Intra-household Food Allocation Research Articles

Birth order and intrahousehold allocation of food: Unequal allocation for unwanted children

Background: Food allocation is a fundamental aspect within households, seemingly capable of being distributed evenly among household members, especially among siblings. However, several factors can lead to differences in food allocation among siblings. Method: Using data from IFLS 4 and 5, with food variety as a proxy for food allocation, this study examines two influential factors on food allocation: birth order and imperfect fertility control status. Additionally, this study attempts to elucidate the mechanism of the birth order effect using the aforementioned imperfect fertility control status. FIndings: The findings of this study reveal a negative effect of birth order on household food allocation. Moreover, children with undesired status or belonging to families with undesired status due to imperfect fertility control tend to have lower food variety. Conclusion: However, this study cannot causally explain the mechanism behind the negative effect of birth order through imperfect fertility control status. Novelty/Originality of this article: This study analyzes the effects of birth order and fertility control status on household food allocation, finding adverse effects of birth order and unwanted status on food variation. As a novelty, this study proposes the development of a family-based nutrition intervention program that considers intra-household dynamics, aiming to reduce the gap in food allocation between siblings and improve children's overall nutritional status.

Intrahousehold food allocation social norms and food taboos in rural Ethiopia: The case of adolescent girls

BackgroundIn low-income countries, social norms play a significant role in intrahousehold food allocation practices. These norms can sometimes lead to discrimination against specific groups, posing a public health concern. This study focuses on the social norm surrounding food allocation within households and food taboos affecting adolescent girls in rural Ethiopia. MethodA qualitative study was conducted using vignettes as prompts for 20 focus group discussions and 32 in-depth interviews. The vignettes were tailored to the local context. Participants were chosen purposefully, and data were collected in a comfortable setting. All sessions were recorded and transcribed verbatim. Data analysis was done using Open Code qualitative analysis software with a thematic framework approach. FindingsIn the community, adolescent girls were expected to eat after serving the male family members. Those who did not follow this expectation faced sanctions such as being labeled as disrespectful and could even be insulted or beaten by their spouses and siblings. However, there were some exceptions to this rule, such as when girls were giving birth, breastfeeding, sick, or when male family members were traveling. Certain foods were also prohibited for adolescent girls, including spicy foods like chili, animal products such as meat and milk, and nuts. These foods were believed to increase girls' sexual desire, potentially leading them to engage in premarital or extramarital sex. Additionally, eating outside of the house was not considered appropriate behavior for adolescent girls in this community. ConclusionIn many households, social norms dictate that adolescent girls are not given enough food or are denied essential nutrients for their health. It is important to challenge these norms to ensure fair food distribution within households and support the healthy development of adolescent girls.

The Association between Intrahousehold Food Allocation Social Norms and Thinness among Young Adolescent Girls: A Community-Based Study.

Inequalities in food allocation related to social norms among household members significantly affect the nutritional status and well-being of the vulnerable members of the household, such as adolescent girls. This study assesses the association between social norms related to intrahousehold food allocation and young adolescent girls' thinness. The study involved 1,083 pairs of mothers/caregivers and young adolescent girls. Data were collected using a structured and pretested questionnaire. Multilevel mixed-effect logistic regression analysis was employed to examine associations using STATA/SE V.14 statistical software. In addition, a stratified analysis was done to investigate the effect of social norms on thinness in food-secure and food-insecure households. The overall prevalence of young adolescent girls' thinness was 15.70% (95% CI 13.52-17.86%). Young adolescent girls' thinness was associated with mothers'/caregivers' conformity to inequitable intrahousehold food allocation social norms in food-secure households [Adjusted odds ratio (AOR): 1.43, 95% CI: 1.14-1.80] but not in food-insecure households. Nearly 16% of adolescent girls were thin. Mothers/female caregivers conforming to inequitable intrahousehold food allocation social norms compromise the nutritional status of adolescent girls, particularly in food-secure households. The lack of statistically significant association in food-insecure households hints at the need to address inequality in food-secure households while addressing food shortage to improve the nutritional status of adolescents in low-income countries. We also recommend more studies in different sociocultural contexts to fully gather the evidence for adopting appropriate policies and practices.

