Contribution of Childcare Centre to the Nutritional Status and Dietary Practices of Children Aged Two to Four Years and Wellbeing of Caregivers

Abstract

In the last twenty years, the number of women in the labour force has increased leading to heightened challenges for women engaged in formal and informal employment as they navigate the paired roles as employees and childcare givers. According to the International Labour Organization (2019, 59.6% of women in Kenya are employed, constituting 62.9% of the national labour force. Consequently, their significant role in the country’s economy cannot be overlooked. In August 2021, the Collaborative Center for Gender and Development, in partnership with the University of Nairobi, Women Economic Empowerment Hub (UoN WEE Hub), established a child daycare centre in Busia town with the aim of supporting women with children under the age of four years while in employment. This initiative emerged from a consultative meeting in which the women raised concerns over the numerous risks associated with bringing their children to the marketplace (workplace) and the negative effects it has on their businesses. In order to assess the impact of the daycare centre on the well-being of the caregivers and the development of the children, a monitoring and evaluation system with four objectives was put in place and baseline data was collected in October 2022. The monitoring and evaluation activities would be conducted every six months for two years until 2024 to monitor the impact of the establishment of the daycare centre on the well-being of caregivers as well as the diet and nutritional status of the children. The baseline survey revealed a significant consensus among caregivers, with 96.4% expressing agreement that the daycare centre played a crucial role in enhancing their well-being. They cited a reduction in the burden of worry for the children’s safety and acknowledged that it afforded them time to pursue other activities, including business, attendance of family events, and engagement in leisure activities. At the time of the baseline survey, the prevalence of wasting, stunting, underweight and overweight among the children enrolled in the daycare centre was 4.2%, 12.2%, 15.1%, and 22.9%, respectively. The girls were more affected by undernutrition than the boys, and less affected by overnutrition (overweight and obesity). The most consumed food groups were oils and fat (96.4%), energy-giving foods (89.3%) and ‘other’ vegetables such as tomato, onion and cabbage (87.5%). The least consumed food groups were pulses (12.5%), eggs (12.5%), nuts and seeds (19.6%) and Vitamin A-rich fruits (19.6%). The meals at the daycare centre covered up some deficiencies (pulses, Vitamin A-rich tubers and fruits) in the home-based meals. Among the caregivers, the most consumed foods fall in the vegetable category (98.2%) energy giving foods (96.4%) and beverages (83.9%). On the other hand, the least consumed foods fall in the category of foods of animal origin, soft drinks, fast foods and some types of fruits. The majority (85.7%) of the respondents observed that the daycare centre greatly contributed to increased physical activity of the child (82.1%), increased tendency to be independent (82.1%), and progressive mental development and (82.1%) better socialization skills. In light of the awareness, knowledge and practice of child-related policies among the Centre’s service providers, half of the respondents were moderately aware of the existence of documents while the other half was either slightly or very aware. Half of the respondents had middle-level knowledge, whereas the remaining three had high-level knowledge of the policies. The following seven recommendations emerged from this baseline survey 1) There is an urgent need to address increasing overnutrition; 2) There is a need for continuous capacity building of the service providers employed at the daycare centre to keep them updated and equipped to enable them to sustainably offer exemplary services from an informed premise; 3) The daycare centre should integrate nutrition education sessions into its regular periodic meetings with the parents/childcare givers by inviting an expert to educate, update and enhance their knowledge of high-nutrient value and nutrient-dense foods, especially fish. The topics could include the need for a diversified diet, food groups, nutrient-dense foods high-value foods, benefits of expressing breast milk and how to, motivational topics to convert child caregivers from inert holders of knowledge to implementers; 4) The centre should establish a link with facility or community-based growth monitoring services and together plan for monitoring the growth of the children, identification and management of detected cases of malnutrition; 5) The centre service providers should be trained on early detection of at-risk children whom they then refer for follow-up through child caregivers; 6) The daycare centre should have the staff trained on how to make yoghurt for use at the centre as well as for sale (income generation); yoghurt making can be extended to schools based 4K Clubs; 7) The centre should also introduce crop farming by establishing kitchen gardens.