Does a wife's bargaining power provide more micronutrients to females?

In the policy discussions related to hunger, malnutrition, poverty and wellbeing, calorie intake is often the focus. Increasingly, however, micronutrient malnutrition appears to be a critical problem in many developing countries. Women and children are most vulnerable to micronutrient malnutrition due to their elevated micronutrient requirements for reproduction and growth. According to some estimates, nearly three billion people (including 56% of the pregnant and 44% of the nonpregnant women) suffer from iron deficiency anemia (IDA), and one-third of the world's population suffer from zinc deficiency. Twenty percent of the maternal deaths in Africa and Asia are due to IDA. One in every three preschool-aged children in the developing countries is malnourished. Undernutrition, coupled with infectious diseases, accounts for an estimated 3.5 million deaths annually. At levels of malnutrition found in South Asia, approximately 5% of GNP is lost each year due to debilitating effects of iron, vitamin A, and iodine deficiencies alone.

To better understand the age-gender dimension of micronutrient malnutrition, it is important to understand how nutrients are allocated within the household. In this connection, viewing calorie intake as a sufficient statistics for nutrients, the previous literature tends to suggest that there is no gender inequality in food distribution within the household, and any apparent gender inequality in calorie distribution is due to gender inequality in energy-intensity of occupations.

In a subsistence economy, males' health have a higher market return than females' as men engage in energy-intensive occupations in which health and food consumption influence productivity and wage rates, while women are mostly confined in (less energy-intensive) household activities. These gender-segregated occupational choices (given by social norms) in turn influence a household's decision to allocate more calories to men as opposed to women, while there is not much gender disparity in calorie allocation among children. Moreover, the households tend to be inequality averse as men, despite being involved in energy-intensive activities, compensate their nutrient allocations in favor of women. Empirically, using nutritional survey data from Bangladesh, these phenomena have been demonstrated in the previous literature.

However, using an innovative survey data from rural Bangladesh collected by International Food Policy Research Institute (IFPRI), I find that calorie intake is not necessarily a sufficient statistic for different nutrients and calorie adequacy often exists alongside micronutrient deficiency. The simple rice-dominated diet with low intakes of vegetables, animal and dairy products, as typically consumed by rural Bangladeshis, meets the calorie need of the people but does not fulfill all the micronutrient requirements as rice is not a significant source of many essential nutrients, such as, vitamin A, vitamin C, iron, calcium, and zinc.

It is also not clear to what extent gender-segregation of occupational choices could explain gender inequality in the intake of various critical nutrients. This is because while the calorie intake is a direct function of calorie expenditure, as the principles of nutrition suggest, the intakes of various macro- and micro-nutrients need not. Despite men's (as opposed to women's) engagement in energy-intensive activities, the requirements for many micronutrients are higher for women, particularly, for pregnant and lactating women, and children than men due to reproduction and growth requirements of the latter groups.

In this connection, I find that (i) while there is lack of gender disparity in the calorie adequacy ratio, for a range of critical nutrients, the disparity is prominent within children, adolescents, and adult groups; (ii) pregnant and lactating women receive much less of these nutrients vis-a-vis their requirements, and; (iii) there is evidence of significant disparity in terms of intrahousehold bargaining, with a wife's bargaining power (as opposed to her  husband's) significantly and positively affecting the allocation of various nutrients for children and adolescents of both sexes and adult females. These findings, combined with the estimates of the impact of health technology, imply that perhaps the nutrition-health-labor market linkage as a key explanation for gender disparity in nutrient intakes is overemphasized in the previous literature.

For more details, see my paper, Does a wife's bargaining power provide more micronutrients to females: evidence from rural Bangladesh, here.