Social and economic factors influencing intrahousehold food allocation and egg consumption of children in Kaduna State, Nigeria.

Adequate intake of high-quality nutritious foods during infancy and early childhood is critical to achieving optimal growth, cognitive and behavioural development,and economic productivity later in life. Integrating high-quality and nutrient-dense animal source foods (ASFs), a major source of protein and micronutrients, into children's diets is increasingly considered essential to reducing the global burden of malnutrition in low- and middle-income countries. While eggs are an ASF that shows promise for mitigating child undernutrition, interventions promoting egg consumption among children have had mixed results in improving egg intake and child growth outcomes. As part of an evaluation of a demand creation campaign promoting egg consumption, qualitative research was carried out in September 2019 to assess sociocultural and household factors affecting egg intake among young children living in Kaduna State, Nigeria, where a thriving egg industry and childhood stunting rates of 50% exist. Methods included freelisting exercises (11), key informant interviews (11), in-depth interviews (25)and FGDs (4). Results illuminated cultural rules that restrict egg consumption among children living in low-income households. These rules and norms reflect social and economic valuations that foster male dominance in household decision-making and guide food purchasing and intrahousehold food allocation that allow men to consume eggs more regularly. Study results highlight sociocultural considerations when selecting food interventions to address child malnutrition in low-income contexts. Interventions encouraging increased consumption of ASFs, and specifically eggs in young children, should be informed by formative research to understand sociocultural norms and beliefs guiding egg consumption.

Gender Differences in Diet Quality and Quantity in Rural Bangladesh. Are Men Still Favored?

ObjectivesStudies from Bangladesh have long documented pro-male biases in intrahousehold food allocation. However, many of these earlier studies were conducted against the backdrop of caloric scarcity and since then, food availability and affordability in the country have significantly improved. This study re-examines gender differences in diet quantity and quality in rural Bangladesh with 2012 data. MethodsThe study uses 24-hour dietary recall data collected in 2012 (12,970 individuals within 5,000 households, ages 15+) from ultra-poor rural Bangladeshi households and OLS regressions to test for gender differences in constructed diet measures. Measures include caloric intake, Caloric Adequacy Ratio (CAR: intake divided by estimated requirements based on sex, occupation, and life stage), Dietary Diversity Score (DDS; range 0–10), Global Dietary Quality Score (DGQS; range 0–49), food group intakes (intake per GDQS food group, grams), and ratios of food group intake to total intake. Between-household differences are accounted for by adjusting for demographic and geographic factors. ResultsPreliminary results show that men consume more calories than women (mean kcal: male = 2217.99, female = 2022.25, p < 0.001), but women consume more in reference to their caloric needs (CAR: m = 0.75, f = 0.90, p < 0.001). Men also score higher on diet quality measures (DDS: m = 3.43, f = 3.32, p < 0.001; GDQS: m = 8.27, f = 7.69, p < 0.001) and have greater mean intakes in 18 of the 25 GDQS food groups, but the absolute magnitude of male-female differences is small (e.g., < 10 gr. differences in all animal sourced foods). Moreover, compared to women, men did not consume significantly higher proportions of nutrient-dense foods groups. ConclusionsResults indicate that while men’s intake quantities and diet quality scores are marginally higher, the slight male advantage disappears when energy requirements and food group proportions are accounted for. Accordingly, the study results do not provide evidence of male favoritism in household food allocation. Funding SourcesNational Institutes of Health (award T32DK007158), German Ministry for Economic Cooperation and Development, UK Department for International Development, Swiss Agency for Development and Cooperation, UN Development Programme, World Food Programme.

Intrahousehold Allocation of Nutritious Food in Livestock Farming Communities in Bangladesh: Does Women’s Empowerment Make a Difference?

