Hidden criteria for out‐of‐home day‐care centre admission in Pokhara, Nepal: a longitudinal observational study

Abstract

This longitudinal observational study evaluated whether admission priorities given to children on waiting lists for out‐of‐home day‐care centres (DCCs), determined as being either an early or late admission to DCCs, are determined by actual childcare needs and are assigned to children of disadvantaged families, in public DCCs in Pokhara, Nepal, between November 2003 and February 2006. Multivariate logistic regression analysis showed high caste, low household weekly income, and father’s absence from the home were associated with children’s early admission to DCCs; but maternal employment and availability of childcare support were not associated with admission priorities. Priorities given to children on DCC waiting lists were not fully based on deprivation and childcare need; caste/ethnicity may influence the prioritisation. Policies should explicitly prioritise those most in need and most deprived, possibly with regulations to reserve seats for those from low‐caste/ethnic groups.

Keywords:

• childcare
• socio‐economic factors
• minority health
• disparities
• day‐care

Acknowledgements

We thank Mr. Raju Subedi, Mr. Om Bahadur Thapa and Ms. Iswori Dhakal for their support and assistance throughout the research process. We also thank the day‐care centre staff for their role in collecting data and thank the management committee members for their cooperation in the study. We thank Dr. Jamie Abdennadher for his critical review of the manuscript and for his advice. This study was partly supported by a Grant for International Health Cooperation Research (13C‐1) from the Ministry of Health, Labour and Welfare. The sponsor had no role in the study design, data collection, data analysis, data interpretation, or writing of the report.