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.

1. 11 October 2018
Women’s Agricultural
Work and Nutrition (WWN)
Survey Findings and Implications

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. 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. 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. Nutrition pathways - simplified
Household
SES
Education
Child
nutrition
Mothers’
health
Food
consumption
Child care
Positive
Negative
Not sure?

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. 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. Section 1
General
Characteristics
• District-wise sample
• Age and Education
• NADRA Registration
• Drinking water
• Sanitation
• Ownership of land and animals
• BISP

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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Section 2
Food Insecurity &
Hunger
• Worry about not enough to eat
• Vulnerable to sleeping hungry
• Food consumption by mothers

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. 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. 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. 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. 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. 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. Section 3
Women’s
Agricultural Work
• In pregnancy
• After childbirth

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. 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. 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. 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. 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. 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. 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. Drivers of work
Household
SES
Education
Child
nutrition
Mothers’
health
Food
consumption
Care
Women’s
work
Positive
Negative
Not sure?

36. Section 4
Care Practices
• Hygiene and Sanitation
• Breastfeeding
• Child Feeding Practices
• Recent Illness
• Time-Use

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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Care
Household
SES
Education
Child
nutrition
Mothers’
health
Food
consumption
Care
Women’s
work
Positive
Negative
Not sure?

49. Section 5
Women’s Health
• Ante-natal care
• Night Blindness
• Body Mass Index
• Depression

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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Care
Household
SES
Education
Child
nutrition
Mothers’
health
Food
consumption
Care
Women’s
work
Positive
Negative
Not sure?

64. Section 6
Child Nutrition
• Wasting
• Stunting
• Stunting Changes

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. 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. 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. 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 3.77 17.72 4.93
Yes 17.42 6.45 20.26 7.89

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 44.27
Poor 44.44 20.37 70.77 32.31
Average 49.10 18.92 63.90 30.73
Rich 41.74 18.81 52.88 21.63
Richest 38.64 13.64 42.42 11.62

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. 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. 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. 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. 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. 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. 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