Child Care Providers Research Articles

How policies created without early childhood educator input create toxic working environments that objectify educators

Through the lens of objectification and toxic workplace theory, this article critically examines Ontario, Canada's policies and regulations on early childhood education and care (ECEC). In the context of Canada's transition to universal child care and the persistent workforce crisis in the ECEC sector, this article highlights how registered early childhood educators (RECE) workplace challenges, including poor working conditions, low wages, and a lack of professional recognition, are theorized within objectification and toxic workplace theory. Specifically, the Child Care and Early Years Act (CCEYA) and the Ontario Early Year Framework, which establish the standards and regulations for licensed childcare providers, are analyzed to determine how they objectify RECEs and create toxic workplaces. Grounded in advocacy to improve working conditions in ECEC, this article provides a unique framework for understanding and interrupting how RECEs are not considered in creating government regulations, how individual centers and organizations can interpret the current rules to continue to devalue the contributions of RECEs to the sector, and how and why this continuation of devaluation is affecting the well-being and working conditions of RECEs.

Are the grandparents alright? The health consequences of grandparental childcare provision

This paper examines the causal effect of childcare provision on grandparents’ health in the United States. We use the sex ratio among older adults’ children as an instrument for grandparental childcare provision. Our instrument exploits that parents of daughters transition to grandparenthood earlier and invest more in their grandchildren than parents of sons. We estimate 2SLS regressions using data from the Health and Retirement Study. The results suggest that providing childcare is detrimental to grandparents’ physical functioning and subjective health. We show that these effects increase with the intensity of grandchild care provision, and the effects are driven primarily by grandmothers.

Co-resident grandparent and maternal employment. A Northern Ireland cross-sectional administrative data analysis

The trade-off between the costs of childcare provision and the benefits of having an increased proportion of women, particularly women with dependent children, in employment is one of the most taxing social issues for Western governments. In countries like Northern Ireland, the limited subsidised childcare provision for preschool and primary school children has been partially offset by a rise in informal childcare though this has been considerably hard to assess both in terms of magnitude and effect. Using the entire 2011 Census cohort of mothers with children aged 1 to 16 years of age, we argue that co-resident grandparents have a substantial positive impact on maternal labour force participation in Northern Ireland. The presence of a co-resident grandparent was associated with an increase of 3.7 percentage points in employment for single-parent mothers and 2 percentage points for mothers in two-parent households. Mothers with co-resident grandparents report an increase of 2.7 percentage points for a single mother and of 3.7 percentage points for a mother in a two-parent household being in full-time employment than mothers without. Overall, the presence of a co-resident grandparent was associated with at least a 3.2 percentage point increase in labour force participation among mothers with primary-school-age children.

A Statewide Program to Test and Reduce Lead in Drinking Water at Schools and Child Cares.

A lead testing act was passed in Colorado mandating that all licensed child care facilities and public schools serving fifth grade and lower test all drinking water locations for lead by May 31, 2023. Colorado's Water Quality Control Division created the Test & Fix Water for Kids program to implement this act. Aspects of the program included establishing a database, outreach and education, technical assistance, lead analyses at the Colorado State Laboratory, remediation, and reimbursement. Of a total of 6000 licensed child care providers and public elementary schools, 4500 entities enrolled and tested 53 000 water samples for lead at drinking water fixtures. Testing results showed that 93% (46 000 total) of the fixtures tested were below the 5 parts per billion (ppb) action level. As a result, 7% (3700) of the fixtures tested were above the action level. Of the fixtures that tested above 5 ppb, 47% were classroom faucets. Many of these faucets had not been used since COVID-19 when several schools switched to using bottle fillers. The program identified all fixtures associated with low usage as well as older fixtures to be replaced with lead-free options to reduce lead levels below 5 ppb. Almost 600 000 children have been protected from potential exposure to lead in drinking water through this program. This article outlines the methods of launching a statewide lead testing program and the importance of testing fixtures for lead in drinking water in early childhood education buildings.

Have later state pensions made people less connected? The effects of older female pension ages in England on social capital

Abstract Many countries have increased their state pension ages (SPAs) to offset demographic ageing and to increase numbers of older people remaining in paid work. Most research attention has focused on the economic outcomes whereas little attention has been paid to impacts on social capital, including rates of volunteering and care-giving. Prior research suggests that these are sensitive to retirement decisions. Using nine waves of individual longitudinal data from the English Longitudinal Study of Ageing, this study examines the effects of increased SPA on volunteering, group membership and providing care. Our results show that higher SPAs have a negative impact on rates of volunteering and providing care, particularly for women in couples. Single women are not affected, and there are not significant effects on group membership and childcare provision. The more work-like aspects of social capital are affected by the increased SPA.

