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Women's Agricultural Work and Nutrition

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Women's agricultural work and nutrition (WWN) - survey findings and implications. This presentation was given by Haris Gazdar at a Consultation on Rights and Wellbeing of Women Agricultural Workers in Beach Luxury Hotel, Karachi.

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Women's Agricultural Work and Nutrition

  1. 1. 30 August 2018 Women’s Agricultural Work and Nutrition (WWN) Survey Findings and Implications
  2. 2. What is LANSA, and how we became interested in this issue • Leveraging Agriculture for Nutrition in South Asia – or how can agriculture lead to improvements in nutrition, given that • High proportion of workforce relies on agriculture for their livelihood • Agricultural change can lead to improved availability and access to an adequate diet • Pakistan Evidence Review – found important knowledge gap with respect to women’s work in agriculture and nutrition outcomes • Labour Force Survey gives different statistics • Some global evidence but none in Pakistan about linkages
  3. 3. Women’s Work and Nutrition (WWN) Survey • Collaborative effort within LANSA between the Collective for Social Science Research and the Leverhulme Centre for Integrated Research on Agricultural and Health (LCIRAH) • How can we address the knowledge gap identified in the Pakistan Evidence Review • Preliminary qualitative research in rural communities in Punjab and Sindh • Uniquely designed sample survey conducted to high globally- accepted standards, particularly for anthropometrics
  4. 4. Sampling and data • Representative survey of irrigated rural areas of Sindh • Randomly drawn sample of villages across # districts, all births in reference period documented • Over 1,000 mother-child recruited in baseline • Unique features • Questions on women’s work based on prior qualitative research • Baseline and endline surveys with same cohort • Allowing analysis of stunting and growth over time • Precision • Rigorous probing of child’s date of birth • Anthropometric measurement training of high globally-recommended standards
  5. 5. Nutrition pathways - simplified Household SES Education Child nutrition Mothers’ health Food consumption Child care Positive Negative Not sure?
  6. 6. Policy dimensions Household SES Education Child nutrition Mothers’ health Food consumption Child care Positive Negative Not sure? Social protection, food security SBCC Health Growth
  7. 7. Women’s (agricultural) work - and gaps in evidence Household SES Education Child nutrition Mothers’ health Food consumption Child care Women’s work Positive Negative Not sure?
  8. 8. Section 1 General Characteristics • District-wise sample • Age and Education • NADRA Registration • Drinking water • Sanitation • Ownership of land and animals • BISP
  9. 9. District No. of Households Population % of total Ghotki 117 1,115 10.5 Hyderabad 16 176 1.7 Kamber Shahdadkot 130 1,475 13.9 Khairpur 155 1,280 12.1 Larkana 45 489 4.6 Matiari 32 290 2.7 Mirpur Khas 98 695 6.6 Naushehro Feroze 138 1,399 13.2 Sanghar 163 1,286 12.1 Shaeed Benazirabad 88 797 7.5 Sukkur 43 442 4.2 Tando Allahyar 41 368 3.5 Tando Muhammad Khan 89 802 7.6 Total 1155 10,614 100.0 Sample households by districts
