scholarly journals Understanding Demand for, and Feasibility of, Centre-based Child-care for Poor Urban Households: A Mixed Methods Study in Dhaka, Bangladesh.

2020 ◽  
Author(s):  
Helen Elsey ◽  
Fariza Fieroze ◽  
Riffat Shawon ◽  
Shammi Nasreen ◽  
Joseph Paul Hicks ◽  
...  
Keyword(s):  
Child Care ◽  
Mixed Methods ◽  
Urban Environment ◽  
Low Income ◽  
Qualitative Interviews ◽  
Childhood Development ◽  
Child Care Centre ◽  
Urban Households ◽  
Care Givers ◽  
The Impact

Abstract Background: Centre-based child-care has potential to provide multiple health and development benefits to children, families and societies. With rapid urbanisation, increasing numbers of low-income women work with reduced support from extended family, leaving a child-care vacuum in many low- and middle-income countries. We aimed to understand perceptions of, and demand for, centre-based child-care in Dhaka, Bangladesh among poor, urban households, and test the feasibility of delivering sustainable centre-based child-care. Methods: We used sequential mixed methods including a household survey (n=222) and qualitative interviews with care-givers (n=16), community leaders (n=5) and policy-makers (n=5). We co-produced and piloted a centre-based child-care model over ten-months, documenting implementation. A co-design focus group with mothers, parents’ meetings, and qualitative interviews with child-care centre users (n=5), non-users (n=3), ex-users (n=3) and staff (2) were used to refine the model and identify implementation issues. Results: We found 24% (95% CI: 16%,37%) of care-givers reported turning-down paid work due to lack of child-care and 84% (95% CI:74%, 91%) reported wishing to use centre-based child-care and were willing to pay up to 283 Takka (~$3.30) per month. Adjusted odds of reported need for child-care among slum households were 3.8 times those of non-slum households (95% CI: 1.4, 10). Implementation highlighted that poor households needed free child-care with food provided, presenting feasibility challenges. Meta-inference across quantitative and qualitative findings identified the impact of urban environment on child-care through long working hours, low social capital and fears for child safety. These influences interacted with religious and social norms resulting in caution in using centre-based child-care despite evident need.Conclusion: sustainable provision of centre-based care that focuses on early childhood development requires subsidy and careful design sensitive to the working lives of poor families, particularly women and must respond to the dynamics of the urban environment and community values.

scholarly journals Understanding demand for, and feasibility of, centre-based child-care for poor urban households: A mixed methods study in Dhaka, Bangladesh.

2020 ◽  
Author(s):  
Helen Elsey ◽  
Fariza Fieroze ◽  
Riffat Ara Shawon ◽  
Shammi Nasreen ◽  
Joseph Paul Hicks ◽  
...  
Keyword(s):  
Early Childhood ◽  
Child Care ◽  
Mixed Methods ◽  
Urban Environment ◽  
Low Income ◽  
Early Childhood Development ◽  
Qualitative Interviews ◽  
Childhood Development ◽  
Urban Households ◽  
Care Givers

