Stark Deprivations: Defying Nature’s Balance
Brinda Viswanathan
GENDER AND DISCRIMINATION: HEALTH, NUTRITIONAL STATUS AND ROLE OF WOMEN IN INDIA by Manoranjan Pal Oxford University Press, 2010, 323 pp., 750
February 2010, volume 36, No 2

China and India are among the few exceptions in the world which continue to show stark deprivations that are specific to women or
girl children while the per capita GDP growth has been moving ahead at a phenomenal pace. Neglect of a section of the population has resulted in the lower survival rates of women and female children which defy nature’s balance of having a more than fifty per cent share of females in the population. Statistics from China at least do not show large rates of undernourishment neither is its GDI/HDI ranking as low as for India. A deep malaise in the subcontinent points to the large deprivations in well-being that is associated with the social status accorded to women which has a strong life-cycle impact. In a region where there are multiple deprivations reflecting in basic needs and physical comfort as well as human dignity, these deprivations manifest themselves in worse forms for women than for men that cut across regions, class, caste or religious affiliations.

Consequently, India also has a rich legacy of research that delves into the issue of gender inequality and has equally contributed in terms of working towards ameliorating it either through public policy or through civil society interventions. Scholarly contributions from time to time keep the concern for the issue alive and try to push the frontier that has indeed brought about substantial changes in the thinking and perspectives.

This edited book is a compilation of 15 chapters dealing with gender discrimination within the Indian context. Nutrition and health issues take up a large share as the title of the book suggests while labour market and policy issues have also found some space. The illustrations are largely through quantitative assessment; however the nature of data used varies from secondary data to primary surveys with the methodology also varying from simple tabular representations to more detailed econometric modelling. In this sense the book also adds to the richness of the nature of enquiry and methodology used to understand the forms of gender discrimination. Public policy and interventions to reduce gender discrimination and women’s empowerment are also considered in some instances. Two chapters deal exclusively with the theoretical issues of measurement of Gender Discrimination/Bias. Caste/class interactions within the realm of gender discrimination are not part of this compilation while one chapter looks into the interaction between religion and gender from the perspective of age at marriage. Overall the book is a welcome addition to an assessment into the nature of women’s well-being vis-a-vis men’s in India.

When pro-poor policies are envisaged not much thought goes into how gender sensitive these are. Unless a policy is specially targeted towards women it tends to become gender blind and even when modifications are made the implementation is once again saddled with gendered notions. Bina Fernandez illustrates this with the case of Swarna Jayanti Swarozgar Yojana (SGSY) programme in India which is a workfare programme addressing access to credit for self-employment among the poorer sections in rural areas. The chapter aptly titled as ‘(en)Gendering poverty policy in India’ shows how this programme assumed that by providing credit, rural entrepreneurship would be promoted taking them away from the ‘beneficiary’ mode to the ‘self-managed’ mode. Amendments in the guidelines allowed for access to credit for self-help groups which have turned out to be largely managed by women along with a larger allocation of the budget for women entrepreneurs. However, there are still imperfect markets and underdeveloped institutions posing several hurdles which once again disfavour women. Reduced amount of loans by the banks as moral hazard problem still plagues credit disbursal; identification of the poor, group characteristic or ‘ethnic identity’ of the self-help group (SHG), and intra-household inequality are some of the ways these imperfections affect access to credit by women or leading to the management of the enterprise by the men of the household. This is illustrated by a case study for the Gadchiroli district in Maharashtra where individual men have a very large share but individual women still had the lowest access though women SHG’s were slowly increasing their shares. The author concludes by indicating that perhaps one has made some progress in policy making that are more gender sensitive but its implementation is still marred by the hierarchical structures of society.

Another policy that has been criticized for its gender bias is the family planning programme of India which shows that it is focussed mainly on women. The short chapter by Amitabh Tewari and Suruchi Tewari indicates the well known aspects of female bias in this policy and would have been good if the consequences of this bias on women’s health in particular and its impact in reducing fertility rate in general had also been discussed.

According to the 2001 census only one-fourth of the women are ‘visible’ women workers or those workers who participated in economically gainful activities. Their ‘ordeals’ form the narrative of the chapter by Amal Mandal which is a detailed description of some well-known aspects of women’s lives and their exploitations within and outside the home. The 2001 census also gives a further indication of the work status of women who are largely marginal workers, mostly agricultural labourers and not cultivators which further marginalizes them from access to productive resources.