  10. 10. Household population By Age and Education Household population by age and sex Age group (years) Numbers % of total Upto 5 2,997 28.7 6-10 1,423 13.6 10+ 6,023 57.7 Total 10,443 100.0 Household members ever been to school by age and sex Age group (years) Total (%) Female (%) Male (%) 6-10 25.6 19.7 31.3 10+ 34.3 19.0 49.1 Total 32.6 19.2 45.7
  11. 11. Registration with NADRA By sex – populated aged 18 years or above Yes (%) No (%) Don’t know Male 78.1 21.5 0.4 Female 61.3 38.6 0.2 Total 69.8 29.9 0.3
  12. 12. Household Characteristics % Electricity Electricity connection 79.0 Cooking fuel Electricity 0.9 LPG/gas 6.2 Firewood 74.8 Animal byproduct 18.2 Roof RCC 4.8 Iron sheets 5.1 Bamboo 41.5 T-iron/wood 47.9 No ceiling 0.3 Others 0.5 Walls Cement blocks 5.5 Burned brick 41.0 Unburned brick 13.5 Wood 5.5 Stone 0.2 Mud 32.7 Bamboo 1.4 Cloth/tent 0.3
  13. 13. Drinking Water Sources Source % Improved water source 94.9 Piped water 7.0 Hand pump 80.9 Tube well/Motorized pumping 6.3 Closed well 0.4 Mineral water 0.2 Filtration plant 0.2 Non-improved source 3.1 Pond/canal/river/stream 3.0 Spring 0.1 Other specify 1.6
  14. 14. Sanitation (Toilet) facilities % % Improved facility 53.4 Non-improved facility 46.1 Flush to piped sewer system 29.8 Pit latrine without slab/Open pit 10.6 Flush to septic tank 2.9 Flush to somewhere else 2.0 Flush to pit latrine 6.9 Flush, dont know where 0.4 Ventilated improved pit latrine 6.5 No facility/bush/field 33.2 Pit latrine with slab 7.3
  15. 15. Ownership of land and farm animals Type of Asset % Agricultural land 33.9 Farm animals* 82.4 *Farm animals include goats, cows, buffalos, sheep, chicken, donkey, mule, horse, camel, bull
  16. 16. Distribution of sample size by Household categories N % Occupation Non-Salaried 938 81.2 Salaried 217 18.8 Land Owner 389 33.9 Tenants 315 27.4 Agrarian Status Only livestock 305 26.5 No agricultural assets but does agricultural work 76 6.6 No agricultural assets or work 64 5.6 Religion Hindu 138 12.0 Muslim 1,017 88.1 Caste Status Other 798 69.1 Historically marginalised 357 30.9 Total 1,155 100.0
  17. 17. Distribution of households by wealth status Poorest (%) Richest (%) Occupation Non salaried 24.0 15.0 Salaried 4.3 41.4 Agrarian Status Land Owner 2.1 42.9 Tenant 26.8 7.6 Only livestock 32.0 7.4 No agricultural assets but did agricultural work 50.0 5.3 No agricultural assets or work 6.6 18.0 Religion Hindu 59.7 0.8 Muslim 15.1 22.5 Caste Other 15.0 24.5 Historically marginalised 32.0 9.9
  18. 18. BISP beneficiaries and CNIC ownership BISP Beneficiaries No of HHs BISP Beneficiaries percent of CNIC holder Freq. % Freq. % All 456 39.5 554 36.9 Wealth quintiles Poorest 76 33.6 95 44.2 Poor 93 42.3 108 44.3 Average 108 48.4 126 43.2 Rich 91 40.7 115 35.9 Richest 70 31.4 90 24.1
  19. 19. Section 1 Highlights • Sample comparable with other surveys – DHS, MICS • Over two-thirds of populated aged under 10 years • Only a quarter of 6-10 year-olds in school • Two-thirds of households landless • Everyone poor, but relative poverty strongly associated with • No assets, being Hindu • Relative wealth strongly associated with land, salaried job • Around two-fifths of adult women still no CNIC • Two-fifths of households BISP beneficiaries
  20. 20. Section 2 Food Insecurity & Hunger • Worry about not enough to eat • Vulnerable to sleeping hungry • Food consumption by mothers
  21. 21. Household worried about Not having enough to eat By Wealth Baseline N= 1153 Endline N=1031 Neither N=1026 Both N=1026 All 59.1 60.9 21.9 41.8 Wealth Quintiles Poorest 82.7 78.0 2.6 64.2 Poor 73.2 72.8 8.2 52.3 Average 62.8 63.7 15.2 44.1 Rich 51.3 57.9 26.3 34.9 Richest 26.9 32.5 55.2 14.4