ObjectivesThe study's specific objective is to assess differences in food allocation among the household members by age and gender in livestock farming communities and identify the determinants of existing differences. In addition, investigating the association between women's empowerment in livestock rearing and the intrahousehold food allocation pattern is the second objective of the present study.MethodsThe study uses a mixed-method approach. A quantitative survey with 275 households collects information about the socioeconomic status of the households and the amount of nutritious food intake (milk, meat, fish, and egg), land, and livestock resource ownership. The study uses vignettes cards to collect information about the women's empowerment status in four areas: decision-related to livestock production, marketing of livestock, use of livestock income, and household nutrition. The study collects qualitative data from nine focus group discussions about the perception of nutritious food intake and health benefits and food allocation among their children, adolescents, and adults.ResultsThe results partly confirm that the children and partners of empowered women by livestock intervention had better protein intake and women's protein intake was reduced. In households with a higher empowerment level of women, the protein food intake of adolescent girls is not increased equally compared with adolescent boys. Sociocultural norms, patriarchal influence, economic conditions, household size, participation in training, and membership in social groups influence food distribution among household members.ConclusionsPolicies and interventions that aim to empower women in livestock for better food security and nutritional outcomes need to be based on understanding the intrahousehold nutritious food allocation.Funding SourcesGerman Academic Exchange Program (DAAD).

Maternal and paternal involvement in complementary feeding in Kaduna State, Nigeria: The continuum of gender roles in urban and rural settings.

Household gender roles influence infant and young child feeding behaviours and may contribute to suboptimal complementary feeding practices through inequitable household decision‐making, intra‐household food allocation and limited paternal support for resources and caregiving. In Igabi local government area of Kaduna State, Nigeria, the Alive & Thrive (A&T) initiative implemented an intervention to improve complementary feeding practices through father engagement. This study describes household gender roles among A&T participants and how they influence maternal and paternal involvement in complementary feeding. We conducted 16 focus group discussions with mothers and fathers of children aged 6–23 months in urban and rural administrative wards and analysed them using qualitative thematic analysis methods. Most mothers and fathers have traditional roles with fathers as ‘providers’ and ‘supervisors’ and mothers as ‘caregivers’. Traditional normative roles of fathers limit their involvement in ‘hands‐on’ activities, which support feeding and caring for children. Less traditional normative roles, whereby some mothers contributed to the provision of resources and some fathers contributed to caregiving, were also described by some participants and were more salient in the urban wards. In the rural wards, more fathers expressed resistance to fathers playing less traditional roles. Fathers who participated in caregiving tasks reported respect from their children, strong family relationships and had healthy home environments. Our research findings point to the need for more context‐specific approaches that address prevalent gender normative roles in complementary feeding in a variety of settings.

Export-Driven, Extensive Coastal Aquaculture Can Benefit Nutritionally Vulnerable People

Export-orientated shrimp and prawn farming in coastal ghers has been associated with negative environmental, social, and nutritional impacts. This study challenges these perceptions based on field observations from four communities in South West Bangladesh. Most households observed (&amp;gt;60%) were either directly involved in seafood farming or engaged elsewhere in the seafood value chain. Our study set out to establish how the type and location of aquaculture impacted on access to and consumption of aquatic animals. Additionally, we assessed the effects of both household socioeconomic status and intra-household food allocation on individual diet and nutritional outcomes. We used a blended approach, including a 24-h consumption recall on two occasions, analysis of the proximate composition of aquatic animals and biomarkers from whole blood from a sample of the target population. The diverse polyculture systems generated broad social benefits, where “export-oriented” production actually supplied more food locally than to global markets. Key findings: (1) worse-off households achieved higher productivity of farmed aquatic animals on smaller landholding than better-off households with larger landholdings; (2) vegetable production on gher dikes was a significant source of nutrition and income in lower saline gradients; (3) more fish was eaten in lower saline gradients although fish consumption was highly variable within and between households; (4) intra-household allocation of specific foods within diets were similar across communities; (5) recommended nutrient intakes of protein and zinc exceeded daily requirements for adolescent females, but energy, calcium, and iron were below recommended intake levels; (6) n-3 LC-PUFA, expressed as percentage of total fatty acids, in whole blood samples of adolescent females declined with ambient salinity level regardless of household socioeconomic status; (7) analysis of aquatic animals consumed found that mangrove species and tilapia harvested from higher saline ghers contained high levels of desirable PUFAs. These findings suggest that export-driven, extensive coastal aquaculture can be nutrition sensitive when co-products are retained for local consumption.

