• TABLE OF CONTENTS
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 Front Cover
 Title Page
 Foreword
 Child care project advisory...
 Table of Contents
 Publications
 List of Tables and Figures
 Chapter 1: Conclusions and...
 Chapter 2: National and Family...
 Chapter 3: Women's Participation...
 Chapter 4: Women's Participation...
 Chapter 5: Health and Nutrition...
 Chapter 6: Patterns of Child...
 Chapter 7: Alternative Child Care...
 Methodology














Group Title: Child care needs of low income mothers in less developed countries : : a summary report of research in six countries in Asia and Latin America
Title: Child care needs of low income mothers in less developed countries
CITATION THUMBNAILS PAGE IMAGE ZOOMABLE
Full Citation
STANDARD VIEW MARC VIEW
Permanent Link: http://ufdc.ufl.edu/UF00080517/00001
 Material Information
Title: Child care needs of low income mothers in less developed countries a summary report of research in six countries in Asia and Latin America
Physical Description: 81 p. : ; 28 cm.
Language: English
Creator: League of Women Voters (U.S.) -- Overseas Education Fund
Publisher: The Fund
Place of Publication: Washington D.C
Publication Date: 1979
 Subjects
Subject: Children -- Care and hygiene   ( lcsh )
Women -- Employment   ( lcsh )
Genre: non-fiction   ( marcgt )
 Notes
Statement of Responsibility: by the Overseas Education Fund.
 Record Information
Bibliographic ID: UF00080517
Volume ID: VID00001
Source Institution: University of Florida
Rights Management: All rights reserved by the source institution and holding location.
Resource Identifier: aleph - 001020097
oclc - 08853635
notis - AFA1484

Table of Contents
    Front Cover
        Front Cover
    Title Page
        Title Page
    Foreword
        Page i
        Page ii
    Child care project advisory committee
        Page iii
    Table of Contents
        Page v
    Publications
        Page iv
    List of Tables and Figures
        Page vi
    Chapter 1: Conclusions and Recommendations
        Page 1
        Page 2
        Page 3
        Page 4
    Chapter 2: National and Family Context
        Page 5
        Page 6
        Page 7
        Page 8
        Page 9
        Page 10
        Page 11
        Page 12
        Page 13
        Page 14
    Chapter 3: Women's Participation in the Labor Force
        Page 15
        Page 16
        Page 17
        Page 18
        Page 19
        Page 20
        Page 21
        Page 22
        Page 23
        Page 24
        Page 25
    Chapter 4: Women's Participation in the Community
        Page 26
        Page 27
        Page 28
        Page 29
        Page 30
        Page 31
    Chapter 5: Health and Nutrition of Children
        Page 32
        Page 33
        Page 34
        Page 35
        Page 36
        Page 37
        Page 38
        Page 39
        Page 40
        Page 41
        Page 42
        Page 43
    Chapter 6: Patterns of Child Care
        Page 44
        Page 45
        Page 46
        Page 47
        Page 48
        Page 49
        Page 50
        Page 51
        Page 52
        Page 53
        Page 54
        Page 55
        Page 56
        Page 57
        Page 58
    Chapter 7: Alternative Child Care Approaches
        Page 59
        Page 60
        Page 61
        Page 62
        Page 63
        Page 64
        Page 65
        Page 66
        Page 67
        Page 68
        Page 69
        Page 70
        Page 71
        Page 72
        Page 73
        Page 74
        Page 75
        Page 76
    Methodology
        Page 77
        Page 78
        Page 79
        Page 80
        Page 81
Full Text








CHILD CARE NEEDS OF LOW INCOME MOTHERS
IN LESS DEVELOPED COUNTRIES

A Summary Report of Research in Six Countries
in Asia and Latin America






by the OVERSEAS EDUCATION FUND



















CHILD CARE NEEDS OF LOW INCOME MOTHERS
IN LESS DEVELOPED COUNTRIES

A Summary Report of Research in Six Countries
in Asia and Latin America






by the OVERSEAS EDUCATION FUND



















September 1979





OVERSEAS EDUCATION FUND
of the League of Women Voters
2101 L Street, N.W., Suite 916
Washington, DC 20037
202/466-3430








FOREWORD


This report on the Child Care Needs of Low Income
Mothers in Less Developed Countries is a summary of a six
country comparative study undertaken by the Overseas
Education Fund with support from the Office of Nutrition,
Agency for International Development in Washington, D.C.*
The project was part of a larger.AID concern to encourage
voluntary agency efforts to improve nutrition in less devel-
oped countries and to increase host country involvement in
promoting services which foster good nutrition.

The goal of the study was two-fold -- to investigate
the degree to which child care acts as a constraint to
women's participation in income generation activities and to
understand how such participation affects child care
patterns, health and nutrition. The study also examined the
quality of care children receive and the alternative
approaches to child care that are available or might be
feasible.

To gather data to assess these questions, field
research was conducted in three countries in Asia -- Korea,
Malaysia and Sri Lanka -- and three countries -in Latin
America -- Brazil, the Dominican Republic and Peru. Counter-
part institutions and/or individuals were responsible for
the project in each of the six countries:

Korea:
Sumi Mo
Nutritionist and Chairman
Department of Food and Nutrition
Seoul National University
Seoul, Korea

Malaysia:
Rita Hashim
Research and Evaluation Officer
National Family Planning Board
Kuala Lumpur, Malaysia

Sri Lanka:
Wimala de Silva
Educator
Sri Lanka Federation of University Women
Colombo, Sri Lanka



* The view and interpretations in this publication are
those of the authors and should not be attributed to AID
or any individual on its behalf.









Brazil:
Sonia Bittencourt
Nutritionist
Federal University of Bahia
Salvador, Brazil

Dominican Republic:
Vivian M. Mota
Sociologist
Santo Domingo, Dominican Republic

Peru:
Blanca Figueroa
Psychologist
Jeanine M. Anderson
Anthropologist
Ana Marinez
Pediatrician
Lima, Peru


The tasks of planning the project, coordinating the
six country research, editing the country reports, preparing
this summary report, and organizing in-country seminars and
an international conference were accomplished through the
collaborative efforts of the child care project staff:

Emily DiCicco, Project Director and Field
Coordinator for Latin America
Carol Rice, Field Coordinator for Asia
Jane Wilber, Conference Coordinator
Silvia Limones, Bilingual Secretary


They were ably guided in these tasks by Katharine D.
Massel, chairman of the Child Care Project Advisory Commit-
tee, Elise Fiber Smith, executive director, and Willie
Campbell, president of OEF. Special thanks are due to Joyce
Bouvier for many hours of typing. Sincere appreciation is
extended to Marion Frazao of AID.

Finally, and most importantly, this project was possi-
ble because of the time and interest given by the inter-
viewed women. They are playing a major, though often invisi-
ble, role in the development of their countries. It is
hoped that this project will make a significant contribution
toward policy and program development to meet the needs
identified by these mothers.












CHILD CARE PROJECT ADVISORY COMMITTEE


Katharine Douglas Massel
Chairman of the Committee;
Trustee of the Overseas Education Fund;
former advisor on exchange programs for women
of developing countries, U.S. Department of State;
free lance writer. Washington, D.C.

Ross Copeland
Child psychologist; Associate Director,
Bureau of Child Research, University of Kansas,
Lawrence, Kansas.

John Harris
Economist; Director,.African Studies Program,
Boston University, Boston, Massachusetts.

Mary Dublin Keyserling
Economist; Co-chairman, National Emergency Task Force
on Juvenile Delinquency Prevention; former director of
the Women's Bureau, U.S. Department of Labor; immediate
past president, National Child Day Care Association and
D.C. Commission on the Status of Women; Trustee of the
Overseas Education Fund.

Dorothy J. Kiester
Social worker; consultant on community development,
human relations, and child welfare questions; recently
retired as Associate Professor/Assistant Director,
Institute of Government, University of North Carolina,
Chapel Hill, North Carolina.

Barbara A. Underwood
Nutritionist; Associate Professor of Nutrition,
Massachusetts Institute'of Technology, Cambridge,
Massachusetts; Resident Coordinator and Program
Assistant, United Nations University World Hunger
Program

Caroline Wood.
Civic worker; Treasurer'of the Overseas Education Fund;
member of the Asia Committee; former Executive Director
of OEF. Annapolis, Maryand.










TABLE OF CONTENTS


Chapter


1


2


3


4


5


6


7


Appendix


Conclusions and Recommendations


National and Family Context


Women's Participation in the Labor Force


Women's Participation in the Community


Health and Nutrition of Children


Patterns of Child Care


Alternative Child Care Approaches


Page


1


5


16


27


33


45


60









PUBLICATIONS


The publications resulting from this project include:

a) an annotated bibliography (1977, updated version
forthcoming December 1979)
b) Child Care Needs of Low Income Women in Urban
Malaysia
c) Child Care in Urban and Rural Peru
d) The Burdened Women: Women's Work and Child Care
in the Dominican Republic
e) Child Care Needs of Low Income Women: Urban
Brazil
f) Child Care Needs of Low Income Women in Rural and
Urban Sri Lanka
g) Child Care Needs of Urban and Rural Korea
h) Child Care Needs of Low Income Mothers in Less
Developed Countries: A Summary Report of Research
in Six Countries of Asia and Latin America
i) Final Report on Child Care Needs Project and
International Conference-Workshop.

A slide presentation has also been prepared on the
project theme.

















LIST OF TABLES AND FIGURES



Table Page


2-1 Economic Indicators of Development by
Region and By Country' 7

2-2 Profile of Women Surveyed, Six Countries 13

3-1 Labor Force Participation Rates for
Surveyed Countries 16

3-2 Women'.s Income Generation Activities,
Three Asian Countries 19

3-3 Women's Income Generation Activities,
Three Latin American Countries 20

3-4 Reasons for Not Working, Three Asian
Countries 22

3-5 Reasons for Not Working, Three Latin
American Countries 23

5-1 Health Status of Children in Selected
Countries 35

6-1 Current Child Care Arrangements, Three
Asian Countries 47

6-2 Current Child Care Arrangements, Three
Latin American Countries 48

6-3 Coverage of Child Care Facilities 52



Figure Page

2-1 Six Countries Surveyed 6

5-1 The Relationship Between Per Capita GNP
and Infant Mortality for Six Countries 34








CHAPTER I


CONCLUSIONS AND RECOMMENDATIONS



Conclusions

1. Child care responsibilities constitute a serious
constraint to the.participation of low income women in
the development process. Other equally serious and
related constraints include the lack of employment
opportunities and marketable skills, and cultural role
limitations.

2. The vast majority of low income mothers in all six
countries currently meet their child care needs within
the family. Mothers themselves bear most of the
responsibility, particularly if they work in the home,
or if they are able to take their children with them to
the workplace. Grandmothers, other female relatives
and older siblings are preferred substitute caretakers.

3. Reliance on family members, and satisfaction with
current child care.arrangements are largely a
reflection of the absence of alternatives. The
existing child care centers, preschools, creches and
nurseries reach less than 1% of the families surveyed.
Where parents are familiar with such services, they
usually desire them for their own children, particular-
ly because of the educational "headstart" for primary
school.

4. The labor. frce participation rates for the women
surveyed are higher than the national averages. The
labor force participation rates of the samples varied
greatly, from 100% in rural Peru to 12% among urban
Muslim Sri Lankan women.

5. Rural women are active primarily in agricultural work
or small scale production of crafts and food items to
sell in the market. In the urban area women are more
likely to work outside the home, and are largely found
in the service sector.

6. Malnutrition among children 0-6 is found in all six
countries researched. It is caused by a lack of
resources to obtain enough food, and inappropriate
food habits.

In two of the countries studied weight/age data was
gathered for a sample of children. The Brazil
investigator found 60% of the children of working
mothers are malnourished (1st to 3rd degree), as
compared to 51% of the children of non-working
mothers. In Peru, 28% of the urban children 0-5 years











of age were found to be undernourished to some degree;
for children of weaning age (12-23 months) this figure
rises to 41%. The nutritional status of the rural
Peruvian community is more alarming: 65% of 0-5 year
olds are undernourished; at the weaning age.(24-35
months), 100% are malnourished.

7. Breastfeeding data for the surveyed communities show
the proportion of mothers who breastfeed varies from
rural to urban areas, as well as among the six
countries. Data give evidence of the trend documented
in many countries that the proportion of mothers who
breastfeed is declining, and the average period of
breastfeeding is decreasing. "Insufficient milk" is
the most frequently given reason for early weaning, but
"inconvenience due to work" is also mentioned.

8. Some of the mothers surveyed had little knowledge of
the causes of disease, the value of immunization, or
proper dietary practices. The health facilities that
are available to them are not numerous, offer only the
minimum of services, are difficult to reach, and in
general, are not meeting their health care needs.

9. The earnings that a woman is able to contribute to the
family income are usually so meager that they make
little difference in improving the nutritional status
of her children. Health is a product of the children's
total environment and not greatly influenced by any
isolated factor (such as mother's work). Given the
opportunity for employment, most women work because
they see this as a small but meaningful contribution
they can make to the overall well-being of their
families.

10. A comprehensive child care policy and program is a
viable alternative which would meet the needs of low
income mothers and children. It should have components
of education, nutrition, parental and community
participation and supervised care during the mother's
work hours.









Recommendations

1. National and international assistance agencies should
give due and explicit attention to meeting child care
and other needs of women, children and families. These
agencies should ensure appropriate distribution of
assistance resources to this end.

2. Comprehensive child care policies and programs should
be initiated to address the needs of low income mothers
for custodial care during the mothers' work schedule,
and to meet the needs of children for education and
nutrition. They should be directed to populations most
at risk:

a) children residing in the urban low income
periphery,
b) children 3-5 years of age,
c) malnourished children,
d) children of women who are heads of households,
e) children of women who currently work outside the
home,
f) children in rural areas.

3. Other alternatives in child care programs should be
developed to meet specific needs identified by parents
and the community, such as:

a) seasonal care in rural areas,
b) half-day preschools
c) industry-based child care facilities, and
d) temporary care for children of women in skills
training programs.

4. Family support services, such as child care should be
decentralized, destandardized and flexible. They
should be community- and parent-controlled, and draw on
local human and material resources. Outside resources
should be coordinated.

5. Vocational training should be provided for women.
Skills taught should respond to current and projected
needs of the regional and national economies.

6. National employment needs should be disseminated
through a variety of information networks, such as the
media and local government channels, to inform women of
work opportunities. Employment referral and job
placement centers should be created to widen the
information base for those seeking employment. These
networks and the media should promote attitudinal
changes and encourage women to enter non-traditional
fields of work.









7. Women's organizations, at both the local and national
levels, should be encouraged to help their constituents
address their needs. Leadership training would give
more women the opportunity to become role models for
other women.

8. Health and nutrition projects should emphasize the
importance of disease prevention rather than just
treatment. Breastfeeding should be promoted among
those likely to discontinue the practice mothers who
are more "modern," who give birth in a hospital and are
more influenced by media.

9. Research, development and evaluation of child care
services to meet women's needs, should be incorporated
in the planning of nutrition, health, and education,
employment and urban/rural development programs.

10. Legislation and policies governing the participation of
women in the labor force should be reviewed to
determine if their needs are being addressed. Women
should be aware of their benefits -and rights, as well
as their responsibilities as employees.









CHAPTER 2


NATIONAL AND FAMILY CONTEXT



The Countries Researched

The six countries researched vary widely in their
peoples and cultures, their economies and work patterns,
their histories and future trends (Figure 2-1). Among the
six countries, seven major languages are spoken: Korean,
Bahasa Malaysia, Chinese, Tamil, Sinhalese, Spanish,
Portuguese, and some English, as well as local languages
(Quechua and Aymara) and dialects. There are many different
ethnic groups practicing different religions: Islam,
Buddhism, Christianity, and Hinduism.

The countries are agriculture-based, but two of them --
Brazil and Korea -- are quite industrialized. Malaysia and
the Dominican Republic both have high rates of industrializa-
tion. Peru and Sri Lanka are the least industrialized of
the six. In four, the population is predominately rural,
but increasing urbanization has dramatically changed the
character of these countries. In Korea and Brazil, the
majority of the population now live in urban areas.

Table 2-1 shows some comparative economic indicators
for the six countries.


LATIN AMERICA


Brazil

Brazil, with an estimated population of 115.4 million
(mid-1978) and an annual rate of natural increase of 2.8% in
1975-76, is the most populous country in South America, the
fifth largest in the world, and one of the fastest growing
countries of over 100 million. Continuous rural to urban
migration has increased the proportion of the population
residing in urban areas from 31.2% in 1940 to 56.1% in 1970,
with an increase to 64% predicted for 1980.

There are significant disparities in socio-economic
development between northern and southern Brazil which are
reflected in higher birth and death rates and lower life
expectancy in the less developed northern regions. Poor
living conditions and lack of work opportunities is causing
more and more of the people of the north to move to the
urban area. Among the women surveyed in urban Brazil, 43%
are working. The most common occupation of women without
children is that of maid. The most common occupation of
women with children is laundress, work which allows a mother
to combine child care and income generation.





,










Table 2-1


ECONOMIC INDICATORS OF DEVELOPMENT BY REGION AND BY COUNTRY

Physical Per Capita
Population Per Capita Quality of GNP Growth
1976 GNP-1976 Life Indexa Rate 1970-75
(millions) ($) (%)

Developing countries 3,163.7 494 56 3.1

Developed countries 1,052.6 5,036 94 2.8

LATIN AMERICA 343.4 1,050 71 -
Brazil 115.4 1,140 66 6.2
Dominican Republic 5.1 780 64 6.6
Peru 17.1 800 65 3.4

ASIA 2,389.4 315 57
Korea 37.1 670 82 8.2
Malaysia 13.0 860 73 5.3
Sri Lanka 14.2 200 82 1.1

AFRICA 435.6 277 32


Source: McLaughlin, Martin M. and the staff of the Overseas Develop-
ment Council. The United States and World Development AGENDA-1979.
New York: Praeger Publishers. 1979. p. 156-168.

a. Each country's PQLI is based on an average of life expectancy at
age one, infant mortality and literacy rates. The best possible
performance is 100.