  22. 22. Worried about not having enough to eat By Occupation and Agrarian Status Baseline N= 1153 Endline N=1031 Neither N=1026 Both N=1026 All 59.1 60.9 21.9 41.8 Agrarian Status Land Owner 40.1 48.6 36.9 25.7 Operate land as a tenant 70.5 72.4 11.7 54.1 Only livestock 70.8 66.5 14.4 51.5 No agricultural assets but did agricultural work 73.7 60.6 9.1 43.9 No agricultural assets or work 48.4 52.6 29.8 31.6 Occupation Non salaried 65.9 65.4 16.3 47.4 Salaried 30.4 42.2 45.2 18.6
  23. 23. Went to bed hungry By Wealth Baseline N=1149 Endline N=1035 Neither N=1026 Both N=1026 All 35.4 25.2 52.8 13.7 Wealth Quintiles Poorest 63.0 51.8 20.5 36.8 Poor 45.4 30.3 41.5 18.1 Average 33.6 26.3 51.0 11.3 Rich 23.7 13.9 66.5 3.8 Richest 12.6 4.6 82.5 0.0
  24. 24. Went to bed hungry By Agrarian Status and Occupation Baseline N=1149 Endline N=1035 Neither N=1026 Both N=1026 All 35.4 25.2 52.8 13.7 Agrarian Status Land Owner 17.0 12.6 73.8 2.9 Operate land as a tenant 45.2 34.5 40.6 20.9 Only livestock 45.2 29.9 42.6 18.5 No agricultural assets but did agricultural work 57.9 39.0 25.7 22.7 No agricultural assets or work 26.6 19.3 63.2 12.3 Occupation Non salaried 40.0 28.4 47.4 16.2 Salaried 15.7 11.9 75.4 3.5
  25. 25. Food Groups consumed by mother Baseline (%) Endline (%) G1 All starchy staples 99.8 99.8 G2 Beans and peas 12.2 18.4 G3 Nuts and seeds 0.3 0.0 G4 Dairy 60.2 50.9 G5 Flesh foods 18.7 17.6 G6 Eggs 5.7 5.5 G7 Vitamin A rich dark green leafy vegetables 29.3 40.1 G8 Other vitamin A rich fruits and vegetables 4.9 3.7 G9 Other vegetables 51.3 79.3 G10 Other fruits 3.8 2.1 Per cent of mothers who failed to achieve adequate diet diversity score 91.4 92.0
  26. 26. Section 2 Highlights • Three-fifths worry about not having enough to eat • A quarter actually experience hunger at least once a month • Food insecurity strongly associated with poverty, but high proportion of ‘richest’ also food insecure • Little dietary diversity – over nine-tenths don’t meet minimal acceptable global standards • Lactating women more likely to drink milk, switch to other foods later
  27. 27. Section 3 Women’s Agricultural Work • In pregnancy • After childbirth
  28. 28. Women’s work By type of work Type of work Ever (%) N=1048 In pregnancy (%) N=1048 After birth of child(%) N=1035 Any work 89.1 75.6 85.8 Agricultural work 81.0 64.6 72.9 Farming 66.6 43.3 54.8 Livestock 69.7 57.0 64.0
  29. 29. Women’s Agriculture Work By tasks Tasks Ever (%) N=1048 In pregnancy (%) N=1048 After birth of child(%) N=1035 Picking cotton 51.2 28.6 36.9 Weeding/Digging 31.0 19.1 31.0 Harvesting grain (mainly wheat and rice) 39.8 14.4 31.2 Sowing/transplanting rice 22.4 11.4 10.6 Harvesting vegetables (chili/others) 17.4 8.0 16.0
  30. 30. Women’s Agriculture Work By tasks and intensity of work N=1035 Wheat harvesting % Rice planting % Cotton picking % Rice harvesting % Chili harvesting % Women who worked during last season 27 10 36 13 11 Distribution of workers by number of full days worked in the season (per cent) 0 9.4 9.5 4.5 14.5 13.3 1-15 33.0 33.3 20.8 32.1 28.3 16-30 40.9 33.3 25.3 35.9 24.8 31-60 13.0 19.1 25.1 14.5 21.2 61-120 3.6 4.8 24.3 3.1 12.4
  31. 31. Women’s Agriculture Work In pregnancy and after child birth By Wealth and Mother’s Education Agricultural work Cotton picking Never (%) Both (%) Never (%) Both (%) N Overall 20.6 58.2 57.1 22.1 1029 Wealth Quintiles Poorest 5.3 76.7 33.9 41.8 189 Poor 14.9 68.2 47.2 30.3 195 Average 21.6 54.9 61.8 19.6 204 Rich 22.5 56.0 67.5 11.0 209 Richest 38.1 35.0 75.1 9.6 197 Mother’s Education No 15.4 64.2 52.8 25.3 825 Yes 41.7 33.8 74.5 8.8 204
