Presentation on theme: "Measurement of Home Environment: The Family Care Indicators"— Presentation transcript:
1 Measurement of Home Environment: The Family Care Indicators Patrice EngleCalifornia Polytechnic State UniversityYuko Nonoyama-TarumiUNICEF
2 Why Indicators for Family Care? Caregiving Practices and ResourcesQuality of Interactions with the ChildChild Development OutcomesIt is widely recognized that caregiving practices during the early years of life have a powerful influence on children’s developmental trajectories, due to (1) rapid gain in all domains, and (2) the importance of stimulation from environment—family is the immediate environment of the child and is the major source of stimulation.There are many programs or polices that are based on this theory both in the industrialized and developing countries: Increased caregiving practices and resources would lead to higher quality of interactions between the caregiver and the child, and hence, result in positive child developmental outcomes.However, in developing countries, there is dearth of data on caregiving practices and resources, because there are no standard measures.Data that exist in developing countries tend to be single country studies with small sample size.In this context, UNICEF, with its partners, took the initiative to develop family care indicators, and have included them in a cross-national household survey.This presentation will consist of three parts.Process of development of family care indicators (Yuko)Preliminary cross-national analyses (Yuko)Validation of the measures from more in-depth analyses focusing on one country (three countries?) (Pat)
3 Multiple Indicator Cluster Survey (MICS) Household SurveyNationally representative sampleMICS 3 (2005)56 countriesHousehold modulehousehold characteristics, education, water and sanitation, nutrition, child labor, support HIV/AIDS orphans, etc.Women modulewomen’s characteristics, child mortality, maternal and newborn health, marriage/union, HIV/AIDS knowledge, female genital mutilation, sexual behavior, etc.Children under five modulechildren’s characteristics, birth registration, early learning, breast feeding, immunization, anthropometry, malaria, etc.
4 Development of Items Phase I: Item identification Literature reviewMeeting of global experts (Nov, 2002)Phase II: Item evaluationField tests in 7 countries (Spring, 2003)Qualitative analyses: Focus groups (Content validity)Quantitative analyses: Frequency analyses (Discrimination)Phase III: Item selectionMeeting of global experts (Nov, 2003)
5 Domains selected Caregiving Practices Caregiving resources Quality of verbal interactionLearning/stimulating activitiesLimit setting and discipline techniquesResponsiveness and acceptanceResponsive feedingCaregiving resourcesCaregiver stressCaregiver physical healthCaregiver knowledgeAlternate caregiverFather’s involvementFamily cohesionSocial networksLearning/stimulating materials
6 Family Care Items in MICS3 (Core Early Learning Module: 52 countries) Learning/stimulating activitiesEngage in any of the activities with the child (in the past 3 days) [multiple responses](Asked to caretakers of children under 5 years old for each child)(MotherFatherOtherNo oneRead books or look at picture booksTell storiesSing songsTake outside the home, compound yard or enclosurePlaySpend time naming, counting and/or drawing things
7 Family Care Items in MICS3 (Optional Child Development Module: 33 countries) Learning/stimulating materials(Asked to caretakers of children under 5 years old once)Number of booksNumber of children’s booksPlay materials that child play with at homeHousehold objects; Objects and materials found outside the living quarters; Homemade toys; Toys that come from a store; NoneAlternate caregiver (in the last week)Number of times the child was left in the care of another child (younger than 10 years old)Number of times the child was left alone
8 Child Discipline Items in MICS3 (Child Discipline Optional Module) Setting Limits (Methods used in the past month)(Asked to caretakers of children 2-14 years old for a randomly selected child)Non-violentForbade something he/she likedExplained why something was wrongGave him/her something else to doPsychological aggressionShouted, yelled at or screamed at him/herCalled him/her dumb, lazy, etcMinor physical assaultShook him/herSpanked, hit or slapped him/her on the bottom with bare handSevere physical assaultHit him/her on the body with something a belt, stick, etcHit or slapped him/her on the face, head or earsHit or slapped him/her on the hand, arm, or legBeat him/her with an implementDo you believe that in order to bring up properly, you need to physically punish him/herDiscipline styles (focusing on physical violence in response to bad behavior) (linked to child dev)Questions asked to the mother or caretaker of the children aged 2-14 years of ageOne child was randomly selected per family“All adults use certain ways to teach children the right behavior or to address a behavior problem. Have you or anyone else in your household used this method with the child in the past month.”