Brazil has an infant mortality rate of 109 deaths per
1,000 children aged 0-1 year, compared to an average infant
mortality rate of 84 for Latin America. A Sao Paulo
Medical School survey found that among the lowest income
group in Brazil, 46% of the children are malnourished.

Of the 21 million 0-5 year old children in Brazil,
approximately 600,000 (2.9%) attend some sort of preschool
facility; however, practically none of these are children of
low income families.











Dominican Republic


The Caribbean nation of the Dominican Republic has
experienced high economic growth in recent years, however,
the great majority of the five million population has not
benefitted. In the capital city of Santo Domingo (popula-
tion one million), the ILO estimates that some one-third of
the families are living on incomes below the poverty line.
For the rural areas, the proportion reaches one-half.

The average age of the Santo Domingo sample of women
was 29 years, 27 for the rural sample. Eighty-five percent
of the women in Santo Domingo and all of the rural are cur-
rently married or otherwise with a male companion. The
urban women surveyed average two preschool children each,
while the rural women average three.

The work women do in the Dominican Republic follows the
pattern found throughout much of Latin America. In Santo
Domingo, unemployment is high and only 23% of the surveyed
women are working. The majority of these are found in the
"service" sector. They work outside the home, receiving
less than US $50 monthly. In the rural area, 78% of the
interviewed women work, mostly in agriculture, but pay is so
low that overall household income is less than US $50 per
month.

Malnutrition is a serious problem in the Dominican
Republic, where 27% of the preschool children of middle and
low income families are second and third degree malnour-
ished. The child care system in the Dominican Republic is
insufficient, reaching less than 1% of the preschool age
population, and the high cost of services precludes use by
low income families.


Peru

Peru is a country of great geographic and socio-
economic diversity. The distribution of goods and services
is extremely unequal, with urban areas receiving more than
rural. Public policy and nearly all public and private
assistance programs also favor the urban areas. The rural
response to this has been an increasing flow of migrants to
the cities and a great expansion of size and numbers of
squatter settlements.

The physical quality of life index (see Table 2-1) of
Peru is lower than the average PQLI of Latin America as a
whole. The per capital GNP growth rate 1970-75 is much lower
than the other two Latin American countries studied. In
1972, 59.6% of tne urban population had not completed
primary school, with the rural figure undoubtedly higher.









All the women surveyed in the rural area and 99% of the
urban women are married, and average three to four children
each, slightly higher than the other two Latin American
countries. The average household has 6.53 members, the
largest of the three surveyed countries.

Unemployment and underemployment are high in Peru, with
women more seriously affected than men. The percentage of
men who are "adequately employed" is 77.5% versus 61.5% for
women. In the urban survey.area, women work at home
making items to sell, run small shops or are market vendors,
earning an average of less than US $10 per month. The rural
women work as vendors of food and agricultural products,
weavers, and agricultural laborers.

Child health and mortality varies greatly among.the
different regions of Peru. The country's infant mortality
rate was estimated in .1970 at 120 to 130 per thousand,
varying from a tragic high of 300 for the impoverished
Cuzco province of Acomayo to a low of 82 for the province of
Lima.

Peru has a system of preschool centers and nurseries
which reach over 7% of the total population, but only a
minute proportion of low income families have access to such
services and there is need for expansion of preschool pro-
grams.



ASIA


Korea

Korea is a rapidly industrializing nation with an
annual growth rate of 10% in recent years. Korea's economic
objectives stress expansion of exports and construction of
heavy'industry. Great emphasis is placed on the impor-
tance of assuring balanced growth between agriculture and
industry. This policy has slowed the rural urban migration,
and the Saemaul Undong or New Community Movement, has con-
tributed to rural community development.

Korea's shift from agriculture to industry has created
many new work opportunities. However, availability of
technical manpower has not.kept pace, and there are labor
shortages in certain areas, while the unskilled poor con-
tinue to compete for limited job opportunities.

Population growth rate has declined from 2.7 in 1960 to
1.7 in 1978. The population is very young with almost 60%
under 25 years of age. The average size of families sur-
veyed in rural Korea is 5.4, the same as the national
average; the urban family average is somewhat smaller, with









5.0 persons per household. The population of Korea reached
37 million in 1978. The national literacy rate is 92%, one
of the highest in Asia.

In the rural survey area, 77% of the women are engaged
in income generating activities; in the urban area surveyed
34% of the women work. Most the women are involved in
jobs requiring low levels of skill and education and receive
low pay. Rural women work in agriculture and animal hus-
bandry; urban women make crafts, operate small shops, and
perform daily, casual labor.

Korea has a day care center system regulated by the
government. There are currently 615 centers reaching 42,000
children but this does not nearly meet the needs of the
people. The government plans to increase the number: of
centers to 1,200 by 1981. With the projected increase in
labor force participation of women, these centers are
vitally necessary.

Families in Korea are very much in favor of child care
facilities because they see them as places of education as
well as custodial care. For this reason, non-working
mothers wish to make use of them as well. The program needs
to be expanded to include all-day care (currently most pro-
vide only half-day care) for working mothers and alternative
modes of care for the non-working mother.


Malaysia

Malaysia is a multi-ethnic country with a population of
just over 13 million. Malays and other indigenous people
constitute 56% of the population; Chinese, 34%; Indian, 9%;
and others, 1%. Roles within Malaysian society are quite
clearly delineated along ethnic lines. The Malays have
traditionally been a money-poor agrarian society, but enjoy
political dominance, which they are now using to institute
programs to improve their economic and educational posi-
tion. The Chinese are a minority who hold very little
political power, yet control a large part of Malaysia's
economy. Caught between are the Indians who enjoy neither
political nor economic power.

The economy of Malaysia is based largely on agriculture
though in recent years a major emphasis of national develop-
ment has been the expansion of industry to make use of the
abundant natural resources. Rural-urban migration is
increasing the population of Kuala Lumpur at a rate of 7%
annually, creating a serious need to expand housing.

Birth rates and infant mortality rates vary consider-
ably among the three ethnic groups, with the Chinese having
the lowest of the three. Distribution of quality health
care throughout Malaysia is extremely uneven.








All of the Malay and Indian women and 96% of the
Chinese women surveyed in urban squatter areas and low-cost
flats are married. Their average age is 29 years and the
average number of children per woman is three,

A 1973 study done by the Malaysia Department of
Statistics found that nearly 80% of the women who work in
Malaysia have had no formal education or only primary school
educations. The sort of work done by the surveyed urban
women varied somewhat by ethnic group,. Production work is
common to all; Malay and Chinese women are also involved in
sales, and Indian women in service occupations. Their aver-
age monthly income is under US $90.


Sri Lanka

Sri Lanka is a multi-ethnic island nation with a popula-
tion ot 14.2 million, of which 39% is under 15 years of
age. The three ethnic groups are the Sinhala, 72%; the
Tamils, 20%; and Muslims, 8%.

The economy of Sri Lanka is based on agriculture for
both domestic consumption and export. Tea, spices, coffee,
cocoa, rubber and coconut are major products. Sri Lanka has
concentrated in the last twenty years on building an exten-
sive social infrastructure, but this has occurred at the
expense of economic growth. Exports have gone down while
imports have gone up. The current government goals are
agricultural self-sufficiency and industrial development,
and Sri Lanka is receiving substantial international assis-
tance to help achieve these goals.

Unemployment and underemployment are serious problems
in Sri Lanka. -In 1973, the national unemployment figure was
nearly one-fourth of the total labor force. Women are more
adversely affected than men,.though the situation is serious
for both country-wide. Over half the women in'the labor
force are involved in agriculture.. '

Three rural villages were surveyed: one Sinhala, one
Tamil, and one Muslim, and each ethnic group was represented
in the urban study done in the capital city of Colombo. In
the rural areas, the women who work are involved primarily
in agriculture or home-based income production. Only 15.9%
of the urban mothers work, mostly outside of the home. The
Sinhala and Tamil women work primarily as casual laborers or
shopkeepers, while the Muslim women are domestics and seam-
stresses.










The average family size varied by ethnic group and by
urban and rural area (Table 2-2). The infant mortality rate
in 1978 was 43 per 1,000. Sri Lanka has a PQLI of 82, which
is considered high.

Education in Sri Lanka is free through university. How-
ever, there is much absenteeism among children of low income
families who cannot afford clothing, books, pencils and
transportation. The Tamils place greater emphasis on educa-
tion than do the other ethnic groups; the Muslims are
currently the least well educated.

The extended family most often meets child care needs.
Child care facilities are a little known phenomenon and
hence are not trusted by the survey women who are unfamiliar
with centers that provide quality care.



PROFILE OF THE SURVEYED WOMEN

In the six countries, differences in cultural tradi-
tions, national economies and policies, and local condi-
tions result in certain variations in patterns of family
life, employment and child care. However, when basic needs
and the ways women have devised of addressing those needs
are assessed,many similarities emerge.

In all six countries a woman's primary role, hence her
identity, is that of wife and mother. Even when she is the
sole wage earner of her family, the fact that she is a woman
means that she continues to be defined in those terms.

As shown in Table 2-2, the surveyed women are almost
all married. They average 3-4 children each, with two of
them of preschool age. Their families are already large and
usually continuing to grow, and most households include mem-
bers other than the nuclear family.

They are poor and are acutely aware of their family's
need for supplementary cash income. While social mores may
prohibit them from engaging in certain types of income
generating activities, almost all are either currently doing
some kind of work to bring in money or wish that they
could. They all realize that paid work must be coordinated
with household and child care responsibilities and not
hinder greatly their primary role as wife and mother.




PROFILE OF WOMEN SURVEYED, SIX COUNTRIES


Married/
United a


Average


Average
Number of


Average
Number of
Preschool


Average
Total Persons


Country zSize % Age Children Children per Household

Brazil urban: 1,057 56 25-29 2 2 4

Dominican urban: 300 84 29 3 2 6.2
Republic rural: 40 100 27 N/A 3 N/Ab

Peru urban: 84 99 N/A 3.38 2C 6.53
rural: 140 100 N/A 3.67 N/A

Korea urban: 108 100 31-33 1.5 5.0
rural: 104 100 33-35 N/A 1.4 5.4

Malaysia urban Malay: 200 100 2.9
Chinese: 199 96 29.3 3.0 1.6 N/A
w Indian: 100 100 3.1

Sri Lanka urban Muslim: 33 100 3.5 1.3 6.2
Sinhala: 64 100d 25-30 3.1 1.4 6.3
Tamil: 43 100d 4.1 1.5 8.3e
rural Muslim: 48 10 Qd 27-32 4.4 1.7 6.4
Sinhala: 42 100d 25-30 2.3f 1.3 5.3
Tamil: 49 100d 25-30 2.3f 1.4 6.5


Source: Six Country Reports
N/A Not available
a. The Brazil sample included women 15-49 who did not necessarily have children, and were not
necessarily independent. Of the total sample, 56% were married, 41% single, 37% widowed or
separated. In all other countries, women with children were interviewed.
b. While an,exact number is not available, it is known that the average size of the-surveyed rural
families was larger than the urban families.
c. Sample criteria included having 1 child under 12 months, and 1 child 12-60 months.
d. Includes widowed, divorced and separated.
e, In addition to having a higher average number of children, the Tamil families living in the
urban area had a considerably greater number of extended family members living with them than did
the Muslim or Sinhala.
f. Average number of children under age 13.


Sample











Notes




1. McHale, Magda Cordell and John McHale, and others.
World's Children Data Sheet. Washington, D.C.: Population
Reference Bureau, 1979.

2. Ministerio de Saude, Instituto Nacional de Alimentacao
e Nutricao, "Relatorio Final: Seminario sobre Desnutricao
Energetico -- Proteico no Brasil". Brasilia, 1977, mimeo-
graphed, pp. 42-43.

3. UNESCO. Statistics Yearbook 1977. Paris: UNESCO,
1978, p. 58.

4. OTEMO DGE. Labor Force Survey in Urban Areas, August
1972, and Regional Urban Labor Force Survey, March-April
1974. Cited in del Valle, Delma, "Factores Determinantes de
la Participacion de la Mujer en el Mercado de Trabajo,"
presented at "Seminario de Investigaciones Sociales acerca
de la Mujer," March 13-17, 1978, Cuzco, Peru, p. 22.

5. Because of the lack of birth registration in many rural
areas, this crucial statistic probably underestimates the
true frequency of infant mortality. The data on infant and
children's mortality are taken from a 1972 UNICEF report,
Peru: Estudio Sobre la Infancia, cited in Castillo Rios,
op. cit., pp. 32-33.








CHAPTER 3


WOMEN'S PARTICIPATION
IN THE LABOR FORCE



In Elise Boulding's book, Women in the Twentieth
Century World, a concept is discussed which she has labeled
"the fifth world." This "fifth world" is the forgotten
domain of women's labor: the world of the kitchen, garden,
village well and nursery. This work usually goes unac-
knowledged whether it is in developed or developing coun-
tries. The women who carry out tasks such as tending to the
crops and animals, preparing the family meals and supplement-
ing the family's income through various cottage industries
are "invisible" workers.

Although women play a substantial role in the economic
development of their countries, it is difficult to locate
"hard data" on women's work activities. Much of their parti-
cipation in the labor force is concentrated outside of work
areas which are defined by the formal wage system. Many
women have been ignored or dismissed by economists and sta-
tisticians when calculations of the GNP (Gross National
Product) are conducted.

According to Boulding, economists have not placed any
"monetary value" on much of women's labor; instead they have
classified women into four areas: a) not economically
active homemaker, to cover women dedicated to household
support; b) other not economically active women, students,
pensioners and others; c) unpaid family workers; d) own
account (self-employed) workers. The ambiguity of these
categories is evident.

Furthermore, that which is included in the calculation
of the GNP varies among countries. For example, in Taiwan,
"the bookkeepers...would leave out handicrafts; they would
however, assign economic value to the women's water carry-
ing. But in Nigeria, it would be argued that, in rural
areas, wood and water are free goods, like air, and so are
the human efforts that make them useful."3

What exactly is work? It is difficult to define
because each society has its own interpretation and values.
Various interpretations set the criteria of who is to be
included in the labor force participation statistics. In
fact, many of these "invisible workers" do not see them-
selves as part of the labor force, even though they may be
adding directly to the family's income through the sale of
handicrafts or food products.








Work is defined in this study as any activity performed
in or outside the home, which leads to income in cash or
kind. Tasks related to the maintenance of the household,
such as laundry, the preparation of food, or house repair,
are not included as work by our definition, although it is
recognized that they are laborious and are a necessary
support service for the entire family, including those who
are part of the labor force.

Thus, the proportion of adult women in the formal labor
force varies enormously from country to country, and the
trends are far from uniform. This fluctuation can be
seen in Table 3-1.

Table 3-1


LABOR FORCE PARTICIPATION RATES
FOR SURVEYED COUNTRIES


COUNTRY/ETHNIC GROUP NATIONAL SAMPLESb
LABOR FORCE
PARTICIPATION
RATE OF WOMENa URBAN RURAL


SRI LANKA 16.9%
Muslim 12.1% 47.9%
Sinhala 15.6 40.5
Tamil 14.0 32.7

KOREA 41.0 34.0c 78.0

MALAYSIA 35.8 36.0 N/Ad

PERU 20.7 28.0 N/A

BRAZIL 18.6 43.0 N/Ad

DOMINICAN REPUBLIC 22.0 23.0 78.0


Source: Six Country Reports

a. References from the six country reports. The years of the data
are as follows: Sri Lanka, 1969/70; Korea, 1974; Malaysia, 1973;
Peru, 1972; Brazil, 1970; Dominican Republic, 1970.
b. The samples surveyed in the six country case reports.
c. Urban labor force participation rates may be low, as there were
many women absent from home when interviewers were conducting the
survey, and it was not always possible to locate the women on
subsequent visits.
d. Research not conducted in rural area.








Throughout the developing world, population growth is
not matched by a growth in jobs. Katherine Newland states,
"For women in the less developed countries, declining labor
force participation is more common than in the industrial-
ized countries, and it has more ominous implications. It
often signals a serious constriction of opportunity as
employment creation fails to keep up with the growth of the
4
working-age population."

In developing nations, this is becoming a common
characteristic, as the society moves from pre-industrial to
post-industrial, without taking the steps in-between. In
the surveyed countries, this trend is reflected in increas-
ing numbers of women joining the ranks of self-employed,
producing saleable items for an already glutted market,
competing as vendors, and further dividing the limited
opportunities for casual labor.

Although the majority of the less-developed countries'
female work force is still in the agricultural sector, rural
to urban migration has brought large numbers of women to the
cities. These women leave the farms in search of employment
opportunities in the industrial sector, but because of their
lack of training and education, they are generally unsuccess-
ful in finding advantageous jobs.

Currently, jobs are being created which favor more
highly educated women (i.e. white collar workers, such as
secretaries and nurses). However, these are unobtainable
for the low income women, who do not have the needed skills
and are unable to get the proper training. Not only are
they unskilled, but often find themselves competing with
men, who are given priority in hiring practices. If women
do locate employment, it is usually characterized by low pay
and long hours -- jobs the male labor force refuse to take.
They may also obtain employment through "default," when
there is a shortage of men, such as during wars, or economic
booms.

