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The impact of gender equity in agriculture on nutritional status, diets, and household food security: a mixed-methods systematic review
  1. Helen Harris-Fry1,
  2. Hayaan Nur1,
  3. Bhavani Shankar2,
  4. Giacomo Zanello3,
  5. Chittur Srinivasan3,
  6. Suneetha Kadiyala1
  1. 1Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
  2. 2Centre for Development, Environment and Policy, SOAS University of London, London, UK
  3. 3School of Agriculture, Policy and Development, University of Reading - Whiteknights Campus, Reading, Berkshire, UK
  1. Correspondence to Dr Helen Harris-Fry; helen.harris-fry{at}lshtm.ac.uk

Abstract

Introduction Undernutrition rates remain high in rural, low-income settings, where large, gender-based inequities persist. We hypothesised that increasing gender equity in agriculture could improve nutrition.

Methods We conducted a systematic review to assess the associations between gender-based inequities (in income, land, livestock, and workloads) and nutrition, diets and food security outcomes in agricultural contexts of low-income and middle-income countries. Between 9 March and 7 August 2018, we searched 18 databases and 14 journals, and contacted 27 experts. We included quantitative and qualitative literature from agricultural contexts in low-income and middle-income countries, with no date restriction. Outcomes were women’s and children’s anthropometric status, dietary quality and household food security. We conducted meta-analyses using random-effects models.

Results We identified 19 820 records, of which 34 studies (42 809 households) met the inclusion criteria. Most (22/25) quantitative studies had a high risk of bias, and qualitative evidence was of mixed quality. Income, land and livestock equity had heterogeneous associations with household food security and child anthropometric outcomes. Meta-analyses showed women’s share of household income earned (0.32, 95% CI −4.22 to 4.86; six results) and women’s share of land owned (2.72, 95% CI -0.52 to 5.96; three results) did not increase the percentage of household budget spent on food. Higher-quality studies showed more consistently positive associations between income equity and food security. Evidence is limited on other exposure–outcome pairings.

Conclusions We find heterogeneous associations between gender equity and household-level food security. High-quality research is needed to establish the impact of gender equity on nutrition outcomes across contexts.

PROSPERO registration number CRD42018093987.

  • child health
  • maternal health
  • nutrition
  • systematic review
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Footnotes

  • Handling editor Stephanie M Topp

  • Contributors HN, HH-F, BS and SK developed the protocol. HN ran the searches; HN and HH-F screened the results; and HN extracted the findings. All authors assessed risk of bias and interpreted the evidence. HH-F conducted the meta-analysis and led report writing with inputs from all authors. All authors read and approved the final manuscript.

  • Funding This research was funded by a Wellcome Trust grant (210794/Z/18/Z). Partial funding of author HH-F during the write-up period was funded by a Sir Henry Wellcome Fellowship (grant 210894/Z/18/Z). Time of the authors (HH-F and SK) was partially funded Bill & Melinda Gates Foundation and UK Government’s Department for International Development (award number OPP1136656).

  • Disclaimer The funders had no role in the research.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.