In discussions about lived experience of nutrition, it doesn’t take long for issues of gender equality to emerge. Women eating last and least in households is a phenomenon experienced all over the world, linked to both economic factors and cultural norms.

It also reflects another truth about the multiple inequalities faced by women and girls globally: Malnutrition is sexist

On International Women’s Day, this blog explores the reasons why women and girls are disproportionately affected by malnutrition, and the changes needed to fulfil their rights to good nutrition. 

Malnutrition disproportionately affects women 

Malnutrition and hunger, although closely related, are distinct conditions. Malnutrition isn’t only a lack of food; it is also caused by insufficient nutrients in food. Nutrients are essential for the body and brain to develop and function at optimal condition and to avoid ill-health. Malnutrition is the single largest cause of death among women, killing women more than any other risk factor, including alcohol and tobacco. In part this is due to physiological vulnerabilities. For example, women of reproductive age are more likely to be affected by anaemia than men due to the loss of iron during their monthly periods and an increased need for iron if they become pregnant and breastfeed. 

Furthermore, the generational impact of a woman’s nutrition status on her children is well evidenced: if a woman with anaemia and other nutritional deficits becomes pregnant, the chances of her having a baby that has a low birthweight is increased, which could result in premature birth, developmental problems, and early child mortality. 

This is compounded by a wide range of social and cultural factors, which is why it is essential to recognise that to effectively tackle malnutrition, we also have to address gender inequality.

A table. First row: iron. First column: necessary nutrients. Iron is particularly important during pregnancy and menstruation due to blood loss. Second column: risks of nutritional deficiency. Women who are not consuming enough iron-rich foods or are eating foods that inhibit the absorption of iron at risk of developing anaemia.  Second row: Iodine. First column: necessary nutrients. Iodine is particularly important during pre-conception and the first sixteen weeks of pregnancy to ensure the healthy development of the baby’s brain.  Second column: risks of nutritional deficiency. Pregnant women who do not consume enough iodine are more likely to miscarry or have a stillborn child.  Third row: Vitamin A. First column: necessary nutrients. The requirements of vitamin A are increased during pregnancy, making pregnant women especially vulnerable to vitamin A deficiency (VAD). Second column: risks of nutritional deficiency. Pregnancy is associated with increased maternal mortality and increased infant mortality rated during the first year of life.
Table shows the nutrients that are needed specifically by women and girls.
From RESULTS UK’s policy report ‘Malnutrition is sexist: The determinants of nutrition for women and girls

Malnutrition is a social and women’s rights issue

Beyond the physiological factors, nutrition isn’t limited to a maternal health concern: it is also a women’s rights issue. A wide variety of social determinants affect women and girls’ nutrition status. These institutional barriers are found in health systems since the COVID-19 pandemic started, for example, when nutrition health services, which deliver essential care for women and girls, are often considered as non-essential services. This is also the case in contexts where women continue to face discrimination in decision-making and in access to information, land and resources related to food and food chains. Malnutrition in women and girls is a multi-layered social issue, which must be addressed as human rights and gender equality issues. 



In the report Malnutrition is Sexist, we explain how multi-sectoral nutrition interventions are needed to address some social barriers to good nutrition. One barrier is when women are actively discouraged from exclusively breastfeeding their infants. The devastating impacts of aggressive marketing of formula milk products on women and children’s health and nutrition have long been known, and are further evidenced by WHO and UNICEF in their recently launched report How the marketing of formula milk influences our decisions on infant feeding. Scaling up exclusive breastfeeding could prevent an estimated 800,000 deaths of children under 5 years as well as 20,000 breast cancer deaths among women each year. This research shows that aggressive formula milk marketing misuses and distorts information to influence decisions and practices, preventing global progress on exclusive breastfeeding. Aggressive marketing shows that promoting breastfeeding isn’t enough, and that an enabling social environment must be fostered to support women.  

Time for accountability on women’s rights

The solutions to this global health issue require treating gender equality as a social determinant of nutrition, while also ensuring that policies and programmes work across sectors to foster a new environment where women and girls have equal treatment and opportunity. More than 1 billion women experience at least one form of malnutrition, and since the implementation of the Global Nutrition Targets by the World Health Organization in 2012, Guatemala is the only country in the world in 2022 to have been assessed as having made sufficient progress to achieve a 50% reduction of anaemia in women of reproductive age. This Global Target was meant to be met everywhere by 2025. 

At the Nutrition for Growth Summit in December 2021, nearly 400 commitments were made by governments and other stakeholders to create enabling environments for improved nutrition and tackling malnutrition. Fulfilling women and girls’ rights to nutrition requires immediate disbursement of financial resources and implementation of adequate policies. This International Women’s Day, let’s remind policy makers around the world that now is the time for accountability on promises made. 

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