Standards for child care settings define expected performance. Other types of requirements applicable to operation of child care facilities include funding requirements, accreditation criteria, and regulations (legal requirements). During licensing inspections, program monitoring by funding agencies, evaluations by accrediting organizations, and self-evaluations, programs become aware of opportunities for improvement. The process of evaluation alone leads to improved program performance1; the majority of providers want to do a good job.
When requirements are used for systematic surveillance, the compliance data generated identify problems to be targeted for quality improvement. Training, technical assistance, linkage to existing resources, and development of new resources are common interventions that lead to improved performance in child care programs. These interventions may be applied at the level of an individual child care facility or at any level involved with child care services. Thus, training and technical assistance may be given to caregivers, to licensors, to policy makers, or to the public.
A surveillance system should continuously measure the impact of interventions and focus attention on problems that require further corrective action. When performance data from individual programs are aggregated, they provide powerful tools to assess the need for communitywide interventions. Some changes cannot be accomplished within the limited resources of an individual child care facility. Sometimes program improvement requires one or more types of intervention at the community, regional, state, and/or national level.
Updating requirements, conducting surveillance to measure compliance with requirements, and analyzing data to target interventions and measure the impact of actions on program performance are the basic elements of a systems model for improving quality in child care (see Figure).
Analysis of Childcare Support Policies and Fertility Rates of the OECD Countries: Focusing on Cash-support Policies, Child-care Facility Policies, and Tax Benefits Policies
