Gender influences on child survival, health and nutrition: a ... - Unicef

<strong>Gender</strong> Influences On Child Survival, Health And Nutrition: A Narrative Review
On the other hand, although women may allocate a greater proportion of the income they control to
children, the benefits of this for child health outcomes may be reduced by women’s access to
relatively lower levels of income. For example in a study of parental characteristics and child nutrition
in male-headed households in Western Kenya, mothers’ income was only weakly significant in
influencing children’s height for age z-scores 7 as compared to fathers’ income. While mothers
spent up to 52% of their income on food commodities as opposed to fathers, who spent only 38% of
their income, in absolute monetary terms expenditure on food by fathers was higher (Marinda 2006).
Researchers have also found that there are different types of female-headed households. For
example, women may become household heads for specific periods of time during which their husbands
migrate for work. This kind of female headship is often referred to as ‘de facto’ since it suggests that
women are not the official, or legal, head of the household, but would possibly experience some level of
autonomy in decision-making during periods in which their husbands were absent. Alternatively, women
may be single mothers, widowed or divorced and therefore have legal, or official status as the
household head (often referred to as ‘de jure’ female heads of household). De jure female heads of
household are likely to bear the sole responsibility for income-earning, which may undermine the
possible benefits they and their children derive from experiencing higher levels of autonomy. While it
cannot be assumed that de facto female heads would always receive remittances from absent husbands,
the possibility that this might occur suggests that they might benefit both from greater levels of income
(in comparison with de jure household heads) and greater autonomy (in comparison with women and
children in male-headed households) (Onyango, Tucker & Eisemon 1994).
Research has shown that the benefits and disadvantages for different types of households may
depend on context. For example a study comparing outcomes among children of resident male-headed
households and children of de facto female-headed households in Western Kenya, found that while
fewer children of female-headed households had low weight-for-age, more of them had low height-forage
which suggests that they had experienced malnutrition for some period in the past (i.e. chronic
malnutrition). The authors demonstrated that there were trade-offs in the ways families of different
types coped under different circumstances and yet did not find clear evidence that one type was more
beneficial than the other for children’s nutritional status 8 (Onyango, Tucker & Eisemon 1994).
Other researchers have argued that comparison of male and female headed households will not
necessarily yield useful insights into intra-household allocation of resources since they are essentially
7 Measurements of malnutrition among children often rely on calculating the deviation of an individual child’s
weight-for-height, height-for-age or weight-for-age deviates from the median value of a reference population
which is then divided by the standard deviation of the reference population to produce a Z-score. These scores
indicate different aspects of malnutrition. Low weight-for-age (WAZ) may demonstrate that the child is moderately
or severely underweight compared to other children in its age group. If a child has been malnourished over a long
period they are likely to have had their growth stunted and have a lower height-for-age (HAZ) score. Where
children have a low weight-for-height (WHZ) they are likely to have experienced acute shortage of food and will be
wasted.
8 While de facto female heads had more control over their agricultural income-generating activities, they grew
fewer food crops and used less for home consumption. However they were able to purchase food for the
household with the remittances of their husbands who had migrated for work. On the other hand, women in maleheaded
households had lower budgets based on the money their husbands gave them for household expenses and
had less control over agricultural income generation. Despite their lack of control over sales of food crops, they
produced more types of crops in their daily work and retained more for their families’ consumption.
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