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Article Contents

Introduction, methodology.

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Child labor and health: a systematic literature review of the impacts of child labor on child’s health in low- and middle-income countries

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Abdalla Ibrahim, Salma M Abdalla, Mohammed Jafer, Jihad Abdelgadir, Nanne de Vries, Child labor and health: a systematic literature review of the impacts of child labor on child’s health in low- and middle-income countries, Journal of Public Health , Volume 41, Issue 1, March 2019, Pages 18–26, https://doi.org/10.1093/pubmed/fdy018

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To summarize current evidence on the impacts of child labor on physical and mental health.

We searched PubMed and ScienceDirect for studies that included participants aged 18 years or less, conducted in low- and middle-income countries (LMICs), and reported quantitative data. Two independent reviewers conducted data extraction and assessment of study quality.

A total of 25 studies were identified, the majority of which were cross-sectional. Child labor was found to be associated with a number of adverse health outcomes, including but not limited to poor growth, malnutrition, higher incidence of infectious and system-specific diseases, behavioral and emotional disorders, and decreased coping efficacy. Quality of included studies was rated as fair to good.

Child labor remains a major public health concern in LMICs, being associated with adverse physical and mental health outcomes. Current efforts against child labor need to be revisited, at least in LMICs. Further studies following a longitudinal design, and using common methods to assess the health impact of child labor in different country contexts would inform policy making.

For decades, child labor has been an important global issue associated with inadequate educational opportunities, poverty and gender inequality. 1 Not all types of work carried out by children are considered child labor. Engagement of children or adolescents in work with no influence on their health and schooling is usually regarded positive. The International Labor Organization (ILO) describes child labor as ‘work that deprives children of their childhood, potential and dignity, and that is harmful to physical and mental development’. 2 This definition includes types of work that are mentally, physically, socially or morally harmful to children; or disrupts schooling.

The topic gained scientific attention with the industrial revolution. Research conducted in the UK, because of adverse outcomes in children, resulted in acts for child labor in 18 02. 3 Many countries followed the UK, in recognition of the associated health risks. The ILO took its first stance in 1973 by setting the minimum age for work. 4 Nevertheless, the ILO and other international organizations that target the issue failed to achieve goals. Child labor was part of the Millennium Development Goals, adopted by 191 nations in 20 00 5 to be achieved by 2015. Subsequently, child labor was included in the Sustainable Development Goals, 6 which explicitly calls for eradication of child labor by 2030.

Despite the reported decline in child labor from 1995 to 2000, it remains a major concern. In 2016, it was estimated that ~150 million children under the age of 14 are engaged in labor worldwide, with most of them working under circumstances that denies them a playful childhood and jeopardize their health. 7 Most working children are 11–14 years, but around 60 million are 5–11 years old. 7 There are no exact numbers of the distribution of child labor globally; however, available statistics show that 96% of child workers are in Africa, Asia and Latin America. 1

Research into the impacts of child labor suggests several associations between child labor and adverse health outcomes. Parker 1 reported that child labor is associated with certain exposures like silica in industries, and HIV infection in prostitution. Additionally, as child labor is associated with maternal illiteracy and poverty, children who work are more susceptible to malnutrition, 1 which predisposes them to various diseases.

A meta-analysis on the topic was published in 20 07. 8 However, authors reported only an association of child labor with higher mortality and morbidity than in the general population, without reporting individual outcome specific effects. 8 Another meta-analysis investigated the effects of adverse childhood experiences (ACEs), including child labor, on health. They reported that ACEs are risk factors for many adverse health outcomes. 9

To our knowledge, this is the first systematic review that attempts to summarize current evidence on the impacts of child labor on both physical and mental health, based on specific outcomes. We review the most recent evidence on the health impacts of child labor in low- and middle-income countries (LMICs) according to the World Bank classification. We provide an informative summary of current studies of the impacts of child labor, and reflect upon the progress of anti-child labor policies and laws.

Search strategy

We searched PubMed and ScienceDirect databases. Search was restricted to publications from year 1997 onwards. Only studies written in English were considered. Our search algorithm was [(‘child labor’ OR ‘child labor’ OR ‘working children’ OR ‘occupational health’ OR ‘Adolescent work’ OR ‘working adolescents’) AND (Health OR medical)]. The first third of the algorithm was assigned to titles/abstracts to ensure relevance of the studies retrieved, while the rest of the terms were not. On PubMed, we added […AND (poverty OR ‘low income’ OR ‘developing countries’)] to increase the specificity of results; otherwise, the search results were ~60 times more, with the majority of studies being irrelevant.

