Intra-household nutrient inequity in rural Ethiopia

• Published in: Food policy 2018-12, Vol.81, p.82-94
• Main Authors: Coates, Jennifer, Patenaude, Bryan N., Rogers, Beatrice Lorge, Roba, Alemzewed Challa, Woldetensay, Yitbarek Kidane, Tilahun, Addisalem Fikre, Spielman, Kathryn L.
• Format: Article
• Language: English
• ISSN: 0306-9192; 1873-5657
• DOI: 10.1016/j.foodpol.2018.10.006

•Rural Ethiopian households exhibited significant intra-household nutrient inequities.•Conventional ‘vulnerable groups’ were not always most affected by inequity.•Inequities were greatest for ‘invisible’ nutrients (iron)•No factor consistently predicted detrimental inequity across groups and nutrients.•Programs must consider intra-household nutrient allocation for optimal targeting. Food assistance interventions directed at households may miss undernourished individuals if intra-household equity in nutrient allocation is assumed. A recent study from Ethiopia revealed that, while all age groups consumed calories in proportion to their fair share, iron and protein were inequitably allocated among household members. Further exploration of individual and household characteristics associated with these allocation patterns is necessary to gain a more complete understanding of existing disparities. This paper sought to quantify energy, protein, and iron allocation inequity between four age and sex groups of household members (children and adults) commonly assumed to be disadvantaged versus preferentially treated in intra-household resource distribution. It then sought to identify individual and household factors that explained the inequity of intra-household nutrient allocation among these paired groups. Data from a survey of 1185 households located in rural Oromiya and SNNPR regions of Ethiopia. A single quantitative 24-hour household-level dietary recall was collected from the primary food preparer who reported the proportion of household food distributed to each household member. Continuous ratios of relative calorie, protein, and iron adequacy for four pairs of age-sex groups (any child vs. any adult, any child vs. adult male, female child vs. male child, and adult female vs. adult male) in the household were computed and compared, along with a binary indicator of inequity. Logistic regressions and standard linear regression with Huber-White heteroscedasticity-adjusted standard errors were run to determine the predictors of household inequity for each pair-group and nutrient, on the full sample as well as on nutrient inadequate households. Common assumptions about inequitable distribution of nutrients within households were not consistently supported by this analysis. Significant intra-household nutrient inequities did exist in these rural Ethiopian households for certain nutrients, but household subgroups commonly presumed to be nutritionally vulnerable in t