Grandparent caregiving in Cambodian skip‐generation households: Roles and impact on child nutrition

Abstract

This study aims to understand nutrition‐related roles, responsibilities and ethical issues of grandparents caring for their grandchildren in skip‐generation households in rural Cambodia. Over the past decade, Cambodia has experienced a rise in economic migration of working age populations. This has resulted in increasing numbers of ‘skip‐generation’ households, in which grandparents and grandchildren co‐reside without parents, reflecting potential household vulnerability. This qualitative study involved in‐depth interviews and focus group discussions with Cambodian grandparents who were primary caregivers to grandchildren for six months or longer. A total of 39 grandparents were recruited at two sites in north‐west Cambodia. Interviews and focus group discussions were conducted in Khmer and were recorded, transcribed and translated into English. Data were analysed using thematic analysis. Grandparents in this study looked after an average of three children, aged between two months and 18 years old. Overall, 40% were sole caregivers. Analysis showed that grandparents, particularly grandmothers, played a central role in their grandchildren's health and nutrition. Although grandchildren's health and nutrition were a major priority to grandparents, they reported facing significant challenges to safeguard their grandchildren's and their own nutritional needs. As a result, grandparents frequently faced difficult ethical trade‐offs and prioritised their grandchildren's health and nutrition over their own. This study highlights that in order to improve child nutrition, policies and interventions need to be designed in ways that support and enable grandparent caregivers to meet their grandchildren's health and nutritional needs without neglecting their own.

Program Impact Pathway of the Positive Deviance/Hearth Interactive Voice Calling Program in a Peri-Urban Context of Cambodia

“…These contextual factors may have contributed to the modest improvements in child nutritional status at the 12-mo follow-up ( 20 ). Our findings align with another study by Schneiders et al ( 24 ), which observed that, in migrant households, grandparents are the primary caregivers for children and tend to their nutritional needs. The study also highlighted that to improve child nutrition, interventions need to be designed in ways to support and enable grandparent caregivers in Cambodia.…”

Research Review: Grandparental care and child mental health – a systematic review and meta‐analysis

“…These negative associations may be attributed to limitations in grandparental care practices as noted in the literature, such as ineffective discipline and low nurturance (Smith, Cichy, & Montoro‐Rodriguez, 2015), a possible result of grandparents' energy and health limitations and their psychological distress (Smith & Hancock, 2010). Some studies also suggest that grandparents of left‐behind children (whose parents had migrated for work purpose) may lack the knowledge and awareness about the importance of stimulating child development (Schneiders et al., 2021; Urrieta & Martínez, 2011). Furthermore, as grandparents age and no longer have a spouse to share the caretaking responsibilities, they can be physically and emotionally overwhelmed, which may further compromise grandparenting outcomes (Chan et al., 2019).…”

Objective and Subjective Stress among Grandparents Providing Assistive Regular Grandchild Care

“…However, assuming the caregiving role is generally not expected from men, male caregivers are more likely to be acknowledged or appreciated than female caregivers, whose efforts are expected and usually unnoticed (Bullock, 2005). Higher depressive symptoms among grandmothers may also be due to different ARC duties taken by grandmothers in contrast to grandfathers; whereas grandmothers take more responsibility for tasks including cooking, feeding, cleaning, doing laundry, and providing basic care to grandchildren, grandfathers could be responsible for peripheral care roles, like taking grandchildren to school or entertaining them (Schneiders et al, 2021). These differences can create both actual load and higher perceptions of subjective stress among grandmothers resulting from their demanding care tasks.…”