  32. 32. Women’s Agriculture work In pregnancy and after child birth By Caste and Religion Agriculture work Cotton picking Never (%) Both (%) Never (%) Both (%) N Overall 20.6 58.2 57.1 22.1 1029 Caste Other 23.0 52.9 63.1 17.4 726 Historically marginalized caste 14.9 71.0 42.9 33.3 303 Religion Hindu 2.7 90.9 18.2 53.6 110 Muslim 22.7 54.3 61.8 18.3 919
  33. 33. Women’s Agriculture Work In pregnancy and after child birth By Food Insecurity, HH characteristics Agriculture work Cotton picking Never (%) Both (%) Never (%) Both (%) N Overall 20.6 58.2 57.1 22.1 1029 Worry about not enough food in the house No 28.1 48.9 67.9 15.0 595 Yes 10.5 71.0 42.6 31.9 427 Vulnerable to sleeping hungry No 22.5 55.8 60.0 19.0 883 Yes 9.4 72.7 40.3 41.0 139 Children less than 3 years other than survey child Yes 18.8 59.6 56.2 21.5 559 Salaried HH No 16.7 63.1 52.5 25.3 830 Yes 36.7 37.7 76.4 8.5 199
  34. 34. Section 3 Highlights • Majority of women work during pregnancy and after child birth • Not always counting their work as work, or as choice • Women’s work – unpaid or underpaid • Digging, weeding, harvesting (grains, cotton, vegetables, chilis), livestock • Cotton (and chili) harvesting relatively less flexible • Livestock seen as chore rather that work • Main drivers • Household poverty • Lack of education • Food insecurity • Interconnected factors but with distinctive policy implications too
  35. 35. Drivers of work Household SES Education Child nutrition Mothers’ health Food consumption Care Women’s work Positive Negative Not sure?
  36. 36. Section 4 Care Practices • Hygiene and Sanitation • Breastfeeding • Child Feeding Practices • Recent Illness • Time-Use
  37. 37. Hygiene and Sanitation Practices By Wealth and Mother’s Education Use of soap post-defecation Animal waste around house/compound Yes (%) N Yes (%) N All 38.1 1035 64.5 961 Wealth Quintiles Poorest 27.2 191 66.2 171 Poor 34.9 195 61.4 176 Average 34.6 205 61.9 194 Rich 45.5 209 69.9 196 Richest 47.2 197 60.1 188 Mother's education No 35.5 829 67.3 768 Yes 48.5 206 53.4 193
  38. 38. Breastfeeding Practices By Sex, Wealth and Mother’s Education Ever (%) Colostrum(%) Breastfeeding after 1 hour of birth (%) Breastfeeding within 1 day of birth (%) Pre-lactal feed (%) Overall 99.31 78.35 28.23 60.52 67.62 Sex Male 99.14 76.90 27.93 60.52 66.72 Female 99.48 79.83 28.52 60.52 68.52 Mother’s Education No 99.25 77.73 28.37 60.6 66.49 Yes 99.55 81.00 27.60 60.18 72.4 Wealth Quintiles Poorest 99.12 79.65 36.73 64.16 52.21 Poor 99.55 75.91 25.91 60.91 68.18 Average 100.00 79.82 30.94 63.23 72.20 Rich 99.55 75.89 24.11 58.93 71.43 Richest 99.10 80.72 22.87 55.61 75.78
  39. 39. Exclusive and Predominant Breastfeeding By Wealth and Mother’s Work Exclusive (%) Pre-dominant (%) N Overall 21.0 31.2 1155 Wealth Quintiles Poorest 33.6 43.4 226 Poor 20.5 28.2 220 Average 19.3 30.9 223 Rich 16.1 24.6 224 Richest 15.7 27.8 223 Any Work No 15.0 27.9 147 Yes 22.2 32.3 888 Agriculture Work No 17.8 32.7 281 Yes 22.2 31.3 754 Cotton picking No 17.8 33.7 653 Yes 22.4 28.3 382
  40. 40. Child Feeding Practices By Sex, Mother’s Education and Diet 4+ food groups Minimal Acceptable Diet (MAD) Mean no. of food groups consumed N Overall 9.18 7.44 1.84 1035 Male 7.59 6.42 1.79 Female 10.75 8.45 1.89 Mother’s Education No 7.72 5.79 1.76 829 Yes 15.05 14.08 2.19 206 Mother consumed at least 5 food groups in previous day No 8.19 6.51 1.8 952 Yes 20.48 18.07 2.4 83
