Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa.
Centre for Social Development in Africa, University of Johannesburg, Johannesburg 2092, South Africa.
Int J Environ Res Public Health. 2023 Jan 31;20(3):2572. doi: 10.3390/ijerph20032572.
Multiple caregiving arrangements have become common for childcare globally, and South Africa is no exception. Previous childcare studies mainly focused on the caregiver and household characteristics. Evidence on the influence of childcare on malnutrition is sparse. This study aimed to examine the relationship between exposure to secondary and multiple forms of care and child malnutrition, with a particular focus on child stunting and overweight among children. A cross-sectional study of a sample of 2966 dyads of mothers and children under five were analysed from the 2017 National Income Dynamics Study (NIDS) Wave 5. Descriptive and inferential statistics were used to analyse the data. The results indicated that 22.16% of the children were stunted and that 16.40% were overweight. Most children were mainly cared for at home (67.16%) during the day. Some results of the obtained multivariable analyses show that lack of being cared for in a crèche or school during the day was significantly associated with stunting (odds ratio (OR) 2; confidence interval (CI) 1.10-3.62, < 0.05) and overweight (OR) 3.82; (CI) 1.60-9.08, < 0.05). Furthermore, in this study, 69.88% of children who were cared for at home by the primary caregiver had no other forms of multiple care arrangements. The results showing high stunting and overweight rates among children cared for at home suggest that the government needs to look into supporting caregiver parenting. The high unemployment rates in the country highlight the importance of socioeconomic status in childcare and its implication for children's nutritional outcomes. The study's findings suggest the need for innovative strategies to address the challenges associated with multi-caregiving which negatively affects children's nutritional outcomes.
全球范围内，儿童保育的多重照顾安排已经变得很常见，南非也不例外。先前的儿童保育研究主要集中在照顾者和家庭特征上。关于儿童保育对营养不良影响的证据很少。本研究旨在研究接触二次和多种形式的保育与儿童营养不良之间的关系，特别关注儿童发育迟缓与超重问题。本研究使用 2017 年国家收入动态研究（NIDS）第五波中 2966 对母子样本进行了横断面研究。使用描述性和推断性统计对数据进行了分析。结果表明，22.16%的儿童发育迟缓，16.40%的儿童超重。大多数儿童白天主要在家中（67.16%）接受照顾。多变量分析的一些结果表明，白天不在托儿所或学校接受照顾与发育迟缓（比值比（OR）2；置信区间（CI）1.10-3.62，<0.05）和超重（OR）3.82；（CI）1.60-9.08，<0.05）显著相关。此外，在这项研究中，69.88%由主要照顾者在家中照顾的儿童没有其他形式的多重照顾安排。在家中接受照顾的儿童中发育迟缓率和超重率较高的结果表明，政府需要考虑支持照顾者育儿。该国高失业率突显了社会经济地位在儿童保育中的重要性及其对儿童营养结果的影响。研究结果表明，需要采取创新战略来解决与多照顾相关的挑战，这些挑战对儿童的营养结果产生负面影响。
