Skip to main content
×
Home
    • Aa
    • Aa

Associations of gender inequality with child malnutrition and mortality across 96 countries

  • A. A. Marphatia (a1), T. J. Cole (a2), C. Grijalva-Eternod (a3) and J. C. K. Wells (a4)
Abstract

National efforts to reduce low birth weight (LBW) and child malnutrition and mortality prioritise economic growth. However, this may be ineffective, while rising gross domestic product (GDP) also imposes health costs, such as obesity and non-communicable disease. There is a need to identify other potential routes for improving child health. We investigated associations of the Gender Inequality Index (GII), a national marker of women's disadvantages in reproductive health, empowerment and labour market participation, with the prevalence of LBW, child malnutrition (stunting and wasting) and mortality under 5 years in 96 countries, adjusting for national GDP. The GII displaced GDP as a predictor of LBW, explaining 36% of the variance. Independent of GDP, the GII explained 10% of the variance in wasting and stunting and 41% of the variance in child mortality. Simulations indicated that reducing GII could lead to major reductions in LBW, child malnutrition and mortality in low- and middle-income countries. Independent of national wealth, reducing women's disempowerment relative to men may reduce LBW and promote child nutritional status and survival. Longitudinal studies are now needed to evaluate the impact of efforts to reduce societal gender inequality.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Associations of gender inequality with child malnutrition and mortality across 96 countries
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Associations of gender inequality with child malnutrition and mortality across 96 countries
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Associations of gender inequality with child malnutrition and mortality across 96 countries
      Available formats
      ×
Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
*Address for correspondence: J. C. K. Wells, Ph.D., Childhood Nutrition Research Centre, Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK. (Email: Jonathan.Wells@ucl.ac.uk)
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

2. C Victora , Worldwide timing of growth faltering: revisiting implications for interventions. Pediatrics 2010; 125: e473e480.

3. R Black , Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 2008; 371: 243260.

4. S Subramanian , Association of maternal height with child mortality, anthropometric failure, and anemia in India. JAMA 2009; 301: 16911701.

5. C Victora , Maternal and child undernutrition: consequences for adult health and human capital. Lancet 2008; 371: 340357.

6. L Adair , Associations of linear growth and relative weight gain during early life with adult health and human capital in countries of low and middle income: findings from five birth cohort studies. Lancet 2013; 382: 525534.

7. J Maluccio , The impact of improving nutrition during early childhood on education among Guatemalan adults. The Economic Journal 2009; 119: 734763.

8. D. Crooks American children at risk: poverty and its consequences for children's health, growth, and school achievement. American Journal of Physical Anthropology 1995; 38: 5786.

9. K Dewey , K. Begum Long-term consequences of stunting in early life. Maternal and Child Nutrition 2011; 7: 518.

10. S Grantham-McGregor , Developmental potential in the first 5 years for children in developing countries. Lancet 2007; 369: 6070.

11. R Martorell , Weight gain in the first two years of life is an important predictor of schooling outcomes in pooled analyses from five birth cohorts from low- and middle-income countries. Journal of Nutrition 2010; 140: 348354.

14. Z Bhutta , What works? Interventions for maternal and child undernutrition and survival. Lancet 2008; 371: 417440.

15. M Ruel , H Alderman , Maternal and Child Nutrition Study Group. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? Lancet 2013; 382: 536551.

17. D. Headey Developmental drivers of nutritional change: a cross-country analysis. World Development 2013; 42: 7688.

18. H Alderman , Association between economic growth and early childhood nutrition. Lancet Global Health 2014; 2: e500.

19. L Haddad , Reducing child malnutrition: how far does income growth take us? World Bank Economic Review 2003; 17: 107131.

20. H Alderman , H Hoogeveen , M. Rossi Reducing child malnutrition in Tanzania: combined effects of income growth and program interventions. Economics and Human Biology 2006; 4: 123.

21. L Smith , L. Haddad Reducing child undernutrition: past drivers and priorities for the post-MDG era. World Development 2015; 68: 180204.

22. S Vollmer , Association between economic growth and early childhood undernutrition: evidence from 121 Demographic and Health Surveys from 36 low-income and middle-income countries. Lancet Global Health 2014; 2: e225e234.

