Gendered Food and Water Insecurity in South Asia

Abstract

Women in South Asia, like women across the world, face disproportionate water and food insecurity. Aspects such as access to education, income, gender roles, and land ownership are cross-cutting themes influencing women’s water and food insecurity. However, country- and region-specific issues, premised in diverse political, economic, cultural, and environmental conditions, also shape differential water and food insecurity for particular groups of women. Understanding the complex and multidimensional aspects of differential gendered water and food insecurity is a core concern for scholars and policymakers. In this chapter, I review the common aspects as well as country- and region-specific issues impacting women’s water and food insecurity in South Asia. A nuanced understanding of how diverse groups of women are impacted by food and water insecurity is important for developing nuanced and targeted interventions towards achieving SDGs 2 and 6.

1 Introduction

Women and girls in South Asia are disproportionately impacted by food and water insecurity in multiple direct and indirect ways. Food insecurity is higher among women than men, and the gender gap in accessing food has increased from 2018 to 2019 in the moderate or severe and severe categories, not just in Asia but also globally (FAO, IFAD, UNICEF, WFP and WHO 2020, see Fig. 8.1). The link between food insecurity and income insecurity and/or poverty is a major reason that women and girls experience unequal food insecurity (Asian Development Bank 2013). Women’s income insecurity in turn is premised in patriarchal land ownership and inheritance patterns, gender roles that have historically kept women tied to unpaid care-work, and unequal access to education, technology, and jobs (Jung et al. 2016; Asian Development Bank 2013). Additionally, and as a consequence of these myriad inequities, climate change also has gendered impacts (Lambrou and Nelson 2010).

Fig. 8.1

Source FAO, IFAD, UNICEF, WFP and WHO (2020)

Prevalence of food insecurity in women versus men, 2014–2019.

The impacts of water insecurity experienced by women are similarly complex and multidimensional. Women often compromise their own water security, restricting their personal drinking and washing needs, to provide more for their family members (Truelove 2019). Confronting realities such as fetching polluted water—sometimes the only water available—for the family, despite knowing the risks this entails, are additional burdens that women disproportionately shoulder (Sultana 2011). Furthermore, the consumption of contaminated water increases the incidence of water-borne diseases, in turn increasing women’s care-giving responsibilities, further confining them within their homes, and limiting their ability to pursue income-generating opportunities (Corcoran-Nantes and Roy 2018; Kher et al. 2015). The responsibility of fetching water from far distances in Central and South Asia falls disproportionately on women and girls, which in addition to being a physical burden in itself, also increases their risk to sexual violence while traveling back and forth (UNICEF 2018). Figure 8.2 illustrates the scale of this burden for the women and girls of Nepal, Afghanistan, India, and Bhutan (adapted from WHO 2017). In Nepal and India for instance, in 53% and 40% cases respectively, the primary responsibility of fetching water from off premises falls on women over the age of 15. This is in sharp contrast to 2 and 6% men over the age of 15 in the same countries.

Fig. 8.2

Adapted from WHO (2017)

Primary responsibility for water collection by gender and age, as a percent.

On account of these multidimensional aspects constituting gendered food and water insecurity, scholars have urged the need to disentangle insecurities experienced by women individually from household-level insecurities (Broussard 2019; Truelove 2019). The Food Insecurity Experience Scale (FIES) used by the FAO since 2014 to record people’s experiences of constrained access to food offers the possibility of recording individual issues impacting women’s food insecurity. Studies separating individual insecurities from those of the household have highlighted certain issues as cross-cutting themes impacting food and water insecurity for women in South Asia. These include patriarchal land ownership, access to education and employment, income inequality, differential access to social networks, geospatial factors, stereotypical gender roles, time spent making food and water available for the family, and additional care-giving burdens from caring for family members suffering malnutrition and water-borne diseases. Yet, country- and region-specific political, economic, cultural, and environmental conditions also differentially impact particular groups of women. For instance, more women face water and food insecurity in conflict-ridden areas of Pakistan, in rural, drought-prone areas of Nepal, Bangladesh, and Bhutan, particularly if they are Dalit,¹ indigenous, and/or poor.

