Improving the quality of child-care centres through supportive assessment and ‘communities of practice’ in informal settlements in Nairobi: protocol of a feasibility study

Abstract

IntroductionInvesting in children during the critical period between birth and age 5 years can have long-lasting benefits throughout their life. Children in Kenya’s urban informal settlements, face significant challenges to healthy development, particularly when their families need to earn a daily wage and cannot care for them during the day. In response, informal and poor quality child-care centres with untrained caregivers have proliferated. We aim to co-design and test the feasibility of a supportive assessment and skills-building for child-care centre providers.Methods and analysisA sequential mixed-methods approach will be used. We will map and profile child-care centres in two informal settlements in Nairobi, and complete a brief quality assessment of 50 child-care centres. We will test the feasibility of a supportive assessment skills-building system on 40 child-care centres, beginning with assessing centre-caregivers’ knowledge and skills in these centres. This will inform the subsequent co-design process and provide baseline data. Following a policy review, we will use experience-based co-design to develop the supportive assessment process. This will include qualitative interviews with policymakers (n=15), focus groups with parents (n=4 focus group discussions (FGDs)), child-care providers (n=4 FGDs) and joint workshops. To assess feasibility and acceptability, we will observe, record and cost implementation for 6 months. The knowledge/skills questionnaire will be repeated at the end of implementation and results will inform the purposive selection of 10 child-care providers and parents for qualitative interviews. Descriptive statistics and thematic framework approach will respectively be used to analyse quantitative and qualitative data and identify drivers of feasibility.Ethics and disseminationThe study has been approved by Amref Health Africa’s Ethics and Scientific Review Committee (Ref: P7802020 on 20th April 2020) and the University of York (Ref: HSRGC 20th March 2020). Findings will be published and continual engagement with decision-makers will embed findings into child-care policy and practice.

Improving early childhood development in the context of the nurturing care framework in Kenya: A policy review and qualitative exploration of emerging issues with policy makers

“…We conducted individual qualitative interviews with policy and decision-makers at national, Nairobi County and sub-County (Makadara and Ruaraka) levels to understand the policy and planning context, the extent to which the components of the NCF have been addressed within policies and plans and any perceived gaps or challenges to their inclusion in future. Nairobi County was the only county involved in the qualitative interviews as this policy review has been nested within a larger feasibility study being conducted in Nairobi ( 35 ). This interview study has been approved by Amref Health Africa's Ethics and Scientific Review Committee (Ref: P7802020) and the University of York Health Sciences Research Governance Committee (Ref: HSRGC).…”

“…To establish the extent to which government policies and plans address the components of the NCF, particularly in relation to center-based childcare, and explore policy makers' views, we carried out a policy review as part of a study that explored feasible models to improve the quality of center-based childcare in informal settlements in Nairobi ( 35 ). The objectives for the review include: (i) To identify the extent to which the NCF is addressed in Kenyan national policies and county government plans; (ii) To identify the extent and characteristics of childcare center provision in Kenya as specified in county-level plans; and (iii) To explore, from the perceptions of decision-makers, the extent to which nurturing care, including quality center-based childcare is addressed within national and county level policies and plans.…”

Editorial: Day-care for healthy child development and wider social and economic gain in urban areas in low- and middle income countries

“…Interventions that respond to one or more issues raised above are needed to optimize care for young children in the urban poor communities. Three papers from one study done in Kenya ( 16 ) highlight that interventions should be designed to fit a given context, to address the existing knowledge gaps, and maximize stakeholder engagement in their conceptualization and implementation. Initiatives that leverage local (government) structures for integration, sustainability and scaling are more likely to be successful as presented in the three publications.…”

Sociodemographic predictors of parenting stress among mothers in disadvantaged settings: evidence from rural and urban study sites in Kenya and Zambia

“…However, such practices are uncommon in urban settings, where mothers often take their children to childcare facilities as they go to work. Notably, the quality of such childcare services is often poor, which could cause parents to worry about whether their child is receiving the right services [44].…”