Madhura Swaminathan in ‘Women in Agriculture in India’ focuses on two aspects: that the nature of jobs performed by the women has changed due to changes in cropping patterns while the wage gaps between men and women seem to have widened post-1990s. Using both census and NSSO data it is observed that female participation rates have declined marginally from early 1960s and have shown a marginal shift to manufacturing sector employment, their share in agriculture continues to remain high at above 80 per cent. Further, the census shows dramatic reversal in the nature of work within agriculture: 60 per cent of them were cultivators in 1961 while only 36 per cent hold that status in 2001. In other words the nature of their work has become more insecure and in the process seems to have lost control of the main productive asset (land) compared to their male counterparts. The author observes that in the presence of segregation in the labour market wage comparisons between men and women becomes difficult. Nevertheless wage gaps show a large variation over time and within regions of Tamil Nadu.There is a sudden disconnect in this chapter moves to a village level study to assess the wage gap in a particular village in Tamil Nadu, as a case in point to further illustrate the gendered notion of work in agriculture. If the author had presented some regional level analysis in wage gaps based on the secondary data then it would have been easier to see how wage gaps vary across regions of rural India in general. This does not however, take away the seriousness of the issue that even in states which were considered progressive in gender empowerment, there are many instances where women are still in a subordinate position.

Several regions in India show that women get married below the legal age of 18 years. Age at (first) marriage could be affected by individual factors like education and employment status as well as social and religious norms. However, this may be influenced by different factors for men and women as Sriya Iyer sets out to assess in the chapter on ‘Gender, Religion and the Age at Marriage’ based on primary survey data from Ramnagaram in Karnataka. The econometric results suggest that the model for women has a better explanatory power with several variables including religion, year of birth, socio-economic characteristics and education. The statistically significant coefficient for the men’s case was only for religion and year of marriage. Though the motivation and methodology are well articulated the chapter does not explain why the average age at marriage of Muslims is estimated to be higher than the Hindus. Given that it was based on primary survey the author may have had some understanding of the ground realities. Further the regression results seems a bit problematic with the intercept (a three digit number) being very different from being close to an expected average age at marriage in the sample which by the way is not reported. This coefficient is in fact negative! Similarly the variable capturing religion also has a large magnitude. Some preliminary analysis of the sample data would have added to a better understanding of the regression results. Clearly a more representative data set is required to further understand the interaction between religious affiliation and other socio-economic characteristics and its impact on age at marriage.

Lisa Smith and Elizabeth Brown address the issue of discrimination against girl children in South Asia (India has a very big share in it) through an index of empowerment comprising of four variables: whether women work for cash income, women’s age at marriage, age gap between the spouse and difference in the years of education between the spouses. These four variables could represent different components of the society that contribute to empowerment that is, the state, market, community, and family though the authors have not stated that explicitly.

The empirical results are unable to bring out a clear picture of the role of empowerment on gender discrimination but it is observed that in a regression equation for nutritional status (height for age z-score) of girls, the coefficient of the empowerment index is higher than for boys for India. Regional variations are observed with Pakistan showing stronger evidence hat an increase in women’s power benefits girls more than boys while for Bangladesh this reflects for children in the age group of 1–2 years.
Vani Borooah on the other hand finds positive impact of parental literacy on stunting and underweight status of children. This chapter mainly considers three different aspects of mother’s education status: mother and father are both illiterate, father is literate but not the mother and is now commonly referred to as proximate literacy, and mother and father are both literate.

The major finding lies in the fact that access to health care facilities and other related infrastructure like anganwadis have a positive impact on stunting and underweight but has the largest effect when the mother is literate, has a moderate effect when she is proximately literate and lowest effect when illiterate. However, birth order which is found to adversely affect nutritional status of the child improves only when the mother is literate. The results show that social infrastructure matters but along with it also matters the literacy status of both mother and father rather than father’s literacy status alone because in the former case as the author argues it also matters as to how these infrastructure facilities are used to improve the nutritional status. The study does not explore further the impact of the level of education of the mother on child’s nutritional status perhaps because it is based only on rural India where educational attainment is rather poor among Indian women. It has always been difficult to capture gender differences in nutritional status using secondary data as this aspect seems to manifest itself in a more nuanced manner which is usually not adequately captured through the questionnaires in secondary surveys. However, carefully designed primary surveys have revealed differences between boys and girls in the care given and/or in feeding practices.

Aparna Pandey finds that early childhood feeding practices like the onset of breastfeeding is delayed for girls within hours of birth when compared to boys. However, with the notion that breastfeeding alone is not sufficient weaning starts early for boys who are put on additional milk supplements and other protein diets earlier than girls.
The chapter by Tara Gopal Das titled ‘Gender and age differentials in health and nutritional status’ is also based in primary survey data for Baroda focussing on micronutrient deficiency. The chapter is more about well known prescriptions to reduce deprivations in general and the content justifies the title in a limited way.

