Busert-Sebela, Laura Katharina; (2023) The association between paternal labour migration and the growth of the left-behind children in the plains of Nepal. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Background Nepal has a high prevalence of child stunting and international labour migration, but little is known about how the fathers’ migration affects the growth of left-behind children. Objectives 1) To identify the determinants of infant growth in Dhanusha district, Nepal. 2) To determine the association between paternal labour migration and the growth of the left-behind children in Dhanusha district, Nepal. Methods I used data from a previous birth cohort study (n=602) conducted in Dhanusha district. Children were enrolled at birth in 2012 and measured every 28 days until they were two years. I followed up this cohort in 2018 when the children were six years. I collected data on the household migration history to determine the children’s exposure to migration during their lifetime and during pregnancy. The main outcome was child length/height-for age z-score. I also measured children’s body circumferences, skinfold thicknesses, body composition, tibia length and grip strength at the 2018 follow-up as secondary outcomes. I used mixed-effects linear regression to 1) examine the impact of household and maternal factors, season, feeding practices and infection on infant growth, and to 2) determine the association between exposure to paternal international labour migration and the growth of the left-behind children. Results 1) Maternal factors related to both the environment in-utero (low birthweight) and in postnatal life (education, adolescent pregnancy) were the most important determinants of infant growth. 2) There was no indication of a positive association between paternal labour migration and any measure of child growth. Under some circumstances such as very young age and shortly after the fathers’ departure, there was a negative association between labour migration and the growth of the left-behind children. Conclusions There is a need for interventions to support pregnant women and mothers with small babies, especially if their husband just left for work overseas.

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