A qualitative assessment of gender roles in child nutrition in Central Malawi | BMC Public Health

Table 2 provides a summary of participant demographic information highlighting the age range of the participants, educational attainment and number of children.

Table 2 Participant information

Generally, men and women play different roles in child nutrition. Table 3 lists activities that are performed by men and women. Both men and women shared their perceptions of who was responsible for each listed activity. Five main themes were identified. The first was productive work, which was defined as activities men and women participated in to obtain food. The second was reproductive work, which included housework and care work. Leisure, gender barriers to nutrition and undoing gender roles were the three additional themes that were identified.

Table 3 Summary of themes and sub-themes

Eleven activities (sub-themes) were identified under the first three main themes. These activities are listed in the second column of Table 3. Men’s roles were mainly associated with four activities, including business, household labour (physical), leisure, and sourcing food. Women’s roles, on the other hand, were associated with nine activities. For some men, their participation in other activities was constrained by social norms with which they were raised. Men’s participation in these activities was exacerbated by barriers they faced when performing work typically associated with women.

Productive work: activities to obtain food

Men and women were involved in three main activities to obtain food, including business, sourcing food and farming.

Business

More men than women mentioned involvement in business activities. Some men said that they had their own businesses such as tin pail making. These tin pails were used for drawing water. Others sold goods and were involved in carpentry. These activities generated income which could be used for food purchases. One woman in a FGD explained that the pail making business, which mainly involved men, was a source of income for food purchases. She said “From this pail, you are able to find money for purchasing food.” – P2, female.

Men who owned businesses invested much of their time and effort in business-related activities; while women’s role in business was only mentioned in one FGD, even though women felt that business was an opportunity to generate income for food, especially when food was scarce. One woman in a FGD in Kasakula said, “When the woman sees that things are really hard in the home, she tries to find some money so that she can start a business.” – P1, female.

Sourcing food

Sourcing food was mainly considered to be men’s responsibility. While many of the income-generating activities were to source food for the household, sourcing food is highlighted as a separate theme because participants emphasised the primary role of men in this specific activity. Much of men’s time was spent sourcing food by participating in ganyu labour (ganyu labour is a form of informal work, usually agricultural, that is compensated with money or food), farming, or hunting for mice. While both men and women expressed this sentiment, more men felt that sourcing food was their responsibility. Men were expected to use their income to buy food. In one FGD with men, participants were asked whose responsibility it was to buy relish and other food items. There was a general consensus that this was a man’s responsibility. One man, for example, said, “But largely it is the man who has that responsibility.” – P1, male.

Some of the items that participants mentioned that men bought included fish, meat, vegetables, maize, and sugar. For example, one woman in a focus group discussion in Kayembe said, “The man sources relish and brings it like small fish, maybe meat.” – P8, female.

Another man in a FGD in Dzoole said,“The role of the man in the home is that he should source food in the home so that it is available, there should be good nutrition.” – P3, male.

It was only in two cases where women mentioned that they were solely responsible for sourcing food. In these cases, both women were widowed. Some women felt that it was the responsibility of both men and women to source food. One woman from Kayembe said, “In terms of sourcing food for the home, we source together. Whether it’s ganyu, then it means we do the ganyu together with the man.” – P1, female.

A religious leader in Kalumo in an individual interview shared, “Eee, in the home, if there is no food, then it means it’s both of them (man and woman) who take responsibility for doing ganyu, both men and women indeed. Where there is lack of food, then the man wakes up early to look (for food). The woman too wakes up early to look (for food). It is the job of everyone to source food, not just the man.” Individual interview, Male.

Men and women identified that they could source food by farming, finding ganyu labour or participating in business. One woman in a FGD in Kalumo said, “For me, if I have gone out to ask for ganyu because we don’t have flour but then he also went elsewhere to look, but he didn’t find it. I tell him that I have found it and I show him the basin of flour. Then I ask him to go and help me. Then where I have found, we take our hoes and go and work together. We do work together.” – P3, female.