Studies based on the nutritional status of the children are more common because of easy measurement across different periods of growth, ease in measurement and access to data and more importantly the evidences give scope for intervention early on to reduce the deprivations. The work of the Nobel laureate Robert Fogel on adult heights across two centuries in large parts of Europe brought to evidence long term changes in nutritional status, impacts of famines and epidemics and other economic booms and busts on well-being as captured by adult heights. However, with the recent availability of data for adult stature in developing countries long term trends in health improvements are being assessed for a better understanding of transitions. Aravinda Meera Guntupalli and Alexander Moradi explore this aspect using a rare data on adult heights of the National Nutrition Monitoring Bureau. Male species always have a larger physical body than females referred to as sexual dimorphism. In the case of human beings if adult heights are used then men are always taller than women at any given age. However, if there is discrimination against women this gap increases more than what can be explained by the natural gap and is referred to as gender dimorphism. Based on rural data for seven states the authors of this chapter show that mean heights increased for both men and women born between 1930 and 1970 but there are variations in gender dimorphism across states. Kerala and Maharashtra stand out indicating decline in gaps while Orissa shows an increase and a few other states show a mixed picture over time. However, during periods of stress like food crisis gender dimorphism increases in both Kerala and Orissa while the study has other important findings like improvements in sex-ratio and poverty reduction reduce gender dimorphism.

There are two chapters that focus on adult health issues. Koumari Mitra on HIV transmission as women are victims of HIV/AIDS and more so among poorer women. As data is difficult to obtain in this area the chapter focuses on aspects that make women more vulnerable to this disease as well as its treatment.

Sumita Das Sarkar and Ahana Sarkar looks at the role of gender on heart diseases in South Asia. The starting point of the chapter provides discussion indicating that South Asians globally have a higher rate of heart diseases and among them women are higher victims than men of the coronary artery diseases. Though in the later sections life-style issues are given as an important reason the discussion is also mixed up with other aspects of deprivation that may not be commonly found among women immigrants living in a better environment of health care access and awareness.

The issue of measurement and methodology play a crucial role in assessing the magnitude of gender discrimination especially when it needs to be quantified for purposes of understanding changes over time as well as for policy making.

Manorajan Pal and Premananda Bharati give a quick overview of several indices of gender discrimination. Though a useful summary it would have been good to have some illustrations to indicate the strengths and weaknesses of a few commonly used measures.
In comparison to this broad overview Diganta Mukherjee provides an index to measure gender bias for son preference. This is based on DSB which is not expanded in the chapter but is defined as ‘parents stop having children when they think they have enough sons’ and is an attempt to capture son preference once the girl child survives—that is if the girl child is not a victim of female foeticide or female infanticide. The theoretical model is rather detailed followed up with an empirical illustration using data for Tamil Nadu which shows that more families are either at the lower or upper ends of the bias for male child while fewer households are at the middle levels. This result is predicted by the theoretical model but whether the estimated proportions at these two ends are similar to that predicted by the model is a question left for future research by the author. Is the choice of state appropriate as this state has a lower fertility rate and average households sizes are small is also another aspect to be enquired into.

Gender discrimination at different stages of growth including foetal growth has had a strong impact on the mortality rate, excess mortality among girls/women compared to men has led to the coining of the term ‘missing women’ by Nobel laureate Amartya Sen. In the concluding chapter of the book Stephan Klasen and Claudia Wink address this issue focussing on improving the methodology to estimate the number of missing women followed by a brief discussion on the variation in trends across regions of the world as well as the determinants of the changes in ‘sex-ratio’. India had the largest share of missing women in the later part of the last century whose numbers are increasing in absolute terms and have also fared worse than its South Asian, and East Asian neighbour China while both North Africa and West Asia show an improvement in the sex-ratio. As has been indicated in several other chapters in this book, better empowered women captured through education level or employment status has a strong impact on bringing down excess female mortality but state intervention in providing adequate nutrition and health as well as access to schooling is equally important.

Overall the book has useful empirical evidences on highlighting how gender discrimination manifests itself in various stages of a woman’s life, aspects that could lead to improving the situation and more importantly that the improvement is slowest in India compared to its South Asian neighbours and several African countries not to mention China and West Asia despite recent sensitivity by policy makers towards these issues. The book will be useful for both practitioners and scholars as its sends a strong message towards periodic enquiry into the status of women, improving data collection and dissemination but more importantly emphasizes a proactive role for the state in ensuring that the environment is conducive for women to live with dignity within and outside the homely confines.

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