  41. 41. Baseline Endline Diarrhoea (%) Fever (%) Diarrhoea (%) Fever (%) All 31.31 42.58 58.36 68.31 Sex Male 33.33 45.94 60.12 69.26 Female 29.27 39.20 56.62 67.37 Mother’s Education None 31.76 42.17 58.21 70.41 Primary+ 29.41 44.34 60.10 61.08 Wealth Quintiles Poorest 31.86 41.15 57.59 74.87 Poor 30.00 41.36 62.05 70.26 Average 30.49 47.09 55.12 68.78 Rich 37.05 43.75 58.85 67.46 Richest 27.35 39.91 55.84 59.90 Child Illness in past 2 weeks By Sex, Mother’s Education and Wealth
  42. 42. Child Illness in past 2 weeks By Food Insecurity and WASH practices Baseline Endline Diarrhoea (%) Fever (%) Diarrhoea (%) Fever (%) Overall 31.31 42.58 58.36 68.31 Worried about not enough to eat No 27.49 38.68 48.38 56.61 Yes 38.33 50.12 65.18 76.52 Vulnerable to sleeping hungry No 31.76 42.17 44.23 64.20 Yes 29.41 44.34 33.08 81.54 Washed hands with soap after using toilet No 30.64 40.72 64.38 73.75 Yes 32.37 47.11 49.10 60.10 Animal waste around house or compound No 18.46 30.38 58.11 69.91 Yes 34.83 46.18 61.81 70.39
  43. 43. Baseline Endline Diarrhoea (%) Fever (%) Diarrhoea (%) Fever (%) All 62.88 74.54 80.96 80.2 Sex Male 64.25 75.56 86.41 82.02 Female 61.31 73.33 75.25 78.35 Wealth Quintiles Poorest 44.44 64.52 83.64 79.72 Richest 72.13 82.02 80.00 78.81 Mother's education None 62.16 73.28 82.37 80.96 Primary + 66.16 79.59 75.41 76.61 Treatment by Qualified Source By Sex, Wealth & Mother’s Education
  44. 44. Mother's 24 hours recall (Mean hours) Personal care , 7.7 Domestic work , 5.4 Leisure and education , 0.9 Childcare , 8.3 Livestock related work , 1.2 Agricultural work , 0.3 Health related activities , 0.0 Travelling , 0.0 Other labour work , 0.1 Personal care Domestic work Leisure and education Childcare Livestock related work Agricultural work Health related activities Travelling Other labour work In whose care was the reference child? Child was under mother's care 18.80 hours Child was under mother's care fully or partially 21.92hours
  45. 45. Leisure Child care All 0.94 8.3 Wealth Quintiles Poorest 0.50 8.14 Poor 0.77 8.10 Average 0.97 8.42 Rich 1.06 8.26 Richest 1.40 8.70 Mother's education No 0.85 8.24 Yes 1.30 8.53 Time-Use Mean Number of Hours Spent By Sex, Wealth & Mother’s Education
  46. 46. Mean Number of Hours Spent By Household composition Leisure Child care All 0.94 8.30 Survey mother has other children aged 3 or less versus not No 0.97 8.63 Yes 0.92 8.02 Other adult women present No 0.90 7.99 Yes 0.96 8.41 Care givers and other children aged 3 or less Other children aged 3 or less and no additional adult women 0.86 7.79 No other children aged 3 or less and additional adult women 0.97 8.71
  47. 47. Section 4 Highlights • Care practices such as use of soap improve with household wealth and education • others such as animal waste don’t • and yet others such as breastfeeding deteriorate • Child feeding strongly associated with mother’s own dietary diversity • High prevalence of mother-reported morbidity • No association with wealth or education but with food insecurity and animal waste • The young child is nearly always with the mother • In addition she spends 8 hours actively caring for her/him • With an additional helping hand she spends MORE time in active caring
  48. 48. Care Household SES Education Child nutrition Mothers’ health Food consumption Care Women’s work Positive Negative Not sure?