Abstract Background: Centre-based child-care has potential to provide multiple health and development benefits to children, families and societies. With rapid urbanisation, increasing numbers of low-income women work with reduced support from extended family, leaving a child-care vacuum in many low- and middle-income countries. We aimed to understand perceptions of, and demand for, centre-based child-care in Dhaka, Bangladesh among poor, urban households, and test the feasibility of delivering sustainable centre-based child-care. Methods: We used sequential mixed methods including a household survey (n=222) and qualitative interviews with care-givers (n=16), community leaders (n=5) and policy-makers (n=5). We co-produced and piloted a centre-based child-care model over ten-months, documenting implementation. A co-design focus group with mothers, parents’ meetings, and qualitative interviews with child-care centre users (n=5), non-users (n=3), ex-users (n=3) and staff (2) were used to refine the model and identify implementation issues. Results: We found 24% (95% CI: 16%,37%) of care-givers reported turning-down paid work due to lack of child-care and 84% (95% CI:74%, 91%) reported wishing to use centre-based child-care and were willing to pay up to 283 Takka (~$3.30) per month. Adjusted odds of reported need for child-care among slum households were 3.8 times those of non-slum households (95% CI: 1.4, 10). Implementation highlighted that poor households needed free child-care with food provided, presenting feasibility challenges. Meta-inference across quantitative and qualitative findings identified the impact of the urban environment on child-care through long working hours, low social capital and fears for child safety. These influences interacted with religious and social norms resulting in caution in using centre-based child-care despite evident need.Conclusion: Sustainable provision of centre-based care that focuses on early childhood development requires subsidy and careful design sensitive to the working lives of poor families, particularly women and must respond to the dynamics of the urban environment and community values. We recommend increased research and policy focus on the evaluation and scale-up of quality centre-based child-care, emphasising early-childhood development, to support low-income working families in urban areas.

scholarly journals Understanding demand for, and feasibility of, centre-based child-care for poor urban households: a mixed methods study in Dhaka, Bangladesh

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
H. Elsey ◽  
F. Fieroze ◽  
R. A. Shawon ◽  
S. Nasreen ◽  
J. P. Hicks ◽  
...  
Keyword(s):  
Early Childhood ◽  
Child Care ◽  
Mixed Methods ◽  
Urban Environment ◽  
Low Income ◽  
Early Childhood Development ◽  
Qualitative Interviews ◽  
Childhood Development ◽  
Urban Households ◽  
Care Givers

Abstract Background Centre-based child-care has potential to provide multiple health and development benefits to children, families and societies. With rapid urbanisation, increasing numbers of low-income women work with reduced support from extended family, leaving a child-care vacuum in many low- and middle-income countries. We aimed to understand perceptions of, and demand for, centre-based child-care in Dhaka, Bangladesh among poor, urban households, and test the feasibility of delivering sustainable centre-based child-care. Methods We used sequential mixed methods including a household survey (n = 222) and qualitative interviews with care-givers (n = 16), community leaders (n = 5) and policy-makers (n = 5). We co-produced and piloted a centre-based child-care model over ten-months, documenting implementation. A co-design focus group with mothers, parents’ meetings, and qualitative interviews with child-care centre users (n = 5), non-users (n = 3), ex-users (n = 3) and staff (2) were used to refine the model and identify implementation issues. Results We found 24% (95% CI: 16,37%) of care-givers reported turning-down paid work due to lack of child-care and 84% (95% CI:74, 91%) reported wishing to use centre-based child-care and were willing to pay up to 283 Takka (~$3.30) per month. Adjusted odds of reported need for child-care among slum households were 3.8 times those of non-slum households (95% CI: 1.4, 10). Implementation highlighted that poor households needed free child-care with food provided, presenting feasibility challenges. Meta-inference across quantitative and qualitative findings identified the impact of the urban environment on child-care through long working hours, low social capital and fears for child safety. These influences interacted with religious and social norms resulting in caution in using centre-based child-care despite evident need. Conclusion Sustainable provision of centre-based care that focuses on early childhood development requires subsidy and careful design sensitive to the working lives of poor families, particularly women and must respond to the dynamics of the urban environment and community values. We recommend increased research and policy focus on the evaluation and scale-up of quality centre-based child-care, emphasising early-childhood development, to support low-income working families in urban areas.

scholarly journals Understanding demand for, and feasibility of, centre-based child-care for poor urban households: A mixed methods study in Dhaka, Bangladesh.