In the six countries surveyed, the labor force partici-
pation rate of low income populations is higher than the
national averages. In the four countries where a rural popu-
lation was studied, the participation rate, ranging from a
low of 12% among urban Muslim Sri Lanka women to a high of
100% in rural Peru (Table 3-1). The rate may be higher than
reported in the national censuses, however, because of the
broad definition of employment used in this study as well as
the care taken in the interviewing process to accurately
identify and classify women's activities.







Poor women around the world work because they "need the
money". They may be the sole support of their families or
supplemental wage earners who augment the low salaries of
primary wage earners. The women surveyed are no different.
All work because of the families' need for additional
income, for the produce raised or for the unpaid services
they provide as family laborers. In these cases, the need
for money or in kind services generated by a women's labor
overrides a husband's objections or a woman's own belief
that her time may be more appropriately spent in household
tasks and/or child care.

In all six countries surveyed (Tables 3-2 and 3-3), the
rural women are primarily involved in agricultural tasks:
daily farm labor, family work at harvest time, small animal
husbandry, or home-based small scale production of items to
sell on the local market. A few in each country own and
operate small grocery stores in their homes. In the urban
areas, women are more likely to work outside the home, as
street vendors, or jobs in the service sector.

In Santo Domingo, Dominican Republic nearly 80% of the
surveyed women who work are employed in production or ser-
vice jobs such as domestics, laundresses and cooks, while
none of the women surveyed in rural Dominican Republic do
this. In Malaysia, among the surveyed urban women, 93% of
the Malay, 98% of the Chinese and 96% of the Indian are
engaged in either clerical, sales, service or production
occupations.

Although economic necessity is the reason why women
work and there is some variety in types of income generating
activities, one common characteristic of the work that women
do is that it pays very little. Lack of saleable skills,
stiff competition for all income producing work, societal
attitudes which close certain fields of education and occupa-
tions to women, discriminatory salary practices and quota
systems which limit numbers of women hired, and the need to
arrange work around household tasks, leave women in
basically unskilled, poorly paid pursuits.

In many of the rural occupations, women receive no cash
for their labor; rather they fall into the category of
unpaid family labor. As Dixon points out in Rural Women at
Work: Strategies for Development in South Asia, "working in
fields is generally considered a normal part of their
(women's) domestic role. It does not translate into econo-
mic independence or greater power within the household."

In other cases the outside observer would classify an
activity as income producing but the woman herself perceives
it as part of her household routine. Such is the case in
Peru where few women consider marketing an income-generating
activity. They sell in order to buy their "salt and pepper."









Table 3-2


WOMEN'S INCOME GENERATION ACTIVITIES, THREE ASIAN COUNTRIES



ACTIVITY PERCENTAGE OF WORKING WOMEN DOING EACH ACTIVITY

Malaysia Korea Sri Lanka
urban urban rural urban rural


Agriculture 0% 16% 80% 0% 30%

Handicrafts 0 30 3 30 64

Commerce 20 38 16 30 4

Factory (production) 39 0 0 0 0

Domestic Service 28 13 0 15 0

Other Services 0 0 0 0 0

Clerical 9 0 0 0 0

Teaching/Nursing 0 0 1 0 0

Other Professionals 3 3 0 0 0

Other 1 0 0 25e 2


Source: Three Country Reports

a. Responses of 249 women in urban Kuala Lumpur; data for those
engaged in service occupations could not be further divided so
the % is shown under the most common service occupation -- domes-
tic service.
b. Responses of 108 urban women and 104 rural women.
c. Responses of 20 urban and 56 rural women.
d. Includes casual labor and animal husbandry.
e. This 25% represents "other" and unspecified casual labor.







Table 3-3


WOMEN'S INCOME GENERATION ACTIVITIES, THREE LATIN AMERICAN COUNTRIES



ACTIVITY PERCENTAGE OF WORKING WOMEN DOING EACH ACTIVITY
Brazilf Dominican Republic9 Peru
urban urban rural urban ruralj

Agriculture 0% 0% 86% 0% 100%

Handicraftsb 9 11 15 100

Commerce 16 14 14i 70 100

Factory 0 6 0 4 0

Domestic Service 26 52 0 7 0

Other Serviced 33 0 0 4 0

Clerical 0 0 N/Ai 0 0

Teaching/Nursing 9 0 0 0 0

Other Professionale 0 16 0 0 0

Other 7 0 0 0 0


Source: Three Country Reports

a. Includes casual labor, animal husbandry.
b. Includes sewing.
c. Includes operating a small shop, selling in the market, and
street vendors.
d. Includes laundress, hairdressers.
e, Includes public administrators, skilled technicians.
f. Responses of 450 urban women.
g. Responses of 140 urban women; it was not possible to break down
the percentages of women in service jobs (domestics, laundresses,
cooks), so the 52% was shown under the most common, domestic
service.
h. Responses of 27 urban women.
i. The Dominican Republic report had small-scale commerce and office
work as one item.
j. Agriculture, crafts and small-scale commerce are universally
performed.








The large number of women workingwithin their homes or
in part-time activities emphasizes the difficulty of
juggling household responsibilities with income-generating
activities. The Brazilian case documents the shift in the
type of work women seek when they begin to have children.
Those who once worked as maids are no longer welcome with
children. The presence of infants under a year keeps Sri
Lankan women out of the labor force. Peruvian mothers turn
to self employment as market or street vendors for the flex-
ibility it allows. Women work seasonally, staying home in
inclement weather. They say the damp winter is hard on them
and the children they must carry on their backs or lead by
the hand. Finally, many turn to home-based activities which
allow a mother to combine, though not nessarily produc-
tively, child care with income generating activities.

For those working outside the home, the pressure is as
great, but instead of combining the two activities, domestic
and economic, one follows the other resulting in the all too
familiar situation of a double work-day for the woman. The
amount of work the majority of the women do in a day is cap-
tured in one woman's response to the question "What do you
do in,your free time?" Her reply? "I think I'm going to
laugh."

Many of the women not currently employed indicated that
they would like to work but they enumerated the various con-
straints: lack of skills for the jobs available, husband's
disapproval and no time due to excessive household and child
care tasks.

A more detailed analysis shows that in three of the six
countries Brazil, Malaysia, and Sri Lanka most of the
non-working women cited household and child care responsibil-
ities as their main reason for staying out of the labor
market. It is difficult to assess, however, the degree to
which child care acts as a serious constraint. While child
care duties are undoubtedly a factor to a great extent, it
should be noted that it may be easier for women to affirm'
their worth by supporting societal expectations in saying
"My children require my attention at home" than it is to
make a self-effacing statement such as "I have .no skills" or
"I am afraid to look for work."

In the three other countries -- Dominican Republic,
Korea and Peru -- the survey.respondents saw lack of job
opportunities and saleable skills as the major obstacle;
child care responsibilities ranked second as a constraint.
(Tables 3-4 and 3-5)..









Table 3-4


REASONS FOR NOT WORKING, THREE ASIAN COUNTRIES

PERCENTAGE OF WOMEN CITING THIS REASON
b c
Reason Malaysiaa Koreab Sri Lankac
urban urban rural urban rural

Child care
responsibilities 69% 42% 47%
23% -35%
Household
responsibilities 5 5 28

No employment
opportunities 1 45 33 8 36


No skills/education 3 19 9 4 8

Not appropriate
for women 0 0 0 25 8

Poor health 0 0 0 3 1

No need/not interested 12 6 11 0d 0

Other/no response 10 6 12 23 8


Source: Three Country Reports

a. Responses of 146 women who stated they "do not want to work".

b. Responses of 47 urban women who have never worked, and 57 rural
women who have never worked. Data do not permit breaking down
of percentages of women who stated "too much work at home" into
"household responsibilities" and "child care responsibilities".

c. Multiple response answers of 120 urban and 83 rural women.

d. While 40% of the women stated they "did not want to work", child
care responsibilities and husband's disapproval later emerged as
the reasons why they did not want to do so.

e. While 33% of the women stated they "did not want to work", child
care and household responsibilities later emerged as the reasons
why they did not want to do so.








Table 3-5

REASONS FOR NOT WORKING, THREE LATIN AMERICAN COUNTRIES


PERCENTAGE OF WOMEN CITING
Brazil a Dominican Republicb


urban


Child care
responsibilities


26%


urban


26%


rural


0%


THIS REASON
Peruc
urban rural


N/A


Household
responsibilities 4

No employment
opportunities

No skills/education

Not appropriate
for women 17

Poor health 6


No need/not interested 9

Studies impede 15

Other 7-


Source: Three Country Reports


N/A


N/A

N/A


N/A

N/A


N/A

N/A

N/A


100

0


a. Responses of 607 in urban Brazil who do not work; data do not
permit breaking down of 16% figure who responded "cannot get a
job" into "lack of employment opportunities" and "no skills/
education".

b. Response of 231 women in urban Dominican Republic who do not
work. In the rural area, 22% of the women do not work. The only
explanation given was that their husbands have a better economic
position in the community.

c. Peru data not available; in general, urban women lack opportuni-
ties and saleable skills; rural women are all working.


Reason







It is interesting to note that women in Sri Lanka and
Malaysia who answered, "I don't want to work" clarified that
they don't want to because "household and child care respon-
sibilities require all their time".

Other hindrances are societal attitudes, the low educa-
tional level of most of the women, and -- except in Korea
and Malaysia -- the generally high rate of unemployment.

A woman's decision to enter the labor market, either
part-time or full-time, inside or outside the home, is influ-
enced at any given time by a series of inter-related fac-
tors. Her family's need for supplemental income, available
job opportunities, the education and saleable skills she
possesses, and the roles permitted within the culture are
all factors taken into consideration in the decision-making
process. Similarly, children and their needs cannot be
isolated from the other factors which influence a woman's
decision to work.

Children create a need for more income and simultane-
ously restrict a woman's ability to be economically active.
Availability of adequate care during the working hours is a
major factor in freeing a woman for employment. Neverthe-
less, many women who cite "child care responsibilities" as
the major reason for not working are not necessarily
referring to the need for custodial care. To a large degree
in all societies, a woman's worth, hence her self image,
continues to be defined by her role as mother.

To conclude, it has been observed in the six countries
that women are playing a vital role in the national econo-
mies as both invisible and visible laborers. The limita-
tions they face in terms of the opportunities that are
available and the skills they possess are magnified by child
care and household responsibilities. Looking to the future,
women will most likely continue be restricted by these
patterns, unless changes in the very process of economic
development begin to facilitate the incorporation of women
into the labor force.









Notes


1. Elise Boulding. Women in the Twentieth Century World.
New York: Halsted Press Sage Publications, 1977, p. 17.

2. Ibid., pp. 17-18.

3. Kathleen Newland. The Sisterhood of Man. New York:
W. W. Norton Company Worldwatch Institute, 1979, p. 130.

4. Ibid., pg. 143.

5. Ruth B. Dixon. Rural Women at Work: Strategies for
Development in South Asia. Baltimore and London: The Johns
Hopkins University Press, 1978, p. 130.







CHAPTER 4


WOMEN'S PARTICIPATION IN THE COMMUNITY



Factors in Participation

The degree of women's participation in community activi-
ties varies greatly worldwide and depends on numerous fac-
tors. The level of national economic development, cultural
attitudes toward the role of women, the social structure of
the society, literacy rate, traditional leadership patterns,
the attitude of men and the attitudes of the women them-
selves all affect what women do in terms of activities
outside the home.

Active women's voluntary organizations exist in all the
countries surveyed; however, the majority of the members of
these groups belong to the middle and upper classes of soci-
ety, are well educated, and are professionally employed.
Some of these organizations are formed to address national
issues and concerns.

For example, in Malaysia the National Council of
Women's Organizations, as its contribution to the Interna-
tional Year of the Child, sponsored a series of seven
seminars ,relating to needs of children. The purpose was to
gather information and to make recommendations to the
Government of Malaysia for policy formation at the national
level regarding needs and rights of children. A similar
organization in Korea is currently focusing attention on
consumer protection.

Other organizations base their activitiesb'n social
welfare needs but the assistance they give to less advan-
taged groups initially comes from outside rather than from
within the low income communities. The Ceylon Social
Service League, in their efforts to up-grade an urban pre-
school and community center, are attempting to generate
interest from within the low income community by encouraging
self-help activities.

When low income women do participate in group
activities, it is usually through community Mother's Clubs,
as in Brazil and Korea.. Recently groups'of low income women
from a number .of neighborhood councils in urban Sao Paulo
joined together to support the "Cost of Living Movement,"
bringing the practical problems of dealing with inflation to
the attention of public authorities. Mother's Clubs in
Korea in the late 1960's effectively disseminated family
planning ,within the community, a policy urged by govern-
ment. Women's efforts are vital to the success of such
endeavors, and with success, continued participation will be
encouraged.









Level of Participation


Community interaction is a key element in all rural
villages and urban neighborhoods. Traditional activities
have been organized around the kinship, social, and
political networks that unite a given community, and the
roles of men and women have been specifically defined.

Men have traditionally dominated the local councils
where decisions are made regarding community activities such
as planting and harvesting, cooperative projects and matters
pertaining to community welfare. Women have been responsi-
ble for organizing and planning community festivities and
ritual activities associated with religion, birth, marriage
and death.

With some modification in complexity of ritual and more
flexibility in modern custom, the above role delineation
generally still exists in most developing countries,
especially in rural areas. Women are expected to be
concerned with matters pertaining to women and the family
but not the community as a whole. This is not to say that
women have no voice in community decisions. Publicly they
may not be encouraged to participate; informally and
privately at home they may have great influence in the
decision making process.

Most of the areas surveyed, with the exception of Peru
and Korea, reveal low levels of participation in community
activities, with women's involvement considerably less than
that of the men. Participation varies by ethnic group as
well. In urban Malaysia, participation by Chinese women is
less than that of either the Malay or Tamil communities
surveyed. Opportunities for participation in these communi-
ties appear limited to Death Fund and Welfare Fund activi-
ties, both considered appropriate for women.

Similar differences in participation by ethnic groups
are noted in Sri Lanka. The participation level in all
communities, rural and urban, is very low; but the lowest
is among the Muslim rural women. Women's participation
in all three groups appears limited to activities associa-
ted with religion. In the rural Sinhala community the women
stated that it is difficult for both husband and wife to
leave the house at the same time, and women prefer "the
children's father" to attend to community matters.

In Sri Lanka two major voluntary organizations with
successful projects based on community participation should
be mentioned. Sarvodaya and Mahila Samiti are both involved
in rural community development activities, with a strong
principle of self help. Sarvodaya offers a more comprehen-







sive program in that it trains both men and women in all
aspects of community work, while Mahila Samiti-concentrates
on meeting the needs of rural women by offering leadership
training and courses in.nutrition, child care and health
care. The Sarvodaya program is now expanding into the urban
areas, as is the Saemaul movement in Korea. None of the
communities surveyed in Sri Lanka had been exposed to either
Sarvodaya or Mahila Samiti, and as noted, the level of
community participation by women, as well as men, is. low.
This would indicate that some kind of impetus must come from
outside the community to encourage participation.

In two communities surveyed, the level of participation
by women has increased as a direct result of the survey.
Interestingly both are Indian communities, one in urban
Malaysia, the other in rural Sri.Lanka. In Sri Lanka, after
the group discussions, the women in the community decided
they needed a Women's Association to deal with matters of
concern to women. Their first act as an organized group was
to form a half day preschool. The preschool mushroomed from
20 to 70'children in less than three months. Not to-be
outdone, the women in the other community surveyed have
formed a Women's Association as well and plans for another
preschool are underway.

In Malaysia the Resident's Association of the Indian
community, inspired by interest shown by a volunteer women's
organization outside of the community, have upgraded their
preschool and' have held fund-raising projects to provide
a better water system for the community.

Korea is a special case in terms of participation of
women in'community activities. Following a policy of
planned development, all citizens are expected to feel
responsible for and contribute to nation building. Through
the Saemaul Undong, or New Community Movement, active
participation of the community in all phases of development
is expected. In the early stages of the program, women
were expected to participate, but were not involved in the
planning and decision making. Leadership training was
directed toward the men; now-women are also included.

Since 1977 emphasis has been directed toward enhancing
the participation of women by consolidating all existing
women's groups -in each community into one Saemaul Women's
Club, for better coordination of activities. In the, rural
area surveyed -the women are very vocal and active. Current-
ly they are involved in a variety of activities including a
dietary improvement campaign, family planning, parasite
control,.rice saving and cooperative effort for rice
transplanting-and harvest.







The low income women of the three Latin American coun-
tries surveyed showed similarly low levels of participation
in community affairs. They are usually supporters rather
than leaders. A woman's voice is usually heard indirectly,
through her husband.

In both urban and rural Peru very few women attend
community meetings. In the rural area, 81% of the women
responded that it is inappropriate for women to attend such
meetings. The women help in cooperative farming activities
as do the women in most rural communities; however, when it
comes,to participation in general community decisions, they
tend to leave such decision making to the men.

In the urban setting in Lima a Women's Council exists,
but it is a weak organization due to lack of active partici-
pation. Those projects that are initiated through the
Council are often at the instigation of outsiders, rather
than the women of the community themselves. Several private
non-profit agencies have been working in the community for
some time, provide support for local activities and give
short training courses specifically directed toward women.
One of the major accomplishments has been the cooperative
construction of a preschool and a primary school, achieved
by community labor, with private funding.

A thesis prepared by two students in conjunction with
the research for the Peru child care needs survey, investi-
gated the members and activities of the Women's Council.
Comparing the 32 women delegates against the survey sample
of women, it was possible to isolate two significant deter-
minants of a woman's participation as leaders: a) having
relatively few children, and b) a higher educational level
of the husband. This finding suggests that the husband's
tolerance of his wife's extra-familial activities is crucial
in determining whether she participates in public life, and
this tolerance is likely to increase the more years he
spent in school.

