and diminish the dimensions of care (Palriwala & Neetha, 2009). It is not only a refusal to recognise care as a public responsibility but an inability to comprehend that women have to combine multiple works (including outside paid work and unpaid domestic work) with their care responsibilities, especially in childcare. It limits women’s ability to acquire the resources necessary to enable care. Gender is an important stratifier that bears upon health operating through norms, social values, and perceptions. Together gender, socio-cultural pathways, and their interplay constitute the gendered structural indicators of health.

Within the socio-cultural factors, the notion of gender has been acknowledged in various studies in the field of malnutrition. While the quantitative correlation of women’s education for the child’s well-being has been acknowledged the qualitative aspect and the need to understand the local cultural beliefs, sentiments, and practices to initiate any change or efforts in the direction of maternal health, childcare, and nutritional well-being is still fragile.

Intersectionality i.e. examination of intersection among different social hierarchies, yields new insights into the social indicators of health (Iyer et al., 2007). Income/wealth is a crucial source of social inequity, but a proper understanding of its impact on health requires an understanding of how it interacts with other sources of inequity, such as gender. The work on gradient and gaps shows us easily enough that the economically poor are worse off in both health access and health outcomes as compared to the economically stronger group. But what is not clearly stated is whether the burden of this inequity is borne equally by different members of different gender groups. Nor does it tell us whether the burden of health inequity is shared equally among members of poor households. The answer to these questions is not easy because of the multidimensional nature of the problem and the complex intersection of multiple factors such as wealth, gender, and kinship. To understand how gender as social structure conditions the nutritional outcomes, the ground-level experience of the mothers needs to be considered to understand the different contexts under which gendered norms and values obstruct/facilitate their role as a caregiver. It is only by emphasizing the everyday lives of the caregiver and explaining the different areas where gendered norms and values affect their capacity to perform childcare practices, one can present insights into how different gender variables condition the nutritional outcome of the child.

References:

Basu, A. M. (1992). Culture, the status of women, and demographic behaviour: Illustrated with the case of India. Clarendon Press.

Choudhary, N. (2015). Malnutrition in Mumbai slums: entitlement analysis of group differentials in basic capabilities. South Asia Research, 35(3), 280-297.

Griffiths, P., Matthews, Z., & Hinde, A. (2002). Gender, family, and the nutritional status of children in three culturally contrasting states of India. Social Science & Medicine, 55(5), 775-790.

Gupta, M. D. (1987). Selective discrimination against female children in rural Punjab, India. Population and Development Review, 77-100.

Haddad, L. J., Peña, C., Nishida, C., Quisumbing, A. R., & Slack, A. (1996). Food security and nutrition implications of intrahousehold bias: a review of literature.

Haddad, L., Brown, L. R., Richter, A., & Smith, L. (1995). The gender dimensions of economic adjustment policies: potential interactions and evidence to date. World Development, 23(6), 881-896.

Iyer, A., Sen, G., & Östlin, P. (2007). Intersectionality in health and health care: a review of research and policy. Paper commissioned by the Women and Gender Equity Knowledge Network

Kishor, S., Gupta, M. D., Chen, L. C., & Krishnan, T. N. (1995). Women’s health in India: Risk and vulnerability. Das Gupta M, Krishnan TN, Chen LC, Gender differentials in child mortality: a review of the evidence: Oxford University, 19-54.

Marcoux, A. (2002). Sex differentials in undernutrition: A look at survey evidence. population and Development Review, 28(2), 275-284.

Mishra, V., Lahiri, S., & Luther, N. Y. (1999). Child Nutrition in India. National Family Health Survey Subject Reports No. 14. International Institute for Population Sciences, Mumbai.

Palriwala, R., & Neetha, N. (2009). The care diamond: State social policy and the market.

Phillips, S. P. (2011). Including gender in public health research. Public Health Reports, 126(3_suppl), 16-21.

Razvi, M., & Roth, G. L. (2004). Socio-Economic Development and Gender Inequality in India. Online Submission.

Sen, A. (1995). Gender inequality and theories of justice. Women, culture and development: A study of human capabilities, 259-273.

Smith, L. C., & Haddad, L. J. (2000). Explaining child malnutrition in developing countries: A cross-country analysis (Vol. 111). Intl Food Policy Res Inst.

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Pragati Dubey completed her BA in Sociology from Presidency College, Calcutta, and MA in Sociology from Presidency University, Kolkata. At present, she has submitted her doctoral research (Sociology) at the IIT Bombay Monash Research Academy. She is advised by Professor Devanathan Parthasarathy (IIT Bombay) and Professor Dharma Arunachalam (Monash University).