Anemia and intestinal parasites in farmers and family members and sheep in two agro-ecological zones in Senegal

The burden of anemia in Senegal is high, particularly in children and women in rural households. The main objectives of the study reported here were (i) to measure and compare the prevalence of anemia and intestinal parasitic infections in farmers and family members and sheep in two agro-ecological zones in Senegal and (ii) to examine the association between anemia and age or sex in farmers and family members. The study was conducted in Mpal (250 km from Dakar, the capital city) and Diawara (700 km from Dakar, a remote location near the Malian border). In humans, the prevalence of anemia was higher in Diawara (64/86 = 74%), compared to Mpal (13/29 = 45%) (p < 0.01). Using logistic regression, the odds of anemia were 20.3, 5.7, and 3.2 times higher in children 1–4 years old, children 5–12 years-old, and teenagers 13–19 years old, respectively, compared to adults 20–60 years old, after controlling for study site and sex (p < 0.05). In Diawara, the odds of anemia were 2.9 times higher in women, compared to men, after controlling for age (p = 0.06). The prevalence of intestinal parasites (Giardia sp.) was the same (7%) at both locations. In sheep, the prevalence of low packed cell volume (PCV) and low body condition was higher in Diawara (48/60 = 60% and 11/60 = 18%, respectively), compared to Mpal (23/46 = 50% and 0/46 = 0%, respectively) (p < 0.05). Clinical anemia was associated (p < 0.01) with low PCV and a positive diagnosis of H. contortus. Overall, the prevalence of anemia was higher in farmers and family members and owned sheep in Diawara. In addition, anemia was more common in children and women, an indication that intra-household food allocation may be regulated in favor of men and older age groups. The consequences of livestock affected with anemia and undernutrition can be significant. High morbidity and mortality in livestock can lead to low household income, inadequate household access to and individual consumption of animal source foods, and subsequent risk of anemia in children and women in rural households in Senegal.

Gender, time use, and food consumption in India

To understand the intrahousehold distribution of calorie, we consider daily calorie consumption and daily calorie expenditure by an individual. This paper uses information obtained from a 24-h recall dietary survey and a time use survey, and a face-to-face questionnaire survey of poor urban individuals in India. We find gender discrimination in the intrahousehold allocation of food and distribution of work over a 24-h period. Combined domestic and market work of a sample wife is 2 h 22 min longer than her husband in a day. The results strongly suggest that wives are overburdened with unpaid household activities, and they are not getting their due share in consumption compared to their husbands. Chronic energy input deficiency is significantly 186.30 kcal points higher in wives than their husbands.

Gender, Intra-Household Discrimination and Cash Transfer Schemes: The Case of Indian Punjab

For many years, the Punjab province of India has had the dubious distinction of having the worst sex ratio among all other states of India. In recent years, both the child sex ratio and the overall sex ratio has shown a marked improvement in the state. This paper analyses whether the improvement in sex ratios has narrowed down gender discrimination against the girl child in Punjab. This paper examines the intra-household gender differences in indicators of nutrition and well-being by employing logistic regression analysis on the latest available data from the National Family Health Survey (NFHS) for the year 2015–2016. It also evaluates the cash transfer schemes currently being implemented in Punjab for the welfare of the girl child and analyses their relative efficacy. The key results from the study reveal that gender continues to have a significant impact on indicators of child well-being and nutrition such as the average duration of breastfeeding and intra-household food allocation. The paper also finds that cash transfer schemes do not have a statistically significant impact on indicators of child malnutrition in the state.

Micronutrient-rich food consumption, intra-household food allocation and child stunting in rural Nigeria.

Children from rural households are often deprived of adequate micronutrient intakes either from food or supplementation. The present study examines: (i) the determinants of households' micronutrient-rich food consumption; and (ii) the combined effect of vitamin A supplementation and micronutrient-rich food consumption on child stunting in households with different food allocation patterns. Cross-sectional study. Households' micronutrient-rich food consumption frequency and vitamin A supplementation were used as a proxy measure for child micronutrient intakes. Intra-household food allocation patterns were assessed from caregivers' perception of the disparity in food distribution within the household. Descriptive statistics and logistic regression were employed in analysing the study's objectives. Rural communities in Kwara State, Nigeria.ParticipantsIncluded 419 children aged 6-59 months and 413 households. Owning small livestock and a refrigerator, knowledge of micronutrient-rich foods and higher parental education had strong associations with households' micronutrient-rich food consumption. Children from households that consumed micronutrient-rich foods and received more diverse diets were less likely to experience stunting. The combined effect of micronutrient-rich food consumption and vitamin A supplementation was stronger on the likelihood of stunting reduction than the separate effect of each. Assets ownership, human capital and knowledge of micronutrient-rich foods improve consumption of micronutrient-rich foods among the study population. Micronutrient supplementation to children with poor access to micronutrient-rich foods may not substantially enhance child growth unless reinforced through consumption of micronutrient-rich foods. Fruit and vegetable gardening, livestock holdings and nutrition education to parents should be integral parts of community nutrition programming.

