Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya
Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya.
BMJ Open. 2021 Mar 5;11(3):e042544. doi: 10.1136/bmjopen-2020-042544.
Investing in children during the critical period between birth and age 5 years 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 child-care centres with untrained caregivers have proliferated. We aim to co-design and test the feasibility of a supportive assessment and skills-building for child-care centre providers.
A sequential mixed-methods approach will be used. We will map and profile child-care centres in two informal settlements in Nairobi, and complete a brief quality assessment of 50 child-care centres. We will test the feasibility of a supportive assessment skills-building system on 40 child-care centres, beginning with assessing centre-caregivers' knowledge and skills in these centres. This will inform the subsequent co-design process and provide baseline data. Following a policy review, we will use experience-based co-design to develop the supportive assessment process. This will include qualitative interviews with policymakers (n=15), focus groups with parents (n=4 focus group discussions (FGDs)), child-care providers (n=4 FGDs) and joint workshops. To assess feasibility and acceptability, we will observe, record and cost implementation for 6 months. The knowledge/skills questionnaire will be repeated at the end of implementation and results will inform the purposive selection of 10 child-care providers and parents for qualitative interviews. Descriptive statistics and thematic framework approach will respectively be used to analyse quantitative and qualitative data and identify drivers of feasibility.
The study has been approved by Amref Health Africa's Ethics and Scientific Review Committee (Ref: P7802020 on 20 April 2020) and the University of York (Ref: HSRGC 20 March 2020). Findings will be published and continual engagement with decision-makers will embed findings into child-care policy and practice.
在儿童出生到 5 岁的关键时期进行投资，可以为他们的一生带来持久的益处。肯尼亚城市非正规住区的儿童在健康发展方面面临着重大挑战，尤其是当他们的家庭需要每天赚取工资而无法在白天照顾他们时。作为回应，非正规且质量差的儿童保育中心如雨后春笋般涌现，且其保育员都未经培训。我们旨在共同设计和测试对儿童保育中心提供者进行支持性评估和技能建设的可行性。
我们将使用顺序混合方法。我们将在内罗毕的两个非正规住区绘制和描绘儿童保育中心，并对 50 个儿童保育中心进行简短的质量评估。我们将在 40 个儿童保育中心测试支持性评估技能建设系统的可行性，从评估中心照顾者在这些中心的知识和技能开始。这将为随后的共同设计过程提供信息，并提供基线数据。在政策审查之后，我们将使用基于经验的共同设计来开发支持性评估过程。这将包括与决策者（n=15）进行定性访谈、与父母（n=4 个焦点小组讨论（FGD））、儿童保育提供者（n=4 FGD）进行焦点小组讨论，并联合举办研讨会。为了评估可行性和可接受性，我们将观察、记录并在 6 个月内对实施情况进行成本核算。在实施结束时，将再次进行知识/技能问卷调查，结果将为有目的选择 10 名儿童保育提供者和家长进行定性访谈提供信息。将分别使用描述性统计和主题框架方法来分析定量和定性数据，并确定可行性的驱动因素。
该研究已获得 Amref Health Africa 伦理和科学审查委员会（2020 年 4 月 20 日批准号：P7802020）和约克大学（2020 年 3 月 20 日批准号：HSRGC 20）的批准。研究结果将发表，并持续与决策者进行接触，将研究结果纳入儿童保育政策和实践中。
