Despite evidence from other regions, researchers and policy-makers remain skeptical that women’s disproportionate childcare responsibilities act as a significant barrier to women’s economic empowerment in Africa. This randomized control trial study in an informal settlement in Nairobi, Kenya, demonstrates that limited access to affordable early childcare inhibits poor urban women’s participation in paid work. Women who were offered vouchers for subsidized early childcare were, on average, 8.5 percentage points more likely to be employed than those who were not given vouchers. Most of these employment gains were realized by married mothers. Single mothers, in contrast, benefited by significantly reducing the time spent working without any loss to their earnings by shifting to jobs with more regular hours. The effects on other measures of women’s economic empowerment were mixed. With the exception of children’s health care, access to subsidized daycare did not increase women’s participation in other important household decisions. In addition, contrary to concerns that reducing the costs of childcare may elevate women’s desire for more children, we find no effect on women’s fertility intentions. These findings demonstrate that the impact of subsidized childcare differs by marital status and across outcomes. Nonetheless, in poor urban Africa, as elsewhere, failure to address women’s childcare needs undermines efforts to promote women’s economic empowerment.

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T o suppress the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the pathogen responsible for coronavirus disease 2019 (COVID-19), many countries have adopted social-isolation measures. 1,2 These efforts have been largely successful but have had major economic implications. As of June 2020, the Canadian federal fiscal response alone was an estimated $169.2 billion. 3 Further, unemployment in June 2020 was 12% 4 and real gross domestic product is projected to fall 8.4% in 2020. 5 These consequences have led to demands to reopen the economy quickly. 6,7 Reverse transcription polymerase chain reaction (RT-PCR) is primarily used to detect acute SARS-CoV-2. 8 Because of capacity constraints, RT-PCR testing was initially reserved for individuals presenting with symptoms consistent with COVID-19. 9-11 As capacity expanded and the initial wave of the epidemic was brought under control, however, testing was subsequently made available to people with minimal or no symptoms. 12 Modelling studies have estimated such individuals account for more than 50% of community transmission. 13-16 This is supported by studies that indicate viral shedding begins before symptom onset 17,18 and case series