Author: Eira Mishra
Gender Discrimination is still prevalent in different dimensions of life throughout the world. This is the situation even when there have been significant advances in gender equality in recent decades. This paper analyses the discrimination in nutrition and childcare for female children in India which has aggravated itself in form of high female mortality as has been highlighted by many studies. This paper explores disparity in childcare, nutritional status and mortality between both genders in Indian society. The final section proposes solutions which aim to direct more attention and resources to the nutritionally marginalized sector of society.
The nature and extent of the discrimination vary considerably across countries and regions. In almost all developing countries, women are not equal to men in legal, social, and economic rights. They lack access to and control of resources, economic opportunities, power and voice in all spheres of life. This inadequacy in turn also hampers the growth of society as women constitute 50% of the population. Insufficient and poor diet and repeated exposure to diseases combined with improper care during childhood are the major causes of malnutrition among children. It is a well recognized fact that malnourished children will grow into malnourished adults with lower capacities and abilities. The disastrous effects of child marriages also aggravate the problem. Various policies have been initiated to guarantee equitable access to life skills. But their effectiveness can be ensured only when the primary issues of food security, nutrition, poverty and gender equity are addressed.
According to the Food and Agricultural Organisation (FAO), mostly women and children experience hunger as a defining characteristic of their lives. Nearly 96% of those suffering from hunger live in the developing countries, with Sub-Saharan Africa and South Asia the hardest hit1. There are numerous ways to describe food security. The FAO provides one of them as “when people must live with hunger and fear starvation”2. Reutilinger defines food insecurity as lacking “access by all people at all times to enough food for an active healthy life”3. Food insecurity thus denotes prevalence of hunger in a society, emphasizing the structural factors affecting an individual, household, group, or country without guaranteed access to food. Children, being dependant on others, suffer increased vulnerability. Girl children are prejudiced against and, hence, form the most food insecure part of the population.
Food insecurity and gender discrimination are widespread issues and as per FAO4approximately 18% of the Indian population suffers from under-nutrition. These issues are extremely gendered and relevant statistics show that women are vulnerable to food insecurity and poverty than men. The 2005-06 National Family Health Survey5established that nutritional deficiency is high amongst Indian women. 36% have a Body Mass Index (BMI) below 18.5, almost half of girls between the ages of 15-19 are undernourished; and 25% of women in urban areas and 41% of women in rural area suffer from under- nutrition.
National Family Health Survey (NFHS) also found that women are twice as much susceptible to anemia than men and more than 50% women in rural India suffer from mild or moderate anemia. 59% pregnant women were found to be anemic severely impacting the health of the child and their own health. Social and economic discrimination are determining factors in women’s accessibility to food.6
Points to remember
Disparity in Childcare
The primary growth of a child is dependent upon the time duration and regularity of breastfeeding received because breast milk provides important nutrients to infants and young children and protects them against certain infections. Even though breastfeeding is universal in India, studies indicate the presence of gender inequality in frequency and duration for female and male children7. As per these studies, female infants are breastfed less frequently and for shorter durations than male infants. They are subjected to weaning earlier than their male counterparts and are fed comparatively low quality food. The results of the NFHS8show that the median duration of breastfeeding for male children is almost two months more than female children. The states that show a very high difference in the duration of breastfeeding include Assam, Punjab and Sikkim, where male children are breastfed for six months longer than female children. However, female children in the states of Madhya Pradesh, Jammu & Kashmir, and Karnataka are breastfed for a slightly longer duration. The lowest gender disparity is observed in Bihar, where median duration of breastfeeding is the same for both male and female children.
It is vital for children to be immunized against many childhood diseases which may be fatal in absence of such requisite immunisation. The Government of India offers free vaccination services to protect children from life-threatening diseases like polio, measles, BCG, DPT, tetanus, whooping cough etc. The Universal Immunization Programme by the Government targeted to cover at least 85 % children against these vaccine preventable diseases.