Farming

Both men and women shared that they had a role to play in farming. Although more women than men expressed this joint role, both described situations where they participated in some form of farm work. One woman from Kalumo said, “It’s the responsibility of both of us in the home. The one who starts off first in the morning is the man. I stay behind so that I can bathe the children, they should go to school. When I am finished is when I go to the garden.” – P5, female.

A man from Kayembe shared that, “In addition, we can say it’s both the man and the woman. Since you mentioned about farming, both are involved with farming work, the man does not do it alone.” – P2, male.

In one FGD in Kasakula, the women joked that the rainy and ploughing seasons were a blissful time for marriage because they worked together with the men. However, when ploughing was completed, men were not as helpful. In some cases, men would leave their wives and marry another woman. One woman said, “It really happens indeed. When you are finished ploughing, that’s it. You harvest, that’s the end of the marriage. This is what she means when she says the wife of the rainy season. The marriage is no longer there, no.” – P3, female.

While farming was generally considered a shared responsibility, some women felt they were mainly responsible for farming. One woman from Kalumo said, “For us women to farm on our own, it’s because of the laziness of the men. They refuse to go to the garden. That is why you find that we farm on our own. Yes, they are lazy.” P2, female.

Alcohol presented a significant barrier to men’s participation in farming activities. One woman from Kasakula shared, “When they are drunk? Then you will go to the garden while he (she used the term “it“; icho) is just there sleeping.” – P7, female.

Another woman in the same FGD said, “But also, when he is extremely drunk, in the morning, he wakes up with no strength at all. So, you just pick up your hoe, and you go to the garden, there you plough.” – P5, female.

Housework

Housework entailed five activities, including childcare, cooking, household labour, drawing water, and cleaning.

Childcare

Although it was reported that both men and women participated in childcare, this was mainly considered women’s responsibility. No men reported solely being responsible for this activity. Childcare, as women’s responsibility, was expressed mainly by men. Activities related to childcare included feeding (including breastfeeding) and bathing children, washing diapers, preparing food for children, washing baby clothes, and putting children to bed. One man from a FGD in Kalumo said,

“It is different because when it comes to the child, the main person is the woman because if the child is breastfeeding, if you take him, then it means they will cry and will not stop soon. But when the child is with the mother, she will just start breastfeeding him. So, it means the main work is done by the mother.” – P3, male.

Both men and women felt that childcare was a woman’s responsibility because women spent more time with children. When asked why only the mother could feed the child, a man from an FGD in Kalumo said, “It is often the mother who stays with the child. As a man, you are out, but the child stays with the mother.” – P4, male.

A mother-in-law in Kasakula shared that, “ … a man does not walk with a child but a woman. Children are for a woman because a man does not go about with children. Breastfeeding, I am the one who breastfed. So, the one who goes about with children will pick up the hoe and go and do ganyu because she is the one who knows about the needs of a child.” – P1, female.

Both men and women mentioned that men also play a role in childcare. Both men and women felt that men do and are capable of being involved in childcare. An equal number of men and women shared this sentiment. In one FGD with men in Kayembe, men were asked whose responsibility it was to care for infants. A few respondents felt that it was both men and women’s responsibility. Childcare activities that both men and women participated in included looking after the baby, cooking food for children, and bathing children. One woman in Kayembe said, “Men who are understanding do play a role.” – P4, female.

In some cases, men shared that they only became involved in childcare when the mother was busy. One man in Kayemba stated, “We help with the baby if the mother is too busy.” – P5, male.

One man from Kayembe shared that because he had provided financial resources, he had contributed towards childcare. He said, “That is for both because if I go out and bring soap and my wife uses the soap to wash the children’s clothes, it means both of us have played a role.” – P1, male.

Cooking

Similar to childcare, more men than women expressed that cooking was women’s responsibility. One mother-in-law in Kasakula said, “The women are the ones who cook. They cook on their own even if they are tired. Here, it is the women who cook. Maybe in our friends’ areas, men are able to cook. But here in our area, women are the ones who cook.” – P2, female.