Recognizing these common themes and differences is important for grasping vulnerabilities experienced by different groups of women. Such disaggregation is crucial for meaningfully grasping interventions towards achieving the Sustainable Development Goals relating to women’s food and water security. SDG 6.1 aims to “… achieve universal and equitable access to safe and affordable drinking water for all”, while SDG 2.1 is geared to “end hunger and ensure access by all people, in particular the poor and people in vulnerable situations, including infants, to safe, nutritious and sufficient food all year round” (UN 2015). Given the culturally, politically, economically, spatially, and environmentally specific issues impacting women, achieving the SDGs is impossible without careful attention to the specific dynamics of food and water insecurity pertaining to different groups of women. In the absence of more grounded and nuanced understandings, interventions to achieve women’s water and food security will remain inappropriately conceived and targeted.

In this chapter, I review existing literature on women’s food and water insecurity in South Asia, highlighting common themes and specific aspects impacting particular groups. I draw on recent studies that shed light on the multidimensional nature of food and water insecurity. For instance, violence across scales—household as well as region—is a cause, as well as effect of women’s food and water insecurity, and is entangled with the impacts of climate change. As well, where relevant, I include intra-national/regional differentiation to locate the multi-scalar role of geospatial unevenness—rural/urban, intra-urban, ecologically or politically vulnerable locations, etc. This review is by no means comprehensive. Rather, I simply wish to emphasize some key complexities that characterize the intractable nature of women’s food and water insecurity, and the overarching perspectives from which these gendered insecurities have been explored. My intent is to show how enduring gendered inequalities and specific vulnerabilities become pathways through which recursive relationships between food and water insecurity are reproduced.

2 Food Insecurity Among Women in South Asia

In 2008, over two-fifths of the women in India and Bangladesh suffered maternal undernutrition² (Asian Development Bank 2013: 12; Ahmed et al. 2012). Varying studies suggest that 41.7 to 77.0% of women of reproductive age in Pakistan are affected by anemia (Ali et al. 2020), as are about half the women in Bhutan (Atwood et al. 2014), and almost a third of the women in Sri Lanka (SAPRI 2017). This disproportionate burden of anemia on women can be associated on the one hand with their physiological needs relating to menstruation, childbirth, and breastfeeding, and on the other hand with long-standing histories of gendered malnutrition. In turn, gendered malnutrition might directly stem from men consuming more calories than the women in patriarchal South Asian households (D’Souza and Tandon 2015). But aspects such as income levels, caste, geospatial location within the country, education level, pregnancy and lactation, and marriage also shape unequal access to food for women (Pandey and Fusaro 2020). For instance, a nationally representative survey of 12,862 women of reproductive age³ in Nepal reported that over half the respondents—56% women—experienced food insecurity (Pandey and Fusaro 2020). Geographically, this survey found that food insecurity was most pronounced among women residing in districts of Nepal’s Mid-Western development region, ranging between 83 to 100% across districts in this part. And while women with a 10^th grade education emerged over twice as likely to be food secure than women without an education, 76% of the Dalit respondents,⁴ irrespective of education and class, reported food insecurity (Pandey and Fusaro 2020). This association between caste and gendered food insecurity is echoed by studies in India, and indeed there might be significant differentiation in women’s food insecurity even across lower caste groups (Rao et al. 2017).

Pregnancy and lactation further increase the impact of food insecurity on women, particularly among women who do not have an income. According to the UN World Food Programme, roughly 1.4 million pregnant and lactating women in Nepal were malnourished and 48% suffered from anemia (USAID 2019). These statistics are substantiated by studies such as by Harris-Fry et al. (2018) who show that pregnant women, unless their income matches their spouse’s, receive the lowest share of food and nutrients within the household. The continuing prevalence of child marriages in Nepal is another predictor of food insecurity for girls (young pregnant women) and their children (Na et al. 2018). Arguably, while young mothers are inadequately informed about their own or their children’s nutritional needs, early motherhood additionally constrains girls’ access to education and employment, further compounding food insecurity. Persistently high rates of teenage pregnancies are a cause of concern across South Asia. In Afghanistan, a third of all pregnancies reportedly occur in adolescence (Akseer et al. 2018). In 2010, 11 to 15% 15- to 19-year-old girls in Bhutan had already given birth (Atwood et al. 2014), while in 2014 over 30% of 15- to 19-year-old Bangladeshi girls had borne children (Osmani et al. 2016).