Disparity in Nutritional Status
The physical growth and development of children is dependent upon the dietary intake and protection from the infectious and parasitic diseases. Few studies have compared gender disparity in the extent of nutritional status of children. A study by Barbara Harris shows that the household dietary intakes in different parts of the subcontinent, of pre-school girls, are worse off than that of boys9. Lavinson10, in his study, found that in both moderately and severely malnourished children the proportion of girls was higher than boys. There is extensive difference in the intensity of under-nutrition at the State level. Bihar, Madhya Pradesh and Orissa have the largest %age of undernourished children. More than half of the children in these states are underweight. The lowest level of undernourishment is seen in Sikkim with nearly one-fifth of the children being underweight. In terms of gender inequality in weight of children, Gujarat shows the highest level of disparity with 50 % of the female children being underweight compared with 40 % of the male children.
Stunting is a more widespread phenomenon in states of Assam, Bihar, Rajasthan and Uttar Pradesh, where more than half of the children are stunted. Stunting is least in Kerala and Goa. In most of these states stunting is higher for female children in proportion to their male counterparts. Disparity in stunting is highest in West Bengal, where 28 % more females are stunted compared to males.11
Disparity in Mortality
Worldwide infant and child mortality rates have witnessed a decline in recent years, with a large portion of the world seeing young girls experiencing higher rates of survival than young boys. On the other hand, India continues to be an exception to this positive trend. A new report, ‘Sex Differentials in Childhood Mortality’12, a project of the U.N.’s Department of Economic and Social Affairs (UNDESA), reveals that a girl aged between one and five years is 75 % more likely to die than a boy, marking India as the world’s most extreme case of gender disparity in child mortality. According to the 2011 Census13and other national statistics, 700,000 girl children are missing at birth (due to termination of pregnancy once a fetus’ sex is confirmed, -infanticide) and experts say this may reach the one million mark in this decade if serious effort is not made to reverse or halt it. The shambled Public Distribution System (PDS), by way of which essential food items are provided to poorer families at subsidized rates, is an important reason for this crisis, since parents who cannot feed their children grow desperate. There is a deep seated ‘son preference’ in our country. Neonatal child mortality is also linked with the problem of malnutrition.
Economic growth is necessary but not sufficient to accelerate reduction of hunger and malnutrition. In a country that thrives on gender discrimination and is biased against half of the population of the country, there remains little hope of eradicating hunger and malnutrition in total. The need of the hour is to develop a gender-equal society. The National Food Security Bill14has been introduced with the intent of providing food security to all sections of people. Yet several parts of the bill need to be re-looked at, to ascertain inclusiveness of equitable distribution so that underprivileged and voiceless sections like girl children are not left out of the ambit of the bill. Anganwadi15centres are a prominent source of food security for children today. Approximately 15,000 of the total of 10.44 lakh anganwadi workers operate in open spaces today. Facilities such as drinking water, toilets and kitchen equipment are lacking in most of them. Moreover, Anganwadi workers are not sufficiently remunerated for their work. The failure to make this initiative fully functional has resulted in a diminution in its impact. An implementation plan and budget should be developed to guarantee that the Food Security Bill is fully implemented. Ensuring full functionality of initiatives contained in the bill, implementation and monitoring mechanisms must be integrated. Furthermore, these mechanisms ought to be transparent and secure in order to ensure that the allocated budgetary amounts are spent appropriately and judiciously.
Women, especially girl children, constitute the most nutritionally marginalised section of society. The bill should be made more gender-sensitive and incorporate specific provisions securing girl child’s right to a sufficient food. The current categorisation of general and priority categories does not clearly relate to women. Hence, additional categories need to be introduced for including women and specifically ensuring their right to food. Otherwise, this would result in excluding girl children from vital food security initiatives. The bill should also contain special provisions for scheduled caste and scheduled tribe girl children as they are victims of triple marginalisation. They are at a higher risk of malnutrition, anaemia and other health concerns. The bill focuses on cereals and cooked meals while essential food items like pulses, oils, millets, etc are excluded. Their inclusion is necessary to provide the requisite intake of proteins and carbohydrates.