  49. 49. Section 5 Women’s Health • Ante-natal care • Night Blindness • Body Mass Index • Depression
  50. 50. Antenatal Care from Qualified Source By Wealth and Mother’s Education N (%) Overall 1151 79.1 Wealth Quintiles Poorest 226 75.7 Poor 220 72.3 Average 223 77.6 Rich 224 83.5 Richest 222 87.4 Mother’s Education No 930 76.6 Yes 221 89.6
  51. 51. N (%) Total 1151 79.0 Any work No 279 84.6 Yes 868 77.3 Agriculture work No 406 84.0 Yes 741 76.4 Cotton picking No 819 81.8 Yes 328 72.3 Ante-natal Care from Qualified Source By Mother’s Work
  52. 52. Night Blindness By Food Consumption and Insecurity N (%) Overall 1152 42.62 Intake of Vitamin A rich foods No 776 40.34 Yes 376 47.34 Worried about not enough to eat No 470 40.85 Yes 682 43.84 Vulnerable to sleeping hungry No 742 40.43 Yes 406 47.04
  53. 53. Mother’s Body Mass Index (BMI) Mean BMI Baseline: 21.1 (N=1146) Mean BMI Endline: 20.4 (N=909) 50.6 36.4 19.7 16.7 13.0 9.7 3.3 64.8 22.1 15.9 6.2 13.1 10.7 2.4 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 18.5-24.99 <18.5 (totally thin) 17.0-18.49 (mildly thin) <17 (moderately and sev thin) >= 25 (totally overweight) 25-29.99 (overweight) >=30 (obese) Norm alThinOverweight Baseline Endline
  54. 54. Mother’s Body Mass Index (BMI) Thinness No time Period (%) Both time periods (%) N Overall 62.4 20.1 909 Wealth Quintiles Poorest 46.8 37.6 173 Poor 57.1 21.2 170 Average 65.9 16.8 185 Rich 63.7 17.3 179 Richest 79.3 10.1 169
  55. 55. Mother’s Body Mass Index (BMI) Thinness No time period (%) Both time periods (%) N Overall 62.4 20.1 909 Mother’s Education No 59.8 21.5 727 Yes 72.5 14.8 182 Caste Other 67.0 16.6 639 Historically marginalized caste 51.5 28.5 270 Religion Hindu 29.6 43.9 98 Muslim 66.3 17.3 811
  56. 56. Mother’s Body Mass Index (BMI) Thinness No time period (%) Both time periods (%) N Overall 62.4 20.1 909 Worry about not enough food (Both periods) No 66.9 18.5 520 Yes 57.6 21.9 375 Vulnerable to sleeping hungry (Both periods) No 65.2 19.4 768 Yes 49.6 22.8 127
  57. 57. Mother’s Body Mass Index (BMI) Thinness No time period (%) Both time periods (%) N Overall 62.4 20.1 909 Any work during both periods No 70.8 16.5 267 Yes 59.2 21.7 632 Agriculture work during both periods No 68.2 17.1 368 Yes 58.8 22.2 531 Cotton picking during both periods No 65.9 17.8 701 Yes 51.0 28.3 198
  58. 58. Mother’s Depression score Depression category Baseline (N=1152) Endline (N=1032) None 36.6 30.0 Mild 33.9 39.0 Moderate 18.6 18.0 Moderately severe 7.4 9.7 Severe 3.5 3.4 Total 100.0 100.0
  59. 59. Mother’s Depression Moderate to Severe N Baseline Endline Both periods All 1032 29.4 31.0 10.7 Wealth Quintiles Poorest 191 20.8 34.6 8.4 Poor 194 35.2 31.3 12.9 Average 205 39.0 33.2 13.7 Rich 209 27.7 35.4 11.5 Richest 197 26.0 20.3 7.1 Mother's education No 826 29.4 33.4 10.4 Yes 206 29.4 21.4 11.6
