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Resources for nurturing childcare practices in urban and rural settings: Findings from the Colombia 2010 Demographic and Health Survey
Authors: Urke HB, Mittelmark MB, Amugsi DA, and Matanda DJ
Source: Child: Care, Health & Development, 44(4):572-582; DOI: 10.1111/cch.12570
Topic(s): Child feeding
Child health
Education
Immunization
Inequality
Nutrition
Country: Latin American/Caribbean
  Colombia
Published: JUL 2018
Abstract: BACKGROUND: The health and development potential of young children is dependent on nurturing care (NC) provided by primary caregivers. NC encompasses attention to nutrition; symptom management; early learning, attachment, and socialization; and security and safety. Despite the importance of NC to child health and development, the measurement and study of NC are neglected. This has become a point of major concern in the public health field in low- and middle-income countries (LMICs) such as Colombia where many families are hard pressed for childcare resources. The aims of this study were therefore to (a) create age-specific NC summary indexes (0-5, 6-11, and 12-23 months) suitable for research in LMICs and (2) examine the relationship of NC to maternal resources. METHODS: 2010 Colombia Demographic and Health Survey data were obtained from mothers and their children ages 0-5 months (n = 1,357); 6-11 months (n = 1,623); and 12-23 months (n = 3,006). Age-specific NC indexes were created including information on child feeding, immunization, hygiene, response to illness symptoms, and psychosocial care. Independent variables included mother's education level and household assets, and enrolment in a government child development programme. Regression analyses with NC as the outcome variable were conducted with urban and rural subsamples in the 3 age groups. RESULTS: Among rural children, NC was significantly higher with greater household assets, maternal decision latitude, and development programme participation, with variation by child age. Among urban children, higher maternal education and white-collar occupation also predicted higher NC, with some variation by age. CONCLUSION: It is feasible to measure age-specific NC in survey research, and NC is related to maternal resources. Age and urban-rural differences in how NC is related to social factors are observed. The findings support the importance of subgroup analysis in the study of NC in LMICs such as Colombia. © 2018 John Wiley & Sons Ltd. KEYWORDS: Colombia; childcare; education; household wealth; maternal decision latitude; nurturing childcare; urban-rural residence