Study selection

Studies that met the following criteria were considered eligible: sample age 18 years or less; study was conducted in LMICs; and quantitative data was reported.

Two authors reviewed the titles obtained, a.o. to exclude studies related to ‘medical child labor’ as in childbirth. Abstracts of papers retained were reviewed, and subsequently full studies were assessed for inclusion criteria. Two authors assessed the quality of studies using Downs and Black tool for quality assessment. 10 The tool includes 27 items, yet not all items fit every study. In such cases, we used only relevant items. Total score was the number of items positively evaluated. Studies were ranked accordingly (poor, fair, good) (Table 1 ).

Characteristics of studies included

* The quality is based on the percentage of Downs and Black 10 tool, < 50% = poor, 50–75% = fair, > 75% = good.

** BMI, body mass index.

*** HIV, human immunodeficiency virus; HBV, hepatitis B virus; HCV, hepatitis C virus.

Data extraction and management

Two authors extracted the data using a standardized data extraction form. It included focus of study (i.e. physical and/or mental health), exposure (type of child labor), country of study, age group, gender, study design, reported measures (independent variables) and outcome measures (Table 1 ). The extraction form was piloted to ensure standardization of data collection. A third author then reviewed extracted data. Disagreements were solved by discussion.

Search results

A flow diagram (Fig. 1 ) shows the studies selection process. We retrieved 1050 studies on PubMed and 833 studies on Science Direct, with no duplicates in the search results. We also retrieved 23 studies through screening of the references, following the screening by title of retrieved studies. By reviewing title and abstract, 1879 studies were excluded. After full assessment of the remaining studies, 25 were included.

Study selection process.

Characteristics of included studies

Among the included studies ten documented only prevalence estimates of physical diseases, six documented mental and psychosocial health including abuse, and nine reported the prevalence of both mental and physical health impacts (Table 1 ). In total, 24 studies were conducted in one country; one study included data from the Living Standard Measurement Study of 83 LMIC. 8

In total, 12 studies compared outcomes between working children and a control group (Table 1 ). Concerning physical health, many studies reported the prevalence of general symptoms (fever, cough and stunting) or diseases (malnutrition, anemia and infectious diseases). Alternatively, some studies documented prevalence of illnesses or symptoms hypothesized to be associated with child labor (Table 1 ). The majority of studies focusing on physical health conducted clinical examination or collected blood samples.

Concerning mental and psychosocial health, the outcomes documented included abuse with its different forms, coping efficacy, emotional disturbances, mood and anxiety disorders. The outcomes were measured based on self-reporting and using validated measures, for example, the Strengths and Difficulties Questionnaire (SDQ), in local languages.

The majority of studies were ranked as of ‘good quality’, with seven ranked ‘fair’ and one ranked ‘poor’ (Table 1 ). The majority of them also had mixed-gender samples, with only one study restricted to females. 24 In addition, valid measures were used in most studies (Table 1 ). Most studies did not examine the differences between genders.

Child labor and physical health

Fifteen studies examined physical health effects of child labor, including nutritional status, physical growth, work-related illnesses/symptoms, musculoskeletal pain, HIV infection, systematic symptoms, infectious diseases, tuberculosis and eyestrain. Eight studies measured physical health effects through clinical examination or blood samples, in addition to self-reported questionnaires. All studies in which a comparison group was used reported higher prevalence of physical diseases in the working children group.

Two studies were concerned with physical growth and development. A study conducted in Pakistan, 11 reported that child labor is associated with wasting, stunting and chronic malnutrition. A similar study conducted in India compared physical growth and genital development between working and non-working children and reported that child labor is associated with lower BMI, shorter stature and delayed genital development in working boys, while no significant differences were found among females. 12

Concerning work-related illnesses and injuries, a study conducted in Bangladesh reported that there is a statistically significant positive association between child labor and the probability to report any injury or illness, tiredness/exhaustion, body injury and other health problems. Number of hours worked and the probability of reporting injury and illness were positively correlated. Younger children were more likely to suffer from backaches and other health problems (infection, burns and lung diseases), while probability of reporting tiredness/exhaustion was greater in the oldest age group. Furthermore, the frequency of reporting any injury or illness increases with the number of hours worked, with significant variation across employment sectors. 13 A study in Iran reported that industrial workrooms were the most common place for injury (58.2%). Falling from heights or in horizontal surface was the most common mechanism of injury (44%). None of the patients was using a preventive device at the time of injury. Cuts (49.6%) were the most commonly reported injuries. 14

