In honour of the more than 20 000 women who marched to the Union Buildings on August 9, 1956, in opposition to the extension of the Pass Laws to women, South Africa observes Women’s Month in August. “Generation Equality: Realising Women’s Rights for an Equal Future” is the topic of this year’s Women Month. Generation Equality’s worldwide initiative connects South Africa to a global campaign to achieve gender equality by 2030.
Despite having different connotations and implications, sex and gender are occasionally used synonymously when they should not. The sex of a person refers to their biological characteristics. Physico-physiological factors, such as chromosomes, gene expression, hormone levels and functions, and reproductive/sexual anatomy are primarily involved. Socio-cultural norms, identities, and relationships that shape societies and organisations are referred to as gender. Gender influences knowledge, settings, products, and behaviours. It is significant to note that gender has multiple dimensions and interacts with other social constructs, including sex, age, socioeconomic status, sexual orientation, and ethnicity. Gender norms, roles, and relationships affect how susceptible people are to various illnesses and health disorders, as well as how they might enjoy good mental, physical, and overall wellbeing. They also affect how well people access and use health services and the health outcomes they encounter over the course of their lives. Gender equality is the idea that men and women have the same opportunities, rights, and responsibilities. Gender equality implies that, while considering the diversity of various groups, the interests, needs, and priorities of both women and men are taken into consideration. Gender equity entails treating both men and women fairly. To do so, it is frequently necessary to take action to make up for biological, historical, and societal disadvantages that prevent men and women from functioning as equals. Equity, therefore, results in equality. Empowering women and girls is about giving women greater power and control over their lives. This process includes raising awareness, boosting self-esteem, enhancing options, increasing access to and control over resources, and taking action to change the institutions and structures that support and sustain gender inequality and discrimination.
Patients’ lives can be harmed by gender bias and sex presumptions in biomedical research. In terms of nutritional science, better dietary outcomes are essential for gender equality, and gender equality is vital for healthy outcomes. A vital element of human dignity and a fundamental human right is access to a healthy diet. Women are more likely than men to experience inadequate nutrition. Food security is the state of having unrestricted access to sufficient, safe, and nourishing food to meet one’s dietary preferences and nutritional requirements for a healthier living. Unfortunately, due to biological and socioeconomic factors such as limited educational opportunities, lack of decision-making authority, subpar work prospects, low income, and the need to put their children’s health and wellbeing first, women are significantly more prone to food insecurity than men. When there is a lack of food, one coping mechanism may be for women to consume less food so that men can consume more. In such circumstances, women could consume lower-quality, unhealthy, or even harmful food. Especially when pregnant or nursing, traditional rituals, beliefs, and food taboos may have an even more significant impact on eating habits and hinder women from obtaining essential nutrients. Furthermore, it is more difficult for women to have the power of choice to alter these traditions in a patriarchal society.
Women’s health and nutrition are also impacted by access to health services and information. Women frequently lack the flexibility and option to access these services, especially those who reside in more remote, rural locations with inadequate infrastructure. This situation could be due to illiteracy, cultural conventions that restrict them from travelling far from home or interacting with strangers, particularly men, or because they lack the confidence to ask for help. These women frequently work long hours in the fields, take long journeys to collect fuel, wood, or water, or work in unfavourable conditions, all of which limit their free time and put them under excessive strain and endanger their general health and nutrition. The health and nutrition of women, as well as the standard of living for their families and communities, improve when they are educated, and are given the freedom to assert their rights. For nutrition outcomes to be improved, women’s ability to make and have an impact on important decisions is crucial. Direct nutrition interventions for women and adolescent girls include food fortification, macronutrient and micronutrient supplementation, and social protection programs. Indirect nutrition interventions for women and teenage girls include breastfeeding support, nutrition-sensitive agriculture, sexual and reproductive health services, treatment for communicable and non-communicable diseases (NCDs), and mental health services. The evidence from these programs, however usually focuses on the health advantages for infants and young children; they frequently lack evidence to conclude mothers’ nutrition and health outcomes. Moreover, although many initiatives connect climate change to agriculture, they often overlook the effects on women, who are probably the ones most impacted by climate-related changes to food security and nutritional status. More research is required to build multi-sectoral programs in health, social safety, education, and agriculture that prioritise nutrition for women and fundamental mainstream ideas like gender equality and planetary health.
Eat Better South Africa (EBSA) runs nutrition education programs to teach – predominately women – how to choose affordable healthier foods that are lower in refined carbohydrates and higher in healthy fats to prevent or manage diet-related NCDs. Its primary focus is to reduce consumption of simple sugars, refined carbohydrates, refined vegetables oils, and ultra-processed food. EBSA encourages the consumption of vegetables, meat, fish, and foods containing healthy fats such as avocado and nuts. EBSA has run several dietary education programs in under- resourced, predominantly mixed-race townships. Women have had higher rates of participation in these programs. The role of women in community engagement has been essential for EBSA to address the root cause of NCDs. EBSA advocates for more equal and equitable communities by providing education to empower communities. Regarding food, sometimes it is not about the budget but about the capacity to make the right decisions. Those who have a stronger perception that a food is healthy are more likely to consume that food than those who do not, and those with a stronger perception that a food is unhealthy are more likely to avoid that food than those who do not. Overall, the EBSA program showed an improvement in women’s health parameters such as blood pressures, body measurements – weight and waist circumference – and blood markers likewise HbA1c, triglycerides.
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About the author
Dr. Georgina Pujol-Busquets Guillén holds a BSc in Pharmacy from the University of Barcelona, Spain and an MSc in Nutrition and Public Health and an MSc in Global Health. She has a PhD in Physiology from the University of Cape Town. She is part of Eat Better South Africa’s research team and her study was a mixed-method project to evaluate the effectiveness of Eat Better South Africa nutrition education program on components of metabolic health and well-being in women from South African under-resourced communities. She is teaching Qualitative Methods at the MSc of Nutrition and Health at the Open University of Catalonia. She is the recipient of the Tim & Marilyn Noakes Grant fellowship, and she holds a Postdoctoral position at MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) at the University of the Witwatersrand.