Women's influence in community affairs may be under-
estimated because of their invisibility at public meetings.
There is evidence that husbands make only tentative
decisions at meetings, contingent on the agreement of their
wives, who are consulted at home before the final vote is
taken at the next session. Women frequently appear in the
forefront in emergency situations. In squatter settlement
ventures, women are often the instigators of action.

It was found in the urban areas of all countries
researched that as substitute caretakers are more available
and acceptable, women participate more frequently in the
community. The responsibility for children is usually given
as the major constraint to participation. In looking







deeper, however, child care appears to be a socially
acceptable excuse, since mothers are usually able to find
some way to care for children for other more pressing
demands. In the rural area, no reason is usually given
whatsoever, and in fact the absence of women at community
meetings is hardly questioned. Most current avenues of
community participation are not seen as needs by the women,
nor is participation part of the women's role as defined by
the culture.

The advantages of community participation are not
readily seen by most women. Some women report that their
children benefit because mothers learn about health,
nutrition, education and care of children. They appreciate
the cooking, sewing and knitting courses that help them feed
and clothe their families. But in the main, women opt to
concentrate on immediate needs of their families.

In all six countries surveyed, when women became
involved in community projects/activities, the activities
selected usually focus around needs of health and children.
Examples of some of the activities observed during the
survey include:

a) formation of child care centers and preschools,
including associated voluntary tasks;
b) courses in nutrition, health, family planning,
child care;
c) cooperative maintenance of home gardens and school
gardens;
d) construction of community centers;
e) cooperative pharmacy; and
f) income-generating activities, such as crafts.


Conclusion

The lack of participation of women in community activi-
ties cannot be attributed to lack of interest or apathy.
Many factors contribute to a low level of community partici-
pation. Opposition of men, lack of education and knowledge
of ways to effect change, the demands of household and child
care activities, all act as constraints to women's partici-
pation.

In most developing countries, community organizations
are led by men and address the issues men want resolved.
Women's participation is frequently not encouraged. This is
not to say that women have no voice in community decisions.
Publicly they may not be encouraged to participate. Infor-
mally and privately they may influence the decision-making
process.









Nevertheless women must have opportunities, motivation
and incentives in order to participate more fully. After a
full day of household chores and child care responsibili-
ties, and often working for income as well, low income women
have little time or energy to spare for additional activi-
ties. More equitable sharing of household tasks among
family members would allow women more time, but this is a
cultural factor which is slow to change.

When women are motivated and see the benefits of partic-
ipation, they find ways to participate. As the female
literacy rate rises and as more mothers find it necessary to
work, patterns of participation in the community are
expected to change.







CHAPTER 5


HEALTH AND NUTRITION OF CHILDREN



A Haitian proverb describes hunger most profoundly:
"An empty sack cannot stand up." Mothers are the persons
most directly responsible for feeding children. But women
are a small element in a very large cycle of malnutrition,
underdevelopment and poverty, which is outside their sphere
of control.

"Malnutrition is unlikely to disappear in the normal
course of development: this is, in the course of normal per
capital income growth... On the contrary the situation may
worsen..."l The consequences of malnutrition are physical
and mental impairment and suffering, which in turn impact
human productivity, and thus national development.

Low income families' children are the group hardest hit
by malnutrition. Infants and young children are dependent
upon others for food, and their nutritional needs are very
high. The infant's needs are usually met as long as breast-
feeding continues. But from the weaning period until the
child is four or five, the intake of calories and protein is
often not sufficient.

At the very root of most malnutrition is poverty. A
great many families are unable to obtain foods that will
meet their nutritional needs. Improving income is one condi-
tion for attacking the problem. But a higher income does
not automatically improve nutrition if the mother must par-
tially sacrifice breastfeeding infants in order to work in
factories, or if her income is not spent on the children's
diet, or if her income is not enough to make a significant
increase in the total household income.

In recent years nutrition scientists have reached some
measure of agreement that many millions of people suffer
from malnutrition, not because they do not know what to eat
or do not have foods available, but because they do not have
2
the means to obtain enough of their accustomed diets,

One billion people, more than half the population of
the developing world, live on calorie deficient diets. The
percentage of the population with caloric intake below
requirements is 30% in Latin America, 59% in Asia, 32% in
the Middle East, and 54% in Africa. In 1975, about 15
million infants and children below 5 years of age died in
the Third World. Had these 15 million children been born in
the developed world, 12 to 13 million of them would have
survived.







Important differences exist among developing coun-
tries, as shown by the countries of our study. Figure 5-1
and Table 5-1 illustrate that some countries have low
mortality rates in spite of low per capital GNP figures.


Nutritional Status

Of the six countries studied, two included a measure-
ment of the weight to age as an element of the research
design. They found a high rate of malnutrition, reaching
100% in some age groups. The Brazil investigator compared
measurements of the nutritional status of children of urban
working and non-working mothers. Her findings show that 60%
of the children of working mothers are malnourished, as
compared to 51% of the children of non-working mothers. The
research did not determine if mothers' employment is the
major factor in malnutrition, however. Income data was not
gathered for households surveyed. It is probable that the
general economic condition of the family resulted in malnu-
trition, rather than the isolated employment factor.

Among children of working women, fewer malnourished
children are found among those left in a relative's care
than among those left in their own home with an older sib-
ling, taken to the work place or left alone. The number of
hours mothers spend away from home does not affect the
nutritional status of the children. However, the period of
the day when mothers are absent does have an affect. The
smallest evidence of malnutrition is found in the Brazil
sample, among the children of mothers who are away from home
only in the afternoon. This might be explained by the
mother's presence at home in the morning when the principal
meal is prepared and served to the family at noon.

The Peru investigators compared the nutritional status
of rural and urban children, and analyzed the data by age
groups. In urban Peru, 28% of the children 0-5 years of age
are undernourished to some degree; for children of weaning
age (12-23 months) this figure rises to 41%. The nutri-
tional status of the rural sample of Peru is even more
alarming: 65% of 0-5 year olds are malnourished; at the
weaning age (24-35 months), 100% are malnourished.

The malnutrition found in the rural area of Peru is
due to the lack of food available for children (and
adults). The diet of the many rural families is tubers and
grains, which are the only items available. Although the
household may have a couple of chickens, several guinea
pigs, a few sheep and maybe a cow or a pig, the meat is
generally eaten only on festive occasions. Eggs, cheese and
milk are often sold to bring cash for other necessities that
can only be purchased.




Figure 5-1 The Relationship Between Per Capital GNP and Infant Mortality for 6 Countries


Infant Deaths
per Thousand
Live Births


250--


200-4-


150--


* Sri Lanka


*Korea


* Dominican Republic
Peru


OMalaysia


i I I I I i I I I I I I i I I I I t I I I I t I I


2 i l I l I II I I 1 j I

$100 $200 $300 $400


$500


I I I l I- I -I I i l I I


SI$6
$600


$700
$700


I$8
$800


' I
$900


$1000 $1100
$1000 $1100


Per Capital Gross National Product in 1976


Source: Adapted from The United States and World Development: Agenda 1979, Washington, DC: Overseas
Development Council, (Praeger Publishers), 1979.


100 -


Brazil


50-


I I 1 I i I I i I


I I I t 1 i t I i I I ] I i I


I I i ii








TABLE 5-1


HEALTH STATUS OF CHILDREN IN SELECTED COUNTRIES


Per Capita
GNP-1976a


Infant Mortality
0-12 mos. (pgr
1,000 births)


Life Expectancy
at Birth (years)


Per Capita Calorie
Supply as % of
Requirements


Developing countries
Developed countries

AFRICA
ASIA

Korea
m Malaysia
11 Sri Lanka

LATIN AMERICA
Brazil
Dominican Republic
Peru


Sources:


(a) Adapted from The United States and World Development: Agenda 1979, Washington, D.C.:
Development Council, Praeger Publishers, 1979.


(b) Magda McHale Cordell, John McHale, with Guy F. Streatfield, Thomas Kane.
Data Sheet. Washington D.C.: Population Reference Bureau, 1979.


Overseas


World's Children


494
5,036


277
315

670
860
200


113
22

147
105


96
132


1,050
1,140
780
800


84
109
96
80


117
115
94

107
106
95
99







Satisfying food *requirements alone cannot solve the
problem of malnutrition. Children must -be healthy enough to
benefit from food. Malnutrition aggravates the severity of
disease because it restricts the body's resistance mecha-
nisms. Disease can provoke malnutrition by increasing food
requirements at a time when the body has the greatest
difficulty in absorbing food. In some societies, 40% of the
children born die before they reach the age of 5, primarily
from nutrition-related diseases.5


Breastfeeding Practices

The decline in breastfeeding is a distinctive feature
behind malnutrition in several of the surveyed urban areas.
In urban Peru breastfeeding is the pattern of 89% of the
women (compared to 100% of the rural women), and they wean
their children much earlier than rural women.

In Sri Lanka, little difference is found between
working and non-working mothers, but there are differences
in rural and urban areas, and among the three different
ethnic groups. In both urban and rural areas, Sinhala
mothers continue unsupplemented breastfeeding longer than
the other women, often up to 2 years. In general, rural
mothers begin giving supplemental foods sooner than urban
women (an occurrence which is the opposite of other
countries surveyed).

In both rural and urban Korea, 82% of mothers breast-
feed their children. Of the 18% who did not breastfeed,
insufficient milk was the primary reason, followed by incon-
venience due to work activities.

Only 61% of the surveyed Malaysian mothers (all urban)
breastfed their youngest child. Reasons for not breast-
feeding included no milk or not enough milk (34%), and
inconvenience due to work (25%). The average length of time
that the surveyed mothers continued unsupplemented breast-
feeding was three months.

Brazil is rapidly urbanizing and industrializing, and
there is evidence from other studies that children are being
breastfed very short periods. In a Medical School study of
children in Sao Paulo, 75% of the children had been breast-
fed at some time, but a high percentage, 46%, had been
weaned during the first month of life. Only 23% of the
mothers continued breastfeeding until the sixth month. It
was concluded that early weaning was prompted by the orien-
tation given to mothers by doctors, rather than by the inter-
ference of work. A study in the same urban community
Bittencourt researched, Nordeste de Amaralina in Salvador,
Bahia, found that the majority of children are weaned by the
time they are six months old. Only a small percentage
receive maternal milk past that age.
receive maternal milk past that age.








The urban sample in the Dominican Republic shows 77%
of the women breastfed their last child, but nearly half of
them had breastfed only to five months. Of those who had
not breastfed their last child, 40% said they did not have
milk, 21% said they were ill, 14% said the child did not
want breast milk, 9% believed that a woman should not breast-
feed, and the remaining 15% cited a variety of reasons. Of
the women who had weaned their children, the greatest number
(38%) said "the milk dried."

It has been suggested that ignorance of breastfeeding
techniques may be causing women to abandon the breastfeeding
practice.7 Responses such as, "insufficient milk" and
"the milk dried up," and "the child did not want to nurse,"
were more frequently cited by mothers surveyed than "incon-
venience due to work activities."

These data give evidence of the trend documented in
many countries8 that the proportion of mothers who breast-
feed is declining, as well as the average number of months
infants are breastfed. Concurrently, many experts have
found that the average age of the onset of malnutrition has
dropped from six or eight months, to as early as three
months in many developing countries.


Weaning Period

Breast milk is the most appropriate food for infants
because it is sterile, nutritious and disease resistant. It
is usually adequate to meet a child's nutritional needs for
the first four to six months of life. Thereafter it is an
important source of protein, but should be supplemented with
weaning foods. Young children require increased quantities
of special nutrients for growth and development.

Grains such as rice, wheat and corn, and root crops
such as cassava and potatoes form the basic diet in many
developing countries, and the six countries researched are
no exception. These foods are not concentrated sources of
protein or energy.

The age at which supplementary food is introduced was
investigated by the six research teams. In Sri Lanka,
twelve months is the average age at which supplemental foods
are first offered. However, a few mothers, particularly
rural and urban Sinhala and urban Muslim, reported that they
continue to offer only breast milk until children were 3-4
years old. (It is highly questionable that a child can sub-
sist only on breast milk at this age.) The rural Tamil
mothers begin giving supplemental foods the earliest, with
nearly 40% having begun by the time their child is six
months.









Twenty-eight percent of the urban mothers in the
Dominican Republic gave infants supplementary food during
the first month of life, and 43% gave it before completing
six months. More than half of the children received infant
formula as a supplementary food, the rest received other
kinds of milk. Powdered milk was preferred by the mothers
over cow's milk, probably because the latter requires refrig-
eration.

Sixty-six percent of the Malaysian mothers preferred
infant formula milk, 14% powdered milk, 7% sweetened con-
densed milk, and 1% evaporated milk. The average age at
which supplementary food was introduced was three months
and the majority had weaned their children by six months.

In all ethnic groups and locations in the Sri Lankan
survey, working mothers gave their children a wider variety
of supplemental foods than did non-working mothers. In many
cases this may be a difference in income, or in the availa-
bility of food, but it also might reflect the age of the
youngest child, in that non-working women had younger
children who do not yet receive many foods given to older
children. A difference between working and non-working Sri
Lankan women is also seen in the type of milk they give
their children: powdered milk was preferred by working
women, cow's milk by non-working women. The most commonly
given supplemental foods were biscuits and bread, rice, and
fruits.

In both rural and urban Korea, 46% of the mothers were
giving children supplemental foods by ten months. The most
common foods were bread and cookies, rice, eggs and fruit.

Prolonged breastfeeding without substantial supplemen-
tary food was a tendency observed in rural Peru as well as
in Sri Lanka. At the ninth month infants are given tubers
and wheat (the only agricultural products at the very high
altitude of the Peruvian community surveyed). None of the
children or any other members of the family consume cheese,
butter, milk other than maternal milk, meat, fowl or
vegetables except on festive occasions.

Urban Peruvian children fare better than their rural
cousins, as demonstrated by nutritional status. After three
months, infants are given a thin vegetable broth, to which
noodles and milk are gradually added. At five months they
are given porridge with milk and sugar. By eight months,
they share most of the food of older family members: pota-
toes, noodles, vegetables, and less frequently beans. Fruit
consumption is limited to bananas and passion fruit juice.








The children of the Dominican Republic consume rice,
milk, beans and plantains. In general, rural diets provide
fewer calories and protein than do urban diets. Nationally,
36% of the households consumed less than two-thirds of the
recommended protein intake.

The researchers in Peru further analyzed the mothers'
backgrounds in the urban squatter settlement. They divided
mothers into categories of "modern" and "traditional". The
former are defined as having more years of formal school-
ing, more years of residence in Lima, as being younger, a
native Spanish speaker as opposed to Quechua or Aymara
speaker, and older when her first child was born. It was
found that the children of the traditional mothers have a
higher nutritional status than those of the more modern
mothers. This is attributed to the tendency of modern
mothers to spend their meager food budgets on more presti-
gious foods, such as rice, noodles, white bread, and
processed milk. However, the children of rural mothers, in
spite of their mothers' reliance on traditional patterns,
have a much worse health status, due to lack of sufficient
quantities and variety of foods.

Local taboos and customs complicate a mother's choice
of foods to give her children. Quinua, a grain native to
Peru, is believed to be a "cold" food, to be given to young
children only with great caution. Some women believe that
when they wash clothes their breast milk turns cold, and
will give the nursing infant a stomach ache.

Lactating and pregnant mothers, particularly those in
rural areas, restrict their own diets by taboos. In all
survey areas of Sri Lanka, more women observe food taboos
while lactating than while pregnant. The specific foods
avoided differ somewhat depending on location and ethnic
group, but the tendency among all women is to avoid acidic
foods. Foods avoided include fish and meat, pineapple,
mango, yoghurt, manioc, papaya, wood apples, yams, tomatoes,
groundnuts, guava, cucumber and eggplant.

Rural Malaysian mothers often refuse certain nutritious
foods such as fruits and seafood because they are considered
too "cooling." Three Korean mothers stated they never gave
children eggs for fear they would be slow in learning to
talk. Pregnant mothers avoid meats, for fear the unborn
child will take on the appearance of the animal.


Immunization

The synergistic effect of infection and malnutrition
can be lethal, particularly for young children. For this
reason, immunization against contagious diseases is impor-
tant.








The mother's understanding of disease prevention and
the importance of immunization was assessed by asking them
to recall their children's vaccinations. In most cases the
mothers seem to feel their children are well protected, but
this is not necessarily the case.

Four-fifths of the Dominican Republic women claim their
children are vaccinated, whereas in asking further ques-
tions, only 44% of the mothers had given their youngest
child DPT vaccinations, 26% for measles, 15% for TB,.and 20%
had three doses of polio vaccine (the last a particularly
low figure considering the country was in a polio vaccina-
tion campaign.)

Korea has the highest levels of vaccination; 72% of
the urban mothers and 60% of the rural mothers claim that
their children have received all the vaccinations necessary,
compared to 43% of urban mothers and 3% of rural mothers in
Peru.

In both rural and urban Sri Lanka, close to 65%'of the
children are immunized; the major reason urban mothers gave
for not immunizing their children is the lack of time, which
was not once the answer of rural women. The lack of -access
to medical services in most rural areas is seen in that only
3% of the children had been vaccinated in rural Peru. The
high rate in rural Korea can possibly be attributed to the
military medical facilities in the surveyed community.
Also, the Saemaul movement in Korea has brought vaccination
campaigns to all corners of the country.