Participatory Women's Groups with Cash Transfers Can Increase Dietary Diversity and Micronutrient Adequacy during Pregnancy, whereas Women's Groups with Food Transfers Can Increase Equity in Intrahousehold Energy Allocation

BackgroundThere is scarce evidence on the impacts of food transfers, cash transfers, or women's groups on food sharing, dietary intakes, or nutrition during pregnancy, when nutritional needs are elevated. ObjectiveThis study measured the effects of 3 pregnancy-focused nutrition interventions on intrahousehold food allocation, dietary adequacy, and maternal nutritional status in Nepal. MethodsInterventions tested in a cluster-randomized controlled trial (ISRCTN 75964374) were “Participatory Learning and Action” (PLA) monthly women's groups, PLA with transfers of 10 kg fortified flour (“Super Cereal”), and PLA plus transfers of 750 Nepalese rupees (∼US$7.5) to pregnant women. Control clusters received usual government services. Primary outcomes were Relative Dietary Energy Adequacy Ratios (RDEARs) between pregnant women and male household heads and pregnant women and their mothers-in-law. Diets were measured by repeated 24-h dietary recalls. ResultsRelative to control, RDEARs between pregnant women and their mothers-in-law were 12% higher in the PLA plus food arm (log-RDEAR coefficient = 0.12; 95% CI: 0.02, 0.21; P = 0.014), but 10% lower in the PLA-only arm between pregnant women and male household heads (−0.11; 95% CI: −0.19, −0.02; P = 0.020). In all interventions, pregnant women's energy intakes did not improve, but odds of pregnant women consuming iron-folate supplements were 2.5–4.6 times higher, odds of pregnant women consuming more animal-source foods than the household head were 1.7–2.4 times higher, and midupper arm circumference was higher relative to control. Dietary diversity was 0.4 food groups higher in the PLA plus cash arm than in the control arm. ConclusionsAll interventions improved maternal diets and nutritional status in pregnancy. PLA women's groups with food transfers increased equity in energy allocation, whereas PLA with cash improved dietary diversity. PLA alone improved diets, but effects were mixed. Scale-up of these interventions in marginalized populations is a policy option, but researchers should find ways to increase adherence to interventions. This trial was registered at www.controlled-trials.com as ISRCTN 75964374.

Longitudinal analysis of the intrahousehold distribution of foods in rural Nepal: Relative variability of child dietary quality across age and sex cohorts

Individual-level dietary data within households are rarely observed over extended periods of time, which limits our understanding of intrahousehold food allocation dynamics. This study explores whether and how dietary patterns of children within households changed over a four-year period in rural Nepal. Fixed-effects analysis of the panel data indicates that there were not disparities in dietary variability between girls and boys, but that there were disparities in dietary variability across age groups. Older children had slightly higher dietary diversity, and their diets were more likely to change as household diets changed, especially for animal sourced foods. For younger children, diets were less diverse but slightly more stable over time. This stability may protect younger children when household diets decline in quality, but younger children may be left out when household dietary quality improves. In contrast, older children reap more gains relative to younger children when household dietary quality improves, but would also bear the brunt of food shortages when they arise. These results emphasize the importance of examining differences in dietary quality within households across age groups, especially for children over five years of age who are less likely to be targeted by international nutrition interventions and programs.