Other studies that investigated the prevalence of general symptoms in working children in Pakistan, Egypt, Lebanon, Jordan and Indonesia reported that child labor is negatively associated with health. 15 – 19 Watery eyes, chronic cough and diarrhea were common findings, in addition to history of a major injury (permanent loss of an organ, hearing loss, bone fractures, permanent disability). 20 One study, conducted in India reported that working children suffered from anemia, gastrointestinal tract infections, vitamin deficiencies, respiratory tract infections, skin diseases and high prevalence of malnutrition. 21 Another study—of poor quality—in India reported that child labor was associated with higher incidence of infectious diseases compared to non-working children. 22

Only a few studies focused on specific diseases. A study in Brazil compared the prevalence of musculoskeletal pain between working and non-working children. Authors reported that the prevalence of pain in the neck, knee, wrist or hands, and upper back exceeded 15%. Workers in manufacturing had a significantly increased risk for musculoskeletal pain and back pain, while child workers in domestic services had 17% more musculoskeletal pain and 23% more back pain than non-workers. Awkward posture and heavy physical work were associated with musculoskeletal pain, while monotonous work, awkward posture and noise were associated with back pain. 23 A study in Nicaragua, which focused on children working in agriculture, reported that child labor in agriculture poses a serious threat to children’s health; specifically, acute pesticides poisoning. 24

A study conducted in India reported that the prevalence of eyestrain in child laborers was 25.9%, which was significantly more than the 12.4% prevalence in a comparison group. Prevalence was higher in boys and those who work more than 4 h daily. 25 Another study conducted in India documented that the difference between working and non-working children in the same area in respiratory morbidities (TB, hilar gland enlargement/calcification) was statistically significant. 26

A study in Iran explored the prevalence of viral infections (HIV, HCV and HBV) in working children. 27 The study reported that the prevalence among working street children was much higher than in general population. The 4.5% of children were HIV positive, 1.7% were hepatitis B positive and 2.6% hepatitis C positive. The likelihood of being HIV positive among working children of Tehran was increased by factors like having experience in trading sex, having parents who used drugs or parents infected with HCV.

Lastly, one study was a meta-analysis conducted on data of working children in 83 LMIC documented that child labor is significantly and positively related to adolescent mortality, to a population’s nutrition level, and to the presence of infectious diseases. 8

Child labor and mental health

Overall, all studies included, except one, 28 reported that child labor is associated with higher prevalence of mental and/or behavioral disorders. In addition, all studies concluded that child labor is associated with one or more forms of abuse.

A study conducted in Jordan reported a significant difference in the level of coping efficacy and psychosocial health between working non-schooled children, working school children and non-working school children. Non-working school children had a better performance on the SDQ scale. Coping efficacy of working non-schooled children was lower than that of the other groups. 29

A study conducted in Pakistan reported that the prevalence of behavioral problems among working children was 9.8%. Peer problems were most prevalent, followed by problems of conduct. 30 A study from Ethiopia 31 reported that emotional and behavioral disorders are more common among working children. However, another study in Ethiopia 28 reported a lower prevalence of mental/behavioral disorders in child laborers compared to non-working children. The stark difference between these two studies could be due to the explanation provided by Alem et al. , i.e. that their findings could have been tampered by selection bias or healthy worker effect.

A study concerned with child abuse in Bangladesh reported that the prevalence of abuse and child exploitation was widespread. Boys were more exposed. Physical assault was higher towards younger children while other types were higher towards older ones. 32 A similar study conducted in Turkey documented that 62.5% of the child laborers were subjected to abuse at their workplaces; 21.8% physical, 53.6% emotional and 25.2% sexual, 100% were subjected to physical neglect and 28.7% were subjected to emotional neglect. 33

One study focused on sexual assault among working females in Nigeria. They reported that the sexual assault rate was 77.7%. In 38.6% of assault cases, the assailant was a customer. Girls who were younger than 12 years, had no formal education, worked for more than 8 h/day, or had two or more jobs were more likely to experience sexual assault. 34

Main findings of this study

Through a comprehensive systematic review, we conclude that child labor continues to be a major public health challenge. Child labor continues to be negatively associated with the physical and psychological health of children involved. Although no cause–effect relation can be established, as all studies included are cross-sectional, studies documented higher prevalence of different health issues in working children compared to control groups or general population.