Data Integration to Support Child Care Business Sustainability: Iowa’s Child Care Connect

Working parents need access to childcare, and the unprecedented COVID-19 pandemic highlighted critical gaps in data system capacities to meet this need. This was particularly acute in the US where many child care providers closed their doors permanently because they could not sustain their business. The state of Iowa estimates losses over $930 million per year to businesses and individuals due to a lack of childcare. Childcare businesses are not sustainable if they cannot fill slots and be consistently paid for care – and families need to be able to find care when they need it to fill those slots. Iowa is addressing this gap by developing a real-time, integrated data solution that includes historically disparate data systems to better identify childcare supply and demand. Through intensive community engagement processes including leadership from state agencies, the development team created a system that includes multiple technology solutions for real-time data sharing; a secure cloud-based system for storage, integration, and analysis; and two public-facing applications that allow data to be aggregated and shared for strategic decision-making as well as used by families to identify available care when and where they need it. This presentation will discuss challenges in cross-sector data linkage with a focus on child care providers, families, and population demand. It will include an overview of the development process, governance structure, and analytic uses of the system. Highlights include identification of real-time vacancies by age group, geography, quality rating, and in relation to estimated potential demand using additional integrated data resources.

COVID-19 School Closures Were Associated With A Decline In Employment For Female Nurses With Young Children.

COVID-19-related school closures may have had unintended consequences affecting the ability of health professionals with school-age children to work-particularly female professionals, who often have disproportionate child care responsibilities. We combined labor-force participation data from the Current Population Survey with measures of school closures based on cell phone mobility data to examine the association between local school closures and labor supply among female nurses during the COVID-19 pandemic. During the six months after large-scale closure of schools at the end of the 2019-20 school year (March-August2020), among counties with above-median school closure rates, the employment rate of female nurses with young children declined by 12.5percentage points versus the rate during the prior four months (November2019-February2020); the change in the employment rate in below-median counties was not statistically significant. No statistically significant changes were observed among female nurses who had only older children or among male nurses. During public health emergencies, policies should consider how disruptions to schooling may affect the labor supply of health care professionals. Strategies might include direct provision of child care by health care facilities, subsidies and other aid to child care centers, or subsidies to health care workers for affordable child care.

Evaluation of the WHO standards to assess quality of care for children with acute respiratory infections: findings of a baseline multicentre assessment (CHOICE) in Italy

BackgroundExperience is lacking on the implementation of the WHO standards for improving the quality of care (QOC) for children at facility level. We describe the use of 10 prioritised WHO...

Implementation of the WHO standards to assess quality of care for children with acute pain in EDs: findings of a multicentre study (CHOICE) in Italy

BackgroundThere is little experience on the use of the WHO Standards for improving the quality of care (QOC) for children. We describe the use of four prioritised WHO Standard-based Quality...

Does increased local female representation result in expanded childcare provisions? Implications from Japan

Does increased local female representation result in expanded childcare provisions? Implications from Japan

European paediatricians need to be more aware of the risks faced by children who swallow button batteries and how to treat them.

The aim of this study was to assess how aware European paediatricians were of the risks faced by children who swallowed button batteries and the advice for managing such cases. An Internet-based survey was conducted among European paediatricians between 1 April 2023 and 31 May 2023. The researchers contacted members of the European Academy of Paediatrics Research in Ambulatory Setting Network and a number of European national paediatric societies. Responses were received from 605 paediatricians (66.0% females) in 41 countries and 64.5% had encountered cases of button battery ingestion. Only 31.2% had received specific training and only 35.7% were familiar with the advice issued by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition and the European Academy of Pediatrics. While 90.8% of respondents correctly recognised the need for hospitalisation of a child after button battery ingestion, only 30.1% of them identified all symptoms and 58.2% could accurately determine the appropriate diagnostic scope. One in ten underestimated the health or life risks. These deficiencies were significantly attributed to a lack of adequate training (p < 0.01). The overwhelming majority of the respondents expressed the need to increase awareness among physicians and childcare providers, mainly through social media campaigns and advertisements. European paediatricians were insufficiently aware of button battery ingestion risks and management, with significant gaps in training and familiarity with advice. Respective education for medical practitioners and raising public awareness should be markedly strengthened.

LEGAL REQUIREMENTS OF HOME-BASED CHILDCARE CENTRES IN MALAYSIA; ARE CHILDCARE PROVIDERS AWARE?