  60. 60. Mother’s Depression Moderate to Severe N Baseline Endline Both periods Overall 1032 29.4 31.0 10.7 Religion Hindu 112 13.9 26.6 4.5 Muslim 920 31.5 31.6 11.4 Caste Other castes 727 29.7 30.9 11.3 Historically marginal 305 28.9 31.4 9.2 Mother has children less than 3 years No 474 26.5 30.0 9.9 Yes 558 31.9 31.8 11.3
  61. 61. Mother’s Depression Moderate to Severe N Baseline Endline Both periods Overall 1032 29.4 31.0 10.7 Worry about not enough food in both periods No 596 23.8 18.1 6.7 Yes 429 33.3 39.3 15.9 Vulnerable to sleeping hungry in both No 884 29.6 26.5 10.2 Yes 141 29.0 44.4 12.8 Any work (both) No 306 29.6 19.1 9.2 Yes 722 29.4 33.0 11.4 Agriculture work (both) No 429 30.2 22.4 9.6 Yes 599 29.1 34.2 11.5 Cotton picking (both) No 801 29.9 26.7 10.7 Yes 227 28.4 38.5 10.6
  62. 62. Section 5 Highlights • High prevalence of night blindness during pregnancy • Widespread, and weak association with • High prevalence of ‘thinness’ among women • Over a third in endline • Associated with poverty and work • High prevalence of self-reported moderate to severe depression • Associated with household food insecurity, work
  63. 63. Care Household SES Education Child nutrition Mothers’ health Food consumption Care Women’s work Positive Negative Not sure?
  64. 64. Section 6 Child Nutrition • Wasting • Stunting • Stunting Changes
  65. 65. Prevalence of Wasting (%) By Sex and Wealth Quintiles Baseline Endline Below -2 Below -3 Below -2 Below -3 All 13.70 4.66 18.63 5.98 Sex Male 12.14 4.11 19.54 5.8 Female 14.88 4.90 17.73 6.17 Wealth Quintiles Poorest 16.89 7.83 32.81 13.02 Poor 11.43 3.81 18.46 6.15 Average 12.56 4.19 17.56 4.88 Rich 14.75 5.07 13.46 3.37 Richest 11.57 1.85 11.62 3.03
  66. 66. Prevalence of Wasting (%) By Mother’s Characteristics Baseline Endline Below -2 Below -3 Below -2 Below -3 All 13.70 4.66 18.63 5.98 Mother's education None 14.03 4.9 19.76 6.75 Primary + 11.27 2.82 14.08 2.91 Mother's BMI Thin 15.42 7.08 25.71 8.57 Normal 12.88 3.97 15.77 5.01 Overweight 14.97 4.08 11.68 3.65 Mother's perception Not good 18.18 5.88 Average 16.03 4.64 Good+ 11.39 4.09
  67. 67. Prevalence of Wasting (%) By Food Insecurity/WASH Baseline Endline Below -2 Below -3 Below -2 Below -3 Overall 13.70 4.66 18.63 5.98 Worry about not enough to eat No 13.72 3.54 14.75 3.25 Yes 13.37 5.17 21.12 7.84 Vulnerable to sleeping hungry No 12.59 3.64 17.06 5.34 Yes 15.05 6.12 23.37 8.05 Use of soap post-defecation No 13.09 5.45 18.52 6.12 Yes 12.76 2.37 18.88 5.87 Animal waste in compound No 15.20 3.6 14.16 3.83 Yes 13.05 4.78 20.29 6.98
  68. 68. Prevalence of Wasting (%) By Mother’s Work Baseline Endline Below -2 Below -3 Below -2 Below -3 Overall 13.70 4.66 18.63 5.98 Any Work No 14.23 3.75 12.24 5.44 Yes 13.37 4.77 19.73 6.12 Agriculture No 13.33 2.82 13.31 3.96 Yes 13.71 5.45 20.64 6.79 Cotton picking No 12.08 795 17.72 4.93 Yes 17.42 310 20.26 7.89