Matching food security and malnutrition indicators: evidence from Southeast Asia

AbstractThis article aims to understand the relation between household food security and individual undernutrition. The multitude of indicators available raises the question which aspects of food security are captured by the respective indicator. In our analysis, we first assess the relation between the dimensions of food security and households’ socioeconomic characteristics. Second, we examine whether household indicators detect undernutrition in children. Finally, we investigate the role of individual‐specific characteristics for child undernutrition. The analysis is based on a novel data set of 1,200 rural households from Cambodia and Lao PDR, which combines household‐ and individual‐level data. We capture household food security by three indicators including a dietary diversity score, a consumption behavior measure, and an experiential measure. Individual nutrition status is measured via anthropometric indicators. Our results show that different household‐level indicators capture fundamentally different aspects of food security. Moreover, household food security fails to explain stunting for children under five. Dietary diversity indicators, however, explain underweight in children to a small extent. We call for more research on intrahousehold allocation of food and stress the implications of our research for the design and targeting of food and nutrition support programs.

Status and determinants of intra-household food allocation in rural Nepal

Background/objectivesUnderstanding of the patterns and predictors of intra-household food allocation could enable nutrition programmes to better target nutritionally vulnerable individuals. This study aims to characterise the status and determinants of intra-household food and nutrient allocation in Nepal.Subjects/methodsPregnant women, their mothers-in-law and male household heads from Dhanusha and Mahottari districts in Nepal responded to 24-h dietary recalls, thrice repeated on non-consecutive days (n = 150 households; 1278 individual recalls). Intra-household inequity was measured using ratios between household members in food intakes (food shares); food-energy intake proportions (‘food shares-to-energy shares’, FS:ES); calorie-requirement proportions (‘relative dietary energy adequacy ratios’, RDEARs) and mean probability of adequacy for 11 micronutrients (MPA ratios). Hypothesised determinants were collected during the recalls, and their associations with the outcomes were tested using multivariable mixed-effects linear regression models.ResultsWomen’s diets (pregnant women and mothers-in-law) consisted of larger FS:ES of starchy foods, pulses, fruits and vegetables than male household heads, whereas men had larger FS:ES of animal-source foods. Pregnant women had the lowest MPA (37%) followed by their mothers-in-law (52%), and male household heads (57%). RDEARs between pregnant women and household heads were 31% higher (log-RDEAR coeff=0.27 (95% CI 0.12, 0.42), P < 0.001) when pregnant women earned more or the same as their spouse, and log-MPA ratios between pregnant women and mothers-in-law were positively associated with household-level calorie intakes (coeff=0.43 (0.23, 0.63), P < 0.001, per 1000 kcal).ConclusionsPregnant women receive inequitably lower shares of food and nutrients, but this could be improved by increasing pregnant women’s cash earnings and household food security.

Formative qualitative research to develop community-based interventions addressing low birth weight in the plains of Nepal.

To explore the factors affecting intra-household food allocation practices to inform the development of interventions to prevent low birth weight in rural plains of Nepal. Qualitative methodology using purposive sampling to explore the barriers and facilitating factors to improved maternal nutrition. Rural Dhanusha District, Nepal. We purposively sampled twenty-five young daughters-in-law from marginalised groups living in extended families and conducted semi-structured interviews with them. We also conducted one focus group discussion with men and one with female community health volunteers who were mothers-in-law. Gender and age hierarchies were important in household decision making. The mother-in-law was responsible for ensuring that a meal was provided to productive household members. The youngest daughter-in-law usually cooked last and ate less than other family members, and showed respect for other family members by cooking only when permitted and deferring to others' choice of food. There were limited opportunities for these women to snack between main meals. Daughters-in-law' movement outside the household was restricted and therefore family members perceived that their nutritional need was less. Poverty affected food choice and families considered cost before nutritional value. It is important to work with the whole household, particularly mothers-in-law, to improve maternal nutrition. We present five barriers to behaviour change: poverty; lack of knowledge about cheap nutritional food, the value of snacking, and cheap nutritional food that does not require cooking; sharing food; lack of self-confidence; and deference to household guardians. We discuss how we have targeted our interventions to develop knowledge, discuss strategies to overcome barriers, engage mothers-in-law, and build the confidence and social support networks of pregnant women.