Health Care Facilities

Health care facilities are not adequate or- available
for the majority'of the'women surveyed in the six coun-
tries. Traditional healers, herbs and teas, taboos, super-
stitions and faith are often the only orientation a mother
has in the treatment of simple illnesses that affect her
children.' The illnesses most'commonly encountered inf the
surveyed families are coughs and colds, diarrhea, fever and
skin rashes. There is little' difference between rural and-
urban areas, or between working mothers and non-working
mothers, in their responses to the question of the illnesses
their children suffer most frequently.

In the urban site in Peru, all the children have been
examined at a hospital at least once in their lives and 75%
have also been treated by traditional practitioners. In
Korea it was found that a fourth of the mothers usually take
their children to hospitals or clinics.. There was little
difference in use of services between urban and rural areas,
although none of the urban mothers claimed to use a tradi-
tional faith healer.


40








The Sri Lankan mothers who work use hospitals and dis-
pensaries more often than non-working women. The difference
between ethnic groups was also seen in Sri Lanka, in that in
both rural and urban areas, Tamil mothers use faith healers,
while Muslims rarely do. In many cases, mothers seek hospi-
tals only after home treatments have failed and illnesses
are worse.

The urban mothers in the Dominican Republic said they
purchase medicine at a pharmacy or use home remedies for
colds. For diarrhea and vomiting, they claim to seek a
physician's advice immediately.

There are differences between the surveyed rural and
urban women in Korea regarding the health facilities they
use when their children are ill. Approximately one-third of
the rural women use provincial hospitals; two-thirds of the
urban women use private hospitals. A few women in rural
areas (and none in urban areas) admit to using herbalists
and faith healers. Both groups of women rely on "modern
pharmacies" to the greatest extent of all the possible
health care providers. In general, urban women are more
satisfied than rural women in evaluating their health facil-
ities. Distance is the major complaint of the rural Korean
women.

While many women feel there are "no problems" with
available health facilities, many complain that the wait is
too long, the center is too far, services are too expensive,
transportation is difficult, and the quality of the service
is poor.

Environmental conditions are often cited by the sur-
veyed families as a major problem. Garbage is a continual
concern, and proper sewage disposal is practically nonexis-
tant in most low income neighborhoods. Water is a grave
problem for most families, and fetching it requires a great
amount of time in women's daily routine. The rural families
in nearly all survey sites commented on detrimental effects
of changes in their environment, such as those brought on by
excessive use of insecticides.


Mothers' Work

The urban Dominican Republic women who work were
queried about changes in their children's health, nutri-
tional status and general well-being due to the mothers'
work outside the home. More than half of them responded
yes, work affects their children's health. Some women feel
the effect is positive, and others feel it is negative.
About half of the women say their children are better fed
and in better health, and a slightly smaller number say









their children are not well cared for and do not eat well,
because the mother does not have enough time to look after
them or because they are left alone.

The Peru survey concluded that the quality of child
care is not affected by the mother's work nor by the availa-
bility of substitute caretakers. Economic and environmental
conditions are,found to be more important determinants of
the children's health than are child-rearing practices.
Family income is highly correlated with children's nutri-
tional status.

All of the Korean mothers were asked if their work
schedules affect the feeding schedules of their infants.
Twenty percent of the rural mothers and 49% of the urban
women felt that working affects infant feeding. When type
and location of work are examined, the urban women are in
occupations that do not permit children to accompany them,
or they work a fair distance' from home and are unable to
return home to feed the children. Those women who feel
their work has affected feeding schedules were vague* in
explaining why or how, but most indicated work means not
having enough time to breastfeed regularly.

In Sri Lanka, the most commonly cited problem faced by
working women is providing adequate child care. While the
research found no concrete proof of decreased..quality of
care, the mothers are concerned about fulfilling their
primary role of wife and mother when they work.


Conclusion

Thus, to summarize this chapter, the question must be
answered, if only very tentatively: Is the health and nutri-
tion status of children affected when a woman works?

When a woman is working within the home, she arranges
her activities in such a way that she is available to feed
her children and meet their needs. The research found no
evidence that work within the home affects child health.

Women's employment outside the home, in occupations
that do not permit children to accompany them probably has a
detrimental effect on infants ages 0-1 because mothers are
not able to breastfeed them, and their meager income is not
usually sufficient to purchase infant formula milk. Work is
probably not detrimental for children aged 1-5 if the child
care arrangements that a woman is able to make are ade-
quate. Once again, health and nutritional status are seen.to
be products of the overall environment of the children. In
a mother's struggle with poverty, appropriate child care is
a great need.











Notes




1. Schlomo Reutlinger and Marcelo Selowsky, "Malnutrition
and Poverty: Magnitude and Policy Options." World Bank
Occasional Papers #23, Washington, D.C. 1976, p. 7.

2. Ibid.

3. Marcelo Selowsky. "The Economic Dimensions of Malnutri-
tion in Young Children." World Bank Staff Working Paper
#294. October 1978, Washington, D.C. p. 1.

4. Sarah K. Brandel and Davidson R. Gwatkin. "Interna-
tional Year of the Child: An Incentive for More Effective
Development Strategies." ODCommunique 1979/2. Washington,
D.C.: Overseas Development Council.

5. Schlomo Reutlinger. "Malnutrition: A Poverty or a
Food Problem?" World Development 5 (1977), p. 716.

6. Escola Paulista de Medicina, Instituto de Medicina
Preventiva, Universidade de Sao Paulo, Instituto de
Pesquisas Economicas, "Estado Nutricional de Criancas de 6 a
60 Meses no Municipio de Sao Paulo." Vol. 2, Data
Analysis, Sao Paulo, 1975, pp. 117; and Nogueira M. R. B.,
"Aleitamento e Morbidade no Primeiro Semestre de Vida,
unpublished master's thesis, Federal University of Bahia,
Brazil, 1977.

7. G. J. Ebrahim. Breast-Feeding: The Biological Option,
London: Macmillan Press, 1978.

8. Alan Berg, with Robert J. Muscat. The Nutrition
Factor: Its Role in National Development. Washington,
D.C.: The Brookings Institution, 1973.

9. R. T. Puffer and C. V. Serrano. Patterns of Mortality
in Childhood, Washington, D.C., Pan American Health
Organization, 1973.









CHAPTER 6


PATTERNS OF CHILD CARE



Determinants of Child Care Arrangement

A family's choice of child care arrangement is
dependent upon a number of factors:

(1) Mother's availability, including location and
hours of her employment;
(2) Availability of substitute caretakers,
including cultural restrictions on sex
roles;
(3) Cost of substitute care;
(4) Quality of care available;
(5) Type of care required.

The degree to which each of these factors influences
the choice of one type of arrangement over another, relates
directly to the socio-economic position of the family
involved. The mother is the primary caretaker of her
children. Regardless of any other roles she may have, it is
she who assumes the major responsibility for her children's
care. Other family members, .particularly other female
members, regularly assist with certain child-related tasks,
but it is the mother who generally performs the basic tasks
of feeding, bathing and dressing her children.

The quality and amount of assistance a mother receives
with child care is greatly influenced by her availability to
meet the child's needs. The husband or other children may
take younger children on social visits or amuse them at
home, but it is the mother who is expected to meet the
primary needs.

Unless she can take her children with her, when a woman
works she becomes less available to perform child care
tasks. While she invariably remains the one primarily
responsible for child care, the amount of help, in terms of
hours of help, she must receive from other persons or facil-
ities increases.

The pattern which emerged from the six country research
is an overall tendency of families, neighbors, childcare
facilities, etc., to relieve a woman somewhat of household
and child care duties when she works. In general, however,
she continues to be responsible for feeding, bathing and
clothing, and is not relieved of the same number of hours of
child care as she has added to her day by income generating
activities.








For example, the field research done in Sri Lanka
reveals that over twice as many working mothers as mothers
who do not work reported that they receive help with child
care. However, all 279 interviewed women, those who work
as well as those who do not, stated that it is they who
perform the majority of the tasks related to child care.

The age of the children is another factor which influ-
ences the amount of assistance a woman receives in regard to
child care. Mothers generally receive less help in caring
for infants than in caring for older children. In most
cultures, it is not well accepted for a mother to leave her
infant in the care of another person. Nor do the surveyed
mothers feel this is a viable solution unless there is no
alternative. Since breastfeeding is an important determi-
nant of good infant nutrition and health, it is advantageous
for women to be available to meet the needs of their infants.

The number of older children a woman has may affect the
amount of help she receives. In many cases the presence of
an older sibling means a woman is helped somewhat with
certain child care tasks, though again, it is the mother who
retains responsibility for meeting the primary needs.

The persons and institutions which assist mothers in
caring for children vary somewhat among the families sur-
veyed in the six countries, though there are more similari-
ties than differences (Tables 6-1 and 6-2). The caretakers/
child care arrangements which were observed include:

(1) Mother
(2) Extended family members
(3) Friends and neighbors
(4) Domestics
(5) Community-based child care centers
(6) Industrial child care centers


Mother

Whenever she is available, the mother is the person who
cares for her children. Many working women continue to be
essentially the only person responsible and keep their
children with them when they work. The proportion of women
who do this varies by the type of work a woman does and the
location of her work.

Women who work at home, producing items to be sold in
the local market, can perform income generating and child-
minding tasks simultaneously. This type of work is most








common in Sri Lanka, particularly among the Muslim popula-
tion. Work within the home is essentially the only income
generating activity acceptable for women within the Muslim
culture,'hence the mother is'nearly always available to care
for her children.

Rural women who do agricultural labor or work on family-
owned land may take their children with them to the fields.
In the rural survey area of the Dominican Republic even
during harvest season, over 60% of the mothers continue to
care for their children. In the rural community surveyed in
Korea where many women do agricultural-work, 43% of the
mothers reported taking their children with them.

Women who work as vendors in both rural and urban
markets also frequently take their children with them. The
number of women who do this sort of work varies greatly
among the six countries, and by ethnic group within coun-
tries. In Sri Lanka, the Sinhala and Tamil women may take
their children with them to the markets, but no Muslim women
work as vendors. Throughout Latin America it is common for
women to work as vendors with their infants on their backs
and their preschool children playing nearby.


Extended Family Members

When a women's work does not permit her to be accom-
panied by her child, the child must be, left with a substi-
tute caretaker. This 'is a necessity much more often in
urban areas than in rural areas, because urban women more
frequently work at jobs and in locations where they cannot
bring their children. In the Dominican Republic, nearly 80%
of the urban working women surveyed are employed in produc-
tion work such as factory employment or service .jobs such as
domestics, laundresses and cooks, while none of the women
surveyed in rural Dominican Republic do this type of work.
In Malaysia nearly 97% of the surveyed urban women are
engaged in occupations which make it difficult to take
children along.

When a mother cannot keep her child with her while she
works and when the family unit includes adult relatives, it
is most often this extended family that meets the child care
needs of a working mother. In all six of the countries
studied, relatives are felt to be acceptable caretakers
because they are trusted by the family to give the best
alternative care.

When unemployed adult female members of the family are
not available to care for children, older siblings may do
so. The preference is generally .for an older 'sister but
when there is no older sister, or she is not available an
older brother will substitute.







Table 6-1


CURRENT CHILD CARE ARRANGEMENTS, THREE ASIAN COUNTRIES




Percentage of Women
Using This Child Care Arrangement


Caretaker
(Relation to Child)


Mother


Koreaa
urban rural


41%


43%


Malaysiab
urban


Sri Lankac
urban rural


67%


21%


Sibling(s)

Extended family

Neighbors/Friends

Domestic

Child care centers

Child left alone

Other


42%


,Source: Six Country Reports

a. Multiple responses of 104 rural and 108 urban women; however,
percentages shown are the percentages of preschool aged children
being cared for by the various persons and facilities. Total
preschool aged children are 158 in the urban area and 141 in the
rural area.

b. Primary caretaker of child for 1348 total children aged 0-12
years of 499 women.

c. Multiple responses of 140 urban and 123 rural women listing
persons who help with child care. The responses of 21% of the
rural women who said that they receive no help are shown under
the caretaker heading "Mother".






Table 6-2


CURRENT CHILD CARE ARRANGEMENTS, THREE LATIN AMERICAN COUNTRIES




S Percentage of Women
Using This Child Care Arranagement
Caretaker Brazila Dominican Republiob Peru
(Relation to Child) urban urban rural urbanc rural d


Mother -- 80% 61% 27%

Sibling(s) 28% 19 33 18 26%

Extended family 49 16 45 28 74

Neighbors/Friends 0 1 11 5 0

Domestic 6 1 0 1 0

Child care centers 0 :0 0 0 01

Child left alone 5 0.3 0 8 0

Other 12 2 0 12 0



Source: Six Country Reports

a. Child care arrangements other than mother herself of.148 women
who work outside the home for children under seven years old.
b Multiple responses from 300 urban women and 40 rural women
regarding child care arrangements for children six years and
younger.
c. Urban sample size of 74 mothers. Data show caretakers used when
mother away from home, hence the percentage listing "mother"
indicates women who take their children with them when they are
away from home.
d, Rural Peru sample of 43 families. Data'on caretakers other than
mother were given by generation. The community is small and
intermarried, and neighbors are almost always family members.
Thus, the.eight families who use caretakers of the parents'
generation, the 18 families who use the caretakers of the
grandparents generation, and the six who use a combination of
caretakers of both generations are totalled as extended family
representing 74%.








It is not clear at what age it becomes less acceptable
for males to care for children in any way other than enter-
taining them or taking them on outings. Data from several
of the groups surveyed, however, indicate that while male
children may help meet many of the primary needs of younger
siblings, it is almost unacceptable for adult males to be
called upon to feed, clothe, and bathe. The Peru investiga-
tion noted that:

"Ironically, child care seems to drop out of
a man's set of acceptable activities the
moment he establishes a household of his own,
fathers his first child, and -- undoubtedly
the most crucial factor -- acquires rights to
the labor of a woman in managing the house-
hold and rearing the child."


Friends and Neighbors

In general, families prefer to meet child care needs
within the family because it is the least expensive way
of providing care and because families are comfortable
leaving their children with relatives. When this is.not
possible, children may be cared for by neighbors who are
trusted. This arrangement is felt to be slightly less
desirable because it may necessitate payment and because
most families believe people who are unrelated will not show
as much interest in the children.

In many places reciprocity is an important element of
the survival system of families in low'income neighbor-
hoods. In the case of Brazil, the "spontaneous" creche is a
common arrangement. The term "spontaneous" creche refers to
women who open their homes to take in children of working
neighbors, with payment of reciprocity. These women offer
mothers a convenient, trustworthy location for their chil-
dren during their absence, and the women try to maintain at
least a minimum of hygiene and attention to the children.
Generally, these are older women who no longer have resident
children of their own. The mothers pay a small monthly fee
to the woman for her services, and must also contribute
milk, cereals, sugar, soap, talcum powder and the other
items for her children. In urban Brazil, neighborhood
friendships have taken over responsibilities formerly met by
the extended family or kinship group.







However, the Peru investigators noted that in he urban
area the use of friends or neighbors was limited 'to emergency
situations. In the rural area, kinship and extended
families are usually available, but rarely needed. Mothers
carry infants on their backs, and older children are always
close at- hand. It is not uncommon to see a child four years
old leading a small flock of sheep to the communal pastures.


Domestics

Use of domestics to meet child care needs is not an
option available to many low income women. In Sri Lanka and
Korea none of the surveyed women reported using the services
of domestics. In Malaysia a- small number reported that
servants cared for the children.

The number of interviewed women in Latin America who
use domestics as caretakers was also small-- one woman in
urban Peru, three in the Dominican Republic, and nine in
urban Brazil. While it is a-display of high status to have
a maid with whom children may be left, women are not satis-
fied with this arrangement. -The-majority of those who
already have this option, as well as those who were asked if
they would prefer to use domestics for child care, are dubi-
ous about entrusting their children with a domestic because
they feel the relationship is one of pure economics.' They
do not trust the domestics to be truly concerned or give
quality care.


Community-Based Child Care Centers

In the six countries surveyed, different terms are
often used to mean similar services and facilities. "Child
care center"., "day care center" and "nursery" are often used
interchangeably, indicating more'the regional choice of
vocabulary, than the actual services rendered. In Korea,
for example, "children's home" is the accepted term, a
phrase that reflects the origins of the institutions
currently used for child care facilities. While we have
attempted to differentiate between preschool centers, those
with the primary purpose of providing education, and child
care centers, those which were initiated to respond to the
need for custodial .care, the differences in meaning of the
two terms should not be construed as clear cut. Facilitie's
outside the scope of this study are orphanages 'and detention
centers.

Although there were differences from country to coun-
try, very few of the surveyed families put their children in
either child care facilities or preschools. In most places
such facilities simply are not available. Where they do







exist, the fees make them too costly to be a viable alterna-
tive for low income families. Child care and preschool
facilities in the six countries are not meeting the child
care needs of the low income women who were surveyed. Even
in Korea, where women have been actively encouraged to join
the labor force, the proportion of women having access to
organized facilities is low.

To a large extent, this is due to the unavailability of
such child care facilities. Table 6-3 shows the relation of
total child population under age five to the number of chil-
dren in formal child care facilities in the six countries
studied. Because there is a serious dearth of reliable
information and data on the total number of child care facil-
ities in developing countries, it is difficult to reach a
high degree of accuracy in assessing the proportion of popu-
lation reached. In spite of this, however, the tentative
figures which are available allow us to gain some understand-
ing of the current situation.

Not only are very few children reached by organized
child care facilities, but those who are cared for by such
facilities are typically not the children of low income
families. The fees charged by a child care facility, the
cost of transportation, and the cost of supplies and
clothing make using such a facility out of the financial
reach of most low income families.

The hours some child care facilities operate also limit
their usefulness to working women. Unless a center is
intended specifically for use by working women, and many are
not, the hours they are open are not sufficient to allow
women to leave their children, go to work, work a full
shift, and return for the children.

