Social inequality, reproductive health and child development : a Chhattisgarh village study

Chanchani, Devanshi (2015) Social inequality, reproductive health and child development : a Chhattisgarh village study. Doctoral thesis, University of East Anglia.

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India’s gains in reproductive health and child development have been slower than anticipated, and significantly the country continues to bear a disproportionate share of the global undernutrition burden. Indian children do particularly poorly in the foundational foetal stage and in the first three years, and public programmes are especially ineffective in reaching this group. While it is recognised that reproductive health and child nutrition is determined complexly, having biomedical and social roots, positions from a policy perspective are oftentimes competing – on whether key barriers are primarily economic or essentially cultural. Additionally, an argument explaining the South Asian nutrition ‘enigma’ emphasises the mediating role of female power, often measured as female decision-making autonomy.
I discuss based on research in a village in the rice-growing plains of Chhattisgarh the complex and interrelated cultural, economic and gender-based variables as they bear on reproductive health and nutrition for the different social groups in the village. I argue that this under-researched geography at the confluence of Indo-Aryan and Dravidian cultural streams has interesting insights to offer for social theory into the determinants of female power. Important elements of northern kinship based on exogamous principles, theoretically less favourable for female autonomy than ‘southern’ kinship systems, counter-intuitively go alongside relatively egalitarian gender relations, also evidenced by sex-ratios, and other telling indicators. Furthermore, not fitting with mainstream discourse on female autonomy’s positive demographic and health implications, relatively egalitarian gender relations and sex-ratios go alongside poor performance on other demographic, health and nutrition outcomes. For caste groups in the village, elements of northern kinship appear to bear on son-preference, and undermine a woman’s independence in fertility related decision-making. However, beyond an influence on fertility the influence of gender-inequality on reproductive and child development outcomes could not be read off from observations or expressions of decision making power. I argue that it may be useful to broaden the gender-lens beyond a narrow conceptual focus on decision-making autonomy to include structural dimensions such as rigidities in gender division of labour.
Behaviours and practices relevant to reproduction and childrearing vary significantly from biomedical recommendations. These reveal both economic and cultural roots. Judged against biomedical norms, health and childcare behaviours shaped by ideational beliefs are at greater variance for the post-partum stage than during pregnancy. Cultural food proscriptions have little relevance during pregnancy, implying that concerns of ‘eating down’ in pregnancy for its influence on foetal growth are of little consequence for this geography. I argue that there are important economic barriers that place limits on diet quality in pregnancy, yet there is some scope for health-facilitating resource reprioritisation. Health and childcare behaviours in the post-partum stage diverge to a greater extent from recommended biomedical practice, and could be damaging to nutritional status of the mother and child. While these practices have a clear ‘ideational’ element, they are also rooted in fear of both ill health and economic distress, deriving perhaps from the historical experience of communities in a poor health environment.
I discuss from the curious case of the nutritionally vulnerable Pardhi tribe, and their rejection of the public works NREGA programme that there are iterative cultural and nutritional factors that influence poverty for this community, notwithstanding oppressive social and political relations. Productive activity perceived to involve high energy expenditure, while seemingly economically attractive can be rejected in contexts where communities aim to preserve ‘body-capital’. Further conventional classifications of what is considered routine unskilled work under NREGA may be rejected because of cultural unfamiliarity and unfamiliar body
techniques. The wider marginalisation of the community and oppressive social relations may further contribute to Pardhi rejection of public programmes.
In addition, entrenched local political rivalries work against public interest to mediate the everyday welfare state and implementation of reproductive health and nutrition programmes such as the Integrated Child Development Services (ICDS).

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Social Sciences > School of Global Development (formerly School of International Development)
Depositing User: Jackie Webb
Date Deposited: 26 Jun 2015 15:14
Last Modified: 26 Jun 2015 15:14


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