Intrahousehold power inequalities and cooperation: Unpacking household responses to nutrition‐sensitive agriculture interventions in rural India

Abstract

Nutrition-sensitive agriculture (NSA) interventions offer a means to improve the dietary quality of rural, undernourished populations. Their effectiveness could be further increased by understanding how household dynamics enable or inhibit the uptake of NSA behaviours. We used a convergent parallel mixed-methods design to describe the links between household dynamics-specifically intrahousehold power inequalities and intrahousehold cooperation-and dietary quality and to explore whether household dynamics mediated or modified the effects of NSA interventions tested in a cluster-randomized trial, Upscaling Participatory Action and Videos for Agriculture and Nutrition (UPAVAN). We use quantitative data from cross-sectional surveys in 148 village clusters at UPAVAN's baseline and 32 months afterwards (endline), and qualitative data from family case studies and focus group discussions with intervention participants and facilitators. We found that households cooperated to grow and buy nutritious foods, and gendered power inequalities were associated with women's dietary quality, but cooperation and women's use of power was inhibited by several interlinked factors. UPAVAN interventions were more successful in more supportive, cooperative households, and in some cases, the interventions increased women's decision-making power. However, women's decisions to enter into negotiations with family members depended on whether women deemed the practices promoted by UPAVAN interventions to be feasible, as well as women's confidence and previous cultivation success. We conclude that interventions may be more effective if they can elicit cooperation from the whole household. This will require a move towards more family-centric intervention models

“Can’t live willingly”: A thematic synthesis of qualitative evidence exploring how early marriage and early pregnancy affect experiences of pregnancy in South Asia

“…In this review, some girls reported actively diminishing their agency during household decision-making, suggesting they acknowledge the benefits of acting in line with rather than challenging hierarchies in decision-making within households [ 49 , 85 , 90 ]. This supports other conceptualisations of household bargaining in South Asia which highlight that an absence of protest does not reflect an absence of questioning [ 13 , 128 ]. As household hierarchies frequently delayed or prevented care-seeking, we join others who call for an update to existing models which seek to understand care-seeking to incorporate the nuance of women’s decision-making capabilities [ 129 , 130 ].…”

“…Early marriage is intimately connected with local cultural and gender norms which simultaneously drive the practice of early marriage and shape experiences [ 10 , 11 ]. In alignment with these norms, households tend to have hierarchies relating to gender and age, meaning young married girls are often discriminated against [ 12 , 13 ]. In South Asia, early marriage has been associated with interrupted education, restricted mobility outside of the home, social isolation, and limited decision-making [ 14 – 17 ].…”

Feasibility, acceptability and equity of a mobile intervention for Upscaling Participatory Action and Videos for Agriculture and Nutrition (m-UPAVAN) in rural Odisha, India

“…A further benefit of the mobile platform was the successful engagement of whole families. Lack of family support is a key barrier to accessing nutrition interventions and adopting promoted behaviours in low and middle-income countries [ 32 ] and family support and cooperation were identified as important enabling factors in the UPAVAN trial [ 10 , 33 ]. Following this, m-UPAVAN actively promoted watching and listening with family members via phone messages and with facilitators after COVID-19 restrictions eased.…”