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GENDER MAINSTREAMING IN POVERTY ERADICATION AND THE MILLENNIUM DEVELOPMENT GOALS >
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ID: 42967Added: 2003-08-28 9:40Modified: 2006-09-01 8:57Refreshed: 2009-01-08 00:36 
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Document(s) 9 of 13
Introduction In addition to the goal of halving income poverty in the world, the Millennium Development Goals are concerned with the achievement of a number of human development outcomes (see Table 1.1, page 8). These relate to:
These human development outcomes, and the MDGs and their targets and indicators, are inter-related. For example, it has been shown that education helps reduce fertility through a number of different routes: (a) by making women more receptive to the idea of birth control; (b) by making it easier for them to access effective forms of contraception; and (c) because increasing investment in children’s education makes large families less affordable. Similarly, improvements in maternal mortality reflect reduced fertility levels as well as improved access to reproductive health facilities. Each of these in turn is facilitated by improvements in access to education and information by men as well as women that enable them to make informed choices. In other words, there are positive synergies between different aspects of human development. Eliminating the gender gap in human capabilities depends on these kinds of factors. However, it also depends on the value attached to girls and women in the family, which in turn reflects their value in the wider society. This is only partly a question of economic value. It is also bound up with social values. Improvements in maternal mortality, for example, will also depend on the kind of nourishment and care that women have received in the course of their lives. Poverty eradication is thus as much a question of values as of resources and the value attached to gender equality is central to its achievement. Human development outcomes at a regional level were discussed in Chapter 4. This chapter focuses at a lower level of analysis and considers in particular the relationship between household poverty and various forms of gender inequality. Gender Inequality and Human Development: The Equity RationaleOne way of exploring gender equality in relation to human development is by looking at outcomes: the extent to which women and men, boys and girls achieve equivalent levels of well-being. This ‘equity rationale’ sees the issue as a manifestation of social injustice. It suggests that improving women’s access to resources is one route through which the MDGs on human development – including those relating in gender inequalities – can be achieved. Gender inequality and basic well-beingThe form and severity of gender inequalities in basic needs are not uniform across the world. Nor are they related in a systematic way to the regional distribution of poverty. Instead, they seem to be connected to regional variations in women’s economic activity, itself a reflection of differences in kinship and gender relations. The most extreme forms of gender inequality – those whose life-threatening consequences for women and girls are evident in excess rates of female mortality – are found in regions of extreme patriarchy, where women’s economic options are most limited. A more systematic relationship between poverty and gender inequality in human development outcomes might be expected to exist within regions, where the effects of regional differences in kinship patterns are less likely to apply. Indeed, an analysis of data on the ‘gender gap’ in school enrolment among 6–14-year-olds from 41 developing countries showed that, in 21 of the countries, the gap was larger among the poorest 20 per cent of households than among the 20 per cent of richest households. In some cases it was considerably larger. However, in none of the countries were gender inequalities in schooling greater among richer rather than poorer households. A somewhat different set of findings was reported in relation to gender inequalities in under-five mortality. A study using data from 32 developing countries found in two-thirds of them that female advantage in under-five mortality was smaller, or male advantage larger, among the poor than the rich. In other words, the tendency to favour boys was greater among poor households than rich ones. On the other hand, there were a small number of low-income countries in which female mortality rates exceeded male rates among rich, but not among poor, households. While the latter finding may be considered exceptional, it provides household-level support for the lack of a consistent relationship noted earlier between gender inequality in life expectancy and levels of national income below a certain level of per capita GNP. This suggests that gender inequality in certain basic outcomes is not always due to poverty, or at least not only to poverty, particularly in some poorer countries. Gender inequality and child survival: the evidence from South AsiaExtreme forms of gender inequality of a life threatening kind have a long history in South Asia. Overall, women have had a lower life expectancy than men, unlike most other parts of the world. Analysis