This reflects a failure of policies not only to eliminate child labor, but also to make it safer. Although there is a decline in the number of working children, the quality of life of those still engaged in child labor seems to remain low.

Children engaged in labor have poor health status, which could be precipitated or aggravated by labor. Malnutrition and poor growth were reported to be highly prevalent among working children. On top of malnutrition, the nature of labor has its effects on child’s health. Most of the studies adjusted for the daily working hours. Long working hours have been associated with poorer physical outcomes. 18 , 19 , 25 , 26 , 35 It was also reported that the likelihood of being sexually abused increased with increasing working hours. 34 The different types and sectors of labor were found to be associated with different health outcomes as well. 13 , 18 , 24 However, comparing between the different types of labor was not possible due to lack of data.

The majority of studies concluded that child labor is associated with higher prevalence of mental and behavioral disorders, as shown in the results. School attendance, family income and status, daily working hours and likelihood of abuse, in its different forms, were found to be associated with the mental health outcomes in working children. These findings are consistent with previous studies and research frameworks. 36

Child labor subjects children to abuse, whether verbally, physically or sexually which ultimately results in psychological disturbances and behavioral disorders. Moreover, peers and colleagues at work can affect the behavior of children, for example, smoking or drugs. The effects of child labor on psychological health can be long lasting and devastating to the future of children involved.

What is already known on this topic

Previous reviews have described different adverse health impacts of child labor. However, there were no previous attempts to review the collective health impacts of child labor. Working children are subjected to different risk factors, and the impacts of child labor are usually not limited to one illness. Initial evidence of these impacts was published in the 1920s. Since then, an increasing number of studies have used similar methods to assess the health impacts of child labor. Additionally, most of the studies are confined to a single country.

What this study adds

To our knowledge, this is the first review that provides a comprehensive summary of both the physical and mental health impacts of child labor. Working children are subjected to higher levels of physical and mental stress compared to non-working children and adults performing the same type of work. Unfortunately, the results show that these children are at risk of developing short and long-term health complications, physically or mentally.

Though previous systematic reviews conducted on the topic in 19 97 1 and 20 07 8 reported outcomes in different measures, our findings reflect similar severity of the health impacts of child labor. This should be alarming to organizations that set child labor as a target. We have not reviewed the policies targeting child labor here, yet our findings show that regardless of policies in place, further action is needed.

Most of the current literature about child labor follow a cross-sectional design, which although can reflect the health status of working children, it cannot establish cause–effect associations. This in turn affects strategies and policies that target child labor.

In addition, comparing the impacts of different labor types in different countries will provide useful information on how to proceed. Further research following a common approach in assessing child labor impacts in different countries is needed.

Limitations of this study

First, we acknowledge that all systematic reviews are subject to publication bias. Moreover, the databases used might introduce bias as most of the studies indexed by them are from industrialized countries. However, these databases were used for their known quality and to allow reproduction of the data. Finally, despite our recognition of the added value of meta-analytic methods, it was not possible to conduct one due to lack of a common definition for child labor, differences in inclusion and exclusion criteria, different measurements and different outcome measures. Nevertheless, to minimize bias, we employed rigorous search methods including an extensive and comprehensive search, and data extraction by two independent reviewers.

Compliance with ethical standards

The authors declare that they have no conflict of interest.

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• developing countries
• mental health
• child labor

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The present work is a concrete example of how physico-chemical studies, if performed in depth, are crucial to understand the behavior of pharmaceutical solids and constitute a solid basis for the control of the reproducibility of the industrial batches. In particular, a deep study of the thermal behavior of glipizide, a hypoglycemic drug, was carried out with the aim of clarifying whether the recognition of its polymorphic forms can really be done on the basis of the endothermic peak that the literature studies attribute to the melting of the compound. A number of analytical techniques were used: thermal techniques (DSC, TGA), X-ray powder diffraction (XRPD), FT-IR spectroscopy and scanning electron microscopy (SEM). Great attention was paid to the experimental design and to the interpretation of the combined results obtained by all these techniques. We proved that the attribution of the endothermic peak shown by glipizide to its melting was actually wrong. The DSC peak is no doubt ...

