Maternal employment and child health in Nepal: The importance of job type and timing across the child's first five years.

The increase in female labor force participation (FLFP) in the paid labor market since the mid-1900s is one of the most pronounced family transitions and increasingly a global phenomenon. While this may improve income and bargaining power of the women, it may also increase stress and decrease time with children. Using the Chitwan Valley Family Study in Nepal, we explore the consequences of this transition for children's health by combining newly collected data on child health outcomes, quarterly data on women's employment, and data on households and neighborhoods. Regression models were used to estimate the relationship between FLFP and child health, exploring both the type (wage, salary, or own business) and timing of work across the child's first five years for 860 children born to 793 mothers. After adjusting for a robust set of individual, household, and community factors, FLFP is associated with worse child health. We find evidence this is largely due to wage labor, the more common but "lower quality" and lower paying type of work women do. Measures of current work are generally inadequate at capturing this negative relationship. Breastfeeding may be an important piece of this story as mothers that worked during the first six months of a child's life were less likely to exclusively breastfeed during this period. Recognizing the challenges faced by working mothers in LMICs and paying attention to the quality of work will be critical as more women enter the workforce.