As part of our work to integrate gender into nutrition programming implemented via women’s groups under the National Rural Livelihoods Mission (NRLM), we conducted a formative study in 2018 to gauge the social-cultural milieu of our Swabhimaan intervention sites in Bastar, Chhatigarh. The study was intended to inform programme design to engage men for gender transformative action, based on the felt need to specifically address gendered underpinnings impacting nutrition interventions in the field. Swabhimaan midline evaluation results also showed little impact on women’s descision making. In this post we share some reflections on our findings on why programmes for women and girl’s nutrition must engage men in conversations on gender, and how we are attempting to do this via NRLM’s women’s groups and their existing platforms.
Gender and Nutrition
Lalita Kashyap, a gender resource person and a master trainer under the Chhattisgarh Rural Livelihoods Mission told us about how her relationship with her husband’s family is strained because her son suffers from sickle cell anemia. They blame this on the kathal sabzi or jackfruit that Lalita had absent-mindedly eaten at a neighbour’s house when she was pregnant with him. The family had heard that if breastfeeding mothers ate kathal, it could make the baby gravely ill. Jackfruit, which is rich in vitamin C, fibre and minerals, available abundantly across Bastar’s barren landscape is one of several nutritious foods including bananas, custard apples, pumpkin, colocasia and red meat that are forbidden to pregnant women and young mothers. Emic explanations reveal various beliefs on the negative effects of these foods on the child, and that eating too much could make giving birth harder. That 57% of Bastar’s pregnant women are anemic and 37% have low BMI (NFHS-4) is then unsurprising. For Lalita this has meant that every time her son is sick and there are hospital bills to be paid, she faces violence and is blamed with a taunt - “Tu kathal khayi, isliye hua” (you ate the jackfruit, which is why he is like this).
Various studies have acknowledged the pervasiveness of food taboos that leave young mothers nutritionally disadvantaged during the first 1000 days. Culturally in South Asia, women are also usually the last to eat in the family and often end up with the least. Further, evidence from South Asia as well as our own research in Bastar has shown that in addition to norm abidance, a partner’s heavy alcohol use and intimate partner violence adversely impact women’s health and food security status and potentially contribute to differential nutritional outcomes within the same household. Poverty may account for the reduced quantity or variety of food on the plate, it does not explain the disproportionate sacrifice made by women.
Why DAY-NRLM’s approach must work engage men
Women’s self-help groups under DAY-NRLM, primarily envisaged as community-based credit institutions, have emerged as promising catalysts to lead behaviour change interventions on health and nutrition, given their vast networks, organisational readiness to manage grants for livelihoods as well as community development activities. But in order to impact women’s overall wellbeing, programmes must take cognizance of how the relation between women’s economic empowerment and improved nutrition levels is complex, as this study highlights. Better economic decision making as a result of improved access to income or livelihood opportunities for women needn’t translate into equal division of food at the table or equal priority for accessing quality healthcare. Key messages used in community- based nutrition interventions must thus be re-worked with a gender lens targeting not just women, but families; particularly mothers-in-law, who are keepers of food traditions and husbands and sons who are often prime decision-makers in the family.
Building on prior initiatives to address gender discrimination
NRLM recognises gender as a cross-cutting socio-cultural variable and has sought to address various gendered forms of discrimination by building capacities of its cadre. To this end, the Chhattisgarh Rural Livelihoods Mission (CG-SRLM) or Bihan which anchors the poverty alleviation programme in the state, had conducted a series of gender sensitisation training to develop community-based gender resource persons or (GRPs) to address gender discrimination in the community. Lalita whose story we shared in the beginning, is one such gender resource persons (GRP). Amongst a range of issues, she is also trained to counsel families on gendered beliefs and practices that leave women eating last and the least. This is part of our ongoing pilot where gender has been layered into Bihan's maternal and adolescent nutrition called Swabhimaan.
The intervention was designed based on a formative study conducted to understand the socio-cultural context of Bastar, as well as men and women’s perceptions around diets, marriage and pregnancy, to assess the programmatic implications of these.
Bihan’s strategy to enhance the adequacy of food intake and diet diversity among adolescent girls, pregnant women and mothers now also focuses specifically on engaging husbands of these target groups. This was also reflected in the IEC material circulated for awareness generation on maternal nutrition practices during COVID -19.
Food; an effective trigger for conversations around gender
Conversations about food are effective triggers for behaviour change as they resonate with everyone. Talking about food is also less contentious than talking about property rights and entitlements, for instance. “When we ask how a family divides a fish, most women will say the fleshy centre goes to the children, the head, which is considered most nutritious goes to the men because men need strength and the tail with all the bones to the women. In fact, women often make do with only rassa or gravy. Both men and women understand this example,” explains Lalita
The GRPs thus use food to segue into larger questions of gender, enabling families to become increasingly receptive to the power dynamics within their homes. This is key as it has also helps avoid backlash from the larger community which is a challenge for implementers of gender-transformative interventions.
For Lalita, having insight on gendered power relations in her family and discussing these with other self-help groups members has been empowering as she feels she is now better positioned to navigate these.
It is now crucial to resume work initiated earlier. Building capacities of more community leaders like Lalita, investing in their social capital and the collective strength of women’s groups to engage men, boys and families, could thus prove to be a sustainable and effective pathway to safeguard women’s nutrition.
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