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Child Labor in the Philippines

PHILIPPINES – A child miner pulls an improvised cart made from a gasoline container carrying heavy rocks. Child laborers in mines are at risk of severe injury and death, and face long-term health problems caused by back-breaking labor, constant exposure to dust and chemicals, and most of all mercury poisoning.

Child labor persists side by side with chronic poverty in the Philippines. While programs to address child labor by the government, international agencies and civil society groups are in place, child labor is still worsening. Based on the latest official count as of 2011, there are 3.2 million child laborers who are mostly in hazardous work, out of the 5.5 million children at work.[1]

The problem of child labor lies deeply in the structural problems of the society, heavily connected to deeply rooted poverty and continuous non-inclusive growth in the economy. Other push factors of child labor include land-grabbing, low family income, lack of regular and decent jobs with living wages for parents, and low awareness on rights of children among poor families. This is aggravated as businesses and companies continue to exploit child laborers through lower wages, lack of benefits and protection, and weak government mechanisms and instruments to combat the employment of children. Child laborers are forced to leave their formal education and focus on their work, leaving them more vulnerable to abuses, violations and little chance and opportunity to have a better future.

BUKIDNON – People in Don Carlos, Bukidnon depend mainly on agriculture and plantation work. Child laborers in sugarcane estates work in weeding, harvesting and fetching of water.

The number of children working in hazardous industries stands at 2.99 million (2011), an increase from 2.2 million in 1995. Child labor is prevalent in rural areas, particularly in mining sites and in agricultural plantations (sugarcane, banana, palm oil). A study conducted by EILER indicates that child labor in the country has worsened as reflected in:

Longer working hours of children, multiple jobs juggled by child laborers, and exposure to social hazards (such as use of illegal drugs) and occupational health and safety hazards.

One out of five households surveyed for the study showed incidence of child labor.

High tendency for child laborers to stop schooling. Child laborers normally work for an average of ten hours daily for a tiny fraction of the prevailing minimum wage and extreme cases of 24-hour shift in mining, even as the magnitude of their work is comparable to those of adults.

Ninety-six percent (96%) of households surveyed were living below the poverty thresholds of their region and have an average monthly family income of P1,000 – P3,000 (highest incidence of child labor at 40%).

Seventy-seven percent (77%) of households surveyed do not own land and has no accessibility to land.

The children and their families have no means to escape the vicious cycle of generational poverty as child laborers work the same kind of low-income, labor-intensive jobs and generate just enough income to eat and work the next day. Unable to finish basic education, they are unable to apply to stable work which demands technical skills they do not have.

Children working in hazardous industries are exposed to the dangers and perils of heavy physical work, exposure to chemicals and unsafe working conditions. At their tender age, these children are deprived of their right to education, right against economic exploitation and right to have everything they need to have a better future.

DAVAO DEL NORTE – Child laborers in banana plantations often serve as fruiters, harvesters, haulers, loaders, and uprooters. Over time, the children have sustained injuries from weeding, harvesting, bagging and de-leafing work.

End poverty. End child labor.

November 20, 2014 marked the 25th year since the U.N. General Assembly adopted the Convention on the Rights of Child (CRC). Throughout the years, there have been significant achievements on upholding the rights of children worldwide, but much has to be done to address the root causes of child labour and build actions to end its worst forms.

The Ecumenical Institute for Labor Education and Research (EILER) with support from the European Union under the European Instrument for Democracy and Human Rights (EIDHR) implemented “Bata Balik-Eskwela: Community-based Approach in Combating Child Labor in Hazardous Industries in Mining and Plantations” from 2013 to 2016 to help curb child labor in Caraga Region, Bukidnon, Camarines Norte, Davao Del Norte, Compostela Valley and Negros Occidental through education and building community-based support network for child laborers and their families.

Read  Bittersweet: Combatting Child Labour on the Sugarcane Plantations in the Philippines   from the European Commission website.

Watch  “Dula-anan” (2016) video documentary on the campaign to end child labor and the Bata Balik-Eskwela Program.

COMPOSTELA VALLEY – Beneficiaries of Bata Balik-Eskwela Program in Southeastern region of the Philippines start their graduation ceremony at the open court of their rural community (on top of Mt. Diwalwal) with a prayer.

