This excellent article explains the process through which indicators of family care for (child) development were drafted and tested in several countries. The article sets out the rational for developing the indicators, the process and conceptual basis for their development and how their validity was tested. This project aimed to develop indicators from a set of items, measuring family care practices and resources important for caregiving, for use in epidemiologic surveys in developing countries. A mixed method (quantitative and qualitative) design was used for item selection and evaluation.
The authors explain that measures of family care practices with global application are useful not only for understanding their influence on child development but also for guiding policy and intervention programmes aimed at improving the developmental trajectories of children the world over. No validated population-level indicators of family care practices for children’s development existed prior to this initiative, although there had been a large number of studies on small samples of children using observational techniques, particularly using the Home Observation for Measurement of the Environment Inventories (HOME). Given the importance of family care in child development, the need to develop measures and indicators of practices with universal applicability was recognized as a major gap and a process initiated by UNICEF in 2002. The goal of the study was to develop a set of items that could be included in the Multiple Indicator Cluster Surveys (MICS) and nationally representative household surveys. The project used the HOME scale as one of its conceptual bases for defining family care for development, together with the UNICEF’s conceptual framework of care for nutrition that had been expanded to other care practices that influence child development.
Seven family care domains and seven caregiving-resource domains were initially developed by an expert panel, derived from the HOME scale and the UNICEF’s conceptual framework as having global applicability. The domains of family care were quality of verbal interactions, support for learning, limit-setting (i.e. disciplinary) techniques, consistency of support, support for emotional well-being and acceptance, support for sense of self, and responsiveness to the child. The domains of resources included four categories at the level of the caregiver (caregiver’s stress, caregiver’s time availability, physical health, and knowledge) and three at the household level (family cohesion/functioning, social support, and organization of the care environment). These 14 domains were later combined into four family care domains: responsiveness and acceptance, support for learning/ stimulating environment, limit-setting techniques, and caregiver responsiveness during feeding and three resources domains: availability and use of alternate caregivers, father’s involvement with child, and maternal depression symptoms.
The items were field-tested in 2003 in Brazil, Burkina Faso, Nepal, Uganda, and Zanzibar (United Republic of Tanzania), representing a variety of cultural contexts. Informant interviews on the items were conducted in Bangladesh, Jamaica, and Mexico as well. The project resulted in a set of globally-applicable items intended for use in household surveys to assess family care for development of young children. The recommended items assess two practices: support for learning/stimulating environment and limit-setting techniques, and one caregiving resource: availability and use of alternate caregivers. The study provided evidence that the selected items assess these domains in a comparable way across countries. These items were included in the MICS3 (2005-2006) for 50 countries and in the MICS4 (2009-2013) for 57 countries. The authors believe that the availability of these items will provide much- needed information about the status of family-care settings globally and that this information will reinforce attention to efforts to improve support for families in supporting their children’s development.
For an article reviewing the use of the Family Care Indicators in Bangladesh, and their applicability and validity in that particular context, please visit:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2975843/
©Journal of Health, Population and Nutrition, 2012 Dec: 30(4): 472-486