2020 ◽  
Author(s):  
Helen Elsey ◽  
Fariza Fieroze ◽  
Riffat Ara Shawon ◽  
Shammi Nasreen ◽  
Joseph Paul Hicks ◽  
...  
Keyword(s):  
Early Childhood ◽  
Child Care ◽  
Mixed Methods ◽  
Urban Environment ◽  
Low Income ◽  
Early Childhood Development ◽  
Qualitative Interviews ◽  
Childhood Development ◽  
Urban Households ◽  
Care Givers

Abstract Background: Centre-based child-care has potential to provide multiple health and development benefits to children, families and societies. With rapid urbanisation, increasing numbers of low-income women work with reduced support from extended family, leaving a child-care vacuum in many low- and middle-income countries. We aimed to understand perceptions of, and demand for, centre-based child-care in Dhaka, Bangladesh among poor, urban households, and test the feasibility of delivering sustainable centre-based child-care. Methods: We used sequential mixed methods including a household survey (n=222) and qualitative interviews with care-givers (n=16), community leaders (n=5) and policy-makers (n=5). We co-produced and piloted a centre-based child-care model over ten-months, documenting implementation. A co-design focus group with mothers, parents’ meetings, and qualitative interviews with child-care centre users (n=5), non-users (n=3), ex-users (n=3) and staff (2) were used to refine the model and identify implementation issues. Results: We found 24% (95% CI: 16%,37%) of care-givers reported turning-down paid work due to lack of child-care and 84% (95% CI:74%, 91%) reported wishing to use centre-based child-care and were willing to pay up to 283 Takka (~$3.30) per month. Adjusted odds of reported need for child-care among slum households were 3.8 times those of non-slum households (95% CI: 1.4, 10). Implementation highlighted that poor households needed free child-care with food provided, presenting feasibility challenges. Meta-inference across quantitative and qualitative findings identified the impact of the urban environment on child-care through long working hours, low social capital and fears for child safety. These influences interacted with religious and social norms resulting in caution in using centre-based child-care despite evident need. Conclusion: Sustainable provision of centre-based care that focuses on early childhood development requires subsidy and careful design sensitive to the working lives of poor families, particularly women and must respond to the dynamics of the urban environment and community values. We recommend increased research and policy focus on the evaluation and scale-up of quality centre-based child-care, emphasising early-childhood development, to support low-income working families in urban areas.

scholarly journals Improving the quality of child-care centres through supportive assessment and ‘communities of practice’ in informal settlements in Nairobi: protocol of a feasibility study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e042544
Author(s):  
Margaret Nampijja ◽  
Kenneth Okelo ◽  
Patricia Kitsao Wekulo ◽  
Elizabeth W Kimani-Murage ◽  
Helen Elsey
Keyword(s):  
Child Care ◽  
Qualitative Interviews ◽  
Informal Settlements ◽  
Poor Quality ◽  
Assessment Process ◽  
Child Care Providers ◽  
Care Providers ◽  
Policy And Practice ◽  
Child Care Centre ◽  
Scientific Review

IntroductionInvesting 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.Methods and analysisA 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.Ethics and disseminationThe study has been approved by Amref Health Africa’s Ethics and Scientific Review Committee (Ref: P7802020 on 20th April 2020) and the University of York (Ref: HSRGC 20th March 2020). Findings will be published and continual engagement with decision-makers will embed findings into child-care policy and practice.

scholarly journals A mixed-methods evaluation of the impact of a person-centered family planning intervention for community health workers on family planning outcomes in India

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nadia Diamond-Smith ◽  
Claire McDonell ◽  
Ananta Basudev Sahu ◽  
Kali Prasad Roy ◽  
Katie Giessler
Keyword(s):  
Mixed Methods ◽  
Family Planning ◽  
Community Health ◽  
San Francisco ◽  
Health Workers ◽  
Qualitative Interviews ◽  
Centered Care ◽  
The University ◽  
Care Worker ◽  
The Impact

