title: Poor maternal schooling is the main constraint to good child care practices in Accra.
abstract: Life in urban areas presents special challenges for maternal child care practices. Data from a representative quantitative survey of households with children < 3 y of age in Accra, Ghana were used to test a number of hypothesized constraints to child care including various maternal (anthropometry, education, employment, marital status, age and ethnic group) and household-level factors (income, availability of food, quality of housing and asset ownership, availability of services, household size and crowding). Three care indices were created as follows: 1) a child feeding index; 2) a preventive health seeking index; and 3) a hygiene index. The first two indices were based on data from maternal recall; the hygiene index was based on spot-check observations of proxies of hygiene behaviors. Multivariate analyses (ordinary least-squares regression for the child feeding index and ordered probit for the two other indices) showed that maternal schooling was the most consistent constraint to all three categories of child care practices. None of the household-level characteristics were associated with child feeding practices, but household socioeconomic factors were associated with better preventive health seeking and hygiene behaviors. Thus, poor maternal schooling was a main constraint for child feeding, health seeking and hygiene practices in Accra, but the lack of household resources was a constraint only for health seeking and hygiene. The programmatic implications of these findings for interventions in nutrition education and behaviors in Accra are discussed.
authors.affiliation: The Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
authors.forename: M
authors.initials: M
authors.lastname: Armar-Klemesu
authors.forename: M T
authors.initials: MT
authors.lastname: Ruel
authors.forename: D G
authors.initials: DG
authors.lastname: Maxwell
authors.forename: C E
authors.initials: CE
authors.lastname: Levin
authors.forename: S S
authors.initials: SS
authors.lastname: Morris
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D002654:Child Care; D002675:Child, Preschool; D004522:Educational Status; D005260:Female; D005869:Ghana; D006801:Humans; D006920:Hygiene; D007223:Infant; D007225:Infant Food; D016487:Parenting; D011314:Preventive Health Services / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population