These numbers and the implications they carry are particularly worrying given the chronic domestic violence faced by women in South Asia, and what this implies for their food security. For instance, over half the women in Bangladesh and Afghanistan reported having experienced physical and/or sexual violence at least once in their lives (Fig. 8.3). The relationship between food insecurity and violence is a complex one. Lentz (2018) insightfully delineates two pathways linking food insecurity and violence: on the one hand, household food insecurity is a trigger for violence against women, on the other, food insecurity (withholding of food) is a mechanism of inflicting physical violence on women. The accounts by Diamond-Smith et al. (2019) for Nepal and by Gibbs et al. (2018) for Afghanistan are instructive of the first pathway, while Ackerson and Subramanian’s study (2008) on India⁵ illustrates the second pathway. Of the 90,000+ Indian women that Ackerman and Subramanian interviewed, nearly half had anemia and almost a third were severely underweight. Of these respondents, 19% women reported domestic violence, and the authors found chronic malnutrition among the women who reported frequent abuse (Ackerson and Subramanian’s 2008).

Fig. 8.3

Adapted from UNFPA (2019)

Proportion of women disclosing experiences of violence.

In addition to being tied to violence against women within households, food insecurity is also a cause and consequence of regional conflicts. For instance, food insecurity in Pakistan is highest in its most conflict-ridden areas—such as some parts of Khyber Pakhtunkhwa and Baluchistan (Malik 2010)—and impacts women in multiple ways. To begin with, regional violence in the conflict-ridden areas of Pakistan has been associated with an increase in domestic violence against women (World Food Programme 2010). Women’s mobility in these parts is also especially restricted and decreases their access to healthcare, schools, and jobs. Violent crises also restrict income-generating activities (poultry farming for instance) that might have been the only source of income for women, in turn compromising their food security. Further, households headed by women in these parts of Pakistan reported disproportionate food insecurity (World Food Programme 2010). This evidence from Pakistan on female headed households (FHHs) being especially food insecure is echoed by findings from Nepal (Pandey and Fusaro 2020), Sri Lanka (Vhurumuku et al. 2012), Bangladesh (Munro et al. 2014), and Bhutan (Aryal et al. 2019). Aryal et al. (2019) suggest that further targeted understandings and interventions need to differentiate between de jure FHHs (i.e., households run by single, widowed, or divorced women) and de facto FHHs (i.e., households with husbands who are not physically present because of their off‐farm work). Munro et al. (2014) show further through their work with Bangladeshi Garo women how indigeneity, income, and culture interact to produce disproportionate impacts on the food security of South Asian households headed by women.

Another cross-cutting theme impacting women’s food security in South Asia is their limited land ownership and relatedly their constrained role in agricultural decision-making. Aziz et al. (2021) illustrate through the case of Azad Jammu-Kashmir in Pakistan how women’s ownership of land and livestock and their decision-making in agriculture can improve their own as well as their family’s food security. This insight is pertinent for other parts of South Asia too, where land ownership and inheritance are largely patriarchal, depriving women of control over assets, income, and decision-making. For instance, in 2002 only 16% of the land in Sri Lanka (FAO 2018) was owned by women, while in 2011, only 12% of agricultural land in India (Rao et al. 2017) was owned by women. Such limited ownership of land limits women’s ability to access agricultural subsidies, loans, and other services and benefits, as well as make decisions regarding agriculture. In this regard, Bhutan fares better than its South Asian counterparts. A key differentiating factor here is Bhutan’s long-standing Inheritance Act of 1980 which enables female children to have equal inheritance rights as male children (Aryal et al. 2019).⁶ India on the other hand has had an equivalent of this law only since 2005 (Rao et al. 2017). However, these statistics are complicated by the fact that land titles in women’s names might not always mean that women have power over agricultural decision-making in male headed households (Rao et al. 2017). In other words, the complex relationship between South Asian women owning land and their food security requires more exploration.

