Milken Institute School of Public Health Poster Presentations (Marvin Center & Video)

Title

"After they've finished their meals, I have my meal from the leftovers; I have to adjust:" How Gender Norms affect Anemia Rates in Odisha, India

Document Type

Poster

Status

Graduate Student - Masters

Abstract Category

Global Health

Keywords

anemia, gender, norms, qualitative, India

Publication Date

Spring 2019

Abstract

Maternal anemia is associated with increased risk of preterm delivery, higher maternal mortality and can affect cognitive development leading to worse health outcomes throughout the lifespan. Anemia also leads to poor physical capacity, influencing work productivity. Half of women of reproductive age in India have iron deficiency anemia compared to only 23% of men. Most research focuses on biological reasons for this discrepancy and access to iron-folic acid and iron-rich foods. However, recent research in India shows that inequitable gender norms may affect a woman's ability or desire to take iron supplements and to eat iron-rich food. To examine how and why gender norms may be affecting anemia rates among women of reproductive age (WRA), 25 key informant interviews and 16 focus group discussions with WRA, adolescents, husbands and mothers-in-law (n = 148) were conducted in Odisha, India. Key informants were purposively and focus group participants were randomly sampled. The data was analyzed using applied thematic analysis in Nvivo software. Results show that unequal gender norms impact behaviors that are directly related to high rates of anemia. Women are often serving their husband, children, and in-laws first and ‚ "adjusting‚" to whatever is leftover which may include nutritionally deficient foods. Men, the main breadwinners, often spend their money on alcohol, money that could be spent on iron-rich food for the household. Women reported that extreme fatigue is a normal part of being a woman and that a woman's plight is to take care of her family. Given that fatigue, the primary symptom of anemia, is normalized women may be less likely to seek treatment. Women tend to prioritize the health of their family over her own which could affect her ability or desire to go to the health center to get tested for anemia or to obtain iron supplements. Pregnant women are more likely to take iron supplements for the health of the baby, rather than for her own health. Non-pregnant women of reproductive age, not currently diagnosed with anemia, tend to focus on chronic illnesses and thus do not engage in preventative measures such as taking supplements. More upstream barriers, like gender norms, may be impinging on a woman's ability to take iron-folic acid and to eat iron-rich foods. Understanding how gender norms contribute to anemia could change the narrative from a biomedical issue to a social justice issue.

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Presented at Research Days 2019.

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"After they've finished their meals, I have my meal from the leftovers; I have to adjust:" How Gender Norms affect Anemia Rates in Odisha, India

Maternal anemia is associated with increased risk of preterm delivery, higher maternal mortality and can affect cognitive development leading to worse health outcomes throughout the lifespan. Anemia also leads to poor physical capacity, influencing work productivity. Half of women of reproductive age in India have iron deficiency anemia compared to only 23% of men. Most research focuses on biological reasons for this discrepancy and access to iron-folic acid and iron-rich foods. However, recent research in India shows that inequitable gender norms may affect a woman's ability or desire to take iron supplements and to eat iron-rich food. To examine how and why gender norms may be affecting anemia rates among women of reproductive age (WRA), 25 key informant interviews and 16 focus group discussions with WRA, adolescents, husbands and mothers-in-law (n = 148) were conducted in Odisha, India. Key informants were purposively and focus group participants were randomly sampled. The data was analyzed using applied thematic analysis in Nvivo software. Results show that unequal gender norms impact behaviors that are directly related to high rates of anemia. Women are often serving their husband, children, and in-laws first and ‚ "adjusting‚" to whatever is leftover which may include nutritionally deficient foods. Men, the main breadwinners, often spend their money on alcohol, money that could be spent on iron-rich food for the household. Women reported that extreme fatigue is a normal part of being a woman and that a woman's plight is to take care of her family. Given that fatigue, the primary symptom of anemia, is normalized women may be less likely to seek treatment. Women tend to prioritize the health of their family over her own which could affect her ability or desire to go to the health center to get tested for anemia or to obtain iron supplements. Pregnant women are more likely to take iron supplements for the health of the baby, rather than for her own health. Non-pregnant women of reproductive age, not currently diagnosed with anemia, tend to focus on chronic illnesses and thus do not engage in preventative measures such as taking supplements. More upstream barriers, like gender norms, may be impinging on a woman's ability to take iron-folic acid and to eat iron-rich foods. Understanding how gender norms contribute to anemia could change the narrative from a biomedical issue to a social justice issue.