We are the first to research how India’s public works program (NREGS), by increasing the opportunity for female employment, subsequently affects investments in child health and child health outcomes. The net effect of public works programs on child health is unclear given the trade-off women face between working and care-giving. NREGS raises the value of working, reducing the incentive for women to spend time care-giving at home, potentially negatively impacting children’s health. But mothers may use their additional income from NREGS to purchase high-quality healthcare, resulting in improved health outcomes for children.

Our results are consistent with the predictions of a maternal labor supply model. Using linear, non-linear, and non-parametric methods, we find that after the implementation of NREGS, women significantly reduce their engagement in time-intensive health inputs in favor of employment, which subsequently increases their use of money-intensive health inputs. As outside employment options become more lucrative, women in NREGS areas delay their first prenatal visit, reduce the total number of visits received, and spend less time breastfeeding children, compared to women in non-NREGS areas. Subsequently, women in program areas increase their utilization of money-intensive health inputs, and are significantly more likely to deliver in healthcare facilities than women in untreated areas. The net effect of decreased time-intensive health inputs and increased money-intensive inputs on child health is ambiguous.