Yet another way that South Asian women’s role in agriculture impacts their food security is in terms of impacts of the increasing feminization of agriculture. For instance, almost a fourth of the total women employed in Sri Lanka were part of the agricultural sector (FAO 2018). Growing engagement of women in agriculture, if in terms of paid employment, can provide women with much-needed incomes. However, it can also burden them with extra work in addition to their domestic care responsibilities, which in turn can impact their food security and nutrition in multiple, contradictory ways (Rao et al. 2019). As well, a number of women engaged in agriculture might be unpaid. For instance, 60% of Pakistan’s rural women in 2014 were reportedly unpaid workers on family farms and other enterprises: only 19% of the country’s rural women were in paid employment (Zaidi et al. 2018). In Afghanistan in the same year, 5.4 million women of working age—71% of the country’s women—were inactive and not seeking employment, and another 1.1 million women in this age group seeking employment were either underemployed or unable to find a job (Zaher 2016). Furthermore, even among paid women workers, there is significant wage inequality between men and women. For instance, in Sri Lanka, the estimated earned income per capita per month for rural women stood at Rs 5,379 (~25 USD), as opposed to Rs 17,275 (~85 USD) per capita per month for rural men (FAO 2018).

These enduring inequalities and their impact on women’s food security need to be reckoned with against the persistently low literacy levels of rural South Asian women. In 2014–2015, the literacy rate among Pakistan’s rural women was at 38%, as compared to 63% for rural men, 69% for urban women, and 82% for urban men (Fig. 8.3). Indeed, differential literacy rates between women and men across rural and urban areas is a trend echoed across South Asia. Given that the national government data cited in Fig. 8.3 for India and Pakistan is not current, I have offered a comparison of more recent literacy rates for men and women (not differentiated across rural and urban areas) as estimated by the UNESCO Institute for Statistics (Fig. 8.4). Across all South Asian countries, literacy rates are higher among men, albeit the gender gap in literacy in Sri Lanka for instance is much smaller, while in Afghanistan and Pakistan is much higher (Fig. 8.5).

Fig. 8.4

Compiled from Census of India (2011), BLSS (2017), and PSLM (2016)

Literacy rates in men and women across rural and urban areas.

Fig. 8.5

Compiled using data from UNESCO (2021)

Gender gap in literacy rates in South Asia.

Together, these persevering inequities have meant that women in South Asia are disproportionately impacted by climate change, and these impacts show up in terms of heightened food insecurity. In drought-prone areas, reduced or untimely rainfall manifests as water shortages, bore-wells and ponds drying up, and reduced fodder and livestock (Lambrou and Nelson 2010). The gendered impacts of these climate change manifestations on rural South Asian women include increased pressure to provide food for the family, consuming decreased quantities of food as well as eating poorer quality food in relation to men, increased domestic responsibilities, and more health issues (Lambrou and Nelson 2010; Alston and Akhter 2016). Alston and Akhter’s (2016) study on gendered climate change perceptions also reports that a greater share of women perceive reduced water availability for agriculture, increased crop damage, increased disease and pests in crops, and increased difficulty in irrigation. Additionally, more women report taking up additional daily wage work than men to meet their families’ needs in the face of climate change impacts (Lambrou and Nelson 2010; Bastakoti and Doneys 2020).