of age-specific mortality rates suggested that girls and women died in larger numbers than boys and men until the age of 35. Declining rates of maternal mortality, however, have meant that excess levels of female mortality are now largely found among the under-fives. There is considerable variation in the distribution of this excess female mortality within the region. For example, using juvenile sex ratios (JSRs) from 1961/71, one study noted that it was largely concentrated in Pakistan and the north-west plains of India. The Himalayan zones of India and Nepal, the eastern and southern states of India and Bangladesh reported more balanced JSRs. Other analysis suggests that gender inequalities in life expectancy in India also reflected socio-economic differentials associated with caste, giving rise to a ‘perverse’ positive relationship between property and inequality. This intersection between region, social status and gender discrimination persists and continues to confound any straightforward relationship between gender inequality and poverty in the country. Research in 2000 confirmed that highly masculine sex ratios were concentrated in the north-west, with more favourable ratios in the northern and south-eastern states. The pattern for the scheduled castes was similarly differentiated by region, with evidence of gender discrimination greater in the north. By contrast, ratios for the scheduled tribes, the poorest social groups in the country, were the most balanced. Micro-level studies from within the different sub-regions confirm this ‘perverse’ pattern. In terms of nutrition, studies from rural Punjab in northern India generally reported that gender disparities in nutrition among children were greater among landowning than landless households. Excess levels of female mortality there also tended to be much greater for higher order female births. The fact that first-born daughters were more likely to survive suggested that parents used the ‘lethal neglect’ of daughters to achieve their preferred number and gender composition of children. Moreover, while absolute levels of mortality were lower among the propertied classes, excess levels of female mortality were higher. In addition, it was also higher among educated mothers. Studies from southern and central India, on the other hand, reported little evidence of gender disparity among the better off or the poor. Within these more egalitarian kinship regimes, the relationship between gender inequality and poverty takes the more conventional inverse relationship. For instance, unexpectedly heavy rainfall in rural India, which increased income, was likely to improve girls’ survival chances relative to boys in the first two years, thereby closing the gender gap in mortality. In rural south India, parents gave more weight to health-related outcomes for boys than girls during the lean season. In rural Bangladesh, one study found that the literacy of
mothers had a positive effect on the nutritional status of boys. Another, using data from the mid-1970s, found that boys benefited more than girls from an improvement in household resources, although this did raise the nutritional status of all children. Discrimination against girl children appeared to be one aspect of household responses to economic crisis, so that excess female mortality in the under-five age group increased during the 1974 famine. It is generally believed in the field of development studies that economic growth and increasing prosperity are likely to lead to a decline in gender discrimination, at least at the level of basic survival. Also, life expectancy and child survival do improve with growth. However, the ‘perverse’ relationship between poverty and gender discrimination shown in some of these studies gives room for pause. And more recent evidence from South Asia provides further confirmation that gender discrimination does not necessarily disappear with economic growth or poverty reduction (see box 6.1). Gender inequality and the quantity-quality trade-offDemographic transition leading to lower levels of fertility has now occurred in many parts of the developing world and is ongoing in others. Family size in East and South-East Asia has halved. This transition is also underway in other parts of Asia as well as in Latin America. The least evidence of demographic change at the regional level is in sub-Saharan Africa. Economists suggest that one of the factors behind demographic transitions is the ‘quantity-quality’ trade off: the reduction in numbers of children as more resources are invested in each child. Studies from South-East Asia suggest that fertility decline has been accompanied by increased investment in the education of girls as well as boys. This has led to a closing of the gender gap in education – and its elimination at primary level – in countries such as the Philippines, Thailand and Vietnam. In Latin America and the Caribbean too, there is little evidence of discrimination against girls. In countries characterised by extreme patriarchy, on the other hand, there is troubling evidence that parents have achieved the reduction in the ‘quantity’ of children through a strategy of sex-selective investments in child ‘quality’. In some parts of India, this has taken the form of sex-selective investments in