Home-based childcare (HBCC) services are among the childcare services available in Malaysia, as ensconsced in the Child Care Centre Act 1984. In Malaysia, HBCC providers are only allowed to care for a minimum of four and a maximum of 10 children. However, this definition does not include small home-based childcare services or childminders who care for less than four children. Employing the qualitative method of content analysis, this study discusses the laws and regulations governing HBCC in Malaysia, particularly the legal requirements that need to be fulfilled. This is further supported by interviews conducted with childcare providers who look after children at their home to examine their level of understanding of the legal requirements under Malaysian childcare laws and regulations. Findings indicate, among others, that the HBCC operators are unaware of the need to register with the Social Welfare Department. The adherence to the legal requirements for this HBCC should not be taken lightly, as it is crucial to ensure the safety and well-being of children. Consequently, greater efforts are required to ensure the children's health and safety because the current procedures rely solely on the experience and expertise of the childcare providers. This paper contributes to the extent of knowledge of HBCC in Malaysia especially towards policy makers, child care operators and parents by exploring the experiences of HBCC childcare providers. It is proposed that continuous improvements need to be made to the laws and regulations on HBCC in ensuring high quality services of HBCC.

State childcare provision in China: Subnational variations and localized policy contexts across 31 mainland provinces

AbstractThe social organization of childcare is of special relevance to gender equality and family wellbeing. Childcare provision in China is often recognized as a case of familism, which highly relies on family care with limited state support. However, this all‐encompassing view may mask the local discrepancy generated by a decentralized social welfare system, especially when emerging initiatives have been enacted due to the government's concern about fertility. This article analyses the variation of childcare policies across 31 China mainland provinces, from the perspective of welfare regime theory. Using hierarchical cluster analysis, six policy patterns with varying configurations of familizing and defamilizing support are identified: (1) dual‐earner support, (2) moderate dual‐earner support, (3) moderate support, (4) general family support, (5) modified family support, and (6) a geo‐special case. We further explore the socioeconomic contexts of various policy profiles, with a particular focus on fertility and female employment. Findings suggest that, although with a nationally shared welfare ideology, subnational governments could exploit divergent strategies to support childcare in response to localized socioeconomic conditions. This research also provides insights into how childcare responsibilities are distributed between state and family in a non‐western country.

Accessibility of the early care and education supply: Variation within the center-based provider sector

Center-based early care and education (ECE) is important for promoting positive early development and supporting families by providing child care so parents can work. However, the center-based supply varies substantially in terms of funding sources, indicators of quality, and services offered; and many families experience a lack of equitable access to providers that meet their needs. Using a nationally representative sample of the center-based supply from the 2019 National Survey of Early Care and Education, this study examined patterns in the services center-based providers offer that may facilitate or pose barriers to families’ access from a multidimensional lens. Two research questions were investigated using latent class analysis: First, are there patterns of provider accessibility within the center-based supply, and second, are there covariates (i.e., funding, community poverty/ urban density, geographic region) that explain patterns of ECE access? Center-based features selected as indicators were informed by a definition of access comprised of multiple dimensions: availability, affordability, supports children’s development, and meets parent’s needs. Class enumeration suggested that a three-class model provided the best fit, indicating three patterns of program accessibility: providers that were: flexible at cost (25.9%), free but inflexible (29.2%), and somewhat accessible (44.9%). Additional covariate analyses revealed providers were significantly more or less likely to be classified into the latent classes of access according to community and funding characteristics. Notably, programs receiving Head Start and public preschool funding and those in communities with high poverty and urban density were more likely to be assigned to the free but inflexible class. A key component driving ECE utilization is the accessibility of providers, and these findings inform recommendations for future research and policy to better serve the needs of families with young children.

Oscillating autonomy: a grounded theory study of women’s experiences of COVID-19 infection during pregnancy, labour and birth, and the early postnatal period

BackgroundTesting positive for COVID-19 was associated with higher rates of detrimental psycho-social and physical health outcomes. The COVID-19 pandemic caused unprecedented disruption to everyday life. This included major reconfiguration of maternal, child, and perinatal mental health and care services and provision. This study aimed to investigate the experiences of those who tested positive for COVID-19 during pregnancy, labour and birth, or the early postnatal period.MethodsNational on-line recruitment from across the United Kingdom resulted in sixteen mothers being invited to qualitative semi-structured interviews to understand the experiences of mothers who had been infected by COVID-19 during pregnancy, labour and birth, or the early postnatal period. Interviews were conducted, recorded, and transcribed using video-conferencing software. A Grounded Theory approach was used to analyse the data gathered pertaining to women’s experiences of their positive COVID-19 diagnosis during pregnancy, labour and birth, or the early postnatal period.ResultsThe theory of ‘Oscillating Autonomy – Losing and Seeking to Regain Control by Striving for Agency’ was developed, comprising three main themes: ‘Anxious Anticipation: The fear of infection was worse than COVID-19 itself’; ‘Fluctuating Agency: What changed when COVID-19 took control’; and ‘Reclaiming Control: Seeking reassurance during COVID-19 positivity’. Testing positive for COVID-19 whilst pregnant, during labour or birth, or in the early postnatal period was associated with a perceived loss of control. Those who were able to regain that control felt more secure in their situation.ConclusionsSupport was paramount to manage increased vulnerability, as was reassurance achieved by information seeking and positive action including increased health monitoring and COVID-19 vaccination.