Abstract Background Person-centered quality for family planning has been gaining increased attention, yet few interventions have focused on this, or measured associations between person-centered quality for family planning and family planning outcomes (uptake, continuation, etc.). In India, the first point of contact for family planning is often the community health care worker, in this case, Accredited Social Health Activists (ASHAs). Methods In this study, we evaluate a training on person-centered family planning as an add-on to a training on family planning provision for urban ASHAs in Varanasi, India in 2019 using mixed methods. We first validate a scale to measure person-centered family planning in a community health worker population and find it to be valid. Higher person-centered family planning scores are associated with family planning uptake. Results Comparing women who saw intervention compared to control ASHAs, we find that the intervention had no impact on overall person-centered family planning scores. Women in the intervention arm were more likely to report that their ASHA had a strong preference about what method they choose, suggesting that the training increased provider pressure. However, qualitative interviews with ASHAs suggest that they value person-centered care for their interactions and absorbed the messages from the intervention. Conclusions More research is needed on how to intervene to change behaviors related to person-centered family planning. Trial registration This study received IRB approval from the University of California, San Francisco (IRB # 15–25,950) and was retrospectively registered at clinicaltrials.gov (NCT04206527).

Financing social entrepreneurship

2018 ◽  
Vol 14 (2) ◽  
pp. 130-155 ◽  
Author(s):  
Erin I-Ping Castellas ◽  
Jarrod Ormiston ◽  
Suzanne Findlay
Keyword(s):  
Mixed Methods ◽  
Performance Measurement ◽  
Empirical Evidence ◽  
Social Enterprise ◽  
Qualitative Interviews ◽  
Social Enterprises ◽  
Online Questionnaire ◽  
Content Type ◽  
Impact Performance ◽  
The Impact

Purpose This paper aims to explore the emergence and nature of impact investment in Australia and how it is shaping the development of the social enterprise sector. Design/methodology/approach Impact investment is an emerging approach to financing social enterprises that aims to achieve blended value by delivering both impact and financial returns. In seeking to deliver blended value, impact investment combines potentially conflicted logics from investment, philanthropy and government spending. This paper utilizes institutional theory as a lens to understand the nature of these competing logics in impact investment. The paper adopts a sequential exploratory mixed methods approach to study the emergence of impact investment in Australia. The mixed methods include 18 qualitative interviews with impact investors in the Australian market and a subsequent online questionnaire on characteristics of impact investment products, activity and performance. Findings The findings provide empirical evidence of the rapid growth in impact investment in Australia. The analysis reveals the nature of institutional complexity in impact investment and highlights the risk that the impact logic may become overshadowed by the investment logic if the difference in rigor around financial performance measurement and impact performance measurement is maintained. The paper discusses the implications of these findings for the development of the Australian social enterprise sector. Originality/value This paper provides empirical evidence on the emergence of impact investment in Australia and contributes to a growing global body of evidence about the nature, size and characteristics of impact investment.

scholarly journals A mixed-methods evaluation of the impact of a person-centered family planning intervention for community health workers on family planning outcomes in India

2020 ◽  
Author(s):  
Nadia Diamond-Smith ◽  
Claire McDonell ◽  
Ananta Basudev Sahu ◽  
Kali Prasad Roy ◽  
Katie Giessler
Keyword(s):  
Mixed Methods ◽  
Family Planning ◽  
Community Health ◽  
San Francisco ◽  
Health Workers ◽  
Qualitative Interviews ◽  
Centered Care ◽  
The University ◽  
Care Worker ◽  
The Impact