With the exception of the one somewhat atypical rural
area surveyed in Korea where low cost rural child care facil-
ities are more available, the majority of such facilities
are located in cities. Thus, the needs of low income rural
women are met by child care facilities even less frequently
than the needs of urban women. Admittedly, their needs for
such facilities may be less acute in that mothers'work more
often permits the children to be taken along.

In the Asian countries studied, only 1% of the 499
women surveyed in urban Malaysia and none of the 279 sur-
veyed urban and rural women in Sri Lanka reported using such
facilities. In Korea, 19.9% of the 141 children of rural
women and 1.9% of the 158 children of urban women in Korea
are cared for by child care facilities and/or preschools.







Table 6-3


COVERAGE


OF CHILD CARE FACILITIES


Country


Brazil


Dominican
Republic


Peru

Korea


Malaysia

Sri Lanka


Total Children
Under 5 (1975)


18,668,000


895,000


2,620,000

4,542,000

2,000,000

1,764,000


Children in a
Preschool Facility
# %


600,000


N/A


172,051

N/A

36,562

N/A


6.63

N/A

1.784

N/A


Children in a
Child Care Facility
# %


N/Ae


N/Aa

1,827


N/A

N/Ac


N/Ae


N/Aa


.92

N/A

N/Ac


Notes:

a. In Santo Domingo the total population of 0-8 year olds is approxi-
mately 175,000. Tthere are five state-supported child care
centers, a ratio of 35,000 children per center.
b. 615 licensed day care facilities serving 42,000 children = 68 per
facility.
c. 1500 day care facilities in the country -- not known how many
children are reached.
d. Four percent of 4-5 year olds.
e. Children in "some form of preschool facility" -- child care
centers maybe included in this preschool figure.
N/A = Data not available


Sources:

1. World's Children Data Sheet of the Population Reference Bureau,
Inc.

2. Ministerio da Educacao e Cultura, Departamento de Ensino
Fundamental, Coordenacao de Educacao Pre-escolar. Atendimento ao
Pre-escolar. Vol. 1, Brasilia, 1977, p. 14.

3. Peru Report, unpublished statistics obtained in interview.

4. Personal communication from Rita Hashim, National Family Planning
Board.






Korea has a government regulated system with minimum-
standard requirements. At the end of 1978, its 615 licensed
day care centers -- 80% privately owned, 20% government-
sponsored, reached 42,000 children -- less than 1% of the
total preschool age population. Theoretically for low
income children -- though not always so in practice -- most
of these are in urban areas; some are in villages, including
one in each of the three survey villages, in addition to
some seasonal centers during the harvest periods. Most of
the day care center directors and teachers have some degree
of professional training. The government plans to increase
the number of licensed day care centers to 1,200 by 1981 and
to integrate them with maternal-and-child health and family
planning programs and possibly vocational training.

Malaysia has the beginnings of a rural preschool
system, but it is still very far from meeting the needs of
low income rural families. The Ministry of Agriculture and
Rural Development provides trained teachers and some mate-
rials for over 900 community-supported "Tabikas" or kinder-
gartens scattered throughout the country. Essentially a
headstart program for the nearly 26,000 children enrolled,
the centers also offer education in nutrition, sanitation,
health, and hygiene to the parents. Another government
rural program is that of the Federal Land Development
Agency, whose 136 kindergartens reach over 9,700 children.
Volunteer agencies and individuals maintain some child care
services in both rural and urban areas, notably the dozen
model day care centers of a Muslim women's service group
whose volunteers offer advice, nutrition information, and
sometimes training. The Malaysian Association of Kinder-
gartens gives training and refresher courses to teachers of
community preschools.

Malaysian law requires rubber plantations to provide
creches and free milk for infants of women workers.
Personnel and conditions in these creches are reported to be
poor. One large State corporation employs an industrial
social worker who is developing community centers, health
services, and preschools -- an example for other plantations
to follow.

In the urban area of Malaysia, there are numerous
alternatives for middle- and upper-class families, including
"24-hour child minders" and trained baby-sitters used by
young professional and semi-professional couples who can
afford the fees. The Labor and Manpower Ministry is explor-
ing with industry the possibility of establishing factory-
related child care facilities; their acceptability to
working mothers has yet to be determined. Meanwhile, how-
ever, urban Malaysia has almost no organized facilities for
the children of poor families. Four of the five survey






areas have small kindergartens for children aged six years
down to ages five or three depending upon the center. None
are adequately equipped or staffed. Very few of the mothers
surveyed used such facilities for' their children.

In Sri Lanka, law requires creches to be provided in.
the rubber, tea and. coconut plantations which employ about
half of the island's working women. Quite inadequate and
little used until recently, these creches have now been
upgraded with help from UNICEF and new centers are being
built to respond to increased demand. Outside of the planta-
tions, in urban areas and elsewhere in the island, a limited
number of creches and child care centers are run by
churches, voluntary organizations, and private owners, some
with a small'government subsidy, and with varying fees and
services. Two rural community development organizations
with a self-help philosophy, Sarvodaya and Mahila Samiti,
have established child care centers in-some 900 of Sri
Lanka's 23,000 villages, training teachers from the commu-
nity, involving the mothers, and integrating preschool,
nutrition, and community health care.

None of the mothers interviewed in Latin America has
met her needs at child care centers, although a few send
children to half-day preschools in preparation for school.

In Brazil, child care programs for-low income families
are increasing in some areas. The quasi-governmental Brazil-
ian Assistance Legion's "Cocoon Units" are community child
care centers which offer a comprehensive program. Sao
Paulo's CEAPE system, which utilizes public school space for
serving meals to preschoolers, is being replicated in at
least three other cities. Social Welfare Coordination
creches, also in Sao Paulo, care for some 9,000 infants.

In the Dominican Republic, only 4% of the four-to five-
year-old children were attending preschools in 1976. In
spite of legislation for preschools which was enacted in
1966, the extent of services has been very limited. The
existing preschools are privately operated and quite
costly. There are five state-supported child care centers
to meet the needs of low income families. Less than'l% of
the total population of children 0-8 in Santo Domingo are
reached. There are some eight private child care centers
that are outside the financial reach of ,low income families.

In Peru the non-formal preschool programs, generally
organized by the private sector with community initiative
and involvement, have a growing enrollment. Following
Ministry of Education guidelines which allow for variety and
flexibility,' they have educational potential for parents as
well as children. But these programs, both formal and non-







formal, usually operate for only three hours a day and do
not solve the problem of a mother who works more than eight
hours and needs full-day care for her child.


Industrial Child Care Centers

The existence of industry-based care was not mentioned
in any of the reports from the three Asian countries. These
facilities are often discussed but as yet nothing concrete
has come of the good intentions.

Brazil, Peru and the Dominican Republic have labor laws
which require that establishments employing a certain number
of women provide an appropriate place where their children
may be supervised and they may nurse infants.

However, no industrial child care facilities were found
in the Dominican Republic or in Peru and there are only a
few isolated examples in Brazil. A cigarette factory in Rio
de Janeiro has a child care center with a capacity of only
30 children for each shift, even though 1,600 women are
employed there.

Some Brazilian companies maintain contracts with
private or public nurseries in order to comply with the
law. One such private entity has contracts with 85 large
businesses employing a total of 12,000 women. In eight
years of operation it has cared for only five children. In
lieu of providing a child care center, some companies offer
employees a subsidy for children.

Female employees are often ignorant of the laws which
guarantee them certain benefits, and rarely demand services
such as child care. It is said that employers sometimes
hire just one female employee less than the number which has
been established as tne minimum requiring child care
services. The laws do not usually include attention to
children past the breastfeeding stage. Women rarely
participate in union activities, and thus unions rarely see
child care as a worthwhile demand.

It must be noted, however, that the surveyed women do
not heartily support the notion of work-based centers. The
long commute required to go to work is arduous enough for
the woman herself, and the thought of toting several young
children on a crowded bus is not appealing. They often see
their factories as dangerous locations, with pollution and
no comforts, and not an appropriate place for children.
Mothers prefer community-based centers, where the children
are cared for in an atmosphere that is comfortable and
familiar.







Actual Child Care Arrangements vs Preferred Arrangements

In general, the women surveyed in all six countries
reported that they are satisfied with their current child
care arrangements. However, the women's satisfaction with
existing child care arrangements is more likely to be a
reflection of the lack of viable alternatives than it is an
expression of contentment with the current situation.

It appears, from interviews and group discussions, that
most women believe that persons other than the family are
not particularly capable or motivated to provide quality
child care. In some places (the three Latin American
Countries and Korea, in particular) women do feel teachers
are good caretakers, but the emphasis is always on
education, not just custodial care or nutrition. In many
places, however, among certain ethnic groups, the Muslim
community surveyed in Sri Lanka for example, it has not been
demonstrated to the mothers that alternative child care
arrangements can provide quality care.

In spite of an overall satisfaction with current child
care arrangements in all of'the countries surveyed,-there
are differences between current actual caretakers, and
mothers' preferences for ideal caretakers. In the urban
survey area of Peru, while 27.0% of the mothers currently
take their children with them, none feel this is the ideal
arrangement. At present,.28.4% of these urban women'have
relatives available to care for their children, while 43.2%
would like to use relatives. Similarly, in the urban area
of Korea, while 16% of the mothers leave their children with
grandparents, 32%, or double that figure, would like'to do
so. However, in spite of these preferences, there is no
indication that family members will become more available in
the future. On the contrary, the pool of available rela-
tives should decrease as more women enter the labor force.

In areas where families are aware of the existence of
child care facilities which offer quality care, they're
anxious to have access to such services. Among the surveyed
population in Korea, for example, for whom preschools are a
slightly more common phenomenon, parents cited such facili-
ties as being the only child care arrangement which is as
acceptable as using grandparents. In the rural area of
Korea, 32% of those surveyed listed grandparents, and 32%
listed a child care center as their first preference. In
the urban area of Korea, 26% cited grandparents'and 20%
cited child care centers.






In the Brazil survey area, while none of the surveyed
mothers currently have children in a child care facility
(there is at least one center in the community), 32.5%
suggested such child care centers as an acceptable arrange-
ment for meeting child care needs.

In urban Malaysia, only 1% of the 499 surveyed couples
use child care facilities, but an average of 30% of both men
and women feel teachers and specially trained women are pre-
ferred caretakers.

It is interesting to note that in Peru, while mothers
feel that using a maid to care for children is unsatisfac-
tory because the relationship between the maid and the
family is purely an economic relationship, one of the most
frequently given reasons for believing child care facilities
are satisfactory is the fact that fees are paid. It appears
that mothers view the fees paid for institutional care as
payment for the educational component, and the act of paying
equates with a belief in the teaching abilities of the child
care center personnel.

The control that families expect to have over the care
their children receive is reflected in their desire for
community-based centers or extended family care. They see
the caretaker, whoever it might be, as an extension of their
role as parents.


Summary

The overall pattern of response in regard-to caretakers
revealed several facts and concerns that are crucial to an
understanding of the child care needs of low income women.

1. Mothers feel that they are the best care-
takers of their children.

2. Many constraints affect mothers' availability
to give adequate care, and when they work,
even if they take children along, this is not
a particularly satisfactory arrangement.

3. Where child care facilities and preschools
are available and within the financial reach
of low income families, they are used. Many
more families listed such facilities as the
ideal child care arrangement for children
other than infants, than currently use them.

4. Parents feel the greatest advantage of child
care facilities is the opportunity for their
children to receive education. Since custo-
dial child care can generally be provided by








the family, those families who feel child
care facilities are a preferred alternative
expect more than custodial care. When pay-
ment for child care services is necessary,
parents expect their children to receive some
education.

5. Community-based cnild care was preferred
because of the element of familiarity and
community control. Industrial care was less
desirable because of the difficulty and
expense of bringing children to work sites
and possibly unsafe conditions. While
community care is the desired arrangement for
children who have been weaned, industrial day
care may be more appropriate for infants in
order to encourage breastfeeding among
working mothers.

6. The degree of malnutrition in the children of
all the countries strongly indicates a need
for arrangements which will provide adequate
nutrition for the children and teach mothers
the elements of good nutrition.



Notes:

1. Peru report, p.2.








CHAPTER 7


ALTERNATIVE CHILD CARE APPROACHES



In situations where traditional mother-family
approaches are no longer adequate to meet all child care
needs, new solutions have been devised. These alternatives
are sometimes small-scale responses of a community to speci-
fic local situations and resources, and in other cases large
national programs. This chapter presents a review of recent
literature on early childhood intervention followed.by
examples of several alternative programs.


A Review of Recent Literature

Several reports have been published within the past
year which document investigation on the effect of interven-
tion programs on children.. A body of literature is begin-
ning to grow, particularly for Latin America, oh the
cognitive development of children in developing countries,
as well as the long term negative effect of malnutrition and
disease. These studies complement the more extensive' work'
undertaken in the United States and Europe.

Preschool Education in Latin America: A Survey Report
from the Andean Region, by the High/Scope Educational'
Research Foundation of Ypsilanti, Michigan (1978), presents
the results of a survey of education programs serving pre-
primary school-aged children and their families in Bolivia,
Chile and Colombia. The objectives of this AID-commissioned
survey are to describe the major preschool education activi-
ties, goals and variables in the host countries, and to
formulated program guidelines for early education programs ,in
developing countries.

Ernesto Pollitt's Early Childhood Intervehtion Programs
in Latin America (presented to the Ford Foundation in 1979)
is a comprehensive review of research on human development,
malnutrition and early-childhood education in Latin
America.' Pollitt also carried out in-depth field studies in
Antioquia, Colombia; Puno, Peru; and Caracas, Venezuela.

Barbara A. Underwood reviewed supplementary nutrition
projects in a paper presented to the Conference on Nutrition
Interventions, "Success or Failure of Supplementary Feeding
Programs as a Nutritional Intervention". She found that in
one sense, supplementary feeding programs are a "band-aid
approach" and from this perspective "should be viewed as a
short-range means of achieving specific nutrition and health
objectives, while long-range programs are being implemented
to attack the root causes of undernutrition. Their
'success' or 'failure' should also be judged within this.
context."









Two World Bank Staff Working Papers (numbers 322 and
323) present broad results of preschool intervention pro-
grams and various family characteristics in developing the
abilities in preschool children, and the subsequent effect
of ability on earnings. The papers are part of the Bank's
efforts to understand the process of human capital develop-
ment as a basic determinant of earnings. The two papers are
Ability in Pre-Schoolers, Earnings, and Home Environment, by
Roger Grawe, and Priorities in Education and Pre-School:
Evidence and Conclusions, by M. Smilansky.

Closely related to these two papers are several publica-
tions by Reutlinger and Selowsky for the World Bank on the
nutritional status of children as associated with poverty,
including Malnutrition and Poverty: Magnitude and Policy
Options (Baltimore and London: The Johns Hopkins University
Press, 1976).

There is general agreement that although heredity
explains an important fraction of children's intelligence
scores, environment is the crucial factor. Bloom found that
in terms of intelligence measured at age 17, at least 20% is
developed by age one, 50% by about age four, 80% by about
2
age eight, and 92% by age 13.

However, "the jury must be considered still out on the
question of general success or failure of pre-school inter-
vention", according to Grawe.3 The U.S. data on preschool
cognitive development from the traditional kindergarten or
preschool (oriented solely to education) has not proven that
preschool per se is a worthwhile investment. "Although IQ
may be raised by some preschool programs, the gains are
often not significant and regardless of program are main-
tained only for a few years."

There is great evidence of the impact of malnutrition
and other health conditions on cognitive development. How-
ever, nutritional supplementation alone did not have such an
effect in the studies conducted in Cali, Colombia.
Initial results show that the combination of cognitive
stimulation and nutritional supplementation produced ability
outcomes from disadvantaged children which were not signifi-
cantly different than those for children from relatively
better backgrounds.

In his review of the findings of quasi-experimental
studies and community service programs, Pollitt finds an
interesting similarity between the results claimed by widely
varying programs. "The pathways used to reach the children
in order to benefit cognitive growth may not matter that
much."








Comprehensive programs are the recommendation of most
program planners, in that a broad approach meets the child's
needs in both nutrition and education. Indeed, the poverty
whidh surrounds most children of developing countries
requires services of a multi-dimensional nature due to the
complexity of the roots of poverty. In low income areas, .
there is no single problem which can be solved by a single '
gesture or simple policy.

Nearly all documents of existing programs and. future
recommendations call for the'participation of the parents
and the family in any programs for children. However, High/
Scope notes that, "While it has become increasingly clear to' ".
early childhood program planners that involvement of parents
in preschool education programs ought to be a central con-
cern, the kinds and levels of involvement envisioned by
those planning and implementing programs vary considerably.
The reasons given for the importance of parent involvement
also vary. Nonetheless, all-agree that parent involvement
should be a big element in any future early childhood educa-
tion programs."7

The justifications for parental involvement include:

a. parents' broad role as the most important
caretaker

b. .opportunity to reach more children in the
family

c. support of the traditional role of the family

d. spin-off effects on the parents' capabilities
and self-esteem.


Other than mentioning spin-off effects, scant attention
is given to early childhood programs as a strategy for
mothers' needs, as well as children's. Nutrition supplemen-
tation and cognitive intervention are measured gains
attained for the children. Other benefits accrued are
rarely taken into account in the analysis of whether the
programs justify the investment made. The benefits accrue
both to individuals (child and parents) and to society
through greater capabilities for current productivity as.
well as future productivity.