The project aimed to reintegrate child laborers to formal education through the establishment of Learning Centers, creation of a community-based support system and advocating children’s rights. It had three (3) components namely Bata Balik-Eskwela Program (BBEP), Community-based Support Network Program (CBSP) and Public Awareness and Advocacy Program (PAAP).

Through the project and in cooperation with the Center for Trade Union and Human Rights , Institute for Occupational Health and Safety Development , Rural Missionaries of the Philippines Northern Mindanao Sub-region , and community organizations, six (6) Learning Centers were established to provide appropriate curriculum and school materials to the beneficiaries. At the end of the project, a total of 618 children enrolled in five (5) batches at each learning center and 518 of them completed the program.

[1] 2011 Survey on Children, National Statistics Office. http://web0.psa.gov.ph/content/number-working-children-5-17-years-old-estimated-55-million-preliminary-results-2011-survey

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The Impact of Productive Assets and Training on Child Labor in the Philippines

Around the world, 152 million children are engaged in child labor, and in the Philippines many of the children working illegally are in occupations that pose a threat to their health and safety. Because poverty is considered to be the root cause of child labor, policymakers have aimed to reduce child labor by improving the economic welfare of poor households that are using or vulnerable to using child labor. In the Philippines, an IPA research team worked with the government to test whether providing poor households with a one-time productive asset transfer equivalent to US$518, along with a short business training, improved economic well-being and reduced in child labor. Preliminary results indicate that the program increased household business activity, food security, and some measures of child welfare, but it also led to a modest increase in child labor from family-based economic activities, specifically for children who had not worked before.  

Policy Issue

The elimination of child labor in all its forms is one of the measurable targets for the UN Sustainable Development Goal 8: “Promote inclusive and sustainable economic growth, employment and decent work for all.” Widespread child labor in low-income countries is thought to damper future economic growth through its negative impact on child development. Child labor also depresses economic growth by discouraging the adoption of skill-intensive technologies, while lowering wages in low-skill sectors. Because poverty is considered the root cause of child labor, policymakers have aimed to reduce child labor by improving the economic welfare of poor households. This study aimed to shed light on whether sustainable livelihoods promotion can stop child labor where it already exists, which many other interventions have failed to do, and prevent it from occurring in households that are vulnerable to using child labor.

Context of the Evaluation

Despite strong economic progress over the last several decades, one in five Filipino families remain below the poverty line, and a 2011 study found 2.1 million Filipino children were engaged in unlawful child labor. Sixty-two percent worked in hazardous labor activities where chemical, physical, and biological hazards exist. 1

The Philippine government is a global leader in the discussion of anti-child labor policies through the Philippine Department of Labor and Employment’s (DOLE) Kabuhayan Para sa Magulang ng Batang Manggagawa (KASAMA) Program. This program provides in-kind transfers of equipment, tools, and/or raw materials and trainings to parents of child laborers in an effort to promote sustainable, alternative forms of income that replace the family’s use of child labor.

This study was conducted in five regions of the Philippine island of Luzon. Two of these regions, Bicol and Central Luzon, account for more than 1 in 5 of all child laborers in the Philippines. 2  Among the families in the study, 73 percent of children living in treated households were child laborers, and these families lived on less than $1.30 per person per day on average.

Details of the Intervention

Innovations for Poverty Action worked with researchers to test the impact of the KASAMA program on child labor, economic activity, household income, and consumption.

The program offered households a productive asset along with a short business training and was designed to support families in moving to more entrepreneurial activities and sustainable livelihoods. Potential beneficiaries were drawn from existing government lists of vulnerable families with children and families with child laborers.

One-hundred and sixty-four communities (barangays) across five regions of Luzon were randomly assigned to one of two groups:

• Program group:   Households in 82 communities could access an asset such as livestock, farming tools, inventory for vending snacks, or materials for producing home goods (such as candles or curtains) worth PHP10,000 (USD$518 Purchasing Power Parity). The program also included three one-day trainings designed to provide assistance on developing a business plan, bookkeeping, marketing and financial literacy. The training also included a brief orientation on child labor: how it is defined legally in the Philippines and how the government is engaging communities to reduce child labor.  Households were not told the program was designed to reduce child labor, however. (1,148 households)
• Comparison group: This group was comprised of 82 communities who did not receive the intervention. (1,148 households)

Researchers measured impacts of the program approximately 18 months after it started.

