Understanding demand for, and feasibility of, centre-based child-care for poor urban households: a mixed methods study in Dhaka, Bangladesh.
Understanding demand for, and feasibility of, centre-based child-care for poor urban households: a mixed methods study in Dhaka, Bangladesh.
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了解城市贫困家庭对中心托儿服务的需求和可行性：孟加拉国达卡混合方法研究。
DOI：
10.1186/s12889-020-09891-z
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发表时间：
2020-12-10
影响因子：
4.5
通讯作者：
Saidur M
中科院分区：
文献类型：
--
作者：
Elsey H;Fieroze F;Shawon RA;Nasreen S;Hicks JP;Das M;Huque R;Hirano I;Wallace HJ;Saidur M
以中心为基础的托儿服务有可能为儿童、家庭和社会提供多种健康和发展益处。随着快速城市化，越来越多的低收入妇女在工作中得不到大家庭的支持，这在许多低收入和中等收入国家造成了儿童保育真空。我们旨在了解孟加拉国达卡贫困城市家庭对中心托儿服务的看法和需求，并测试提供可持续中心托儿服务的可行性。我们采用了顺序混合方法，包括家庭调查（n = 222）和对照护者（n = 16）、社区领袖（n = 5）和政策制定者（n = 5）的定性访谈。我们共同制作并试点了一个以中心为基础的儿童保育模式，历时10个月，记录了实施情况。共同设计焦点小组包括母亲、家长会议和对托儿中心用户（n = 5）、非用户（n = 3）、前用户（n = 3）和工作人员(2)的定性访谈，以完善模型并确定实施问题。我们发现24% （95% CI: 16,37%）的看护人报告说，由于缺乏托儿服务而拒绝有偿工作，84% （95% CI: 74,91%）的看护人报告说希望使用中心托儿服务，并愿意每月支付高达283塔卡（约3.30美元）。经调整后，贫民窟家庭报告的托儿需求是非贫民窟家庭的3.8倍（95%置信区间：1.4,10）。执行情况强调，贫困家庭需要免费托儿并提供食物，这对可行性提出了挑战。通过定量和定性研究结果的元推理，确定了城市环境对儿童保育的影响，包括工作时间长、社会资本低和对儿童安全的担忧。这些影响与宗教和社会规范相互作用，导致尽管有明显的需要，但在使用以中心为基础的托儿服务时仍然谨慎。可持续地提供以幼儿发展为重点的以中心为基础的照料需要补贴和对贫穷家庭、特别是妇女的工作生活敏感的精心设计，并且必须对城市环境和社区价值的动态作出反应。我们建议加强研究和政策重点，以评估和扩大以中心为基础的优质托儿服务，强调儿童早期发展，以支持城市地区的低收入工薪家庭。
Centre-based child-care has potential to provide multiple health and development benefits to children, families and societies. With rapid urbanisation, increasing numbers of low-income women work with reduced support from extended family, leaving a child-care vacuum in many low- and middle-income countries. We aimed to understand perceptions of, and demand for, centre-based child-care in Dhaka, Bangladesh among poor, urban households, and test the feasibility of delivering sustainable centre-based child-care. We used sequential mixed methods including a household survey (n = 222) and qualitative interviews with care-givers (n = 16), community leaders (n = 5) and policy-makers (n = 5). We co-produced and piloted a centre-based child-care model over ten-months, documenting implementation. A co-design focus group with mothers, parents’ meetings, and qualitative interviews with child-care centre users (n = 5), non-users (n = 3), ex-users (n = 3) and staff (2) were used to refine the model and identify implementation issues. We found 24% (95% CI: 16,37%) of care-givers reported turning-down paid work due to lack of child-care and 84% (95% CI:74, 91%) reported wishing to use centre-based child-care and were willing to pay up to 283 Takka (~$3.30) per month. Adjusted odds of reported need for child-care among slum households were 3.8 times those of non-slum households (95% CI: 1.4, 10). Implementation highlighted that poor households needed free child-care with food provided, presenting feasibility challenges. Meta-inference across quantitative and qualitative findings identified the impact of the urban environment on child-care through long working hours, low social capital and fears for child safety. These influences interacted with religious and social norms resulting in caution in using centre-based child-care despite evident need. Sustainable provision of centre-based care that focuses on early childhood development requires subsidy and careful design sensitive to the working lives of poor families, particularly women and must respond to the dynamics of the urban environment and community values. We recommend increased research and policy focus on the evaluation and scale-up of quality centre-based child-care, emphasising early-childhood development, to support low-income working families in urban areas.
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