children’s education. Even more alarming, however, is evidence that fertility decline there has been accompanied by sex-selective investment in child survival. The relative chances of survival among female children has gone down so that the worsening of the JSR has been more marked than the sex ratio at all ages. Discrimination against girl children allows parents to simultaneously reduce their fertility rates and achieve the desired sex composition of children. These practices are now in evidence in the southern states of India, particularly in Tamil Nadu, where fertility decline has been most rapid. Even Kerala, long held up as a model of gender egalitarianism, appears to be achieving further fertility decline through a widening of gender disparities in child survival – though it continues to have higher levels of absolute welfare for girls and boys than the rest of the country. Gender-discriminatory practices have also extended to the pre-natal stage so as to influence the sex composition of births as well as of surviving children. Amniocentesis and ultrasound screening technologies are increasingly used to detect the sex of the foetus and then the females are aborted. This is shown by a marked shift in sex ratios at birth in north and north-west India and urban areas of central India and supported by various smaller scale studies and reports. These practices are not confined to South Asia, although they have been more extensively researched there. The Republic of Korea, along with China, has the highest male to female birth ratios in the world: around 113.6 males per 100 females in 1988. Because measures to identify the sex of a child, followed by sex-selective abortion, tend to be resorted to after the first birth, birth ratios become more male dominated for higher order births. Between 1985 and 1987, the sex ratio was more than 130 males to 100 females for third births and the estimate in 1988 was 199 for fourth births. However, it is probably in China – with its a rigidly enforced one-child policy and deeply-entrenched preference for sons – that the most devastating consequences on the survival and well-being of girl children have occurred (see Box 6.2). East Asian economies all experienced very high rates of economic growth and remarkable declines in poverty in the 1980s. Indeed, they were the basis for the labour-intensive growth strategies advanced in the 1990 World Development Report (WDR). These findings are a reminder that neither economic growth nor rising rates of female labour force participation necessarily eradicate gender inequality. Sex selective investments in the human capabilities of children cannot be explained in this case in terms of differential employment opportunities. Instead the reason can be found in the social values and practices that reflect the patriarchal ordering of social relations. The state could potentially take action to undermine these values and practices but this has not occurred. From gender inequalities in citizenship rights entrenched in the constitutions of Bangladesh, India and Pakistan – all three of which recognise religious law in the arena of personal life – to China’s one child policy and its tragic consequences, the state has been a force for greater inequality.
Gender inequalities, work burdens and nutritionElsewhere in the world, gender discrimination rarely takes the systematically life-threatening form that it takes in regions of extreme patriarchy. Moreover, it is generally related to poverty and tends to be greater among poor households and communities. Studies from South-East Asia, for example, reveal weak evidence of gender bias in well-being in the household. A study in Indonesia found little evidence of discrimination against girls in choice of health treatment and standardised child weights, but mild malnourishment among girls and higher birth-order children. Data from some of the poorer rural provinces in the Philippines found mild gender discrimination in favour of husbands, who received more of their protein requirements compared to wives and children. Among children, boys and lower birth orders were relatively favoured. Evidence from Vietnam does not show significant gender inequalities in basic nutrition and health care. Early analysis of nutritional data from 94 Latin American villages, however, indicated that girls aged 0–4 were 87 per cent of their expected weight/age measurements while boys were 90 per cent. Studies from sub-Saharan Africa show high levels of infant and child mortality but little evidence of differences suggesting gender bias. A report from the Subcommittee on Nutrition of the UN Administrative Committee on Coordination (ACC/SCN) estimated that around 20 per cent of African women were undernourished, compared to 60 per cent in South Asia. However, there is evidence of rising excess female mortality in recent years. Demographic and Health Surveys (DHSs) from the early 1990s report excess death rates among girls in the 0–5 age group in 9 out of 14 countries, while UN estimates suggest a decline in the ratio of women to men in most regions of Africa except the south. Inequalities in health care, rather than nutritional bias, probably explain this deterioration. In addition, there are high levels of maternal mortality (see Box 6.3).