The present poverty line of India is too low and hence reduces the effectiveness of implementation of government policies. Poverty line must be set at such levels so as to ensure that it becomes representative of poverty, hunger and food insecurity. Targeted programs specially designed to address malnutrition, hunger, immunisation, etc. among girl children need to be implemented In addition, the bill must make special provisions for other vulnerable groups such as the aged, disabled, widows, and migrants with a particular focus on women who are more likely to experience poverty. The bill ought to embrace a universally integrated Child Development Service, and a universal PDS must also be gravely considered.
The training of personnel in charge for implementing the Bill as well as a considerable number of women from all social groups (such as Scheduled Caste and Scheduled Tribe women, widows, single women and disabled women) is crucial and needs to be specified within the Bill. Reforms in the PDS are necessary to guarantee the equitable distribution of food grains. Payment delays and penalties in the implementation of schemes must be addressed to ensure that beneficiaries of the scheme have improved access to food. Government expenditure on agriculture must increase to ensure that food production meets the demands of a growing population.
The study reveals that India has experienced a positive change in social development and level of living. However, there exists a substantial difference in the development opportunities available to male and female children. The disparity exists in the child care practices as well as in the opportunities for educational attainment. Though there is a slight decrease in child care disparity and educational disparity, nutritional disparity has increased in the country. The disparity exists in varying degrees in all states and is noticeably high in larger states like Bihar, Uttar Pradesh, Orissa and Rajasthan. Increasing social development may help in reducing gender disparity in nutritional status of children. Although educational disparity is strongly related to social development, level of living and female autonomy, it is related to government policies towards child education and implementation of these policies.
The most prominent discovery from all these analyses is that preferential treatment of boys is very strong in the case of nutrition. There are evidences to show differences in immunization coverage and provision of treatment to girls and boys.
Eventually, gender inequalities in food and nutrition security lie at the root of the cycle of hunger and malnutrition. It is an issue of woman’s own perception of her status. Only when women begin to feel empowered and equal in status to men, will the iron grip of gender disparities weaken and break. It is then that food security will become merely an economic issue with simple solutions to the problem. Improvements in food availability and in women’s education are the keys for future progress in child nutritional status. Priority should be given to strengthen health environments. Policies should be designed in such a way so that food availabilities can increase with a reduction in mortality rate and population growth.
- Food and Agriculture Organization of the United Nations (1996). Focus: Women and Food Security, Women and Population Division (P,1). available here [↩]
- Food and Agriculture Organization of the United Nations (1996). Mapping under nutrition: An ongoing process, Rome, Italy: FAO. [↩]
- Reutlinger, S. (1986). Poverty and hunger: Issues and options for food security in developing countries. Washington, DC: The World Bank. [↩]
- Available at http://www.fao.org/docrep/016/i3027e/i3027e00.htm [↩]
- National Family Health Survey. available here [↩]
- CDE.Gov [↩]
- World Bank. Gender and Poverty in India. A World Bank Country Study. Washington, D.C. 1991 [↩]
- National Family Health Survey available at http://www.measuredhs.com/pubs/ [↩]
- Harriss, Barbara. 1990. The Intra Family Distribution of Hunger in South Asia. Dreze, J. and Sen, A., eds., 1990, The Political Economy of Hunger. Oxford, Vol. 1, Oxford, Clarendon Press: pp351-424. Print [↩]
- F.J. Levinson, Morinda: An Economic Analysis of Malnutrition among Young Children in Rural India, Cornell/MIT International Nutrition Policy Series. Cambridge, Mass., 1914 [↩]
- National Family Health Survey, 1998-99. [↩]
- United Nations Department of Economic and Social Affairs (UNDESA) (2006b) The World’s Women 2005: Progress in Statistics, New York: United Nations, available at: http://unstats.un.org/unsd/Demographic [↩]
- available at: censusindia.gov.in [↩]
- available at: http://eac.gov.in/reports/rep_NFSB.pdf [↩]
- as on 15-December, 2011. available at: http://www.pib.nic.in/newsite/erelease.aspx?relid=78742 [↩]