23. S Vollmer , Association between economic growth and early childhood nutrition – authors’ reply. Lancet Global Health 2014; 2: e501e502.

24. D Stuckler , S Basu , M. McKee Drivers of inequality in millennium development goal progress: a statistical analysis. PLoS Medicine 2010; 7: e1000241.

25. A. Singh Why are economic growth and reductions in child undernutrition so weakly correlated – and what can public policy do? Lancet Global Health 2014; 2: e185e186.

27. J. Wells Maternal capital and the metabolic ghetto: an evolutionary perspective on the transgenerational basis of health inequalities. American Journal of Human Biology 2010; 22: 117.

28. J. Wells Adaptive variability in the duration of critical windows of plasticity implications for the programming of obesity. Evolution, Medicine and Public Health 2014; 109121.

29. S Osmani , A. Sen The hidden penalties of gender inequality: fetal origins of ill-health. Economics and Human Biology 2003; 1: 105121.

30. S Bhalotra , B. Rawlings Intergenerational persistence in health in developing countries: the penalty of gender inequality? Journal of Public Economics 2011; 95: 286299.

31. E Özaltin , K Hill , S. Subramanian Association of maternal stature with offspring mortality, underweight, and stunting in low- to middle-income countries. JAMA 2010; 303: 15071516.

32. E Gakidou , Increased educational attainment and its effect on child mortality in 175 countries between 1970 and 2009: a systematic analysis. Lancet 2010; 376: 959974.

33. M Shroff , Maternal autonomy is inversely related to child stunting in Andhra Pradesh, India. Maternal and Child Nutrition 2009; 5: 6474.

34. A Prost , Women's groups practising participatory learning and action to improve maternal and newborn health in low-resource settings: a systematic review and meta-analysis. Lancet 2013; 381: 17361746.

36. E Brinda , A Rajkumar , U. Enemark Association between gender inequality index and child mortality rates: a cross-national study of 138 countries. BMC Public Health 2015; 15: 97, 16.

41. K Harttgen , S Klasen , S. Vollmer Economic growth and child undernutrition in sub-Saharan Africa. Population and Development Review 2013; 39: 397412.

42. M Bishop , M. Green We are what we measure. World Policy Journal 2011; 28: 1115.

43. M Subramanyam , Is economic growth associated with reduction in child undernutrition in India? PLOS Medicine 2011; 8: e1000424.

44. D. Elson Social reproduction in the global crisis: rapid recovery of long-lasting pepletion? In: P Utting , S Razavi , R Varghese Buchholz , eds. The Global Crisis and Transformative Social Change. Palgrave Macmillan, Basingstoke, 2012, pp. 6380.

48. N. Folbre Measuring care: gender, empowerment, and the care economy. Journal of Human Development 2006; 7: 183199.

50. A Marphatia , R. Moussie A question of gender justice: exploring the influence of unpaid care work on girls’ educational success. International Journal of Educational Development 2013; 33: 585594.

51. D. Stuckler Population causes and consequences of leading chronic diseases: a comparative analysis of prevailing explanations. Milbank Quarterly 2008; 86: 273326.

52. J. Wells The thrifty phenotype as an adaptive maternal effect. Biological Reviews 2007; 82: 143172.

53. J Wells , Associations of economic and gender inequality with global obesity prevalence: understanding the female excess. Social Science and Medicine 2012; 75: 482490.

55. J Wells , J DeSilva , J. Stock The obstetric dilemma: an ancient game of Russian roulette, or a variable dilemma sensitive to ecology? American Journal of Physical Anthropology 2012; 149: 4071.

56. I. Permanyer A critical assessment of the UNDP's gender inequality index. Feminist Economics 2013; 19: 132.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Global Health, Epidemiology and Genomics
  • ISSN: -
  • EISSN: 2054-4200
  • URL: /core/journals/global-health-epidemiology-and-genomics
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Type Description Title
WORD
Supplementary Materials

Marphatia supplementary material
Supplementary Online Figure

 Word (2.9 MB)
2.9 MB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 29
Total number of PDF views: 163 *
Loading metrics...

Abstract views

Total abstract views: 340 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 23rd August 2017. This data will be updated every 24 hours.