However, along with overall levels of poverty, high rates of maternal mortality in this region also show the effects on women’s well-being of their survival strategies at the lower end of the income scale. The value given to labour in otherwise resource-poor agrarian economies, which lack well-developed markets and basic health services, has resulted in high levels of both fertility and child mortality that are mutually reinforcing. The intersection of women’s long working hours in production and reproduction combined with their high rates of fertility takes its toll on their physical well-being. This is compounded by the risks of childbirth. While women work longer hours than men in most parts of the world, as noted in the previous chapter, it was in sub-Saharan Africa that the concept of women’s ‘time poverty’ first emerged and where it continues to have the greatest resonance. For example, women’s excessive workload was identified by both women and men in one poverty assessment based in Guinea as a major factor in their disadvantage. Long working hours in energy-intensive forms of work also have implications for women’s nutritional status. The most common nutritional deficiencies among females are iron-deficiency anaemia and protein-energy malnutrition. Variations in the severity of female nutritional deprivation draw attention to: (a) life cycle factors; (b) the poverty of their households; and (c) aspects of their wider environment. It is at its most severe among women in the reproductive age group, often reducing energy among mothers for any activities beyond those essential for basic survival. It also has a regional dimension. Along with high percentages of low birth weight infants (a reflection of mother’s nutritional status) and high rates of maternal mortality, nutritional anaemia is also much higher among women from West Africa than the rest of the continent. Women’s nutritional status also has a seasonal dimension, reflecting fluctuations in their workloads during the agricultural cycle. The period of greatest nutritional stress for rural women is the ‘lean months’ of the pre-harvest period when household stocks and energy intake are low but the energy demands of agricultural work tend to be highest. Heavy work during pregnancy can lead to premature labour and, without increased caloric intake, to low birth weight babies. Finally, and not surprisingly, women’s nutritional deficiency has a poverty dimension. The main cause is household food insecurity due to unreliable food availability and very low incomes. The interaction between female nutritional deprivation and the heavy demands on their labour leads to high rates of miscarriage. In fact, ‘reasonably adequate’ birth weights reported in sub-Saharan Africa may reflect the fact that the most malnourished foetuses, infants and mothers simply do not survive. Micro-level studies confirm not only that women from lower income households tend to be at a greater nutritional disadvantage than those in better off households but also that they often pay part of the price of household attempts to cope with crisis. A study from Côte d’Ivoire found no significant difference between the body mass index (BMI) of males and females but noted that women’s nutritional status was more likely than men’s to be affected by fluctuations in household income and per capita expenditure. In Zimbabwe, the drought of the early 1990s was found to have significantly decreased women’s BMI but not men’s. In situations of severe shortage in Cameroon, women coped by going hungry for the whole day while men were more likely to migrate. It would appear, therefore, that while households’ coping strategies in times of economic hardship and crises generally include cutting back on food consumption, women bear the brunt of this strategy far more than men. The link between poverty and female ill-being is also supported by evidence from the Gambia that an increase in overall household income – the result of increased productivity of rice production due to improved technology – led to improvement in the nutritional status of women and children and a reduction in seasonal fluctuations of women’s weight. Gender inequality and hazardous livelihoodsAnother strategy adopted by households, particularly in times of crisis, is to resort to exploitative or hazardous forms of livelihoods. This is likely to have adverse effects on the well-being and also self-worth of members. For both men and women, there are certain forms of work that are more physically exhausting, worse for their health or more degrading. For example, rickshaw-pulling in South Asia, an extremely energy-consuming and almost entirely male occupation, is associated with tuberculosis (TB). Since these forms of work are avoided by those who can afford it, involvement in them is often an indicator of poverty.
Prostitutes in Mumbai, India Prostitution is one response to crisis more frequently adopted by women and girls than men and boys. In parts of South-East Asia, where tourism is a major source of foreign exchange, ‘export-orientation’ has been associated with the rise of a female-dominated ‘hospitality industry’ in which sex work plays an important role. Remittances from daughters who have entered prostitution represent the sole source of income for many poor rural households in the region. While prostitution has traditionally been associated with a variety of sexually transmitted infections (STIs), the spread of AIDS has introduced a potentially fatal risk to what has always been a hazardous form of livelihood. Moreover, it is not only those who supply sexual services who are at risk but also those who ‘demand’ and, through them, the wider population. While this demand is not necessarily confined to any particular section of the population, it does appear to be higher in certain areas and among certain occupational groups (see box 6.4).