3 Water Insecurity Among Women in South Asia

Water insecurity among South Asian women has similarly been probed from myriad perspectives, including infrastructure politics and urbanization, geospatial unevenness, caste, religion, income, domestic care responsibilities, wage inequality, land/property ownership, and climate change (Molden et al. 2020). And like issues pertaining to food (in)security, the political, economic, cultural, and environmental conditions across regions mediate the impacts of each of these aspects. These impacts are then unequally experienced by particular groups of South Asian women. As some examples, Dalit women in rural India and Nepal are one such group (Dutta et al. 2018; Wali et al. 2020), so are women living in parts of rural Bangladesh with arsenic-laden groundwater (Sultana 2011), women living in low-income informal settlements in urban areas of India and Pakistan (Das and Safini 2018; Truelove 2019; Anwar et al. 2020; Subbaraman et al. 2014; Mawani 2022), and low-income pregnant women in Afghanistan (Gon et al. 2014).

Caste-based water insecurity can be grasped by contrasting the number of Dalit households in India that have access to water within their premises against the country’s total number of households (Table 8.1) Less than a third of India’s Dalit households report being able to access water on their premises as compared to the much higher numbers reported nationally (Dutta et al. 2018; Johns 2012). Differentiated water access based on caste has been tied on the one hand to notions of untouchability in the country’s rural areas, and to long-standing conflicts and assertions of authority by upper and lower castes on the other (Dutta et al. 2018; Johns 2012). These persevering inequities in turn manifest as uneven access to education, jobs, income, and land/property for Dalit groups. Markedly poor access to water for Dalit households means unequal burdens on Dalit women, who have to fetch water from off-site sources much further away than other women to avoid conflict with upper caste people (Dutta et al. 2018). In addition to the extra time and labor involved in fetching water from further away, discriminatory access to water might even involve Dalit women in rural India being subject to abusive language, and physical violence (Dutta et al. 2018).

Table 8.1 Caste-based unevenness in water access in India

An increasing number of studies are illustrating the disproportionate impacts of chronic water insecurity on women’s physical health. Studies from Nepal highlight that persistent water insecurity is a “gendered physiological stressor” leading to chronic diseases such as high blood pressure among women (Brewis et al. 2019). For women in poor urban areas that lack household water connections and are dependent on water tankers, tubewells, and/or informal water lines, water insecurity as a physiological stressor acquires additional intensity in the summer (Mawani 2022). In these months, groundwater levels recede, tankers become less frequent, and informal water connections become less reliable. This places additional physical stress on women, especially on pregnant women or women with existing physical challenges, who have to stand in long queues to fill water and carry buckets over long distances (Mawani 2022).

Equally, water insecurity also has negative psychological impacts on women (Aihara et al. 2016). The emotional distress reported by the latter study pertains to new mothers being unable to spend time to care for their children given the amount of time that securing water takes up, as well as being unable to maintain hygiene as a result of scarce access to water. These findings from Nepal are echoed by earlier studies from urban India (Subbaraman et al. 2014) and rural Bangladesh (Sultana 2011). In addition to stresses of not being able to maintain hygiene, women are also confronted with trade-offs between paying for water or paying for food: choices that entail yet another set of emotional stresses (Subbaraman et al. 2014). Or, as Sultana (2011) describes in relation to the arsenic waterscape of rural Bangladesh, women might know that they are compromising water quality, yet might have no choice but to use contaminated water for drinking and cooking. Making these choices knowingly—in the absence of water that might be safer to consume—are also stressors that fall disproportionately on women. It is on account of these myriad stresses that Subbaraman et al. (2014) have linked chronic water insecurity with a higher prevalence of general mental disorders among women living in urban South Asian low-income neighbourhoods. Accounts from urban Pakistan add further depth to this understanding by reporting increased domestic violence as a result of chronic water insecurity (Anwar et al. 2020).

