Child care in Chiang Mai: determinants and health consequences for preschool aged children.

The northern city of Chiang Mai Thailand and nearby rural areas have experienced a rapid decline in fertility to below replacement levels; other significant demographic trends have been in-migration changes in married couples post-nuptial residence and an increase in maternal employment. As more mothers work outside of the home formal day care is increasingly utilized. Studying 526 urban and 223 rural mothers aged 15-49 this report investigates the determinants of child care arrangements and the consequences for child health. Results indicate that nonworking mothers tend to care for their own children. In Chiang Mai the childs age the mothers work status the mothers occupation and maternal education affect care arrangements. In rural areas care is affected by the childs age and maternal earnings. No evidence suggests that child health suffers when children are cared for in formal group settings. Further a much higher degree of formal child care was found in this province compared to previous findings from Bangkok. Potentially linked to the regional fertility decline a greater number of formal care providers are available in Chiang Mai with mothers taking advantage of their services. To ease daily parental burdens the authors recommend encouraging employers to provide day care for employees and expanding the public school system to include pre-kindergarten education.