Women’s Employment and Child Care and Nutrition in Urban Areas: Examples from Ghana and Guatemala

1. Women’s Employment and Child Care and Nutrition in Urban Areas: Examples from Ghana and Guatemala Marie T. Ruel Multi-country Program on Urban Challenges to Food and Nutrition Security IFPRI

2. Urban Women

3. Survival, Growth, and Development Dietary Intake Health Household Food Security Care For Children and Women Health Services Healthy Environment Education Resources and control Human, Economic & Organizational Political and Ideological Superstructure Economic Structure Potential Resources

4. Child survival Growth Development Diet Health Caregiving behaviors Care for women Feeding/breast-feeding Psychosocial care Cognitive stimulation Hygiene practices Home health practices Food preparation and storage HH food security Healthy environment Health resources Clean water Sanitation Health care avail. Safe environment Food/economic Resources Food production Income Labor Land assets Maternal resources for care Knowledge/beliefs/education Health/nutritional status Control over resources Workload/time/social support

5. 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

6. 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

7. The Accra Case Study • Participatory Rapid Appraisals • Quantitative representative household survey (n=560) • Observational positive deviance study (n=22)

8. 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?

9. Differences between male- and female-headed households in sociodemographic characteristics

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

11. 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)

12. 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.

13. Working women and child care practices

14. Nutritional status of children < 3 years of age, by maternal employment 12 18 20 12 18 20

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

16. Mother’s working patterns and child’s age

17. 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”

18. 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)

19. 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

20. 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)

21. 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)

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

26. How expensive are the different child care alternatives (including supplies, etc.)?

27. Who are the women who use the Hogares Comunitarios program?

28. What are the characteristics of their employment?

29. Impact Evaluation:Characteristics of beneficiaries and control mothers

30. Impact Evaluation:Employment characteristics of beneficiaries and controls

31. 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

32. 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.

33. 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