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The constraints to good child care practices in Accra


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  • Armar-Klemesu, Margaret
  • Ruel, Marie T.
  • Maxwell, Daniel G.
  • Levin, Carol E.
  • Morris, Saul Sutkover


Life in urban areas presents special challenges for maternal child care practices. Data from a representative survey of households with children less than 3 years of age in Accra were used to test a number of hypothesized constraints to child care, including various maternal (education, employment, marital status, age, health, ethnic group, migration status) and household-level factors (income, calorie availability, quality of housing and asset ownership, availability of services, household size, and crowding). An age-specific child care index was created using recall data on maternal child feeding practices and use of preventive health services. A hygiene index was created from spot check observations of proxies of hygiene behaviors. Multivariate analyses showed that maternal schooling was the most consistent constraint to both the care and the hygiene index. None of the household-level characteristics were associated with the care index, but better housing quality and access to garbage collection services were associated with better hygiene. Female head of household and larger family size were associated with poorer hygiene. The programmatic implications of these findings for nutrition education and behavior change interventions in Accra are discussed. The focus is on using the information to target the right practices to be modified as well as the main constraints to their adoption.

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Bibliographic Info

Paper provided by International Food Policy Research Institute (IFPRI) in its series FCND discussion papers with number 81.

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Date of creation: 2000
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Handle: RePEc:fpr:fcnddp:81

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Keywords: FCND ; Child care. ; Ghana. ; Maternal and infant welfare Developing countries. ; Urban health. ;

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Cited by:
  1. Assaad, Ragu & El-Hamidi, Fatma & Ahmed, Akhter U., 2000. "The determinants of employment status in Egypt," FCND discussion papers 88, International Food Policy Research Institute (IFPRI).
  2. Ruel, Marie T. & Menon, Purnima, 2002. "Creating a child feeding index using the demographic and health surveys," FCND discussion papers 130, International Food Policy Research Institute (IFPRI).
  3. Ruel, Marie T. & Armar-Klemesu, Margaret & Arimond, Mary, 2001. "A multiple-method approach to studying childcare in an urban environment," FCND discussion papers 116, International Food Policy Research Institute (IFPRI).
  4. Garrett, James, 2004. "Living life," FCND discussion papers 171, International Food Policy Research Institute (IFPRI).
  5. Smith, Lisa C. & Ruel, Marie T. & Ndiaye, Aida, 2004. "Why is child malnutrition lower in urban than rural areas?," FCND briefs 176, International Food Policy Research Institute (IFPRI).
  6. Babatunde, Raphael O. & Qaim, Matin, 2010. "Impact of off-farm income on food security and nutrition in Nigeria," Food Policy, Elsevier, vol. 35(4), pages 303-311, August.
  7. Ruel, Marie T. & Haddad, Lawrence James & Garrett, James L., 1999. "Some urban facts of life," FCND discussion papers 64, International Food Policy Research Institute (IFPRI).
  8. Alderman, Harold & Watkins, Susan Cotts & Kohler, Hans-Peter & Maluccio, John A. & Behrman, Jere R., 2000. "Attrition in longitudinal household survey data," FCND briefs 96, International Food Policy Research Institute (IFPRI).
  9. Babatunde, Raphael O. & Qaim, Matin, 2010. "Impact of Off-farm Income on Food Security and Nutrition in Nigeria," 2010 AAAE Third Conference/AEASA 48th Conference, September 19-23, 2010, Cape Town, South Africa 97332, African Association of Agricultural Economists (AAAE);Agricultural Economics Association of South Africa (AEASA).
  10. Ruel, Marie T. & Levin, Carol E. & Armar-Klemesu, Margaret & Maxwell, Daniel G. & Morris, Saul Sutkover, 1999. "Good care practices can mitigate the negative effects of poverty and low maternal schooling on children's nutritional status," FCND discussion papers 62, International Food Policy Research Institute (IFPRI).
  11. Babatunde, Raphael O. & Qaim, Matin, 2009. "Impact of off-farm income on food security and nutrition in Nigeria," Proceedings of the German Development Economics Conference, Frankfurt a.M. 2009 27, Verein für Socialpolitik, Research Committee Development Economics.
  12. Zeller, Manfred & Lapenu, Cécile & Minten, Bart & Ralison, Eliane & Randrianaivo, Désiré & Randrianarisoa, Claude, 2000. "Pathways of rural development in Madagascar," FCND discussion papers 82, International Food Policy Research Institute (IFPRI).


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