The role of fathers and care-giving arrangements in informal settlements in Kenya and Ethiopia.

Introduction: Quality childcare has been associated with multiple long-term benefits for children including improved school readiness, better educational outcomes and improved health and productivity. Evidence suggests that returns on investment are much higher when targeted at the youngest children, especially during the first 1,000 days. Despite the evidence and the ever-increasing need and potential benefits, investments made so far to make high-quality childcare accessible to the neediest families are not commensurate. It is estimated that nearly 350 million eligible pre-primary school-age children have no access to quality childcare, especially in low-and middle-income countries. The purpose of this study was to establish the role of fathers and the childcare arrangements in selected urban informal settlements in Kenya and Ethiopia. Methods: A mixed methods design was adopted with quantitative data being collected using a structured household questionnaire administered to 635 mothers of children of 0-3 years from both countries. In both countries, data was collected from three vulnerable communities namely urban informal settlements, large commercial agricultural settlements associated with flower farms, and female penal institutions where women with young children below 4 years old are incarcerated. Quantitative data was not collected from the penal institutions because during the time of the study (at the height of the Covid-19 pandemic), access to members of the public including researchers was restricted and so here only qualitative data was collected. The data reported in this article therefore does not include data from penal institutions. Results: Findings show that fathers played a major role in childcare according to 74% of respondents in Kenya and 57.7% in Ethiopia. This involvement is mainly defined in terms of providing financial support for basic needs for the family and child and for accessing health care. Some fathers were found to be either minimally involved or not involved at all. Key reasons advanced for minimal engagement included fathers having either left home permanently, had another family, was working far from home or was working long hours. Findings regarding care arrangements established that significant proportions of children had been left behind without adult supervision. Neighbors and siblings younger than 18 years provided most of the alternative care. House helps also accounted for 20.3% of care in Ethiopia with none being registered for Kenya. Daycare services only accounted for 13.4% of care in Kenya and 6.3% in Ethiopia, respectively. Conclusion: The findings revealed that fathers are fairly involved in childcare even mainly through providing necessary resources. Significantly high proportions of children were left under the care of their underage siblings leading to questions of the safety of these children. Parents and guardians in these settlements had access to a mix of care arrangements including both unpaid and paid neighbors, toddler's siblings and in limited cases, daycare services. The low levels of utilization of daycare services indicate either limited services or inability to pay for the same. It is recommended that governments consider investing in childcare services in informal settlements.

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.

Introduction: The Nurturing Care Framework (NCF) describes "nurturing care" as the ability of nations and communities to support caregivers and provide an environment that ensures children's good health and nutrition, protects them from threats, and provides opportunities for early learning through responsive and emotionally supportive interaction. We assessed the extent to which Kenyan government policies address the components of the NCF and explored policy/decision makers' views on policy gaps and emerging issues. Methods: A search strategy was formulated to identify policy documents focusing on early childhood development (ECD), health and nutrition, responsive caregiving, opportunities for early learning and security and safety, which are key components of the NCF. We limited the search to policy documents published since 2010 when the Kenya constitution was promulgated and ECD functions devolved to county governments. Policy/decision-maker interviews were also conducted to clarify emerging gaps from policy data. Data was extracted, coded and analyzed based on the components of the NCF. Framework analysis was used for interview data with NCF being the main framework of analysis. The Jaccard's similarity coefficient was used to assess similarities between the themes being compared to further understand the challenges, successes and future plans of policy and implementation under each of the NCF domains. Results: 127 policy documents were retrieved from government e-repository and county websites. Of these, n = 91 were assessed against the inclusion criteria, and n = 66 were included in final analysis. The 66 documents included 47 County Integrated Development Plans (CIDPs) and 19 national policy documents. Twenty policy/decision-maker interviews were conducted. Analysis of both policy and interview data reveal that, while areas of health and nutrition have been considered in policies and county level plans (coefficients >0.5), the domains of early learning, responsive caregiving and safety and security face significant policy and implementation gaps (coefficients ≤ 0.5), particularly for the 0-3 year age group. Inconsistencies were noted between county level implementation plans and national policies in areas such as support for children with disabilities and allocation of budget to early learning and nutrition domains. Conclusion: Findings indicate a strong focus on nutrition and health with limited coverage of responsive caregiving and opportunities for early learning domains. Therefore, if nurturing care goals are to be achieved in Kenya, policies are needed to support current gaps identified with urgent need for policies of minimum standards that provide support for improvements across all Nurturing Care Framework domains.