More women than men expressed that cooking was sometimes a shared responsibility. One woman from Kayembe said, “For me, I don’t experience abuse in my marriage. He helps me … cooking, feeding the children, chopping firewood.” – P2, female.

One man from Kayembe shared that, “But for me, I am able to help in cooking. At times I can tell my wife that today you can rest, I will do this one.” – P4, male.

The other men laughed when he shared this comment. Most men felt that cooking was still predominantly women’s responsibility. However, there were certain circumstances under which men also cooked. These circumstances included when a woman was busy, ill, pregnant, or away from home. One man from Dzoole said, “There are some chores that have stayed with women. Like here, for them to find you cooking, then it means the woman is sick, or she is away from the home.” – P3, male.

A woman in Kasakula shared, “It is us, women. We do not have the man cook, no. But when we are away, he cooks and also when we are sick is when he cooks.” – P1, female.

Drawing water

Both men and women felt that drawing water was women’s responsibility. No men reported participation in collecting water. Women shared that water could be collected up to three times a day. This water was used for cooking, washing clothes, bathing, and washing dishes. One woman said, “Maybe the water she drew in the morning is finished, she will go again to draw more water from the well.” – P1, female.

Sometimes children helped women to collect water, which eased the workload of women. Even pregnant women were expected to collect water. In some cases, mothers-in-law helped when a woman was further along in her pregnancy. One woman in Kasakula shared, “Women who are expecting fetch water a lot. If there are children, they help her. But for those who do not have children, the mother-in-law can also help when they see that the woman is very tired (with pregnancy).” – P1, female.

Cleaning and other housework

More men than women felt that housework was women’s responsibility. Housework included: sweeping, washing dishes, collecting firewood, going to the maize mill, and washing clothes. One man in Kayembe said, “She must clean the house when she wakes up, clean the plates, prepare porridge for the baby and for everyone then thereafter go farming.” – P2, male.

A woman in Kayembe said, “In the afternoon, the man goes to chat. Then I continue with the work. I should wash the dishes, put them in their place where they go. If there is something else that needs to be done, I do that, whether it’s washing, I should wash if that day things were not washed. I should also sweep the house after we have eaten nsima.Footnote 4 – P1, female.

Some men and women shared that housework is the responsibility of both sexes. Again, there were certain circumstances under which men participated in housework. One woman from Kayembe said, “That is how I see it. When I am expecting, he helps me cook, chop firewood, even going to the mill.” – P2, female.

Household labour

There are certain activities related to the physical maintenance of the home that were considered men’s responsibility. These activities were mentioned in four FGDs. Both men and women felt that women could not perform these specific activities because they required physical strength. One woman said that men were responsible for, “Constructing houses. We women cannot manage.” – P2, female.

Another man in a FGD in Kayembe said, “The tasks must be different since we men do some things that women cannot do, and the women have tasks too that we can’t do. If we went to farm and come back, the wife will occupy herself with cooking while will we be busy constructing a tobacco shed. You can’t ask the wife to construct a tobacco shed which involves digging and climbing on a roof. So, our tasks are indeed different.” – P1, male.

Leisure

Men spent more time than women on leisure activities, especially when there was not much farm work to be completed. Men’s leisure time activities were identified mostly by men themselves however, both women and men noted that men’s leisure activities included chatting, playing bawo,Footnote 5 drinking alcohol, playing soccer, watching sports, and resting. One man in a FGD in Kayembe said, “Because we are not usually home, we are always up and about, like we said before that we go drinking, interacting with friends, playing soccer, meanwhile, the children are with their mothers.” – P1, male.

Women were generally unable to enjoy the same amount of leisure time because of domestic responsibilities and socially-prescribed gender role expectations. One woman in Kayembe said, “Men like going to chat more than women because you cannot go out the whole day and then the next day, the whole day, no. But for them, there is the opportunity to go to bawo. You continue your work in the home, you cannot leave. But the man goes to bawo.” – P1, female.

Women had far less leisure time than men. Women’s leisure was only mentioned by a few men. Women’s leisure time included chatting with friends, going to church groups or choir, and reading the Bible. One woman from Kayembe said, “When we eat in the afternoon, we have to chat. If you go to church groups, you need to go. If there is choir, you go and return and then come and take care of your home.” – P3, female.