  69. 69. Prevalence of stunting (%) By Infant Sex and Wealth Quintiles Baseline Endline Below -2 Below -3 Below -2 Below -3 All 45.84 19.60 61.10 28.19 Sex Male 47.29 21.54 63.44 30.17 Female 44.17 17.49 58.77 26.20 Wealth Quintiles Poorest 53.13 25.89 73.44 73.44 Poor 44.44 20.37 70.77 70.77 Average 49.10 18.92 63.90 63.90 Rich 41.74 18.81 52.88 52.88 Richest 38.64 13.64 42.42 42.42
  70. 70. Baseline Endline Below -2 Below -3 Below -2 Below -3 Overall 45.84 19.60 61.10 28.19 Mother's BMI Thin 64.43 31.23 67.43 31.12 Normal 43.72 17.81 61.78 29.35 Overweight 24.83 8.72 43.07 16.10 Mother's education None 47.01 20.85 65.06 31.57 Primary plus 40.28 13.89 45.15 14.56 Mother’s perception Not good 55.33 30.46 Average 45.64 17.84 Good+ 43.19 17.07 Prevalence of stunting (%) By Mother’s Characteristics
  71. 71. Baseline Endline Below -2 Below -3 Below -2 Below -3 Overall 45.84 19.60 61.10 28.19 Worry about not enough to eat No 44.81 17.75 56.50 22.25 Yes 46.29 20.77 64.32 32.16 Vulnerable to sleeping hungry No 44.60 18.60 58.46 25.26 Yes 47.38 21.20 69.35 37.16 Use of soap post- defecation No 47.4 21.55 63.42 29.67 Yes 41.86 15.12 57.65 26.02 Animal waste in house/compound No 42.58 18.75 56.64 22.12 Yes 46.58 19.82 63.47 31.33 Stunting Prevalence (%) By Food insecurity and WASH
  72. 72. Stunting Prevalence (%) By Mother’s Work Baseline Endline Below -2 Below -3 Below -2 Below -3 Overall 45.84 19.60 61.10 28.19 Any No 41.61 17.52 55.10 21.77 Yes 47.14 20.30 62.24 29.37 Agriculture No 40.85 18.30 55.76 21.58 Yes 48.50 20.36 63.25 30.76 Cotton picking No 42.40 18.17 57.78 24.96 Yes 54.35 23.29 67.11 33.95
  73. 73. Section 6 Highlights • Wasting and stunting prevalence increases with age • Endline wasting associated with household poverty, food insecurity and mother doing agricultural work and some care practices • High proportion of children already stunted at baseline (aged 0.5-3 months), then further deterioration • Stunting associated with mother’s BMI, household poverty and food insecurity, and work (particularly cotton-harvesting)
  74. 74. Back to the fuller picture Household SES Education Child nutrition Mothers’ health Food consumption Care Women’s work Positive Negative Not sure? Social protection, food security SBCC Health Growth
  75. 75. Women agricultural workers rights and wellbeing at the centre Positive Negative Not sure? Social protection, food security SBCC Health Growth Women workers’ recognition, protection, promotion
  76. 76. Possible areas of action • Law and legislation • Drafting laws, garnering cross-party support • Data and research • Changing definitions, methodologies • Existing policies and programmes • Growth • Food security and social protection • Health and nutrition interventions • Mobilisation and organization • Forming unions, associations; articulating demands • Networking within country and global/regional experiences

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