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. 2025 Feb 25;25(1):769.
doi: 10.1186/s12889-025-21978-z.

Balancing maternal employment and child nutrition and health: a grounded theory study of rural communities in Northeastern Uganda

Joseph Lule Kyanjo  1 , Alice Turinawe  2 , Agneta Hörnell  3 , Kristina Lindvall  4
Affiliations

Balancing maternal employment and child nutrition and health: a grounded theory study of rural communities in Northeastern Uganda

Joseph Lule Kyanjo et al. BMC Public Health. .

Abstract

Background: Child undernutrition remains a serious public health concern particularly in poor households where limited financial resources hinder proper child nutrition. Improving women's access to productive resources and employment is crucial for addressing undernutrition. However, maternal employment may reduce the amount of time available for childcare, leading to poor child nutrition and health. This study explored rural community perceptions and experiences regarding maternal employment in relation to aspects of child nutrition and health in northeastern Uganda to inform the design of interventions that can effectively support maternal employment without compromising child nutrition and health.

Methods: Twelve gender-separated focus group discussions (FGDs) were conducted with pastoral and agro-pastoral communities in northeastern Uganda. Data from the FGDs were analysed using a constructivist grounded theory approach.

Results: Analysis of the FGD data revealed that cultural norms and economic pressure were crucial factors in maternal employment decisions. We constructed a model that represents maternal employment as a delicate balance to maximize the benefits for child nutrition and health while minimizing the negative consequences. The model comprises the core category, mothers' solitary struggle for better child nutrition and health, and four interrelated categories: (1) mothers conforming to societal expectations, (2) mediating the effect of maternal employment on child nutrition and health, (3) suffering consequences of maternal employment, and (4) mothers striving for better child nutrition and health.

Conclusion: Access to income emerged as the main pathway through which maternal employment leads to better child nutrition and health. However, this benefit often comes at the cost of reduced time for childcare, which is perceived to be detrimental to child nutrition and health. Based on these results, enhancing access to productive resources and employment, particularly for women is crucial for addressing undernutrition. To ensure that maternal employment does not compromise childcare, policies must support the development and access to childcare options that are affordable and appropriate for women in rural areas and in informal employment to effectively balance employment and childcare.

Keywords: Child nutrition and health; Focus group discussion; Grounded theory; Maternal employment; Sociocultural norms.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. The study received ethical approval from the Research Ethics Committee at Makerere University, Uganda (CAES-REC-2023-1), and from the Swedish Ethical Review Authority (Dnr 2021-05780-01). Verbal consent was obtained from all study participants prior to the FGDs. Participants were informed verbally that the FGDs would be audio recorded, that their information would be treated confidentially, and that they had the right to withdraw their consent at any time. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Illustration of the analysis process moving from transcript extract to category
Fig. 2
Fig. 2
A seesaw theory that conceptualizes maternal employment and child nutrition and health nexus. In the model, the categories are represented by bold headings with their respective sub-categories presented as numbered lists. The text in italics under the category of “Suffering consequences of maternal employment” represents the consequences directly related to the child whereas the underlined text represents consequences directly related to the parents
See this image and copyright information in PMC

References

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