Gender equality is defined as “the absence of discrimination on the basis of a person’s sex in opportunities, the allocation of resources and benefits, or access to service.” It is the concept that everyone—regardless of gender—has equal conditions, treatment, and opportunities to exercise all their human rights and contribute to and benefit from social, cultural, economic, and political growth. Therefore, gender equality goes beyond merely being a “women’s issue” as it is a fundamental human rights issue, and a prerequisite for and indicator of sustainable development. Unfortunately, despite significant progress across the Middle East and North Africa (MENA), guaranteeing equality for those who identify as women and girls is a persistent challenge and concern.
While national laws are meant to provide for the equality of all citizens in countries including Lebanon, Syria, Jordan, Sudan, and Egypt, the reality is that gender disparities are rampant in countries across the MENA region. According to Plan International, the region ranks lowest on the Global Gender Index, scoring poorly on essential indicators like health, education, economic involvement, and political participation. Gender-based violence is the most widespread right violation, with one out of every three women in the MENA region having endured or being at risk of enduring abuse. In terms of employment, the region has about 21.3% of females participating in the workforce, the lowest compared to the global average of 52.6%. Furthermore, the female unemployment rate in the Arab states is three times higher than the world average at 15.6%.
Statistics on gender discrepancies in Lebanon further illustrate the various challenges in realising gender equality. The UN Women reported that employment for women in Lebanon will drop between 14-19% due to the ongoing economic and political crises, COVID-19, and the August 2020 Beirut explosion. In fact, Lebanon has one of the highest overall gender gaps, ranking 145 out of 153 countries in the 2020 World Economic Forum’s Gender Gap Report. Approximately one in three married women in Lebanon experience violence from male relatives, there are only about 6% women in Lebanon’s parliament, and refugee women in Lebanon have the most disrupted food intake of their community and are far more likely to lack legal status or proper shelter.
Gender inequality has a wide range of negative consequences in terms of employment, education, child marriage, unpaid domestic work, and sexual violence. It also has a significant impact on nutrition, especially for women who are often victims of malnutrition instead of playing an active role in its elimination. The main contributors to poorer nutrition in women are less education, lower economic standing, and limited decision-making authority in the household and community. Consequently, a multidisciplinary approach must address the discriminatory conventions that impede the ability of those who identify as females to ensure that they are adequately nourished.
Gender Equality, Nutrition, and Food Security
Food security refers to peoples’ full access to sufficient, safe, and nutritious food that fulfils their dietary preferences and nutritional needs for a healthier lifestyle at all times. Unfortunately, women are much more vulnerable than men to food insecurity due to biological and socio-economic conditions such as lack of opportunities for education, absence of decision-making power, poor employment, low income, and the drive to prioritise their kids’ health and well-being. Since men are predominantly the bread winners and control cash income, they typically hold the decision-making power and control the quantity and quality of food purchased, especially in the largely patriarchal households across the MENA region. According to IMAGES MENA’s data, 46% of male respondents, compared to only 16% of females, reported being the primary decision-makers for food purchasing.
When food is scarce, one coping strategy might be for women and girls to eat less so that men and boys can eat more. In such situations, women and girls may eat meals that are of worse quality, unhealthy, and even dangerous. To make matters worse, poor sanitation and lack of access to safe drinking water put women and their children at greater risk of sickness, starvation, and death. Even if a sufficient supply of nutritious food is available, women as primary caregivers and mothers redistribute their food and resources to keep their families healthy and free of illness. By embodying the caregiving role during periods of economic stress, they sacrifice their hunger for their children and other family members, jeopardizing their own physical and mental health. Traditional practices and beliefs and food taboos such as eggs, beans, and butternut may further impact eating patterns, preventing women from getting the nutrients they need, especially when pregnant or lactating. Furthermore, in patriarchal societies, it is more challenging for women to have the authority or option to change these customs.
Gender Equality, Nutrition, Healthcare Services, and Accommodation
Access to health services and information also impacts women’s health and nutrition. For example, learning about the causes and preventive measures of anaemia can help minimize maternal mortality and undernutrition among infants born to anaemic mothers. Women, particularly those living in more isolated and rural areas with poor infrastructure, are often deprived of the freedom and choice to get these services. This could be due to illiteracy, lack of confidence in seeking help, or cultural norms that forbid them from travelling far from home or interacting with strangers, particularly men. Additionally, these women often have limited spare time due to various responsibilities like having to work long in the fields, lengthy walks to get fuel, wood, water, or employment under poor working conditions. Such roles cause overexertion, and threaten their overall health and nutrition, especially if they are pregnant or breastfeeding. According to IMAGES MENA 2016 Egypt’s data, 32% of female respondents declared that they were denied the right to seek medical care due to their families’ “disapproval” or the financial burden.