Selected Examples of Projects

Occasionally an alternative child care' approach is
"discovered" by a government, private, or international
agency which gives the ideas circulation, and support..
However, there may be a number of interesting approaches









being tried by individuals elsewhere, which are unknown out-
side the immediate vicinity. The selected examples have not
been limited to developing countries, in order to present a
wider assortment of ideas. The intent of this section is to
convey concepts and approaches which may be adapted to local
needs, conditions, culture and resources. In these projects
common elements can be seen which made the efforts viable
and "successful":

a. high level of community participation in
defining needs, and planning and
implementing projects;
b. utilization of local resources and
training of local persons;
c. starting small and building, as
community confidence and resources
develop;
d. on-going assessment of needs and
resources;
e. flexibility to adapt as conditions
change;
f. clear conceptualization of the project
and its objectives shared by all;
g. coordination of the project with other
community activities;
h. active involvement of parents;
i. use of paraprofessionals who are members
of the local community.

Contact persons and institutions have been included
where appropriate and available.


Mobile Creches, India

The Mobile Creche Programme, operating in New Delhi and
Bombay, India, specializes in caring for children from one
of the poorest sections of Indian society -- children of con-
struction laborers. Mobility is built into the program as a
direct response to the special needs of thousands of
families engaged in an occupation which takes them from site
to site, building makeshift shelters near the worksites.
The child care centers are set up in whatever accommodations
are available at a particular construction site, basements,
unfinished skyscrapers, or tents. When work at one construc-
tion site is completed and families of the laborers depart
for a new site, the mobile creche also moves to the new
location.

Begun in 1969 with the opening of one creche in New
Delhi, the program was initially the charitable effort of
two concerned women who provided a supervised playing and
resting place and some food for children while the parents
were working. Since then the program has expanded to








include provision of lunch or nutritious snacks, regular
visits by doctors and treatment of diseases and malnutri-
tion,, and teaching of primary skills. The creches have
evolved into community centers which also address the needs
of parents and offer classes'in nutrition and hygiene for,
the mothers, adult literacy training, and training in
vocational skills.

The varied components of a particular creche are
determined by community needs and available resources, both
financial and personnel. During the early years, financial
limitations were a major constraint. However, once the pro-
gram had proven its capability to make good use of available
resources contributions of money, services and materials
came from varied sources -- social welfare organizations,
international agencies, government departments, and private
individuals. Where once program workers had to approach
building contractors to request that space be available to
house a creche,- now contractors often come to the program
coordinator during the planning stages of construction pro-
jects to request that a mobile creche be provided.

Creche workers receive small salaries and are recruited
from the local communities. Most are young women who may be
part-time students or unemployed, though recently more older
boys are becoming interested in the program. Creche workers
receive on-the-job training and participate in special
seminars to learn basic nutrition, child care and hygiene.

Program workers are quite creative and thorough in
making use of all available resources. Training of center
personnel may be done by voluntary organizations; blankets,
clothing and supplies solicited from social welfare agen-
cies; cash contributions accepted from, numerous sources. As
more needs are identified, workers set about determining
appropriate responses and finding necessary resources.

Originally supplies were given to the children free of
charge but center workers'found that parents, as well as
children, did not value such materials. Currently every-
thing is sold to families at subsidized prices -- prices
high enough to make families respect and value the mate-
rials, but not so high as to be cost prohibitive.

An ongoing process of assessing community needs,
finances', and available human and material resources has
meant gradual but continual growth and acceptance,: by the
migrant community as well as the community at large., The
secret of the mobile creche program success lies both in
the services it offers and in the process by which it has-
evolved, learning from experience while meeting an important
need. It may be argued that "ready-made", "full bloom"
programs with all the same services now being offered
through the mobile creche program might not enjoy the same









success simply because all concerned (community people,
program staff, 'and donors) need to grow slowly with pro-
grams, struggle together, develop mutual trust, and learn
from experience.

Further information about the program may be obtained
from:

Mobile Creches
5B Telegraph Lane
New Delhi 10001
India


Day Care Homes Program, Venezuela

The Child Foundation of Caracas, Venezuela is meeting
some of the child care needs of working parents through the
establishment of a Day Care Homes Program. Groups of five
or six children are assigned to a neighborhood child minder,
to be cared for in her own home. The day care homes are
selected according to the following criteria:

1. The caregivers must be Venezuelan and
between the ages of 15 and 18.
2. The caregivers should be healthy and
enjoy working with preschool children.
3. The family's house must have basic
facilities.

The program supplies the caregiver with the equipment
for efficient operation of the home. In addition to the -
participation fee paid by the working mothers, the care-
givers are provided a stipend from the Foundation, to cover
costs of meals and care for each child.

The costs of the program are minimal since donations
and contributions are received from many sources, including
the federal government, businesses, and private voluntary
agencies. Due to this fact, the program is able to focus
its activities in low income communities.

A team composed of a social worker, a teacher, and a
para-professional health worker is responsible for train-
ing twenty caregivers in any particular neighborhood.

Parents who desire to leave their children for the day
at such a home can be confident that their child's basic
needs will be met, in a home setting, in an environ-
ment which is familiar and natural.

For more information contact:

Hogares de Cuidado Diario
Fundacion del Nino
Caracas, Venezuela









Mothercraft Centers, Zaire

Rehabilitation of-malnourished children and prevention
of malnutrition through education of the mothers are two
aspects of the Mothercraft Centers Project in Zaire.
Supported by the Task Force on World Hunger, the program
operates two types of nutrition centers in the Bulape area
(West Kasai region) of Zaire.

Prevention centers aim at preventing malnutrition of
children by offering practical nutrition education directly
to mothers and other caretakers in the form of 3 month
seminars. In Zaire, as in many less developed countries, it
is a cultural practice and economic necessity to leave
infants in the care of an older child while the mother
works. Infants are deprived of breast milk fox long periods
each day,' and usually receive nothing but a thin cassava
porridge.

At the preventive centers, therefore, the caretakers as
well as the mothers are taught to prepare protein-rich
porridges for very young children. Every mother must agree
to spend one full day a week in the center. It is observed
by the program personnel that many mothers choose to come
much more frequently. Whenever a mother is not present in
the center, she must send the child's caretaker, usually a
child of 7 or older. The caretaker must prepare the meals
for the young child, just as he or she will have to do when
left alone at home in charge of the baby.

Each preventive center conducts training for the
mothers and caretakers of an average of 30 children per
seminar. When a village contains more than 30 children in
critical age group, the ones with lowest weight-for-height
are selected.

Children who are not reached by these preventive
centers enter a rehabilitation center which is attached to
a hospital. The children are admitted to the hospital with
their mother for a period of 4 to 8 weeks. The first
objective is to rehabilitate the children through feeding,
supplemented by special medicines that re-establish growth
and health (iron, vermifuge, malaria prophlaxis). The
second objective is to teach the mothers to continue.good
feeding practices at home after discharge. To this end,
under the supervision of a nutritionist, each mother is
required to prepare the food for her child three times ai
day. Only locally grown grains and legumes are used.
Children are discharged when weight gains are normal and
when mothers have sufficiently learned feeding.








Further information on the Mothercraft Centers Project
may be obtained from:

Judith Brown
Institute Medical Chretien du Kasai
B. P. 117
Kananga, Zaire


Child Minders, Sweden

The inconvenience and loss of income for a working
mother when her child is ill and cannot be taken to the
child care center normally used, has been addressed in
Sweden by providing "child minders" who go to a child's home
in the cases of a short-term illness, thus permitting a
working mother to go to her job. It would be possible to
design a system of child care which includes additional
child minders working in conjunction with a number of cen-
ters. When none of the children who are regular users of
the centers is ill, the extra person would either not work
that day or remain at a center to help the staff.


Child to Child Programme

In such diverse locations as Guatemala, Kuwait, India,
Jordan, Brazil, Burundi, Chile, Papua New Guinea, Transkei,
and Western Samoa, projects based on an innovative approach
to child health care are being adapted to local needs and
conditions. These projects make use of techniques pioneered
by the Child to Child Programme of the Institute of Child
Health (London, England) and revolve around the fact that in
most developing countries, older siblings participate in the
care and upbringing of younger children. With training in
observation and basic preventive and curative methods, older
children can do much to prevent their brothers and sisters
from becoming ill, treat them when they are ill, and mini-
mize the effects of illness.

Much of the success of such a project depends upon
making health care an enjoyable activity. Games, role
playing, adaptations of traditional songs and dances, and
various experiments are used to train the children in health
management. For example, to help children understand dehy-
dration from diarrhea, experiments may be conducted with two
cut plants or flowers, placing one in water and one with-
out. The children observe that the flower placed in-water
does not wilt, while the other dies. With such-a vivid
example before them, children understand better the effect
of water loss. Discussion of how a baby with diarrhea loses
water then makes much more sense.








Translating concepts into visual representations and
tangible examples through devising and .maintaining growth
charts, drawing pictures of the identifying signs for parti-
cular diseases, preparing !'special drinks" of salt, sugar
and water for diarrhea control, etc., help children to
visualize and make use of ideas. By finding out about local
and new foods which are most'nutritious, then actually grow-
ing these foods in schools or cooperative plots, children
not only learn techniques related to gardening, but also
discover that new foods are more than just descriptions in
books and can be very real and useful additions to their
diets.

In the formal and non-formal training of the older
sibling, the emphasis is on using training activities
children find enjoyable, encouraging a sense of pride,
responsibility -and initiative, and presenting new ideas
in a non-threatening manner.,

Child-to-Child is an approach to health maintenance
with many techniques and ideas that may be adapted to fit
the particular needs, resources and learning environments
of schools or groups throughout the world. Materials are
available from Child-to-Child in Arabic, English, French,
Hindi, Portuguese and Spanish. Further information may be
obtained from:

Child-to-Child Programme
c/o.Institute of Child Health
30 Guilford Street
London WC1N 1EH, England
Telephone 01-242-9789


Bench Schools, Colombia

The residents of the southeastern section of the city
of Cartagena, Colombia have developed a system to make use
of their available resources in meeting child care and educa-
tion-related needs. More than 100 "bench schools" have been
set up in the Cartagena area. The term "bench school"
derives from the fact that children bring their own benches
or seats to the house of a neighbor who serves 'as the
teacher. Each bench school has an average of 30 children,
aged 4-10 years. The use of bench schools emerged as public
schools were unable to meet needs of numerous families of
this rapidly growing city. The inhabitants of the area are
largely migrants from rural areas and an estimated 120,000
share the insufficient housing which is available. Unemploy-
ment is high (over 20%) and families are impoverished so
private schools for their children are out of the question.
More than 50% of the mothers work, primarily as domestic
servants, and thus must find alternative child care arrange-
ments while they are away from home.









Among the large number of unemployed persons are women
who have not completed the requisite schooling-to become
licensed teachers; but they are literate and possess skills
gained during an average of 6 years of formal education.
From these groups of educated women, neighborhoods select
those whom they know and trust to care for their children.
Each woman, with the support and assistance of her commu-
nity, sets up a bench school in her compound or home.
Parents pay a modest fee per child per month. The children
receive the rudiments of reading and writing while being
cared for near their own homes, by a neighbor who under-
stands the community.

Many of the bench schools operating in the Cartagena
area have added other services in response to community
needs and availability of additional resources. With UNICEF
support, creative learning materials have been-introduced.
Teachers have been instructed in techniques that shift the
emphasis of education from rote memorization to discovery
and experiential learning. Parents have been encouraged to
become involved in their children's education. Interested
parents receive instruction in the use of learning games and
materials which are loaned to the children for use at home.

One of the government departments, the Office of Slum
Rehabilitation, is supporting the bench schools by helping
to supply running water and drainage systems, and has
supported rebuilding of roofs and other repairs to bench
school homes.

Bench schools began as community-based and organized
responses to local problems. Neighborhoods continue to
identify changing and additional needs. With their own
resources, plus support from government agencies and interna-
tional organizations, new needs are assessed and met. In
some neighborhoods, in response to community needs, the
bench schools have become centers for other community activi-
ties -- youth clubs, recreation programs, family education
courses and communal stores.

Further information concerning the bench schools of
Cartagena may be obtained from:

Oficina de Rehabilitacion de Tugurios
Calle de Cuartel Edificio Pombo, 2do piso
Cartagena, Colombia

UNICEF
-Apartado Aereo 7555
Bogota, Colombia

Centro Internacional de Educacion y
Desarrollo Humano
Apartado Aereo 50262
Medellin, Colombia










Women's Sericulture Cooperative, Bangladesh


The experience of the Nijera Kori Women's Sericulture
Cooperative in Bangladesh illustrates the need for inte-
grated programs which recognize the interrelated nature of,
mothers' and children's needs.

The Nijera Kori Project was initiated in 1975 to rehab-
ilitate malnourished children by teaching mothers to prepare
nutritious diets from locally available, inexpensive foods.
Although the women were interested to learn about such
foods, their learning was seldom applied and had little
impact. This was due in part to the fact that the women
were simply too poor to purchase even local vegetables and
products and in part to an inability to recognize the impor-
tance of good nutrition and future benefits of improved
diets.

By the end of the first year, the focus of the Nijera
Kori project shifted to skills training in silk production,
supplemented by kitchen gardens and fish culture. At a
later stage, nutrition, education was incorporated into the
project. By this time women'had begun to earn money, felt
less desperate, and were more able to make use, of nutrition
education.

An understanding of and-responsiveness to local condi-
tions, practices and attitudes, a built-in flexibility which
can accommodate a shift in emphasis as necessary, and an
appreciation of the need to expand and evolve gradually, in
tune with women's readiness, are essential elements of the
Nijera Kori project that apply to programs anywhere.

Further information on this project may be obtained
from:

Nijera Kori
Women's Sericulture Cooperative
c/o World Food Programme
United Nations
'Dacca, Bangladesh


Fathers Fight Malnutrition, Kenya

"Add an egg...or some beans" is the message conveyed by
a nutrition education project in Kombu within the Machakos
district of Kenya. Formal nutrition programs which had been
conducted in the Machakos region had consistently failed to
alleviate malnutrition.

At the suggestion of Mutua Muide, one of the village
elders, a new nutrition education program was developed.,









Muide and other men from the area were also to take part in
the new program. The community decided that each village
would enlist and train a man and a woman to give short,
uncomplicated demonstrations. These presentations were
given in the bazaars and the .community meeting places. The
focus was on the nutritional value of locally available
foods.

The project was launched in villages with the aid of
two members of the East Africa Medical Research Foundation.
The villagers were instructed to "add an egg to the young
child's porridge. If you don't have an egg, add some mashed
beans".

After 18 months, the results showed that the overall
malnutrition rate had dropped from 55% to 39%. However,
the malnutrition rate continued to rise in certain areas
reached by the program. It is not known what caused this
rise, though the possibility exists that fathers still
believed that child care and nutrition are strictly a
woman's task.

UNICEF, which is involved in nutrition projects
throughout Kenya, hopes to continue the promotion of-such
programs through the use of radio announcements and broad-
casts. Further information may be obtained from:

UNICEF Regional Office for East Africa
P. O. Box 44145
Nairobi, Kenya


Elderly Persons Enlisted in Child Care-Jamaica

In some societies where nuclear families have replaced
extended families, programs have been designed to involve
older persons, who are no longer occupied full-time, in
community child care. Just as elders who share the same
house-compound have traditionally assumed many of the child
care responsibilities within their extended families, older
people who live apart from their own children and grandchil-
dren, may be enlisted to meet many child care needs.

A Jamaican project allows mothers to bring their chil-
dren to be cared for during the day at the community's home
for elderly people. Many other arrangements are possible to
enlist older persons in meeting child care needs. Older
persons may provide their services free of charge, while
other programs may charge the recipients of services small
fees which are given to the older persons. Services pro-
vided may include childminding, counseling, and visits to
hospitalized children. Retired women and men may also be
organized to teach vocational skills to older children.









Child Care Cooperative


One child care approach which works well in urban
residential areas is the "child care cooperative". A
cooperative is run on a barter system: exchanging hours of
babysitting rather than paying for the service.

In the city of St. John's, Newfoundland (a northern
province of Canada) a group of six families share child care
responsibilities. This type of cooperative can operate with
any number of participants, though the larger the group, the
easier it is to find a caretaker with little advance notice.

In a similar Maryland (USA) cooperative, the system has
evolved to include payment by chits. At the beginning of
every month, a mother receives a certain number of chits,
each chit worth one hour of babysitting. A mother who uses
all of her chits before the end of the month may purchase
chits or exchange another service, for chits, from a mother
who has accumulated extras.

1. Money need not be involved, hence, out-
of-pocket expenses are reduced
2. The coop sitters live in the immediate
neighborhood, therefore, no transporta-
tion is required
3. The caretakers are neighbors and
friends; individuals who are accepted by
the community and trusted with the care
of the children
4. Cooperative care may involve the entire
family. Husbands, older children or
other adult residents of the household
may participate when schedules permit
5. The children have the opportunity to be
with their friends. Parents have at
times used the services when their
children are in need of playmates
6. There are no strict schedules or hours
of operation which limit the availabil-
ity of services.

For further information 'contact:

Mrs. Elaine Fredericksen
Early Childhood Development Association
21 King's Bridge Road
St. John's, Newfoundland, Canada


Cluster Centers

The New York City Agency for Child Development has an
interesting program incorporating groups or "clusters" of










family day care centers into coordinated units. Fifteen to
twenty caretakers, each of whom operates a day care center,
are coordinated by a professional staffperson. All of the
caretakers have gone through a basic training period and
they continue to meet once a month to attend workshops and
to update their methods of instruction. Some of the topics
presented during the workshop training are the development
of the child, health, nutrition and personal hygiene, and
arts and crafts.

Joining together the caretakers from the day care
centers allows for volunteer organizations and welfare
agencies to aide in reducing expenses.