Abstract Background: Person-centered quality for family planning has been gaining increased attention, yet few interventions have focused on this, or measured associations between person-centered quality for family planning and family planning outcomes (uptake, continuation, etc.). In India, the first point of contact for family planning is often the community health care worker, in this case, Accredited Social Health Activists (ASHAs). Methods: In this study, we evaluate a training on person-centered family planning as an add-on to a training on family planning provision for urban ASHAs in Varanasi, India in 2019 using mixed methods. We first validate a scale to measure person-centered family planning in a community health worker population and find it to be valid. Higher person-centered family planning scores are associated with family planning uptake. Results: Comparing women who saw intervention compared to control ASHAs, we find that the intervention had no impact on overall person-centered family planning scores. Women in the intervention arm were more likely to report that their ASHA had a strong preference about what method they choose, suggesting that the training increased provider pressure. However, qualitative interviews with ASHAs suggest that they value person-centered care for their interactions and absorbed the messages from the intervention.Conclusions: More research is needed on how to intervene to change behaviors related to person-centered family planning. This study received IRB approval from the University of California, San Francisco (IRB # 15-25950) and was retrospectively registered at clinicaltrials.gov (NCT04206527)

Stress and family relationships among college student parents: A mixed methods study

2020 ◽  
pp. 026540752097519
Author(s):  
Aryn M. Dotterer ◽  
Audrey C. Juhasz ◽  
Kristin N. Murphy ◽  
SuJung Park ◽  
Lisa K. Boyce
Keyword(s):  
Mixed Methods ◽  
College Student ◽  
Low Income ◽  
Family Relationships ◽  
Online Survey ◽  
Qualitative Interviews ◽  
Multiple Roles ◽  
Structured Interviews ◽  
External Resources ◽  
Student Parents

College student parents represent a unique population because they are typically low-income, accrue more debt than traditional students, and must balance the role of student and parent. Using a mixed methods design, this study examined the relation between college student parents’ stress and distress in their relationships with their children and examined how parents managed their multiple roles. Parent participants ( n = 80; 54 mothers, 26 fathers; M age = 28.74 years, SD = 4.72) completed an online survey and a subsample ( n = 14) participated in semi-structured interviews. Results revealed that college student parents experience a variety of stressors that spillover into their relationships with their children and these associations appear more detrimental for father-child relationships. However, in-depth qualitative interviews not only highlighted the various sources of stress (e.g., time demands, multiple roles), but also revealed internal and external resources that college student parents draw on to help cope with stressors. Findings suggest that program efforts to strengthen the co-parenting relationship and to help college student parents more effectively manage their stress may be beneficial for improved parent-child relationships.

Overcoming Obesity: A Mixed Methods Study of the Impact of Primary Care Physician Counseling on Low-Income African American Women Who Successfully Lost Weight

2017 ◽  
Vol 32 (2) ◽  
pp. 374-380 ◽  
Author(s):  
Elaine Seaton Banerjee ◽  
Sharon J. Herring ◽  
Katelyn E. Hurley ◽  
Katherine Puskarz ◽  
Kyle Yebernetsky ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
African American ◽  
Mixed Methods ◽  
African American Women ◽  
Low Income ◽  
Positive Deviance ◽  
American Women ◽  
Patient Reported ◽  
The Impact

Purpose: Low-income, African American women are disproportionately impacted by obesity. Little is known about the interactions between low-income, African American women who successfully lost weight and their primary care physicians (PCPs). Design: Mixed methods, positive deviance study. Setting: Urban university-based family medicine practice. Participants: The positive deviance group comprised low-income, African American women who were obese, lost 10% body weight, and maintained this loss for 6 months. Measures: The PCP- and patient-reported weight-related variables collected through the electronic medical record (EMR), surveys, and interviews. Analysis: Logistic regression of quantitative variables. Qualitative analysis using modified grounded theory. Results: The EMR documentation by PCPs of dietary counseling and a weight-related medical problem were significant predictors of positive deviant group membership. Qualitative analyses of interviews revealed 5 major themes: framing obesity in the context of other health problems provided motivation; having a full discussion around weight management was important; an ongoing relationship with the physician was valuable; celebrating small successes was beneficial; and advice was helpful but self-motivation was necessary. Conclusion: The PCP counseling may be an important factor in promoting weight loss in low-income, African American women. Patients may benefit from their PCPs drawing connections between obesity and weight-related medical conditions and enhancing intrinsic motivation for weight loss.

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