The Framework
Why a Gender-Transformative Framework for Nutrition?
Nutrition and gender are intimately interconnected. Every day, women and girls experience poor nutrition disproportionately — 60% of the world’s people with chronic hunger are women and girls. Gender inequality is both a cause and a consequence of malnutrition, which can trap women and girls in a vicious multigenerational cycle of poverty and unmet potential.
Limiting access to nutritious foods and nutrition education among other issues have debilitating impacts on women and girls’ nutritional status and contribute to poorer health. This threatens women, girls’ and people of diverse gender identities’ overall wellbeing and opportunities across their lifetimes, and for the generations that follow.
To date, some efforts have been made to “integrate” or “mainstream” gender into nutrition programs, but wide gender disparities persist because these efforts have not addressed the root causes of the problem. It is insufficient, and many times harmful, to seek to improve individual women and girls’ situations without addressing the discriminatory gender norms and unequal power imbalances between women and men that contribute to gender inequality and malnutrition.
An effective response requires that gender equality and the empowerment of women and girls becomes the central foundation upon which multi-sectoral responses to nutrition are built. Traditional power holders and influencers must be engaged in this process. They are important gender champions. Mobilized as agents of change, working together with women and girls and people of diverse gender identities, they can use their positions of power to shape systems to create a more equitable world for all.
Localized, transformational change that is profound and resilient is vital to deep and lasting impact. This demands radical breakthroughs in paradigms, beliefs and behaviour at various levels. We need to think differently so that we can do differently.
What is the Gender-Transformative Framework for Nutrition?
At its core, the Framework has an understanding that agency, resources, and opportunity structure are fundamentally linked and interact to influence the degree to which women and girls will experience empowerment across the areas of their lives. Within the GTFN, these are expressed as the empowerment circles.
At the centre of the framework is the concept of agency, or the ability to define one’s goals and act upon them. Agency is most often thought of as decision-making power, but it also includes the ability to negotiate, influence or exert control over one’s life.
In order to be able to act, women and girls must also have the necessary resources to do so. This can include everything from financial assets and material wealth, to essential infrastructure, information, time and labour, mobility, and bodily integrity.
It is possible that women have the capacities above, yet find themselves constrained by the opportunity structure around them and are unable to act towards their intended goals. Opportunity structure refers to the presence and operation of formal and informal institutions, including the laws, regulatory frameworks, and norms governing behaviour that affect women and girls’ agency and access to resources.
Women’s empowerment occurs when each of these elements are activated and mutually reinforcing. A key element of applying women’s empowerment theory within nutrition programming is to understand that power imbalances and resulting gender inequalities have a direct impact on the nutritional status of women and girls, and that poor nutrition is fundamentally disempowering.
The GTFN then modularizes the multi-sectoral dimensions of malnutrition to form the outer circle. The central placement of the empowerment circles enables users to understand the systemic impacts of gender inequality within each of these domains, to identify the interaction between domains that contribute to malnutrition among women and girls, and the entry-points for action that harness agency, resources and opportunity structure to drive large-scale, enduring change.
Focusing on single domains or individual delivery channels in isolation will limit achievements towards improved nutrition and gender equality. Catalytic progress towards equitable nutrition requires greater collaboration and sharing of assets across domains. This shifts the visual analogy of delivery from linear silos to a puzzle, where all pieces fit into the broader picture of gender equality and empowerment.
This re-framing can help us understand how gender norms, institutions, and power relations are disempowering women and girls and causing unequal access to food, health and nutrition services, education, agricultural resources, markets, and technologies. In doing so, the Framework uncovers entry-points and facilitates solutions to address the complexity of interactions between the drivers of malnutrition while building resilience to unanticipated shocks that undermine pathways to improved nutrition and gender equality.
The Intersection of Food Systems and Health Services
The GTFN demonstrates that even when sectoral responses to address the underlying causes of malnutrition are delivered in silos, these still interact. These interactions culminate in either enabling or frustrating a woman or girl’s overall effort to engage with these delivery systems to satisfy their own nutritional needs, or that of their family’s.
This intersection can be clearly seen as adolescent girls navigate both food and health systems to satisfy their needs. Challenges around dietary and health-seeking practices are particularly acute for adolescent girls who biologically have increased nutritional needs, yet are often the most marginalized, with least power to make decisions regarding access to health services, diet and their own bodies. For adolescent girls, having agency over what they consume and their Sexual and Reproductive Health and Rights (SRHR), has a direct impact on their ability to participate in formal and informal education. Girls who have control over their diet, including the consumption of iron rich foods and supplementation, are less likely to suffer from anemia, miss less days of school, have better school performance, and overall, more energy. Coupled with increased agency over SRHR, it means these girls will avoid unintended pregnancies, stay in school longer and succeed in higher levels of education. This has a significant impact on their transition into adulthood, both for their nutritional and economic well-being.
How the Information was Gathered
A review of existing gender and nutrition frameworks was completed to assess how gender norms and inequalities could be addressed within a new framework. Key frameworks, such as the original UNICEF framework, Engle et al.’s adaptation of the framework expanding on adequate care, the empowerment conceptual framework by Kabeer and by Batliwala and Pittman created the foundational pieces for the research.
A rapid evidence review was performed to identify the associations between empowerment and nutrition. The initial search was performed on Mendeley’s online database using key words such as women’s empowerment, nutrition and community. An abstract review of over 1,000 articles was conducted to select articles that described studies specifically exploring gender and nutrition. The inclusion criteria of the literature review included articles with reported indicators for empowerment (direct or indirect) and nutrition. Only 41 articles fit this inclusion criteria. Using the snowballing technique, other papers and new publications were included in the review.
As the research was complied, the UNICEF framework was applied to organize the findings. From this foundation, the different domains of malnutrition were expanded, while considering the complexity of empowerment and gender norms. The framework concept was refined through several technical consultations with partners and participants, including at the June 2019 Women Deliver Conference, the Canadian Conference on Global Health and the Micronutrient Forum.