Women’s Employment and Child Care and Nutrition in Urban Areas:

Examples from Ghana and Guatemala

Marie T. RuelMulti-country Program on Urban

Challenges to Food and Nutrition Security

IFPRI

Urban WomenCharacteristics Consequences for children (and hh)

Positive Negative

Higher female education

More likely to work, Greater income, control over resource,Better knowledge, practices, caring skills

More likely to work, hence less time for child care and household maintenance

Greater participation of women in the labor force

Greater income, Autonomy, control over resources

Less time for child care and household responsibilities, greater use of processed/street foods

Higher percentage of female headed hh

Less economic, emotional support, need to work

Smaller household size

Less support for child care and other hh responsibilities

Greater availability (and access?) to wider variety of foods

Greater dietary diversity, greater micronutrient intake, better nutritional status

Use of street foods: risk of contamination; poor choices - risk of chronic diseases; displacement of breast milk

Survival, Growth, and Development

Dietary Intake Health

Care For Childrenand Women

Health ServicesHealthy Environment

Household FoodSecurity

Resources and controlHuman, Economic & Organizational

Potential Resources

Education

Political and Ideological SuperstructureEconomic Structure

Child survivalGrowth Development

Diet HealthCaregiving behaviorsCare for womenFeeding/breast-feedingPsychosocial careCognitive stimulationHygiene practicesHome health practicesFood preparation and storage

Maternal resources for careKnowledge/beliefs/educationHealth/nutritional statusControl over resourcesWorkload/time/social support

HH foodsecurity

Healthy environment

Food/economicResourcesFood productionIncomeLaborLand assets

Health resourcesClean waterSanitationHealth care avail.Safe environment

Objective

• Use data from 2 case studies (Accra and Guatemala city), examine:– Livelihoods and vulnerability of women in urban areas

(working women and women head of households)

– Constraints faced by working women in provision of child care and in protecting their children from malnutrition

– Patterns of women’s employment and child care use

Data used

• Accra case study of urban livelihoods, poverty, food insecurity and malnutrition (1997)– Participatory Rapid Appraisal (PRA) methods– Representative quantitative survey (n=560)– Observational study of sub-sample (n=22)

• Guatemala case study (1998-99): – Evaluation of Government Sponsored Community Day

Care Program (operational and impact evaluations)– Random sample of hh with children < 7 years of age in

the zone where evaluation took place

The Accra Case Study

• Participatory Rapid Appraisals

• Quantitative representative household survey (n=560)

• Observational positive deviance study (n=22)

The Questions

• Households headed by women (33%): Are they more vulnerable to poverty and food insecurity?

• Working women (75%): – How different are they from non-working women?

– Does their work affect their child care practices?

– Does this in turn increases their children’s nutritional vulnerability?

Differences between male- and female-headed households in sociodemographic

characteristicsMale head Female head

(33%)

HH size 5.2 4.8

Dependency ratio 1.1 1.5

Years of schooling 12.2 7.5

Income/capita/mo $26.50 $16.19

Source of income

- Self-employment

- Wages

- Gifts/transfers

34.4%

50.7%

7.8%

38.1%

18.9%

43.2%

Differences between male- and female-headed households in expenditures and food security

Male head Female head

Expenditure/capita/mo $48.51 $35.48

Food budget share 51.5 60.2*

Health budget share 4.0 5.6*

Energy intake/aeu 2,552.9 (88%) 2,781.5 (96%)*

Energy from :

- street foods

- meat and fish

618

183

764*

151

% food insecure 11.6% 17.4%

% vulnerable 20.5% 37.9%

Conclusions

• Livelihood strategies for both men and women in Accra are predominantly labor based, but sources and levels of income vary

• There are important differences in expenditure patterns, women more likely to allocate higher % of their budget to food and health

• Despite lower income, female-hhh more likely to have adequate calorie adequacy, but at what cost? (higher food budget shares increases their vulnerability to shocks)

Women’s work and child care and nutrition in Accra

• 55% of mothers with children < 3 years of age were working full time, 9.5% part time

• Mothers worked across socioeconomic status levels, education levels, ethnic groups, head of householdship, etc.

Working women and child care practices

Not working Full time work (55%)

Breastfeed 55% 55%

Exclusive BF (0-4) 20% 12%*

BF less because work - 22%

Comp foods right time 42% 25%*

Good hygiene 36% 25%

Mother clean 77% 68%*

Child clean 77% 67%*

Growth monitoring 72% 59%*

Immunization (DPT) 75% 90%*

Nutritional status of children < 3 years of age, by maternal employment

-1.2

-1

-0.8

-0.6

-0.4

-0.2

0

HAZ WHZ

Not workingPart time workFull time work12

18

20

12

1820

Mean HAZ and WHZ by age (0-36 months)