Gender Equality and the Nutrition of Future Generations
Malnutrition between conception and a child’s second birthday has lasting physiological, cognitive, and medical repercussions which can lower a person’s lifetime earning potential. The regional average of exclusive breastfeeding, defined as only breast milk for the first six months of life, is a significantly low average of 29.3%, indicating poor conformity with the World Health Organization’s (WHO) baby feeding guidelines and a highly possible negative impact on the burden of disease in the region. The consequences have a flow-on effect. If the mother is malnourished, she cannot properly breastfeed, which will cause her baby to most probably suffer from low birth weight, high mortality rate, inadequate mental development, suboptimal physical growth, flawed metabolic balance, and weak immunity in the first six months of life. Consequently, if that baby does not get proper care and timely feeding, they face a greater risk of acquiring physical and intellectual developmental problems, and with continued inadequate food and care, there is a higher chance that this will continue well into their adolescence. Then, if that child grows to be a mother, they will grow to be malnourished and subsequently have malnourished babies. This is how malnutrition is a vicious multigenerational cycle.
Furthermore, the low birth weight (LBW) rate in the region (defined as the percentage of infants that weigh below 2.5 kg at birth), is at 19.31%. This is problematic as LBW children have a high rate of abnormal growth, diseases, neuro-developmental disorders, and cognitive abnormalities. In most cases, it is linked to poor maternal health and prenatal factors. Malnutrition does not merely create LBW, but also contributes to pediatric obesity. Among children under five, the estimated regional average for this is significantly high at 8.42%, exceeding the global average of 6.7%. Interestingly, pediatric obesity is associated with lower levels of exclusive breastfeeding, parental obesity, and maternal body mass index, in addition to other factors related to the high intake of sugar and fatty foods. Strengthening women’s authority, access to resources, and decision-making positions in the family and community can be an effective technique to not only improve their nutritional intake and health, but also improve the health and well-being of their children.
Conclusion and Recommendations
To combat the disproportionate differences in malnutrition rates between women and men in the MENA region, gender inequality must be addressed. Gender inequality is embedded in all aspects of life including laws and regulations, social expectations, and most importantly, nutrition. The nutritional status of women and children is an excellent measure of a society’s overall well-being. It does not only impact pregnancy and child-rearing, but also household, food security, health, and the family environment. To ensure food and nutrition security, women must be empowered to promote healthy, balanced diets through the cultivation and consumption of nutrient-dense crops using sustainable local food systems. Hence, immediate action is needed to address the double burden of malnutrition in women in the MENA region.
Such actions can include increasing women’s accessibility to land, improving their ability to make decisions regarding its use, and expanding their management of physical and financial assets. This increase in access to land, control, and decision-making will simultaneously improve agricultural production and their children’s health and nutrition. Governments and civil society must work together on distributing inclusive nutrition packages from the first 1000 days of pregnancy to the second birthday of the child. They must also increase resources and provide pregnant women with vitamin A, iron, and folic acid supplements, as well as treatment for malaria and tapeworms. Educational campaigns that encourage adults to follow a healthy diet and feed their children foods that satisfy their unique nutritional demands should also be developed to improve public awareness. Moreover, local and regional governments can pursue agricultural and dietary programs that make more nutrient-dense, inexpensive meals that can be produced locally. Similarly, given the low rates of exclusive breastfeeding found, multifaceted approaches in the region are required to protect, maintain, and promote breastfeeding, including the establishment of effective communication initiatives and culture-specific education. All of these initiatives can combat the high levels of malnutrition amongst women in the MENA region and the consequences it has on gender inequality.
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Luna Awada is a 21-year-old pre-medical student studying Biology at the American University of Beirut (AUB). Awada is an alumna of the U.S.-Middle East Partnership Initiative’s Tomorrow’s Leaders Gender Scholars Program (TLS) at AUB (also known as MEPI-TLS). She strives to fight for other women through writing about them, sharing their struggles, and contributing to their empowerment.