Out today

Systematic review with @HayaanNur on #health impacts of #gender inequity in agriculture #equity #nutrition @IMMANA_res @LSHTM

This was a mammoth project, and I’m proud of it. http://gh.bmj.com/cgi/content/full/bmjgh-2019-002173

Does gender equity improve health?
Thread (1/12)

Gender inequity is often *assumed* to be bad for health.

This quote by
@FAO
(SOFA report 2011) says:
“If women had the same access to productive resources as men, they could increase yields by 20-30”
... “which could reduce # of hungry people in the world by 12-17%.”

(2/12)

“could” = operative word! It relies on a lot of assumptions. Like additional yields or income being consumed by hungry people.

We noticed 2 or 3 papers on this were being cited as evidence of a truism.

(3/12)

We searched a LOT of databases, websites, reference lists, and contacted experts. (Really, a lot!)

Our protocol: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=93987

Exposure: gender equity in land, livestock, income & workload

Outcome: maternal & child nutrition, diets & HH food security

(4/12)

We found almost 20k records. 34 were relevant.

Grimacing faceYes, it was tedious.

Shushing face No, I won’t do another systematic review for a while!

(5/12)

The evidence is MESSY. It is heterogeneous in terms of quality, measurement, study design, analysis, and effects. We faced that challenge of untangling whether we had absence of evidence, or evidence of absence.

(6/12)

The gender gap is pretty large and persistent (but heterogeneous, of course).

(7/12)

Meta-analyses showed null effect of women’s share of:

household income earned
household land owned

.... on % of household budget spent on food.

0.32, 95% CI -4.22 to 4.86; 6 results

2.72, 95% CI -0.52 to 5.96; 3 results

(8/12)

But we noticed better studies showed consistently +ve associations.

We think conclusions are limited by quality of evidence.

In fact, a higher quality study by lechene & @orazio_at illustrated this by showing how diff estimation methods changed direction of effect!
(9/12)

Qualitative evidence tells us effects of equitable asset ownership may be suppressed by inequity in participation and control.

We need to understand gender equity across livelihood strategies, decision-making, access to inputs, services, markets & social support.

(10/12)

Almost no quantitative evidence on time use, but qualitative research discussed it a lot.

Women’s relative lack of time seems to cause anxiety, loss of appetite, lack of time to eat or cook for others.

So, will policies like women’s land titling schemes, equitable land inheritance laws, or gender-sensitive agriculture interventions improve nutrition?

We can't assume they will.

But they matter if gender equity is considered a normative goal in its own right.

(12/12) Fin.

Urgh. All my gifs are men or cats.