Going beyond the surface: gendered intra-household bargaining as a social determinant of child health and nutrition in low and middle income countries.
A growing body of research highlights the importance of gendered social determinants of child health, such as maternal education and women's status, for mediating child survival. This narrative review of evidence from diverse low and middle-income contexts (covering the period 1970-May 2012) examines the significance of intra-household bargaining power and process as gendered dimensions of child health and nutrition. The findings focus on two main elements of bargaining: the role of women's decision-making power and access to and control over resources; and the importance of household headship, structure and composition. The paper discusses the implications of these findings in the light of lifecycle and intersectional approaches to gender and health. The relative lack of published intervention studies that explicitly consider gendered intra-household bargaining is highlighted. Given the complex mechanisms through which intra-household bargaining shapes child health and nutrition it is critical that efforts to address gender in health and nutrition programming are thoroughly documented and widely shared to promote further learning and action. There is scope to develop links between gender equity initiatives in areas of adult and adolescent health, and child health and nutrition programming. Child health and nutrition interventions will be more effective, equitable and sustainable if they are designed based on gender-sensitive information and continually evaluated from a gender perspective.
Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK. esther.richards@liv.ac.uk
Esther
E
Richards
Sally
S
Theobald
Asha
A
George
Julia C
JC
Kim
Christiane
C
Rudert
Kate
K
Jehan
Rachel
R
Tolhurst
D002664:Child Nutritional Physiological Phenomena; D002669:Child Welfare / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003906:Developing Countries; D004522:Educational Status; D005195:Family Relations; D005260:Female; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D017008:Negotiating; D011209:Power, Psychological; D012737:Sex Factors; D012923:Social Class; D064890:Social Determinants of Health