Unequal access to childcare in cities: Is equal public funding sufficient?

This article examines inequalities in the spatial accessibility of childcare between high- and low-status neighbourhoods in the city of Vienna and asks (i) whether specific public and non-profit provider types contribute to these inequalities and (ii) which factors may cause these inequalities in a mainly tax-funded childcare system. For our analysis, we combine data on the location and characteristics of childcare providers with spatially granular information on demand and neighbourhood characteristics. The results show that two provider types – church-related and independent non-profit providers – are mainly responsible for the higher accessibility of childcare in neighbourhoods with higher socio-economic status. Specifically independent providers charge significantly higher prices and offer more special services in these high-status areas. Public funding of a large part of the production costs, therefore, seems insufficient to ensure equal access in all neighbourhoods. These findings suggest that the exclusive comparison between public, private non-profit and private for-profit providers often found in the literature may be too narrow.

Effectiveness of training on primary care nurses' knowledge and screening practice in identification of children at risk for developmental delay: An Indian perspective.

In India, overall, 1.5-19.8% of the children were found to be developmentally delayed. The evaluation of development in young children and health professionals' early referrals for diagnostic assessment will accelerate appropriate early intervention as early as possible. Nurses can screen the children and help the parents by providing the necessary information and support. To train the primary care nurses on developmental screening and early identification of developmental delay (DD) in children and find the effectiveness of the same. To evaluate the effectiveness of the training program on the knowledge and screening practice of the nurses towards the identification of children at risk for DD and to find out the relationship between nurses' knowledge and screening practice. A quasi-experimental, one-group pretest, post-test design was adopted among 69 nurses, who were providing child care services and working in the selected government hospitals in Bengaluru, South India. Nurses' knowledge and screening practice in identifying children at risk for DD were assessed before and after the training. SPSS package 21.00 version was used to analyse the descriptive and inferential statistics. The training program was effective in the enhancement of primary care nurses' knowledge and screening practice in the identification of DDs in under-five children. The findings of this study concluded that developmental screening can be performed by nurses with suitable training programs. The training program played a significant role in the enhancement of nurses' knowledge and screening practice in the identification of DDs in under-five children.

The elements of end-of-life care provision in paediatric intensive care units: a systematic integrative review

BackgroundDeaths in paediatric intensive care units (PICUs) are not uncommon. End-of-life care in PICUs is generally considered more challenging than other settings since it is framed within a context where care is focused on curative or life-sustaining treatments for children who are seriously ill. This review aimed to identify and synthesise literature related to the essential elements in the provision of end-of-life care in the PICU from the perspectives of both healthcare professionals (HCPs) and families.MethodsA systematic integrative review was conducted by searching EMBASE, CINAHL, MEDLINE, Nursing and Allied Health Database, PsycINFO, Scopus, Web of Science, and Google Scholar databases. Grey literature was searched via Electronic Theses Online Service (EthOS), OpenGrey, Grey literature report. Additionally, hand searches were performed by checking the reference lists of all included papers. Inclusion and exclusion criteria were used to screen retrieved papers by two reviewers independently. The findings were analysed using a constant comparative method.ResultsTwenty-one studies met the inclusion criteria. Three elements in end-of-life care provision for children in the PICUs were identified: 1) Assessment of entering the end-of-life stage; 2) Discussion with parents and decision making; 3) End of life care processes, including care provided during the dying phase, care provided at the time of death, and care provided after death.ConclusionThe focus of end-of-life care in PICUs varies depending on HCPs’ and families’ preferences, at different stages such as during the dying phase, at the time of death, and after the child died. Tailoring end-of-life care to families’ beliefs and rituals was acknowledged as important by PICU HCPs. This review also emphasises the importance of HCPs collaborating to provide the optimum end-of-life care in the PICU and involving a palliative care team in end-of-life care.

“Don’t Really Figure Wages . . . Just Pay Bills”: Family Home Child Care Providers as Small Business Owners

“Don’t Really Figure Wages . . . Just Pay Bills”: Family Home Child Care Providers as Small Business Owners

Preventing Child Maltreatment: Beneficial Side Effects of Public Childcare

Abstract We investigate the impact of public childcare provision on the incidence of severe child maltreatment. For identification, we exploit a reform that expanded early childcare in Germany, generating large temporal and spatial variation in childcare coverage at the county level. Using high-quality administrative data covering all reported cases of child maltreatment in Germany by county and year, we find that an increase in childcare slots by one percentage point in a county reduced child maltreatment cases leading to out-of-home placement by about 1%. Our results suggest that the provision of universal public childcare may be more cost effective than previously thought.