DevExplains: Why the food crisis is worse for women and girls

Globally, women play a huge role in ensuring everyone has enough to eat — with responsibility for an estimated 90% of all food purchases and preparation — yet gender inequality means that they are more vulnerable to hunger and malnutrition. In times of crisis, it’s women who forgo the most meals. Between 2019 and 2021, the gender gap in food insecurity more than doubled from 49 million to 126 million, as the COVID-19 pandemic impacted livelihoods, income, and access to nutritious food for women. Meanwhile, the number of pregnant and breastfeeding adolescent girls and women suffering from acute malnutrition has risen by 25% since 2020 in the 12 countries hit hardest by the global food and nutrition crisis, according to UNICEF. In response to this escalating situation, a new initiative, the Gender Nutrition Gap was launched at last week’s Women Deliver conference in Rwanda. Supported by over 40 organizations including FHI 360, Kirk Humanitarian, Action Against Hunger, and Stronger Foundations for Nutrition, the campaign aims to coordinate action across the sector in eight areas identified as contributing to the gap. Areas of focus include tackling social norms that discriminate against women and girls, food system market failure, and the need to prioritize women and girls’ nutrition in humanitarian crises. Global development organizations involved in fighting hunger are educating women and adolescents on their nutritional needs, supporting them to make decisions around the crops they plant and how household income is spent, and involving male family members in conversations about gender roles. Decision-making power In many places, such as Malawi, cultural practices mean that women eat last and therefore usually the least, Grace Mgabadere Chikowi, country manager for The Hunger Project, an NGO that deploys women-led grassroots strategies to fight hunger, told Devex. “It’s a custom which is dying,” she said, “[but if] there is limited food in the house, you prioritize your husband, and then you prioritize your children.” Lack of gender equality in education and decision making also plays a role, Chikowi continued. For example, in Malawi, as with many other countries, “most women do not have land ownership and if they own land, the land size is not big enough to help them grow enough and diversified food stuff to meet their household needs,” Chikowi said. “Decision[s] on what to plant on that land usually are influenced by the decisions of men.” Research from CARE in 2022 highlighted that not only is there a high correlation between countries with high gender equality and women going hungry — but that “as gender inequality rises, people get less food to eat on a national and global scale.” Emily Janoch, the senior director of thought, leadership, and learning at CARE, said that in addition to women saying that they “eat last and eat less,” rising food prices are another burden. Often in being the person who buys the household’s food, women are “having to economize because they have less money themselves, or they're having to bear this additional burden of negotiation with somebody else in their life who's controlling the income, “Januk said. “And that often can lead to gender-based violence — not all the time, but it's one of the factors.” Malnutrition risks Rasa Izadnegahdar, the director for Maternal, Newborn and Child Health Discovery & Tools at the Bill & Melinda Gates Foundation, said his team is interested in the relationship between nutrition and gut inflammation affecting women. As a result of eating last, women often don’t consume sufficient protein sources — which can lead to gut inflammation — then that gut inflammation in turn prevents the efficient absorption and integration of nutrients, he explained. Izadneghdar’s team is also keen to understand how nutritional risks during pregnancy, for example, anemia, can mean adverse outcomes in labor, such as postpartum hemorrhage. Generally, malnutrition weakens women’s ability to survive childbirth — making them more susceptible to infections, and leaving them with fewer reserves to recover from illness. Adequate nutrition is also critical for the health of their children, with malnutrition causing lifelong effects such as stunting, where a child has a low height for their age and is prevented from reaching their physical or cognitive potential. Women and girls need more nutrients than men, especially in their adolescent years and as they prepare for pregnancy, Danielle Porfido, associate director of global advocacy at the Eleanor Crook Foundation, told Devex. “A very high percentage of malnutrition in children occurs in utero,” she added. “If we don't address malnutrition, be that child malnutrition or women's malnutrition, we're not going to see progress on lots of other development issues [because] it really does undermine health, education, [and] labor,” said Porfido. What is halting progress? Despite the life-long impacts, funding to fight malnutrition accounts for less than 1% of official development assistance. Porfido said malnutrition can be “lower on the agenda than some of these other major health issues.” “Nutrition doesn't really have a home like other issue areas do – it kind of straddles between health and food security,” she added. “It's not really owned in terms of the U.N. system or even at a country level – there's not a ministerial ownership often,” Porfido explained. Izadneghdar believes a lack of baseline data contributes to serious knowledge gaps. Data is often taken from white men in high-income settings and calculations are made by applying that to the weight of a pregnant woman, he explained. "We don't have great empirical data on what is the healthy micronutrients level for women's health, and for the developing fetuses' health,” he said. Many policy decisions — both by national governments and by the international community during emergencies — can end up disadvantaging women making decisions around food. During the COVID-19 lockdowns many governments restricted the use of public transport to one member of the family — almost always men — or put in place curfews that made it difficult for women to do much of the unpaid labor they do, such as collecting water or going to the fields, Care’s Junak said. Meanwhile, cash relief payments in emergencies tend to be assigned to the male head of the household, or food distribution points can require women to walk long distances and put themselves in danger doing so, she added. What needs to change? A shift in approaches to preventative interventions that prioritize women’s health is giving cause for optimism. Traditionally, a lot of malnutrition programming focused on child malnutrition, but increased recognition is being given to the woman’s health. This includes girls in their adolescent years, which is a period of huge growth and nutritional needs but one which is very poorly understood, Izadneghdar explained. In Malawi, where adolescent fertility rates are high, the government is targeting adolescent girls in nutrition interventions, including addressing myths around supplements during pregnancy, said The Hunger Project’s Chikowi. Focused on early intervention in pregnancy and ensuring that expectant mothers have access to a broad complementary set of micronutrients — not only iron and folic acid — the Gates Foundation’s team is working with partners to scale up access to multiple micronutrient supplements, or MMS. These contain 15 essential vitamins and minerals, which can be taken daily during pregnancy to improve anemia. In 2020, the World Health Organization updated its recommendations to include MMS for pregnant women and adolescent girls; however, the recommendation was conditional on further research on the supplement's effects on premature birth and low birth weight. Fighting gender inequality However, greater consideration of gender equality across nutrition programming — as well as financial and agricultural programming — is still needed in order to change norms and tackle the root causes of the gender gap in food security, Januk said. “We've learned you can't do it just by saying, we're going to do a lot of training [around nutrition] for women”, she said. “Women can't change this problem by themselves – it requires a bigger change [with] gender dialogues where it's men and women talking together.” Chikowi also believes a holistic approach, whereby the entire community is involved and economically empowered, is key to change. In addition to dietary diversification education — which includes promoting high-nutrition crops such as orange sweet potatoes which are rich in vitamin A — Chikowi’s team implements microfinance interventions that allow community households to generate income through small businesses, as well as through village savings and loans groups, to cover their household food needs. When a woman is empowered economically and in decision making, she is able to better protect her own needs and those of their children, Chikowi said. Update, July 24, 2023: This article has been updated to reflect the correct spelling of Emily Janoch’s name. Visit Food Secured — a series that explores how to save the food system and where experts share groundbreaking solutions for a sustainable and resilient future. This content is produced in partnership as part of our Food Secured series, which is funded by partners, including Action Against Hunger and Stronger Foundations for Nutrition. 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