Let's shift systems and promote childcare as a vital public good

Most interventions are elevating the important agenda of women's economic empowerment in which providers are viewed as micro-entrepreneurs. [iStockphoto]

Home-based childcare (HBCC) is a form of non-parental care that takes place in the home of the child, or a provider as opposed to a centre.

It is one of the most popular forms of childcare globally, particularly for low-income families due to typically greater affordability. In the US alone, it is estimated that almost 30 per cent of infants and toddlers receive care primarily in a home-based setting by someone other than a parent, compared to 11.9 per cent in a centre (Paschall, 2019).

While there is little current data on the landscape in developing countries, emerging research conducted in one of the informal settlements in Nairobi by the African Population and Health Centre and the London School of Hygiene and Tropical Medicine estimates that about 70 per cent of young children aged below three years are taken care of in the homes of providers.

Data and evidence, such as that from the Kenya Women Economic Empowerment Community of Practice (a project funded by the Bill and Melinda Gates Foundation and convened by the International Center for Research on Women -- ICRW), shows that despite its prevalence, home-based childcare is under-resourced, under-regulated, under-researched and undervalued. To survive, providers, mostly women, rely on payments from families and support from funders and civil society organisations.

Often, providers expend their own resources on their work without reimbursement. Additionally, the burden of care for children is unevenly distributed with the provider-to-child ratio ranging from 1:18 and in the extreme 2:50. This situation not only reinforces women's role as altruistic nurturers/carers but fuels the stigma that surrounds childcare work and its value in our societies. HBCC providers represent a significant sector of the childcare workforce and need greater support to realise equal opportunities.

Fortunately, investments in childcare have grown in the last few years. In 2022, the World Bank and partners launched the multi-million dollar Invest in Childcare Fund which aims to incentivise countries to increase public investments in childcare.

Private philanthropists and bilateral funders have also put in significant resources into childcare and women's economic empowerment initiatives and there are innovative models that are providing pathways to scalable solutions that governments could adopt. However, most interventions are elevating the important agenda of women's economic empowerment in which providers are viewed as micro-entrepreneurs.

This framing exempts governments from responsibility because it positions childcare services as private goods and programmes will typically not cover the breadth of childcare workers. A child's right to parental responsibility is articulated in human rights law with governments having correlated obligations to support parents to access childcare services and to create accessible childcare infrastructure.

Childcare should therefore be understood as a human right and a public good. This framing should under-gird public and private investments in childcare systems. This is the ideology that guides the work of NurtureFirst (formerly the Home-Based Childcare Initiative), established in 2022 following a 2020 Study on Support Programs for HBCC Providers.

The study sought to understand from whom and how home-based childcare providers in Brazil, Chad, Colombia, France, India, Kenya, the UK, the US and South Africa, received support. The study recommended that governments and donors increase financing for systems of support for HBCC providers. The study also recommended that policymakers embed support programmes in the public sector, that stakeholders create a global learning community and define standards for quality in HBCC settings.

To truly empower the providers, we need to change the environments that providers operate in, and catalyse policies that recognise their work, identify ways to compensate them and ensure they access critical health, nutrition, sanitation and other services from community-based organisations and the government. NurtureFirst undertook mapping of the HBCC system in Mombasa, Murang'a and Kisumu by holding focus group discussions with parents and HBCC providers. These provided insights into how providers interact with the government and civil society.

Parents also shared their challenges in affording care and the factors that inform their choice of a provider, which ranged from positive referrals to the warmth exuded by the provider. Parents were categorical that quality of care ranks high as a key priority and defined initial features of care which include cleanliness. The mapping also established that providers, many of whom are women, offered services on an unpaid or very low-paid basis with fees ranging from as little as 30 US cents to 15 dollars.

The few support programmes offered by civil society organisations barely cover the extent of need among the providers in the three counties, which our mapping estimates to be about 27,000. The mapping enabled us to identify specific levers of change that could be the game-changer for providers. Our work in Kenya in collaboration with community-based organisations will reveal which interventions, including policy changes and programmes, have the most impact on changing the systems in which providers operate.

As a result, we will learn how we can recognise providers' critical work and support them to access services, including, but not limited to nutrition, sanitation, nurturing care practices and stable, increased compensation. To effectively empower childcare providers and uplift families so that all our children, particularly our most vulnerable ones aged 0-3 receive quality care, we need to collaborate across movements to ensure we achieve child development and gender equality.