Parents are actively involved in the centers. Many
centers have "Parent Advisory Committees" and some parents
are active on the directing boards of the centers. A survey
showed that homes involved in the cluster system produced a
higher quality of care than the homes not in the system.

For further information, refer to:

Mary Dublin Keyserling
"Viewpoints in Teaching and Learning"
Journal of the School of Education
55(3) 1979
Indiana University, Bloomington


Puno Project, Peru

"Learning by doing" is the concept behind the pre-
school program of Puno, Peru. The major goal of the project
is to make the child an aware and productive person in the
community. Through the education and development of the
child, the government of Peru hopes to achieve active
participation of the parents and community. The outcome of
the project depends largely upon the decisions made by the
community members.

The program is carried out by paraprofessional teach-
ers, who are chosen by the community. These layteachers, who
have already had six years of primary schooling, undergo a
short training course. The layteachers are coordinated by a
small group of professionally trained teachers, who are them-
selves from the region. Although the whole project is
coordinated by the Ministry of Education, the layteachers
are directly responsible to the community.

The layteacher acts as a community leader and encour-
ages involvement of the people. For example, to stimulate
learning, parents and children create educational materials
that are appropriate within the environment, in terms of
cost, availability and familiarity. Rather than introduce




i'"




educational toys developed for young children in industrial-
ized countries, in the Puno early childhood centers,
creative play.makes use of clay, water and straw. The
ultimate value of the learning taking place is dependent
upon how these materials are used in the student-teacher
interaction. But the choice of materials is more culturally
appropriate and just as pedagogically useful as bright
plastic blocks, scissors, paper, expensive building
materials and tools.

Nutrition and health are also important aspects of the
program. One way in which nutrition is encouraged is
through the raising of domestic animals. The residents of
Puno have a poultry farm project, through which the children
learn about chickens and the nutritional value of eggs.

Each activity in which the child participates.must have
a specific purpose, whether it be motor development, nutri-
tion or hygiene. The child and the parents learn to be flex-
ible by adapting to new activities and to understand that
personal and group interaction are essential in the child's
educational process.

For further information contact:

Direccion de Educacion Inicial
Ministerio de Educacion
Lima, Peru


On-The-Spot Day Care, Bangladesh

In Bangladesh, the World Food Programme supports a
number of Food for Work projects that employ large numbers
of women. The major work of these relief schemes involves
earth-moving work such as constructing dirt roads and embank-
ments, and dredging rivers and fish tanks. Workers' payment
is made in wheat rations. Many young women, including
mothers of young children, participate in this heavy work.
However, older needy women generally cannot because of the
nature of the work.

Young mothers in need of someone to take care of their
children, and older women in need of an income, have devised
a way to meet each other's needs. Groups of mothers engage
the services of an older woman who goes to the work site to
watch the young children there. Because the children are
close, mothers are able to breastfeed and attend to special
needs as necessary. In payment, the working mothers give
portion of their wheat ration to.the older woman who keeps
some for'her own consumption and sells the remainder to earn
cash for other needs.










Bernard Van Leer Foundation

The Bernard Van Leer Foundation supports a number of
projects which cover diverse intervention approaches, geared
toward integrating preschool activities with various commu-
nity projects. The Van Leer programs range from preschool
training centers and curriculum development in Brazil,
Malaysia and Venezuela to pre-primary education linked with
adult education in Nigeria and Iran and teacher training
groups in Singapore and the Dominican Republic. The Van
Leer projects focus mainly on the rural areas and are
generally conducted with the use of mobile training units,
in conjunction with the traditional child care institutions.

Further information may be obtained from:

Bernard Van Leer Foundation
P. O. Box 1905
The Hague
Netherlands


"Padrinos", Cuba

In Cuba the traditional "padrino" (godparent) concept
has been adapted by the national government to stimulate
voluntary community involvement in child care. State farms,
factories, neighborhood committees, women's groups and other
organizations "adopt" child care centers and schools, pro-
viding needed services which are unobtainable for financial
and other reasons. The "padrinos" offer a variety of ser-
vices such as help with building repairs, special training
sessions, counseling, construction of school equipment,
organizing of fund-raising activities, and sponsoring visits
by the children to the "padrino's" work places.

Patrons are proud of their adopted schools and often a
good-natured competition evolves among these patrons. The
"adoptive godparents" have the satisfaction of helping their
communities, while schools and child care facilities receive
needed support.


Child Care in China

Child care is provided for the children of working
parents in both rural and urban China. Such care is consid-
ered a responsibility of the State, although the three-
generation family is still a strong force in Chinese life.

In China, most of the parents work an average of 8
hours a day, 6 days a week, often requiring nightmare for.
the child when they work a factory night-shift.








There are three areas within the early childhood pro-
gram: nursery rooms for infants, generally 2 or 3 months of
age, nurseries for children up to 2 or 3 years of age and
kindergartens for those between the ages of 3 and 7.

These centers are generally located near or at the
place of work of the parents. For example, many of the
nursery rooms are located in the factories, hospitals, or
high schools. By having her infant so close to her
workplace, a mother is able to breastfeed and be with the
child. Ninety percent of the mothers in China work outside
the home, and of these, 50% utilize the nurseries for infant
care; the other half rely on grandparents or friends to
care for their children.

The second stage in the child's development is the
nursery. In the rural areas, these nurseries are part of a
large communal system. Each commune in China has between
30,000 and 100,000 people. Within the communal complex,
there are two smaller units: the production brigades and
the work teams,.-each of which usually has 15-30 families.
These units assume the responsibility for child care.

The emphasis at the kindergarten level is .placed on the
child's motor development. It is here that formal programs
are introduced, for instance, health and hygiene, children's
opera and ballet, arts and crafts and instrumental music.
In rural areas, groups of students are sent to the urban
kindergartens so that the rural children can also be exposed
to cultural activities.

The educational background of the teachers and child
care workers is varied. Some have degrees from teachers'
colleges while others have taken part in a six month
training program which is funded by the Municipal Health and
Municipal Education Bureaus. This knowledge is supplemented
by on-the-job training.

The major purpose of the Chinese day care centers is
the children's mental, physical, and cultural development
and political awareness. They also meet the needs of
working parents.

More detailed information on child care in China can
be found in Ruth Sidel's book, entitled Women and Child
Care in China: A Firsthand Report New York: Hill and Wang,
1973.



t ,' ,










Notes




1. Shlomo Reutlinger, "Malnutrition: A Poverty or a Food
Problem?" World Bank Reprint Series: (47) reprinted from
World Development 5 (1977) p. 715-724. Marcelo Selowsky,
"The Economic Dimensions of Malnutrition in Young Children."
World Bank Staff Working Paper #294 (October 1978),
Washington, D.C. Marcelo Selowsky and Lance Taylor, "The
Economics of Malnourished Children: An Example in
Disinvestment in Human Capital." Economic Development and
Cultural Change, 22 (October 1973), pp. 17-30. Marcelo
Selowsky, "A Note on Preschool-Age Investment in Human
Capital in Developing Countries," Economic.Development and
Cultural Change 24(4) July 1976, pp. 707-720.

2. B. Bloom. Stability and Change in Human Characteris-
tics, New York: John Wiley & Sons, 1964.

3. Roger Grawe. "Ability in Pre-Schoolers, Earnings, and
Home Environment," World Bank Staff Working Paper #322,
April 1979.

4. M. Smilansky. "Priorities in Education: Pre-School
Evidence and Conclusions," World Bank Staff Working Paper
#323, Washington, D.C. April 1979, p. 19.

5. H. McKay, A. McKay, and L. Sinistera. "Stimulation of
Intellectual and Social Competence in Colombian Preschool
Age Children Affected by the Multiple Deprivations of
Depressed Urban Environments," Human Ecology Research
Station, Cali, Colombia, September 1973.

6. Ernesto Pollitt. Early Childhood Education Programs in
Latin America. Report presented to the Ford Foundation,
January 1979, p. 126.

7. High/Scope Educational Research Foundation. Preschool
Education in Latin America -- A Survey Report from the
Andean Region. Vol. 1, Summary Report, 1978, Ypsilanti,
Michigan, p. 102.









APPENDIX

METHODOLOGY



A number of research techniques were employed to gather
data on the child care.needs of low income mothers. 'The
project has encompassed four phases in the investigation and
the dissemination of research findings: an initial litera- i
ture search; field research in six countries -- three in
Asia and three in Latin America -- including surveys con-
ducted in low-income communities; seminars in three of those: .,
countries to review the research data and make recom-
mendations on national needs;, and finally, an international
conference-workshop in Washington. The purpose of the inter-
national conference, with representatives from .the six
countries plus one NearEastern and one Southern African
nation, is to discuss child care needs as a crucial element
in development,.-to suggest alternative ways of meeting those
needs, and to make policy recommendations directed to inter-
national agencies specifically to the Agency for Interna-
tional Development which provided funding for the project,


Literature Search

The initial literature search was undertaken (a) to
identify existing information on child care systems and
models; (b) to identify persons involved in child care
projects and research on child care needs; and. (c) to
supply background information which would assist in the
selection of countries-and the development of the field
research design. The search was restricted.to material
published after- 1966, in English, pertaining to developing
countries. Some writings on highly developed systems of
public day care facilities were included because they were
comparative studies having relevance to LDC's.

Mctre than 300 institutions, libraries, and agencies
around the world were contacted for the literature search.
These included -public and private international development
organizations, private voluntary organizations, United.
Nations agencies, U.S. governmental agencies, schools of
social work, and universities. Eight computer searches
were made. The bibliography has been published as a
separate document.


Country and site selection

Asia and Latin America were agreed upon before the.
start of the project as the two developing regions to be
studied. Selection of countries within those regions was









based on the literature search and on the advice of the
project advisory committee and other experts. The countries
were chosen to provide a variety of cultures and condi-
tions. Korea, an ethnically homogeneous nation, and
Malaysia and Sri Lanka, each with several different ethnic
groups, were chosen for study in Asia. A Caribbean island
nation, the Dominican Republic, an Andean country, Peru, and
in contrast the largest western hemisphere nation, Brazil,
were the choices for Latin America.

The survey sites in the six countries were selected by
the project's research coordinators during an initial field
trip, in consultation with local experts and with the
investigators selected to carry out the surveys. In four
countries the study sites included both urban and rural low-
income areas; in two, Malaysia and Brazil, the research was
confined to urban communities.

Except in Brazil, all urban surveys were conducted in
the national capital city, which in each of the five
countries is also the largest and most rapidly industrial-
izing city. The city of Salvador was selected as the
research area for Brazil because it is in that country's
most underdeveloped region, the Northeast, and is a focus
of government development policies and programs. With a
population of over a million, Salvador faces the same
problems of urbanization, migration, and industrialization
as Sao Paulo and Rio de Janeiro but has been much less
studied. The survey site is the second largest low income
neighborhood in Salvador and suffers, like the Peruvian and
Sri Lankan urban survey sites, from its isolation from areas
of the city which offer job opportunities. In Malaysia, on
the other hand, at least half of the squatter areas and low-
cost flats chosen as survey sites in Kuala Lumpur were
located near factories or other job opportunities.
Selection criteria also included representation of
Malaysia's three ethnic groups Malays, Chinese, and
Indians.

In Sri Lanka, where over 90 percent of the population
belongs to one of three ethnic groups, three rural communi-
ties were surveyed one predominantly Sinhala, one Tamil,
and one Muslim. Within the single urban area selected,
representative numbers of persons from each ethnic group
were interviewed. An effort was made to choose communities
considered "typical" in terms of economic activities and
living environment for each group.

In Korea both urban and rural survey sites were
selected with the assistance of the Community Development
Foundation, a U.S.-based private organization working in
the low income areas. The urban survey site was a
resettlement community on the edge of Seoul where the









government has been relocating former inhabitants of
squatter colonies. For the rural survey five.Villages were
chosen 'in.what is considered the least advantaged of Korea's
farming provinces.

The urban survey in the Dominican Republic was done in
23 low-income neighborhoods of Santo Domingo which had been
identified in a previous, somewhat related study. The
rural survey in the ,Dominican Republic was carried out in
the southwestern region, considered the most poverty-
stricken in the country. The rural survey community is
surrounded by one of the Republic's largest cotton planta-
tions, which employs a large number of women.

For the Peruvian study, an "average" squatter settle-
ment on the southern outskirt's of Lima',- neither one of the
older ones nor one of the most recent --was'chosen as having
material conditions close to the mean for what are now
called "young towns" (pipebl6s' jovenes). The rural community
was picked for its location in the Andes of northern Peru,
its traditional culture, the inhabitants' knowledge of
Spanish, and relative ease of access from Lima. An essen-
tial ingredient in the choice' of both field research sites
was the presence within the investigating team of a person
with previous personal contacts with communities which might
otherwise be unwilling to cooperate in such a study,


Field Research

The methodology in the field used a combination of
techniques. The primary research instrument was a
structured survey of a sample of women in the selected site
or sites. The women's husbands were also interviewed in
four of the six countries. Other techniques included
observation of respondents by researchers and the field
coordinator, discussions with community leaders and groups,
interviews with government planners and representatives of
national and international organizations, and a review of
existing literature and policy.

All six countries in the project followed the same
general research design developed by the Overseas Education
Fund child care project staff to meet the study objectives.
Questionnaires were adapted to the conditions and needs of
each country by the local investigators in collaboration
with the OEF field coordinator and translated intothe
national languages. In each case the survey instrument was
pretested in at least two areas and necessary revisions
incorporated. Thus the six questionnaires were not exactly
alike. Similar in their essentials, they produced, in the
main, comparable information. Samples of the questionnaires
are included in each country report.








In each country the OEF field coordinator arranged with
a national institution or a qualified researcher or group of
researchers to adapt the research design, to recruit and
train interviewers, to carry out the survey, and to produce
a preliminary report. In Korea the principal investigator
was, the chairman of the Nutrition Department of Seoul
National University, with a research team of six graduate
students in the department. In Sri Lanka the Sri Lanka
Federation of University Women was the institution respon-
sible for the survey. The National Family Planning Board
conducted the research in Malaysia.

The investigator in Brazil was a nutritionist in a
neighborhood health center and a graduate student in the
Community Health Program of the Federal University of
Bahia, working under the supervision of the department
chairman. In the Dominican Republic the investigator was
an experienced Dominican sociologist who had previously
carried out studies of women, relating especially to health
and employment. The Peruvian research team consisted of an
anthropologist, a psychologist, and a pediatrician who
worked in the public health center serving the urban survey
site. For the rural field research the team was joined by a
graduate student in anthropology native to the area and with
experience as a rural school teacher there.

Interviewers, generally residents of the survey areas
or familiar with the neighborhoods, were recruited by the
investigators and were trained in use of the questionnaire
in two-to-three day workshops. Except in Brazil, the
Dominican Republic, and Korea, the interviewers were both
men and women.


Sample Selection

Criteria for sample selection included low income and,
with the exception of Brazil, the presence in the household
of at least one preschool child. Income is a sensitive
issue, and it proved impossible to obtain precise informa-
tion. In Korea low income families were identified by the
local leaders. In Sri Lanka they were choose from district
lists of families entitled to free rice under the government
subsidy program. In Malaysia low income families were
selected on the basis of residence in a poor neighborhood.
Residence in a low income neighborhood was also the
criterion in the three Latin American countries.

The size of the samples varied from one country to
another. In general, however, determination of sample size
for each community was based on available time and
resources, with consideration of what would be the minimum
acceptable as statistically valid in relation to the size
of the selected area. The Korean urban sample consisted









of 108 households, the rural sample of 104. In Sri Lanka a
total of 136 families were surveyed in the two urban sites
and 40 to 50 families in each of the three rural villages.
The Malaysian sample included just under 500 households,
divided among several urban neighborhoods and giving appro-
priate weight to the three ethnic groups. In Peru the urban
sample consisted of 74 households and the rural of 43. The
Dominican Republic survey covered 300 women in the urban
areas, 40 in the rural; and the Brazilian sample consisted
of 1,022 women. The urban survey in the Dominican Republic
made use of the sampling framework developed for a "Study of
Women: Employment and Fertility" which was conducted in the
summer of 1978. Of 67 blocks of Santo Domingo selected at
random for that study, the 23 low income blocks were
selected for the child care needs sample. Those homes
identified as having a preschool-age child were noted, and
the desired number of homes were then picked at random.

The Peruvian samples, both urban and rural, were drawn
on the basis of the physical layout of the communities. In
the urban survey site, the Women's Council block delegates
assisted in finding families which met the sample cri-
teria. From among these, two families in each of the 37
blocks were selected at random. For the rural survey, the
field workers estimated the total number of houses in the
community and calculated the interval necessary to derive
the sample. They then selected cases by walking along each
of the community's three paths and applying the interval.

The Brazilian investigator used the random sample of
quadrant technique, taking advantage of a previous study of
the area which established the expected prevalence of women
of fertile age who work for pay. To allow time for inter-
viewing a large number of women, it was decided not to inter-
view husbands. Three categories of women were interviewed:
those with children of preschool age, those with older
children, and those without children. Thus it was possible
to show that responsibility for young children operates as a
constraint to participation in the labor force or the
community.

Constraints of time and funds, the need for respecting
cultural sensitivities, and the lack of recent, accurate
census data, made it impractical to develop and apply consis-
tent sampling methods to the six country surveys, or to test
fully the representativeness of the samples selected. How-
ever, the methods followed show no intended or obvious
bias. The supplementary information collected in each coun-
try suggests that, as a guide to general areas of policy
regarding child care needs of poor mothers, the surveys
provide a reasonably accurate picture of the kinds of
situations to be found. In view of the broad nature of the
inquiry, there seems no reason to believe that larger,
samples, more consistent or exact methods, would have pro-
duced a noticeably different result.




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