of family and social barriers, maternal undernutrition will
persist.
One way to organize nutrition interventions during
the 1,000-day “window of opportunity” from pregnancy
until a child’s second birthday is to provide an “integrated
nutrition package.” Pregnant women are given iron and
folic acid supplements, medications for malaria and
conditions such as tapeworm, and extra food. Support for
exclusive breastfeeding is a critical postpartum component
of the package. Universal salt iodization and vitamin A
fortification—meaning that iodine and vitamin A are provided
to the entire community by adding them to commonlyused foods such as salt and cooking oil—are also important
components. Education campaigns and the development
of nutrition messages designed to motivate people to eat a
healthy diet and feed their babies and children foods that
meet their special nutritional needs are additional activities
that benefit everyone. Another “whole-community” benefit
is agriculture/nutrition programs that make available more
nutrient-dense, affordable foods that can be produced locally.
Integrated nutrition packages can significantly reduce
maternal and child malnutrition and mortality.
Helen Keller International, a U.S.-based development
organization, has evaluated the results of four of its integrated
nutrition programs—in Bangladesh, the Philippines,
Cambodia, and Nepal.22 These projects combined
agricultural training with targeted nutrition education.
The primary goal was to improve nutrition among women
and young children. Women who had opportunities to
improve their skills in homestead garden farming became
empowered to increase the amount of healthy food their
families ate (and, of course, their intake of micronutrients).
The programs improved the health and nutritional status
of the most vulnerable members of the household. In turn,
women’s increased control over household resources also
promoted gender equality. The success of these programs
demonstrated that women’s equal status and control over
income are critical to improvements in nutrition.
A similar understanding of these connections underlies
Save the Children’s new two-year program in Mali,
Agricultural Financing for Women Farmers.23 Women’s
ability to earn an income and grow more food leads to both
increased economic independence and better nutrition
and health outcomes for themselves and their children. By
Table 1 Linking Gender and Nutrition through the Program Cycle
Policy and Strategy Formulation
Support equal representation and active engagement of both women and men in nutrition policymaking processes so that their
varying needs and priorities are appropriately targeted. Adocate for policy changes that promote gender equality (e.g., in land
ownership and tenure security, access to financial services) as well as impact evaluation to address the inequitable status of women
in nutrition and food security policies.
Program Design, Planning, and Implementation
It is important to develop gender-sensitive criteria and integrate gender principles from the beginning of the program design
process. A participatory gender analysis within the country context assesses and prioritizes age-specific gender roles, power
differences, and cultural norms that affect nutritional needs and access to and control over resources among and between women,
—
girls, and males. This includes analysis of the reasons for inequalities in malnutrition rates; cultural, practical, and security-related
obstacles to accessing nutritional support; and the dynamics of men’s and women’s decision making for nutrition. This analysis
informs the design of projects and activities and identifies existing gender gaps. Gender planning24 should be participatory, take
into account the needs and perspectives of both women and men in the development process, and identify appropriate strategies to
address the power imbalance that prevents many women from becoming full partners and beneficiaries of development.
Human Resources Planning
Addressing gender discrimination and inequality in human resources policy and planning, workforce development, and workplace
support is essential in tackling the complex challenges of improving access to nutrition services.25 Develop gender policies, plans,
and strategies to create a supportive, fair, and safe work environment; protocols for recruitment, retention, training, and pay equity
should be included.26
Monitoring, Evaluation, and Reporting
Use gender- and nutrition-sensitive indicators and collect sex- and age-disaggregated data on nutrition program coverage27 to
help inform program design and improve accountability mechanisms for action on gender equality. Conduct qualitative analyses of
behavior adaptation for gender norms related to key areas of change—for example, optimal feeding and care practices for infants
and young children. Conduct routine gender audits (through spot checks and discussions with communities) to monitor whether
gender mainstreaming is being accomplished within the nutrition program and the degree of women’s, girls,’ boys,’ and men’s
access to services. Promptly address obstacles to equal access.
4 Briefing Paper, March 2012