Women's time: a factor in the use of child survival technologies?

Abstract

What are the actual time costs to women and whether time costs are important determinant in mothers participation in the GOBI technologies are analyzed. GOBI is an acronym for growth monitoring oral rehydration therapy (ORT) breast feeding and immunization the primary health care elements of the child health revolution. These activities are managed by mothers. Third world women average an 18-hour work day taking care of agricultural and household production child care and cash income generation with little time left for personal or leisure activities. Very little data are available on the actual hours spent on child care or the specific GOBI activities. Women in the third world spend 2-4 hours per day on breast feeding. For them whether bottle feeding takes more or less time is not an issue rather the fact that someone else can feed the baby a bottle is perceived as time-saving. Time costs for women for immunization and growth monitoring are probably much higher than program costs considering transportation time and time lost from other work. Time costs for ORT have not been estimated: they would entail constant attendance over several days for each episode to prepare boiled solution spoon feed ORS gradually perhaps 40 days a year for 2 children each having 6 diarrhea episodes. Time savings in illness and death prevented is also unknown although women may spend appreciable time on care of ill family members and funerals. Recommendations for research are made such as the suggestion that determining whether time costs are a significant barrier to the success of the child survival program. It is also suggested that programs emphasize the immediate advantages to women of these technologies; bring the services to mothers; and consider ORT an interim time-costly way to manage diarrhea.