Table 4 summarises the gender distribution of work, how it relates to components of the UNICEF framework and the frequency with which the activities are performed. The summary illustrates that women perform more activities related to securing children’s nutrition. While men participate occasionally, activities related to childcare and healthy environment, in particular, are reserved for women. These activities are performed daily. In rural Malawi, limited infrastructure means that more time and energy is spent on activities such as collecting water and firewood.

Table 4 Gender distribution of work and frequency

Gendered barriers to child nutrition

The gendered roles men and women play in food, care, and health often constrained their ability to meet children’s nutrition needs. These included women facing time constraints and barriers to men performing work that is typically associated with women.

Time constraints and barriers to men performing women’s work

Women’s multiple roles often meant that they made trade-offs between performing their household responsibilities or sourcing food. As previously noted, collecting water was one of the tasks that women felt was particularly time-consuming. Women also shared that they could not freely pursue ganyu labour because of household responsibilities. One woman from Dzoole said, “The difference is that we are busy, so the ganyu that we do is limited. We have to first do household chores, compared to men (who don’t).” – P8, female.

Societal expectations of men often prevented them from supporting women in reducing their work burdens. Some men experienced shaming if they performed work that was associated with women. This fear of backlash prevented men from performing this work when women were home. A man from Dzoole explained that you only help with household chores when the woman is away, “But if she is there, then people will disrespect you that your wife has fed you medicine. In refusing the saying that they have fed you medicine, this is why women are suffering with these chores.” – P3, male.

These gender roles appeared to be learned through a process of socialisation from childhood and a lack of exposure to role models who did not follow traditional gender norms. One man in a FGD in Kalumo said, “The difference between this work … like us, we also observed from our parents because like in the area of cooking like this then it means our parents, they have never really been involved with this issue of gender so that some things we take it from our parents, differentiating work.” – P5, male.

Keeping things the same, as they were in the past, challenges changing gender norms. As another man from Kayembe said, “This is how it has been from the past, that a woman must cook.” – P1, male.

Mothers-in-law from Kasakula shared that their children behaved a certain way because they learned these behaviours from their parents. One woman said, “A chick imitates what the mother hen does. She is doing it, and the child is there. You cannot say it will not see. It will see.” – P1, female.

Undoing gender roles

The results of the first three themes suggest that some activities, although considered women’s responsibility, were performed to some extent by both sexes. There was an indication that men and women were subverting some of the socially-prescribed traditional gender roles. When asked how this change came about, one woman from Dzoole said, “It started some years back when the issue of gender just came. They [men] actually changed.” – P7, female.

Women suggested that both men and women had an equal role to play in the home. One woman from Kayembe said, “Yes, it was different in the past. In the past, the one who was seen to be at the forefront was the man. But today, no. Everyone has their own role. The man needs to participate in whatever way will be helpful. The woman needs to participate in whatever way will be helpful.” – P3, female.

Another woman from Kayembe said, “In the past, it was different from nowadays. In the past, they said the man is the head of the family. But today, “gender“ has come. Everyone has the right to play a role.” – P1, female.

One woman from Kayembe mentioned that she is part of an organisation that offers education on gender. They teach the communities that there is no difference between a man and a woman and that women can also perform men’s tasks. She said, Things indeed, have changed. They are different from what it was like. Even in the home, you find that when the man is not there, and the roof is leaking, you just say, there is just need for some paper, bring a stick. And you climb up indeed, you take a paper, and you place it there. Then it means everything is well there.” – P4, female.

A man in a FGD in Kalumo said, “It’s important that when it comes to the role of cooking, we all need to play a role because there are some of us men, we just pressure women that you should go cook when perhaps the woman is also doing other work. Yet you have the opportunity, you have time that you can also take over from the woman, it doesn’t mean that you will not have intelligence, no. But household chores are about helping one another, both of you want to work towards good nutrition in the home.” – P5, male.