Maternal Education and Children Home Alone in 63 Low- and Middle-Income Countries.

Background. Maternal education may influence child supervision practices in low-and middle-income countries (LMIC). However, little is known about the maternal factors that can improve child supervision in LMIC with scarce childcare facilities. Objective. To investigate the prevalence of children under 5 years home alone and examine the association between mother's formal education and children home alone across 63 LMIC. Methods. The study used data from 50 Multiple Indicator Cluster Surveys and 13 Demographic and Health Surveys with a sample of 501 769 children. We estimated Prevalence Ratios (PRs) for the association between maternal education and children home alone using multivariable Poisson regression, adjusting for covariates such as child's age and sex, mother's age and marital status, number of adults inhabiting the households, and urbanicity. Results. Prevalence of children home alone across 63 LMIC ranged from 1.1% to 50.1%. A significant negative association between mothers with more years of formal education and children home alone was found across 16 LMIC. However, the opposite trend was observed in Nigeria, Senegal, and Côte d'Ivoire. Null association was found across 44 LMIC. Conclusions. The varied pattern of the associations observed across LMIC underscores the importance of regional and local factors when developing policies and interventions to ensure safety and adequate care for children aged under 5 years in LMIC.

The Increasing Prevalence of Children Home Alone in Ghana: The Importance of Considering Regional Inequalities.

Research from industrialized settings has linked inadequate child supervision with various negative consequences. Nevertheless, empirical research in lower- and middle-income countries about correlates of inadequate child supervision has been scarce. The few studies that exist tended to focus on individual- and household-level factors, and reported associations that are not significant or in mixed directions depending on the context. Structural factors are left underexplored, but taking a more macro-level lens in settings with high regional disparities can hold the key to explaining increases in prevalence of inadequate child supervision. Exploring the evolution over time of child supervision practices can also enrich this explanation. We use data from two rounds of Ghana Multiple Indicator Cluster Surveys to examine factors associated with children left home alone, and employ regional analysis using strata-level mixed effects. We found that in Ghana, the prevalence of children left home alone without adult supervision increased by 8.5% between 2011 and 2018 - an increase of more than 500,000 children over seven years. Statistical analyses suggest that variation between regions likely are associated with the growth of inadequate child supervision in this country. Future research should pay closer attention to how structural conditions, proxied by regions, can serve as either barriers or facilitators to adequate child supervision practices, helping shed light on residual variance unexplained by individual- and household-level factors. Supplementary Information: The online version contains supplementary material available at 10.1007/s12187-023-10038-w.

Nonadult Supervision of Children in Low- and Middle-Income Countries: Results from 61 National Population-Based Surveys.

Despite scarce empirical research in most countries, evidence has shown that young children are unsupervised or under the supervision of another young child while their adult caregivers attend work or engage in other activities outside the home. Lack of quality supervision has been linked to unintentional childhood injuries and other negative outcomes. Nationally representative, population-based data from rounds four and five of the Multiple Indicator Cluster Surveys (MICS) and four to eight of the Demographic and Health Surveys (DHS) from 61 low- and middle-income countries were used to estimate prevalence and socio-economic factors associated with leaving children under five years old home alone or under the care of another child younger than 10 years of age. Socio-economic factors included age and sex of the child, rurality, wealth, maternal education, and household composition. Large variations in the prevalence rates (0.1⁻35.3% for children home alone and 0.2⁻50.6% for children supervised by another child) and associated factors have been recorded within and across regions and countries. Understanding why and under what conditions children are home alone or under the supervision of another child is crucial to the development of suitable policies and interventions to protect young children, promote healthy growth, and support caregivers.