The influence of maternal schooling, cognitive skills, and general cognitive abilities on child care behaviors among women in rural Guatemala

Approximately 11 million children under the age of 5 die each year, the majority of whose deaths are attributed to treatable and preventable infections and the exacerbating effects of malnutrition. The cycle of malnutrition and repeated infections in early childhood contributes to impairments in growth and motor and cognitive development, and diminished educational achievement, work capacity, and economic productivity. Maternal schooling has been consistently associated with reduced child malnutrition, morbidity and mortality, likely via improved child care practices. The objectives of the current dissertation project were to describe the hygiene, infant feeding, and illness management practices of rural Guatemalan women and examine how these behaviors were independently and interactively influenced by maternal schooling (MS), cognitive skills (MCS) as measured by academic achievement tests, and cognitive abilities (MCA), as measured by Raven's Colored Progressive Matrices (RCPM). Regression models were used to analyze prospective, longitudinal data collected from 1996-1999 among women and their children living in rural Guatemala.; Women in the lowest categories for MCS and MS were more likely to score lower on a summary index of hygiene practices and on indices of food and personal hygiene. Scoring in the lowest category of MCS was associated with reduced odds of initiating exclusive breastfeeding (EBF) while increased MS was associated with increased hazards of ending EBF before 6 months. Completing more than 1 but less than 3y of formal schooling was associated with lower scores on an index of illness management (IMI) when compared to completing more than 6y. Lower MCA was associated with increased odds of scoring lower on the IMI among mothers with less than one year of schooling.; In summary we observed significant, independent associations between measures of MS, MCS, and MCA and child care practices that are associated with child health outcomes. These relationships were influenced by SES and years of schooling. Our findings support interventions that promote formal schooling of young girls and the promotion of cognitive skills, such as literacy and numeracy, in adulthood as a means to improve child care practices.