The highest rates of HIV/AIDS are currently found in sub-Saharan Africa, which accounts for 79 per cent of people living with the disease and 81 per cent of deaths associated with the epidemic, massively outweighing its share of the global population (10%). However, AIDS is spreading rapidly in other parts of the world, particularly in Asia. While AIDS clearly poses risks for all sections of the population, it also has certain gender-specific aspects. As in the case with most STIs, women are at greater biological risk than men of contracting the HIV virus from each sexual intercourse. Forced sex increases this risk because micro-lesions make it easier for the virus to enter the bloodstream. Social beliefs that younger women are either free of or able to ‘cure’ AIDS has made them a particularly vulnerable group in Africa. Women under 25 represent the fastest growing group with AIDS in the region, accounting for nearly 30 per cent of all female cases. In Burkina Faso, where 7 per cent of the population is affected by the epidemic, the incidence among girls aged 19–24 is four or five times higher than boys of the same age. It has been found that circumcision provides men with some degree of protection from STIs and HIV, which partly explains the low incidence in West Africa. In addition, however, the spread of AIDS is related to wider gender inequalities in income, wealth and economic opportunity. In contrast to, for example, South Asia where sex is viewed as either acceptable (marriage) or unacceptable (prostitution), there is a continuum of possible sexual relationships between these two extremes in other regions of the world. Women may exchange sex for money, goods or services as part of their survival strategy, and on a transient or permanent basis. Studies from Zimbabwe and South Africa have pointed out that the decision by women to sell sex is usually in response to economic need. Poverty, along with peer pressure, leads young schoolgirls to get involved in sexual relationships with fellow students and teachers in schools and ‘sugar daddies’ outside. They need money for basic necessities such as uniforms, books, fees and bus fare as well as to participate in the social life of the school. Whenever sex is part of an economic exchange, women’s ability to protect themselves from STIs is limited. Gender Inequality and Family Well-being: The Instrumental RationaleAs well as an end goal of development, gender equality can also be seen as a route to achieving other human development goals. There are a number of links between women’s well-being, agency and resources, on the one hand, and a variety of demographic and welfare outcomes on the other. Some of these links work through biological synergies. One example noted above is that between a mother’s nutritional status and the birth weight of her baby. Gender discrimination in access to food and health care explains why South Asia has the highest rates of low birth weight babies in the world. Nutritionally deprived women are likely to give birth to low-weight babies whose chances of survival are severely limited. While these links are biological, they reflect social processes. Moreover, there are other synergies where the social causalities are even clearer. They provide a rationale for investing in gender equality on the grounds of what might be called ‘welfare instrumentalism’. Gender, resources and children’s well-being: the social connectionsSome of these links work through improvements in women’s education and many relate to demographic outcomes. One of the most widely documented findings, and one that appears to hold true across much of the world, is an inverse relationship between mother’s schooling and child mortality, particularly in lower-income countries (see box 6.5).
A variety of explanations have been put forward for these findings. Education:
There is considerable empirical evidence for this interpretation. In Kenya, for example, women were able to understand the instructions for administering oral rehydration salts after four or more years of schooling. Education in Nigeria was seen to increase women’s capacity to deal with the outside world, including the world of health service providers. In rural areas, uneducated women preferred not to deliver in hospitals because of the treatment they received at the hands of nurses, a treatment not meted out to more educated women. Several studies show that mothers’ education consistently affects the chances that:
This effect is particularly strong in poorer areas where proper health services are not available. In such cases, education puts women at an advantage in accessing available services. Gender, resources and family welfare: preferences and prioritiesIn addition, there is evidence to suggest that women may use resources at their disposal differently to men. Brazilian data, for example, indicated that unearned income in the hands of mothers had a far greater effect on family health than income in the hands of fathers. For child survival, the effect was 20 times larger. The effect of maternal education was also larger than that of paternal education. Women were slightly more likely to use unearned income in favour of daughters while men were slightly more likely to favour sons. A study in Côte d’Ivoire reported that raising women’s share of household income reduced household expenditure on alcohol and cigarettes but increased spending on food. An increase in male share of income increased expenditure on alcohol and cigarettes but also on clothing for children and adults. In Rwanda, holding income constant, members of female-headed households consumed 377 more calories per adult equivalent per day than male-headed households. This difference was greatest among lower income households. In the Gambia, the share of cereal production under women’s control added 322 more calories per adult equivalent per day to house-
Woman carrying her infant while selling pineapples in Côte d’Ivoire hold energy consumption. In Kenya and Malawi, moderate to severe levels of malnutrition were much lower among children in female-headed households, whether de jure or de facto, than children in male-headed households. In fact, children in de facto female-headed households received a higher proportion of total household calories than did children from other household groups. Similar ‘welfare’ effects in relation to children are reported for the rural Philippines, where male household heads were found to be favoured in nutritional allocation. Increased wages for husbands and fathers had a positive effect on share of calories allocated to themselves and their spouses but a negative effect on children’s share. However, an increase in the wages of wives and mothers had a significant positive impact on their own and their children’s relative share of household calories and a negative effect on husbands’ share. The evidence of a link between women’s access to resources or capacity to exercise agency and family welfare in South Asia has varied over time, location and level of analysis. However, an analysis that controlled for differences in ‘gender regimes’ across the subcontinent showed that variations in child mortality could be explained by variations in female literacy and labour force participation. Female literacy was associated with lower levels of under-five mortality while female literacy together with labour force participation reduced mortality rates of female children and led to a closing of the gender gap.
