Sedlander Erica, Talegawkar Sameera, Ganjoo Rohini, Ladwa Chandni, DiPietro Loretta, Aluc Aika, Rimal Rajiv N
Milken Institute School of Public Health, Department of Prevention and Community Health, The George Washington University, Washington DC, USA.
Milken Institute School of Public Health, Department of Exercise and Nutrition Sciences, The George Washington University, Washington DC, USA.
Nutrition. 2021 Jun;86:111159. doi: 10.1016/j.nut.2021.111159. Epub 2021 Jan 24.
In India, 50% of women of reproductive age, compared with 23% of men, have iron deficiency anemia. Extant research focuses on biological, not social, determinants of this disparity.
The aim of this study was to examine how gender norms may affect anemia prevalence among women in rural India.
We conducted 16 focus group discussions (N = 124) with women of reproductive age, husbands, and mothers-in-law and 25 key informant interviews in four villages in Odisha, India.
We identified the following themes that help explain how inequitable gender norms exacerbate anemia among women from different castes and tribes: Due to a double burden of work outside the home and completing the majority of unpaid work in the home, women lack time to visit health centers to get tested for anemia and to obtain iron supplements. Women are expected to prioritize the health of their family over their own, thus affecting their access to health care. Women's autonomy to leave the house to seek health care is limited. Men are the primary breadwinners for the family, but often spend their money on alcohol, rather than on iron-rich food for the household. Intra-household food allocation favors men, in-laws, and children, thus women serve their family first, often being left with little food.
Anemia reduction interventions need to include examination of the whole social context to successfully increase iron supplement use and iron-rich food intake. Understanding how gender norms contribute to anemia could change the narrative from a biomedical to a social justice issue.
在印度，50%的育龄女性患有缺铁性贫血，而男性的这一比例为23%。现有研究关注的是这种差异的生物学而非社会决定因素。
本研究旨在探讨性别规范如何影响印度农村女性的贫血患病率。
我们在印度奥里萨邦的四个村庄，与育龄女性、丈夫和婆婆进行了16次焦点小组讨论（N = 124），并进行了25次关键 informant访谈。
我们确定了以下主题，有助于解释不公平的性别规范如何加剧不同种姓和部落女性的贫血状况：由于承担家外工作的双重负担以及完成家中大部分无报酬工作，女性没有时间前往健康中心进行贫血检测和获取铁补充剂。女性被期望将家人的健康置于自身之上，从而影响了她们获得医疗保健的机会。女性离开家寻求医疗保健的自主权受到限制。男性是家庭的主要经济支柱，但往往将钱花在酒精上，而非为家庭购买富含铁的食物。家庭内部的食物分配有利于男性、姻亲和孩子，因此女性首先为家人服务，常常所剩食物无几。
减少贫血的干预措施需要包括对整个社会背景的审视，以成功增加铁补充剂的使用和富含铁食物的摄入量。理解性别规范如何导致贫血，可能会将这一问题的叙述从生物医学问题转变为社会正义问题。
