Going beyond the surface: Gendered intra-household bargaining as a social determinant of child health and nutrition in low and middle income countries

Abstract

A growing body of research highlights the importance of gendered social determinants of child health, such as maternal education and women's status, for mediating child survival. This narrative review of evidence from diverse low and middle-income contexts (covering the period 1970-May 2012) examines the significance of intra-household bargaining power and process as gendered dimensions of child health and nutrition. The findings focus on two main elements of bargaining: the role of women's decision-making power and access to and control over resources; and the importance of household headship, structure and composition. The paper discusses the implications of these findings in the light of lifecycle and intersectional approaches to gender and health. The relative lack of published intervention studies that explicitly consider gendered intra-household bargaining is highlighted. Given the complex mechanisms through which intra-household bargaining shapes child health and nutrition it is critical that efforts to address gender in health and nutrition programming are thoroughly documented and widely shared to promote further learning and action. There is scope to develop links between gender equity initiatives in areas of adult and adolescent health, and child health and nutrition programming. Child health and nutrition interventions will be more effective, equitable and sustainable if they are designed based on gender-sensitive information and continually evaluated from a gender perspective.

Food and nutrition security as gendered social practice

“…A similar pattern was found among single migrant women in Accra (Tufuor et al 2015). Richards et al (2013) highlight the supportive role of senior women (grandmothers) in younger women's child care practices. In the Ethiopian study discussed above (Szava 2015) the mother's mother turned out to be a much valued source of information and support regarding child nutrition and health.…”

“…Quisumbing et al 1995;Ulmer 2003). In an overview article Richards et al (2013) conclude that a large body of literature spanning twenty years provides evidence of the links between women's status and child health and nutrition. Consequently, to turn the vicious circle into a virtuous one, reducing gender inequalities by empowering women would be the obvious starting point (IFPRI 2015).…”

Tracing shadows: How gendered power relations shape the impacts of maternal death on living children in sub Saharan Africa

“…As such, women continue to be subordinated in South Africa, particularly in terms of gender-based violence, caretaking and access to health care (Coovadia et al, 2009). At the household level, the gendered interactions between poverty and the lack of education and employment opportunities which collectively undermine women's decision-making power regarding finances and resource allocation impact the level of care that women are able to provide to children, thereby perpetuating intergenerational cycles of poverty and suffering (Haddock, 2013;Richards et al, 2013).…”

The Effect of Early Marriage Timing on Women's and Children's Health in Sub-Saharan Africa and Southwest Asia

“…11 In addition, a few more years outside of marriage can increase the likelihood of these young girls to stay in education 12,13 and, relatedly, their degree of health literacy. 14 The aim of the paper is twofold.…”