Gender equity in agriculture for improving nutritional status, diets, and household food security: a mixed-methods systematic review

Introduction: Undernutrition rates remain high in rural, low-income settings, where large gender-based inequities persist. We hypothesised that increasing gender equity in agriculture could improve nutrition. Methods: We conducted a systematic review to assess the associations between gender-based inequities (in income, land, livestock, and workloads) and nutrition, diets, and food security outcomes in agricultural contexts of low- and middle-income countries. Between 9 March and 7 August 2018, we searched 18 databases and 14 journals, and contacted 27 experts. We included quantitative and qualitative literature from agricultural contexts in low- and middle-income countries, with no date restriction. Outcomes were: women’s and children’s anthropometric status, dietary quality, and household food security. We conducted meta-analyses using random effects models. PROSPERO registration: CRD42018093987. Results: We identified 19,820 records, of which 34 studies (42,809 households) met the inclusion criteria. Most (22/25) quantitative studies had a high risk of bias, and qualitative evidence was mixed-quality. Income, land, and livestock equity had heterogeneous associations with household food security and child anthropometric outcomes. Meta-analyses showed women’s share of household income earned (0.32 (95% CI -4.22, 4.86), 6 results) and women’s share of land owned (2.72 (-0.52, 5.96) 3 results) did not increase the percentage of household budget spent on food. Higher-quality studies showed more consistently positive associations between income equity and food security. Evidence is limited on other exposure-outcome pairings. Conclusion: We find heterogeneous associations between gender equity and household-level food security. High-quality research is needed to establish the impact of gender equity on nutrition outcomes across contexts.