On the other hand, in those regions in India that practise extreme forms of gender discrimination, women are likely to share the values of the wider community. Here female educa- tion is not necessarily associated with a benevolent effect. For example, a study in rural Punjab reported that female education increased the likelihood of excess female mortality among daughters. While evidence on education from India is complicated by the interactions between class, caste and gender, that from neighbouring Muslim countries appears less ambiguous. Studies from Bangladesh and Pakistan suggest that the educational levels of both parents have played an important role in increasing the likelihood of children’s education. However, women’s education levels were far more important than that of their spouse. A separate study using household data from Pakistan also found that mother’s education was more powerfully associated than that of fathers with the likelihood of children going to school, but also of girls going to school. In Bangladesh, growing employment opportunities for women appears to be translating into higher levels of children’s education – as well as on reducing the gender gap in education (see box 6.6). Altruism or interests? Explaining the ‘welfare’ effectAttempts to explain these findings have varied between those who emphasise gender-differentiated preferences and those who suggest they might reflect gender differentiated interests. The former tend to emphasise socialisation processes by which women acquire a more ‘connected’ sense of self and pursue more altruistic forms of behaviour while men define themselves in more ‘separative’ terms and display more self-interested forms of behaviour. This interpretation is supported by findings from a wide range of contexts that men are likely to retain a greater percentage of their income for personal use while women tend to spend a greater percentage of their income on collective welfare. On the other hand, it has also been pointed out that women’s fortunes are more closely bound up with the fortune of their families and children (particularly their sons in South Asia). Women tend to live longer in most parts of the world and will be reliant on their children for support in old age. Older men are also far more able to marry younger wives, particularly in polygamous marriages. The ideology of maternal altruism may thus merely disguise self-interested forms of behaviour (investments in family as a form of ‘social capital’) or distract attention from non-altruistic forms of discrimination against daughters. Alternatively, of course, both explanations might be true. Gender differences in upbringing and socialisation play a role in shaping values and preferences and also experiences. The close physical bonding that occurs between mothers and children in the first years of the child’s life and the very direct care and emotional support that mothers provide are all likely to make their bond with their children a special one. And women’s domestic responsibilities means that they are more likely to hear a child crying from hunger than men who work away from the household. At the same time, inequalities in access to independent resources mean that women have a greater stake in nurturing their family networks and thus discriminating in ways that are likely to secure their status in the family. As those directly responsible for the care and welfare of infants, excess forms of female mortality must at least partly reflect women’s agency. The finding from some places that educated mothers meant higher levels of excess female mortality among daughters, particularly those born later, suggests that education can increase women’s effective agency in lethal, as well as benevolent, ways. Nevertheless, these findings help show how patterns of behaviour at the micro-level, including improvements in women’s access to education and employment, translate into discernible trends at the macro-level. These trends include demographic transition and the formation of human capital and human capabilities. They provide some of the micro-foundations for the macroeconomic models discussed in Chapter 1 that sought to explore the implications for the social distribution of income on the human capital dimensions of economic growth. ConclusionThese various findings underscore the fact that the connection between women’s productive and reproductive work is critical for their families (particularly their children) and for themselves. This is partly historical and entrenched in the deep structures of their societies. In regions where women have been denied an economically visible and socially acknowledged role in production, and have been confined to an economically devalued and socially invisible role in the domestic arena and reproductive work, they and their daughters have had shorter life expectancies, poorer health status and more circumscribed life choices than both men and boys in their own cultures and women and girls elsewhere. Such patterns persist into the present. The issue of poverty is also crucial. Poorer women are far more likely than women from better off households to experience conflicting demands on their time from these two sets of responsibilities. Their attempts to balance them can lead to a variety of adverse outcomes, including:
On the other hand, the positive synergies that have been identified between different aspects of human development can be built on. This means addressing gender inequality in access to resources, including time, within the household and various welfare failures, including gender inequalities in welfare distribution and the inter-generational transmission of poverty.
Document(s) 9 of 13
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