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Family Structure and Child Health in Cambodia, 2000-2010


In developing countries, where there are limited resources and social support, children rely primarily on their family for their well-being. Their lives are affected by the configuration of household members, by the type of family structure, and by household decision processes that determine the resources that are allocated for their well-being. This dissertation examines the influence of family structure on the outcomes of children's well-being, using the case of Cambodia, where between 2000 and 2010 the children composed more than a third of the population.

To assess the link between family structure and the well-being of children in Cambodia, this dissertation uses multilevel modeling. It examines three aspects of well-being. The first is the amount of time invested on children. The second examines the nutritional status of children. The third is the risk of infant mortality. In this investigation I focus on two forms of family structure: nuclear and multigenerational. For our purposes, a multi-generational household is one containing one or more grandparents.

To consider the investment of time, I take advantage of time-use data collected by the Cambodia Socio-Economic Survey and assess time spent on childcare individually and collectively by members of the household. My analysis reveals that children in multigenerational households receive more childcare time than those in nuclear households. Moreover, the additional care time these children receive is due to the presence of grandparents. Grandparents supplement maternal care time.

To assess the nutritional status of children in Cambodia, I use three waves of the Cambodia Demographic and Health Survey from 2000, 2005 and 2010. My findings reveal that children in multigenerational households have better nutritional outcomes than children in nuclear households. The gains of children in multigenerational households increased over the decade. This finding suggests that even though national economic development improves the overall health status of children, those coresiding with grandparents are the most advantaged.

To detect possible influences of family structure on infant and child mortality, I explore whether or not the health advantage of children in multigenerational households extends to a survival advantage. Findings reveal that even in the earliest stages of life, the presence of grandparents safeguard infant survival more than the presence of a father in the household.

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