Results and Policy Lessons

Overall, households offered the program had better food security and improvements in some measures of child welfare (e.g., life satisfaction), but it also led to a modest increase in the number of children who worked. The increase in child labor appears to be driven by the increase in work opportunities brought on by the family businesses.

Livelihoods : Households assigned to receive the program were more likely to start new businesses and preserve existing businesses.

• Households offered the program were 9 percentage points more likely to report the presence of either an agricultural or non-agricultural family firm, an 11 percent increase over comparison households.
• These households reported 0.26 new non-farm enterprises over the study period (a 61 percent increase over the comparison group).  Overall, households offered the program have 0.36 more non-farm enterprises at follow-up compared to the comparison group.  Because this 0.36 is bigger than the number of new non-farm enterprises, we can infer that the program helped some existing enterprises survive.
• The most common assets transferred were for the creation or expansion of small convenience stores (“sari-sari ” stores ) .
• Flexibility in asset choice appeared important to beneficiaries according to qualitative interviews with frequent reports of experimentation in different enterprises to find what worked best for the household and some suggestion that the best asset for one household was not necessarily the best asset for another household, even in the same community.

Economic well-being:  Household food security improves:

• Adults and children less than age 14 report not having to cut meals, being able to eat preferred food options, and not needing to borrow food or purchase food on credit.

Child labor: There was no overall effect on primary or secondary measures of child labor.

• For children not involved in child labor at baseline, employment in family based economic activities increases by 10 percentage points, a 16 percent increase over the comparison group.  Economic activity rates increased for this group overall by 8.4 percentage points or 13 percent.
• For children already involved in child labor at baseline, the program seemed to have little effect on their time allocation.
• There is no evidence to suggest that increasing the value of the productive asset transfer would change the child labor findings, although that could be subject to further study.

Child welfare: Child welfare increased on average. 3  This appears to be driven largely by changes in life satisfaction and is concentrated among children already in child labor before the program started. These improvements in welfare for children who were laborers before the program began seems to again be due to improvements in life satisfaction. Children were more likely to report that they were thriving and had higher scores on the Student’s Life Satisfaction Survey. For children not in child labor before the program, the main outcome in which they show improvements in welfare is that they were less likely to report they were suffering. It is worth noting that children in homes that already had businesses before the program was offered did not experience these gains in child welfare and life satisfaction, which could be due to the increase in work in this group.

Policy Lessons

Overall, these findings raise questions about the value of providing a productive asset transfer to families in order to reduce child labor. Yet they also highlight the value of KASAMA in ameliorating poverty, increasing food security, and improving very poor children’s life satisfaction.

This highlights one of the important––and previously unknown–– tensions in using a sustainable livelihood program to combat child labor.  Families with child labor present are amongst the poorest and most disadvantaged, and livelihood support can make them less impoverished (as KASAMA has done).  However, when introducing a new enterprise into a household, available laborers are needed to work in the new enterprise.  In this context, there was not a large surplus of prime-age adult labor.  Poor families were working hard to make ends meet, so the addition of a new economic activity or expanding an existing activity brought in more marginal workers, which were often children and the aged (unreported above, elder women increased their economic activity by 48 percent from being offered the program).  Thus, it is critical to be clear on the goals of a sustainable livelihood program.  If the goal is to improve the lives of families with child labor, then KASAMA was an impressive success. However, if the goal was to eliminate child labor in beneficiary families, then the program was not successful in reaching that goal and other approaches should be considered and tested.

Funding for this project was provided by the United States Department of Labor.

This material does not necessarily reflect the views or policies of the United States Department of Labor, nor does the mention of trade names, commercial products, or organizations imply endorsement by the United States Government.

[1] “Philippines - 2011 Survey on Children 5 to 17 Years Old - Final Report,” Report, February 1, 2014. p. 8  http://www.ilo.org/ipec/Informationresources/WCMS_IPEC_PUB_26815/lang--en/index.htm.

[2] “Philippines - 2011 Survey on Children 5 to 17 Years Old - Final Report,” p. 56.

[3] The primary life satisfaction metric is Cantril’s (1965) Ladder which researchers collected for each child 10-17 in the household. The respondent provided a scaled response of their life quality ranging between 0 to 10, and researchers examine the impact of KASAMA on the child’s raw score and on indicators consistent with how the Gallop Organization uses Cantril’s Ladder, creating indicators by splitting the responses into thriving (7+) and suffering (4-).