How Women’s Empowerment Reduces Child Hunger

Burkina Faso, a small West African country, is experiencing a child public health crisis. 88 percent of children under five years old are anemic, 16 percent are wasted — meaning they weigh too little for their height (a good predictor of mortality), and 35 percent are stunted. Past studies have suggested that interventions offering education about nutrition alone are unsuccessful in improving child health outcomes.

A recent study by Jessica Heckert, Deanna K. Olney, and Marie T. Ruel from the International Food Policy Research Institute (IFPRI) evaluates the impact of the Enhanced Homestead Food Production (E-HFP) program in Burkina Faso, a two-year “integrated agriculture, nutrition, and health program” that aimed to mitigate undernutrition in children by empowering women.

The E-HFP program empowered mothers by providing agricultural training and supplies, behavioral change communication programming to improve child feeding, health, hygiene, and care practices, and community-driven land-use agreements that center women’s right to land. The authors measure the program’s effect on women’s empowerment and control of household resources via four distinct domains: spousal communication, purchasing decisions, healthcare decisions, and family planning decisions. Their conclusions show that improving women’s agency to act on increased knowledge about nutrition is essential to combatting the detrimental effects of malnutrition.

The authors to examine the effects of the four above-mentioned domains of women’s empowerment on wasting rates and hemoglobin concentration (lower than normal levels of which indicate anemia). They find that empowering women to control their children’s nutrition leads to decreased rates of child wasting, specifically improving average height for age and weight for height ranges.

The study examines E-HFP data to test three hypotheses. First, that women’s empowerment is associated with lower rates of wasting and higher concentrations of hemoglobin. Second, that empowerment and household income status go hand in hand to enable families to leverage the limited resources available to them, supposing that higher household income status means families have more resources available to them and are better positioned to provide healthy food options and frequent doctor visits. And finally, that the E-HFP’s impact on wasting and hemoglobin levels was due in part to its ability to empower women through the previously described four domains.

Wasting rates were lower for children aged 3-5 months when women were empowered to make purchasing and healthcare decisions and came from economically better-off households, which aligns with both the first and second hypotheses. For children aged 6-12 months, they found a decrease in wasting rates when their mothers were evaluated based on their aggregate empowerment score, and especially based on their empowerment to make purchasing decisions.

Surprisingly, hemoglobin concentration in children aged 6–12 months had a negative association with spousal communication and family planning decisions. This is the opposite of what was hypothesized but, as the authors suggest, the results need to be evaluated within the context of Burkina Faso. In a low-income country where the average household lacks basic resources, high rates of anemia in children may mean that signs of low hemoglobin concentration, such as fatigue, go unnoticed by parents. Therefore, programs that combat child undernutrition should also educate mothers on mitigation techniques, such as supplying more iron-rich foods, and warning signs of low hemoglobin levels.

In evaluating the E-HFP’s impact on mother’s empowerment, the authors find the program to be effective in increasing women’s agency to make purchasing decisions and communicate with their spouses about their family’s nutritional needs. It had no significant effect on women’s healthcare or family planning decisions. None of the empowerment domains had an effect on hemoglobin levels.

Based on these results, Heckert, Olney, and Ruel conclude that their hypothesis was partially confirmed: women’s empowerment is positively associated with lower rates of child wasting, perhaps due to the freedom of making purchasing decisions that financial stability allows. Lower child wasting rates are more likely when women are empowered to choose nutritious food at the market, make healthcare decisions for their children, choose how many children to have and the time between each pregnancy, and most importantly, advocate to their husbands about these decisions. The women in the study were able to leverage their voices and resources to better support the health of their children.

This study offers the first experimental evidence demonstrating that women’s empowerment is an instrument for alleviating the effects of child undernutrition.  The authors show that by incorporating stronger gender programming in nutrition-sensitive agriculture programs, policymakers can increase the overall impact of such interventions. Policies that aim to end gender inequality will have widespread effects, creating healthier families and better prospects for generations to come, proving the importance of prioritizing gender equity.

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Article Source: Heckert, Jessica, Deanna K. Olney, Marie T. Ruel. 2019 “Is Women’s Empowerment a Pathway to Improving Child Nutrition Outcomes in a Nutrition-Sensitive Agriculture Program?: Evidence from a Randomized controlled Trial in Burkina Faso.” Social Science & Medicine, 233, July: 93-102. https://doi.org/10.1016/j.socscimed.2019.05.016.

Featured Image: Gilles Paire, iStockPhoto