Improving the quality of childcare centers through supportive assessment and ‘communities of practice’ in informal settlements in Nairobi

• In Event: The care of young children in informal and marginalized settlements: The case of Nairobi and Kajiado Counties in Kenya

Proposal

Introduction: Investing in children during the critical period between 0-5years can have long-lasting benefits throughout their life. Children in Kenya's urban informal settlements face significant challenges to healthy development, particularly when their families need to earn a daily wage and cannot care for them during the day. In response, informal and poor quality childcare centres with untrained caregivers have proliferated. We conducted a study to co-design and test the feasibility of an intervention of supportive assessment and skills-building for childcare center providers in the slums in Nairobi.
Methods: The study employed a sequential mixed-methods approach. First we conducted qualitative interviews with various teams (Nairobi County, n=10; Ruaraka and Makadara sub-County health and early childhood development (ECD) teams, n=20; community health volunteers (CHVs) from both sub-counties, n=20; center care providers, n=44; and parents, n=47) to understand their opinions of the state of childcare in informal settlements and their thoughts on what could be done to improve childcare in these communities. Based on the information obtained from these interviews, and working with Kidogo (experts in childcare), an intervention was drafted and discussed with the stakeholders in two co-design workshops in which the content and mode of its delivery were further refined. We mapped and profiled childcare centers in two informal settlements in Nairobi, including assessing the quality of care provided and the knowledge and skills of the center providers before receiving the intervention. The intervention involved monthly trainings of center providers on health and ECD and support by CHVs for a period of 6 months while observing and recording key learnings on the feasibility and acceptability and costing its implementation. At the end of the 6 months, we reassessed the quality and knowledge/skills assessment and compared these with baseline assessments to see if there were improvements attributable to the intervention. Descriptive statistics and thematic framework approach were respectively used to analyse quantitative and qualitative data and identify drivers of feasibility.
Findings: We present key findings on the profiles/status of childcare centers in informal settlements, the feasibility and potential impact of an intervention in improving quality of informal childcare centers as well as the facilitators and barriers to implementation and reflections on opportunities for scale up.
Discussion: The need to support the improvement of informal childcare facilities in informal settlements is critical. A ‘community of practice’ approach and supportive supervision of CHVs are potential solutions.

Author

• Margaret Nampijja, African Population and Health Reserach Center, Nairobi