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Differential effects of out-of-home day care in improving child nutrition and augmenting maternal income among those with and without childcare support: A prospective before-after comparison study in Pokhara, Nepal

Listed author(s):
  • Nakahara, Shinji
  • Poudel, Krishna C.
  • Lopchan, Milan
  • Poudel, Om Raj
  • Poudel-Tandukar, Kalpana
  • Ichikawa, Masao
Registered author(s):

    Objectives We examined (1) whether attending out-of-home day care centres (DCCs) has differential effects on improvement of child nutrition and facilitation of maternal employment depending on availability of non-institutionalised childcare support and (2) whether attendance increases infectious diseases.Methods In a prospective before-after comparison study at public DCCs in Pokhara, Nepal, we compared weight-for-age Z-score (WAZ) and height-for-age Z-score (HAZ) among children attending DCCs between at admission, after 6 months, and after 1 year and determined differential changes in these measures between those with and without appropriate childcare support. We used repeated measures analysis of variance with interaction terms between support availability and DCC attendance. We compared maternal income and incidence of diarrhoea and fever in children between the periods of waiting and attending.Results After 6 months, neither WAZ nor HAZ significantly changed. After 1 year, WAZ significantly improved, but HAZ did not change among all participants. Those without appropriate childcare support showed greater improvement in both WAZ and HAZ than those with support. While children were attending, income increased only among those mothers who were already working without any childcare support at baseline. Neither diarrhoea nor fever increased.Conclusions DCCs can be more beneficial for child nutrition and working mothers in households lacking childcare support than in those with support.

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    File URL: http://www.sciencedirect.com/science/article/pii/S0168-8510(10)00057-6
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    Article provided by Elsevier in its journal Health Policy.

    Volume (Year): 97 (2010)
    Issue (Month): 1 (September)
    Pages: 16-25

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    Handle: RePEc:eee:hepoli:v:97:y:2010:i:1:p:16-25
    Contact details of provider: Web page: http://www.elsevier.com/locate/healthpol

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    1. Doan, Rebecca Miles & Popkin, Barry M., 1993. "Women's work and infant care in the Philippines," Social Science & Medicine, Elsevier, vol. 36(3), pages 297-304, February.
    2. Wong, Rebeca & Levine, Ruth E, 1992. "The Effect of Household Structure on Women's Economic Activity and Fertility: Evidence from Recent Mothers in Urban Mexico," Economic Development and Cultural Change, University of Chicago Press, vol. 41(1), pages 89-102, October.
    3. Tucker, Katherine & Sanjur, Diva, 1988. "Maternal employment and child nutrition in Panama," Social Science & Medicine, Elsevier, vol. 26(6), pages 605-612, January.
    4. Engle, Patrice L., 1993. "Influences of mothers' and fathers' income on children's nutritional status in Guatemala," Social Science & Medicine, Elsevier, vol. 37(11), pages 1303-1312, December.
    5. Patricia Apps, 2003. "Gender, Time Use and Models of the Household," CEPR Discussion Papers 464, Centre for Economic Policy Research, Research School of Economics, Australian National University.
    6. Zoritch, B. & Roberts, I. & Oakley, A., 1998. "The health and welfare effects of day-care: A systematic review of randomised controlled trials," Social Science & Medicine, Elsevier, vol. 47(3), pages 317-327, August.
    7. Hallman, Kelly & Quisumbing, Agnes R & Ruel, Marie & de la Briere, Benedicte, 2005. "Mothers' Work and Child Care: Findings from the Urban Slums of Guatemala City," Economic Development and Cultural Change, University of Chicago Press, vol. 53(4), pages 855-885, July.
    8. Lamontagne, Jessica F. & Engle, Patrice L. & Zeitlin, Marian F., 1998. "Maternal employment, child care, and nutritional status of 12-18-month-old children in Managua, Nicaragua," Social Science & Medicine, Elsevier, vol. 46(3), pages 403-414, February.
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