-2

-1.5

-1

-0.5

0

0.5

1

0 3 6 9 12 15 18 21 24 27 30 33 36 HAZWHZ

Mother’s working patterns and child’s age

0102030405060708090

100

Works Works fulltime

Cares forchild at all

times

Takes childto work

0-3.94-8.99-17.9>=18

Early return to work after delivery: source of vulnerability?• PRA studies:

“When I have to leave my child (to go back to work), my stomach burns me, but I have to work to earn money. Caring for your child is important, but you also have to earn money to provide for your child”

Early return to work after delivery: source of vulnerability?• Observational study:

Mothers of positive deviant children were much less likely to be working when child was < 12 mo of age and still when child was 20-34 mo

(Note that children were matched on age)

Early return to work after delivery: source of vulnerability?• Quantitative survey (sample < 12 mo)

Mothers who returned to work early were not different in any personal or socioeconomic characteristics or financial help from father (same expenditure level suggests they needed to work)

Few care practices were different (only BF less because of work)

Nutritional status was not associated with maternal work in multivariate analysis

Bottom Line

• Maternal employment did not have a marked negative effect on child care practices or nutritional status

• This is largely due to the fact that mothers adapt their work patterns to the special caring needs of their children

• This may increase their vulnerability and that of their children and family (taking child to work; strapping them on their back)

Guatemala Case Study

• Evaluation of Program: Hogares Comunitarios (260 pairs: matched beneficiary and controls). Impact on:– Women’s work patterns

– Children’s diet

– Household expenditure patterns

– Older siblings’ schooling

• Random sample of households with children < 7 years of age in area (n=1363)

What type of child care arrangements do women use in Guatemala City?

Child care arrangement

(37% of women worked)

N=491

%

Mother 42%

Relative living in same house 3%

Relative living elsewhere 21%

Neighbor/other paid help 7%

Day care center 22%

Child stays alone 2%

Program of Hogares Comunitarios 3%

How expensive are the different child care alternatives (including supplies, etc.)? Type of arrangement Price/hour Cost/month

Mother $0.00 $0.00

Child stays alone $0.00 $0.00

Relative living in house $0.06 $11.84

Relative living elsewhere $0.12 $21.61

Neighbor/other paid help $0.17 $35.29

Day care center $0.14 $14.09

Program Hogares Comunitarios

$0.04 $9.10

Who are the women who use the Hogares Comunitarios program?

Characteristics Beneficiaries

(n=14)

Random sample

(n=489)Age 25 years 31 years

Education 6 years 6 years

Single mother 43% 29%

Married/partner 57% 71%

Years living in city 14 23

No children < 7 y 1.3 1.5

HH size 3.4 5.4

Nuclear family 29% 37%

Value of assets $1469/capita $1350/capita

What are the characteristics of their employment?

Employment characteristics

Beneficiaries

(n = 14)

Random sample

(n=489)

Salaried 93% 53%

Informal sector 0% 39%

Factory worker 71% 21%

Days worked/mo 19.6 19

Earnings/month $110 $106

Earnings/hour $0.65 $0.79

# work benefits 4 2

Impact Evaluation:Characteristics of beneficiaries

and control mothers

Maternal Characteristics

Beneficiaries

(n=260)

Control

(n=260)

Age (y) 28.2 29.6

% illiterate 6.2% 10.0%

% single moms 40.2% 44.8%

HH size 4.2 5.8

% Nuclear family 18.9% 37.5%

% paying rent 73.0% 47.1%

% living in single room 56.8% 31.7%

% hh members working 17.9% 23.8%

Impact Evaluation:Employment characteristics of beneficiaries

and controls

Maternal Employment Beneficiaries

(n=260)

Control

(n=260)

Independent worker 7.3% 15.1%

Factory/industry 62.5% 46.7%

Petty trade, sells in market 6.6% 12.7%

Days worked in past month 23.7 25.3

Salary per month $139 $149

% who receives employment benefits

90.9% 77.9%

Bottom Line • Women in Guatemala use a variety of child care

arrangements, although a large proportion take the child along

• Only small proportion benefited from HC program, the cheapest alternative

• Beneficiaries are more likely to be younger, single, work in factories, receive work benefits; no difference in total earnings, hrs worked, earnings/hour

• Program seems to be reaching high risk group and filling an important gap

Overall Conclusions

• Urban areas of Ghana and Guatemala do host a high proportion of female-headed households and working women

• Women in both countries were clearly facing the challenges posed by their dual role as income-earners and principal caretakers

• In Accra mothers seemed particularly successful at achieving food security and at maintaining good care practices and nutrition while working, but this may have increased their vulnerability

• In Guatemala the HC program seems to respond to a great need for alternative childcare, but current coverage is extremely low.

Programmatic Implications

• Relative to employment and child care, urban women need support in: – Reliable, safe, flexible, affordable child care

arrangements (especially single mothers)– Help with care of very young infants– Facilities at the work place to permit optimal

child feeding practices (especially for < 6 mo)– Targeted nutrition and child care education

programs