Integrating Gender in Nutrition Programming: Some Considerations and Strategies
Athena Infonomics

Today day marks 110 years since International Women's Day was first celebrated in 1911. More visible forms of gender discrimination have, unarguably, reduced over these years, but less visible inequities continue to exist and persist in all aspects of life, including access to and utilization of nutritional provisions and services. Women's biological functions and roles imply loss of iron during menstruation and childbearing, making them vulnerable to deficiencies in diet, care, and health or sanitation services. Achieving progress towards SDG 2 (which seeks to end hunger, achieve food security and improved nutrition, and promote sustainable agriculture) and SDG 5 (which aims to achieve gender equality and empower all women and girls) requires effective integration of gender in nutrition-sensitive programming.

The mainstreaming of gender into programming requires integration with nutrition-sensitive sectors—such as agriculture, health, education, and WaSH—which directly or indirectly impact nutritional outcomes. Possible synergies in these interventions, achieved through an understanding of local contexts, may help increase women's status in the household, thereby leaving them with greater autonomy to make decisions. However, despite these opportunities, there exist several challenges to integrate gender into nutrition-sensitive and specific programming.

This blog shares insights from our recent work titled 'Gender Analysis to Promote Gender Mainstreaming in Nutrition Actions in Uganda' to demonstrate how a gender lens can be applied to the design, implementation, and monitoring of nutrition-sensitive programs. The research was funded by UNICEF with a focus on Development in Northern Uganda (DINU) initiative's districts.

1. Integrate strategies in existing nutritional programs to enhance women's role in household decision-making

At the household level, the effect of decision-making on nutrition plays out through multiple direct and indirect pathways. Research from Sub-Saharan Africa shows that children in households where women have lower decision-making power relative to men have a lower nutritional status (McKenna et al., 2019). In Uganda, the FANTA project found that male- headed households are more likely to spend income on non-food items and contribute less to household food security (The Analysis of the Nutrition Situation in Uganda, 2010). Our findings from Uganda also show that women and children in female-headed households had better dietary diversity scores, as compared to male-headed households. The positive relationship between nutritional status and women's autonomy drives the need for championing equitable roles and responsibilities at the household level. Activities that could be considered in program design and implementation include social and behavior-change programs targeted at: engaging men in household chores; redefining notions of "masculinity" through community male champions; leveraging Father's Day and other occasions to provide visibility on the role and importance of fathers in nutrition; and the direct caregiving of children.

2. Focus on women's education and skills development

Education is directly linked to nutrition through a direct transfer of knowledge. This includes nutritional literacy and the development of essential skill sets that enable individuals to lead better lives. Research shows that the number of stunted children would be reduced by 36% if women in low- and middle-income countries finished their secondary education ("Nutrition & Education," 2018). Our analysis of the confounding determinants of nutritional status in Uganda found that education was the most significant factor for both women and children: the body mass index (BMI) of women with some form of education was nearly a unit higher than women without any educational attainment, and the odds of a child being well-nourished was higher if the mother had attained any level of education. Since returning to formal education is not always feasible, for various socio-economic reasons, functional adult literacy programmes, such as those run by the national governments in Uganda and India, can further women's education and deliver lessons in nutritional literacy. These lessons can also train women on nutrition planning and food preservation—especially during periods of bad weather and food insecurity—and is a feasible and immediate point of entry for government agencies working in this domain.

3. Integrate economic strategies in nutrition-sensitive programmes

Sectoral economic interventions that are nutrition-sensitive in design could be effective points for entry in scaling gender-inclusive/transformative nutrition action. Facilitating women's economic advancement through sectors such as agriculture, WaSH, and trade and commerce offer opportunities for attaining two-fold targets: enhancing women's decision- making on income allocation and; addressing the importance of nutrition. This is because it has been recognized that women tend to spend a larger portion of their additional income and other resources on their household's nutrition, health, sanitation, and education (World Bank, 2003; World Bank, 2007; Meinzen-Dick, 2011; FAO, 2009; FAO, 2012). Some considerations for interventions could include: the provision of small ruminants such as poultry and goats; training on vaccination and deworming; and feeding and preparing animals for market. In the WaSH sector, women's roles can be enhanced through the establishment of women-run water ATMs and the provision of vocational training to manage, maintain, and repair WaSH facilities such as handpumps, wells, and toilets. These two-fold impact targets can be achieved through both men and women's equal participation in such interventions. Discussion on good nutrition practices, gender responsibilities, and equality, accompanied with livelihood training and techniques for all beneficiaries, may help with the acceptance of women as equal participants in their respective livelihoods. The information imparted to parents or caregivers could reflect on their future actions, thereby reinforcing positive change.

4. Build the gender capacity of implementors

To achieve the long-term goal of fulfilling the nutritional needs of individuals throughout their lives, it is important to move towards gender-sensitive or transformative nutrition programming. A lack of gender-transformative nutrition efforts has been a consistent pattern globally, which was reiterated in our findings from Uganda. Due to the complex and delicate topic of gender inclusion, there are limited time and resources spent on gender-sensitive actions by nutrition and food-security specialists (FAO, 2012). Our findings from Uganda also reported that ministerial and sectoral actors were cognizant of the social structures and the disadvantages faced by vulnerable groups, but were less aware of technical aspects, such as gender concepts or the linkages between their sector and nutrition. The lack of technical capacity for addressing the complexity of gender inclusivity in programming is often either seen as a "theoretical driver" (that is, it is not explored empirically) or seen only through a single factor, such as time allocation (Gomez, et al., 2013; Kabeer, 1999; Robeyns, 2003; Alkire, et al., 2012; Narayanan, Fontana, Lentz, & Kulkarni, 2019). These factors undermine the multi-dimensional complexity of the factors involved in affecting women and their children's nutritional needs. Therefore, expanding capacity-building initiatives can enable community workers and implementation partners to efficiently deliver their mandates through a gender- and nutrition-transformative approach. Periodic trainings can also help to enhance staff capacity in terms of gender and disability sensitivity, mainstreaming, and budgeting. A mix of training methods (such as the use of e-learning platforms) can be employed and may enable practitioners to understand multi-sectoral gendered linkages to nutrition and implementation in their daily responsibilities.

5. Gender-responsive data collection

Generally, gender-disaggregated indicators are seen to be collected only in national surveys, such as Demographic and Health Surveys (DHS) (CanWaCH, 2020). In this case, the consistency varies, and the data does little to support specific program interventions. Furthermore, there is a complete lack of indicators related to the linkages between nutrition and gender equality in the data collected for nutrition-specific and sensitive interventions. To overcome this challenge, the integration of gender into M&E systems must be strengthened to ensure better tracking of nutritional outcomes and to foster the availability of information for planning and subsequent resource allocation towards gender and nutrition. Gender and equity dimensions should be considered as key evaluation areas when assessing the effectiveness of nutritional programmes and interventions.

This blog post is based on a research study led by Athena Infonomics on 'Gender Analysis to Promote Gender Mainstreaming in Nutrition Actions in Uganda'. This study was funded by UNICEF Uganda.


Anupama Ramaswamy, Principal Consultant - Gender and Social Inclusion

Aparna Stephen, Consultant

Prakriti Sharma