Do boys eat better than girls in India? Longitudinal evidence on dietary diversity and food consumption disparities among children and adolescents

This paper examines the dynamics of gender-based disparities in the intra-household allocation of food during childhood and adolescence in Andhra Pradesh and Telangana by using three rounds of longitudinal data from two cohorts. While boys are advantaged at all ages (except for the Younger Cohort at 12 years old), the pro-boy gap widens markedly at 15 years old. Specifically, mid-adolescent girls tend to consume fewer protein- and vitamin-rich foods such as eggs, legumes, root vegetables and fruit. This result is robust to gender differences between adolescents in terms of puberty onset, school enrolment, time use and dietary behaviours. Finally, gender disparities in dietary diversity during early and mid-adolescence do not vary by maternal education, poverty or place of residence, whilst they are moderated by levels of caregiver’s educational aspirations at 15 years old.

Family, Gender, and Women's Nutritional Status: A Comparison Between Two Himalayan Communities in Nepal

ABSTRACTDuring the last decades, the focus of food and nutrition security research has shifted from issues of macro-level availability to problems of unequal access, and distribution within the household. Little systematic attention has however been paid to the role of family systems in household food allocation processes. This study focuses on the extent to which family relations, and particularly gender roles, in two Himalayan communities with different family systems influence intra-household food allocation, and the subsequent nutritional status of women of reproductive age (15–49). In-depth interviews were conducted with 15 Buddhist and 15 Hindu women, the latter belonging either to the higher Chhetri or lower Dalit castes. Additionally, anthropometric data of women were collected. Results show that women from Hindu families were worse off than women from Buddhist households in terms of nutritional status, which is due to different intra-household allocation patterns. Secondly, women's nutritional status varied over the reproductive life course. Women were most vulnerable during menses, pregnancy, and the post-partum period. Comparison with research conducted in the 1980s in this area suggests that the influence of family-level values and practices on women's nutritional status is slowly changing.

Effect of Gestational Biological, Social, Economic Factors on Undernutrition in Infants 6-12 Months in Cilacap

Background : Undernutrition in children under five can cause disorder in the physical growth, mental development, low intellegence, or even death. This study aimed to test the hypothesis that under nutrition in infants aged 6-12 months is associated with gestational biological, social, and economic factors. Subjects and Method : This was an analytic and observational study with case control design. This study was conducted in Cilacap, Central Java. A total of 144 infants aged 6-12 months were selected by fixed disease sampling, consisting of 72 undernutrition cases and 72 control. The dependent variable was undernutrition. The independent variables were birthweight, breastfeeding complementary food intake, exclusive breastfeeding, maternal education, paternal education, family income, MUAC at pregnancy, intra-household food allocation, and rural-urban residence. The data were collected by questionnaire and anthropometry. The data were analyzed by multiple logistic regression. Results : Birthweight <2500 gram (OR=8.12; 95% CI=0.92 to 71.64; p=0.059), inadequate intake of breastfeeding complementary food (OR=3.93; 95% CI=1.59 to 9.75; p=0.003), and non-exclusive breastfeeding (OR=2.46; 95% CI=1.13 to 5.36; p=0.023) increased the risk of undernutrition in infants aged 6-12 months. Paternal education (OR=1.50; 95% CI=0.61 to 3.71; p=0.377), family income (OR=2.54; 95% CI= 1.03 to 6.28; p=0.43), MUAC (OR=1.32; 95% CI=0.512 to 3.38; p=0.562), intra-household food allocation (OR=1.84; 95% CI=0.85 to 4.02; p=0.123), maternal education (OR=0.78; 95% CI=0.31 to 1.97; p=0.599) and rural-urban residence (OR=0.82; 95% CI= 0.36 to 1.85; p=0.630) had non-significant effect on the risk of undernutrition in infants aged 6-12 months. Conclusion : Birthweight <2500 gram, inadequate intake of breastfeeding complementary food, and non-exclusive breastfeeding increase the risk of undernutrition in infants aged 6-12 months. Paternal education, family income, MUAC, intra-household food allocation, maternal education and rural-urban residence have non-significant effect on the risk of undernutrition in infants aged 6-12 months. Keywords : birthweight, gestational, biological, social, economic factors, undernutrition, infants aged 6-12 months Correspondence: Majestika Septikasari. School of Health Al-Irsyad Al-Islamiyyah Cilacap, Central Java. Email: jeaflava@gmail.com Indonesian Journal of Medicine (2016), 1(3): 184-194 https://doi.org/10.26911/theijmed.2017.02.01.06