9 ECD Indicators in MICS3 Indicator Definition Support for learning % of children aged 0-59 months living in households in which an adult has engaged in four or more activities to promote learning and school readiness in the past 3 dayFather’s support for learning% of children aged 0-59 months whose father has engaged in one or more activities to promote learning and school readiness in the past 3 daysSupport for learning: non-children’s books% of households with three or more non-children’s booksSupport for learning: children’s books% of households with three or more children’s booksSupport for learning: materials for play% of households with three or more materials intended for playNon-adult care% of children aged 0-59 months left alone or in the care of another child younger than 10 years of age in the past weekPre-school attendance% of children aged months that attend some form of early childhood education programmeSchool readiness%of children in first grade that attended some form of pre-school the previous year
10 Preliminary cross-national analyses To what extent do countries differ in their level of family care?To what extent is positive family care equally distributed within the country?
11 Learning/stimulating activities (four or more) by wealth
14 Inadequate care (left in the care of another child or left alone) by wealth
15 How well do these scales work? Item comparison across countriesValidation on the HOME and Bayley ScalesValidation within country dataRecommendations for next steps
16 Descriptive data on activities by country Selected three countries with publicly available data from different parts of the worldKyrgyzstan (n=2987) Bangladesh (n=34710) and Sierra Leone (n=5904)Examined activities separately to see which have reasonable variability and if they vary as expected
19 Conclusions based on descriptive data Differences by country are reasonableAll families do somethingSome questions have little variability (e.g., taking child outside, play with child).
20 Validity study: Bangladesh 800 children at 18 monthsHOMEBayley MDI and PDILanguage Comprehension and Expression129 of them also measured at 12 months on same measures40 given 7-14 week test-retest on Activities and ToysGrantham-McGregor, Hamadani, and Engle, 2008
21 Measures 6 activity items Sources of toys Variety of toys Books Play – “play with toys” rather than “play”Sources of toysVariety of toysBooksChildcare situation
22 Reliability Measure 1 week (18 months) 12 to 18 months Family Activity Score.64**.57**Number of sources of toys.91**.09N40129
23 Associations of Activity Index with Outcome Measures (n=798) FCIFCI regr+Source of toysSource regrHOME.72****.39**nsMDI.29***PDI.19**.09*Language.44**.23**+Controlling for maternal education, wealth, family size, birthweight, gestational age, paternal education, income, age, gender, other family care measures
24 Means of MDI by Number of Family Activities controlling for age (N=800; 18 months) ANOVA significant at p<.001
25 Conclusion Family Activity Index appears to be reliable and valid Increases with MDI in a linear fashion – no clear cut-offSources of toys is not so strongVariety of toys much stronger (not reported here)
26 Validity assessment with MICS data: Bangladesh (N=34,710) Internal consistencyAssociation of items with ageAssociations with maternal education, household wealth, genderAssociations with two parent report measures: Do you do anything to prepare your child for school (3 and 4 only); and do you do things to develop your child’s intelligenceValue of individual activity questions
27 Which items are related to age? Bangladesh, N= about 34,000 Total activities.34**Read books.47**Tell stories.24**Sing Songs.01Take outside.08*Play.02Naming, counting, drawing.40**Do something to develop intelligence.17**Prepare for school.15**
29 Correlations of items with SES measures controlling for age M EdWealthDevelop IQPrepare schoolTotal.22.214.171.124Read Books.35.23.24Tell stories.19.16Sing songs.21.17.12Outside.07.05.06Play.15.13.09Name, count..02
30 Conclusions Family Activities Scale works quite well Sources of toys functions less wellNeed more work to define a cut-off point – four or more activities may not be the best
31 Recommendations Analyze role of fathers separately Make a separate code for some activities such as “read books”May revise wording on some questionsCould replace “take outside”Might use “play with toys” rather than “play”Complete analyses with the rest of the countriesApply and use for Advocacy
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