4 Compounding Impacts of COVID-19 on Gendered Food and Water Insecurity in South Asia

COVID-19 broke out across South Asia in early 2020. And while lockdowns led to a widespread loss of livelihoods, the pandemic too disproportionately impacted women generally, and some groups of women more specifically. Across South Asia, violence against women increased, with over 37% women reporting having experienced intimate partner violence (UNICEF 2020). This increase in violence against women and girls has been critically associated with economic and food insecurity. A study with 2424 women in Bangladesh (Hamadani et al. 2020) confirms this association. According to this study, while 5.6% and 2.7% women reported experiencing moderate and severe household food insecurity before the pandemic, these numbers rose significantly to 36.5% and 15.3% during the lockdown in 2020. The number of participants reporting emotional, physical, and sexual violence also rose through this period, as did the number of women reporting symptoms of depression and anxiety (Hamadani et al. 2020). In Pakistan, along with increased domestic violence, women also reported reduced decision-making and increased domestic responsibilities (The Asia Foundation 2021), which in turn, as discussed in Sect. 8.2, impact gendered food insecurity in multiple ways.

Simba and Ngcobo (2020) show, the uneven impacts of pandemics on women stem from the deep entanglements between enduring patterns of economic and food insecurity, gender-roles, precarious employment, violence, unpaid care work, and access to healthcare. McLaren et al. (2020) analyse these additional and intensifying gendered impacts for Sri Lankan women in terms of the long-standing triple burdens that women have historically experienced as a result of their productive, reproductive and community roles (cf. Moser 1993). As one example of precarious employment, women comprise 70% of the workforce engaged in healthcare and social services globally (Boniol 2019), so the COVID-19 outbreak meant a directly increased risk of infection for women. The case is no different for South Asian women. India for instance has the world’s largest all-female community health worker programme, which employs almost a million women as accredited social health activist (ASHA) workers (Ved et al. 2019). And while ASHA workers took on additional work and risk during the pandemic to address new and more intense community health issues across India, these women healthcare workers themselves had to deal with disproportionate economic and social burdens (Kidangoor 2020). Their hours of work increased but their pay remained the same (Kidangoor 2020), and as discussed in Sect. 8.2, women’s economic independence or the lack thereof affects food (in)security in multiple ways.

Additionally, long-standing inequalities within households in consumption of nutritious food, and the higher incidence of malnutrition and poor health associated with these patterns, itself also becomes a greater risk for negative outcomes in pandemics for women. Similar patterns have been observed in Bangladesh by Rahman et al. (2021), who draw connections between increased food insecurity among women in the first and second waves of the pandemic and increased gendered mental health impacts. In addition to healthcare workers, unequal impacts of COVID-19 on women’s food insecurity have also observed for migrant women workers across India engaged in a range of precarious employment settings (Manral 2021). According to a report by UN Women (2020), “COVID-19 could cause 25 million jobs to be lost globally, with women migrant workers particularly vulnerable”. A report by the ILO (2020) presents more grim estimates, suggesting that the COVID outbreak has caused a loss of 81 million jobs in just the Asia—Pacific region, of which 32 million are jobs lost by women. This report suggests that the pandemic has led to a loss of 50 million jobs in South Asia alone. Arguably, such sweeping loss of livelihoods will affect women’s food and water insecurity in numerous direct and indirect ways. In addition to the loss of livelihoods, the report by UN Women (2020), states the millions of migrant women employed as workers in a range of domestic and healthcare settings also face increased risks of abuse, exploitation, violence, loss of shelter and in close connection, I suggest, food and water insecurity.

Some clear pathways for improving gendered food and water security in South Asia then involve providing better access to education for girls, and targeted interventions relating to women’s livelihoods. Similarly, comprehensive sexuality education and family planning among men, boys, girls, and women, and increasing awareness of the disproportionate burdens girls and women face is important to increase attention to women’s food and water security at household and community levels. Further, the uneven impacts of COVID-19 on the food and water insecurity experienced by South Asian women given their specific health, social, and economic contexts and conditions are only beginning to be understood. Inquiring into how enduring patterns of food and water insecurity make women more susceptible to disproportionate impacts of pandemics, and how pandemics in turn exacerbate gendered food and water insecurity for specific groups of women are crucial research directions for government and policy organizations. The pandemic has had a profound impact on the lives and livelihoods of already marginalized South Asian women. A disaggregated understanding of gendered food and water insecurity in light of the pandemic is crucial for developing nuanced and targeted interventions towards achieving SDGs 2 and 6.