A vacinação é uma das medidas de maior impacto na diminuição da morbimortalidade de doenças. No entanto, sua história é marcada por êxitos e contratempos. No contexto brasileiro, a vacinação se afirmou como premissa do cuidado infantil, extrapolando a perspectiva médica e alcançando a população geral. Em contraponto, desde os anos 2000, foi observada uma diminuição da cobertura vacinal infantil em estratos de alta renda e escolaridade em São Paulo-SP, segmento social que valoriza a individualidade e a autonomia dos sujeitos. Esse estudo tem por objetivo compreender o processo de (não) vacinação dos filhos e sua interface com o cuidado infantil, em casais de camada média e alta escolaridade em São Paulo/SP. Foi utilizada a abordagem qualitativa, por meio de entrevistas em profundidade com dezesseis casais, dos quais cinco vacinaram, cinco selecionaram as vacinas e seis não vacinaram os filhos. O percurso analíticointerpretativo dos dados empíricos foi realizado pelo referencial metodológico da antropologia interpretativa geertziana com o recurso da análise de conteúdo temático e os achados foram discutidos em articulação com os referenciais teóricos interrelacionados de cuidado, família e gênero. O estudo encontrou diferenças significativas quanto à tomada de decisão dos casais...

OBJECTIVE: To quantify the influence of the type of child-care on the occurrence of acute diarrhea with special emphasis on the effect of children grouping during care. METHODS: From October 1998 to January 1999 292 children, aged 24 to 36 months, recruited using a previously assembled cohort of newborns, were evaluated. Information on the type of care and occurrence of diarrhea in the previous year was obtained from parents by telephone interview. The X² and Kruskal-Wallis tests were used to compare proportions and quantitative variables, respectively. The risk of diarrhea was estimated through the calculation of incident odds ratios (OR) and their respective 95% confidence intervals (95% CI), crude and adjusted by unconditional logistic regression. RESULTS: Using as reference category children cared individually at home, the adjusted ORs for diarrhea occurrence were 3.18, 95% CI [1.49, 6.77] for children cared in group at home, 2.28, 95% CI [0.92, 5.67] for children cared in group in day-care homes and 2.54, 95% CI [1.21, 5.33] for children cared in day-care centers. Children that changed from any other type of child-care setting to child-care centers in the year preceding the study showed a risk even higher (OR 7.65, 95% CI [3.25...

Existing studies of child care have not been able to determine whether higher quality child care protects children from the effects of poverty, whether poverty and lower quality child care operate as dual risk factors, or whether both are true. The objective of the current study was to test two pathways through which child care may serve as a naturally occurring intervention for low-income children: a direct pathway through child care quality to child outcomes, and an indirect pathway through improvements in the home environment. Children were observed in their homes and child care settings at 6, 15, 24, and 36 months. An interaction between family income-to-needs ratio and child care quality predicted School Readiness, Receptive Language, and Expressive Language, as well as improvements in the home environment. Children from low-income families profited from observed learning supports in the form of sensitive care and stimulation of cognitive development, and their parents profited from unobserved informal and formal parent supports. Policy implications are discussed.

This paper reassesses how the costs associated with child care influence Australian families’ decisions about their work and child care arrangements. Using data from the Negotiating the Life Course Survey, we suggest that the cost of care may not be an important barrier to labour market participation. Non-employed mothers do not cite child care as the barrier preventing them from working and many two-earner families appear to be able to adjust their schedules so as to avoid paying child care costs at all. Instead, factors such as the cost structures associated with formal, informal and parental care; attitudes regarding work and child rearing; and the work arrangements of working couples to be more important in the labour-supply decision. In addition, the data suggests there are important differences in the cost structure of different types of care. While costs in formal care appear to be fixed, information and parental care has a larger variable cost component. Results indicate that the relative importance of fixed costs influence the decision about which type of child care arrangement is utilised.; no

This thesis has four main goals: (1) to examine the association between different measures of time in childcare on children’s cognitive and social development; (2) to investigate the influence of child-care-related variables (i.e., structural and process features of quality child care, caregivers’ mental health status and job satisfaction) on child developmental outcomes; (3) to determine whether child care predicts developmental outcomes after controlling for the effects of family-background variables (e.g., family social environment, parental discipline practices and parental mental health status); and (4) to examine the moderating effect of family and other predictor variables on the relationship between the amount of time spent in child care and its effect on children’s cognitive and social development. To achieve these goals, data were collected from 147 children between 3-4 years of age in Study I and 89 children aged 4-5 years in follow-up studies. These children were attending nationally accredited child care centres in South Australia, but in areas that differed socio-economically. The first finding was that different measures of time in childcare were not equally related to child developmental outcomes. The number of day(s) in a week...

Despite increases in availability of center based child care and preschool services in Turkey over the last decade, both the supply of services and utilization remain low. There are regional disparities in availability and the majority of children and households remain unserved in terms of child care and preschool services. This report has collected and assessed information on the supply and demand for child care services in Turkey with the objective of identifying key constraints and opportunities to expand quality and affordable access. The analysis in this report shows that current utilization of child care services cannot be construed as lack of demand for services, but rather as a lack of demand for services at existing cost and price-quality structures. Existing services that respond to the needs of working mothers are mainly private services and tend to be more expensively priced than the willingness and ability to pay of the average household. For most women the difference between earnings and the cost of care is too low to justify joining the labor force and their willingness to pay for care does not cover the current median prices for child care and kindergarten services.

Grandparents are regular providers of free child care. Similar to any other form of child care, availability of grandparent-provided child care affects fertility and labor market decisions of women positively. We find that women in Germany, residing close to parents or in-laws are more likely to have children and that as mothers they are more likely to hold a regular part- or fulltime job. However, different from any other type of child care, for individuals to enjoy grandparent-provided child care on a regular basis, residence choices must coincide with those of parents or in-laws. Thus while living close provides access to free child care, it imposes costly spatial restrictions. We find that hourly wages of mothers residing close to parents or in-laws are lower compared to those residing further away, and having relatives taking care of ones' children increases the probability of having to commute. We build a general equilibrium model of residence choice, fertility decisions, and female labor force participation that can account for the relationships between grandparent-provided child care, fertility and female labor market outcomes. We simulate our model to analyze how women's decisions on residence, fertility, and labor force participation change under distinct scenarios regarding availability of grandparent-provided child care and different family policies.

This paper analyzes the effects of maternal employment and non-parental child care on child cognitive development, taking into account the mother's time allocation between leisure and child-care time. I estimate a behavioral model, in which maternal labor supply, non-parental child care, goods expenditure and time allocation decisions are considered to be endogenous choices of the mother. The child cognitive development depends on maternal and non-parental child care and on the goods bought for the child. The model is estimated using US data from the Child Development Supplement and the Time Diary Section of the Panel Study of Income Dynamics. The results show that the productivity of mother's child-care time substantially differs by a mother's level of education. Moreover, the childcare time of college-educated mothers is more productive than non-parental child care. The simulation of maternity leave policies, mandating mothers not to work in the first two years of the child's life, reveals that the impact on the child's test score at age five is either positive or negative, depending on whether the leave is paid or not. The heterogeneous productivity of mothers' time leads to different allocation choices between child care and leisure: college-educated mothers re-allocate a larger fraction of their time out of work to child care than do the lower educated...

This version: 19 September 2013.; This paper investigates the effects of public child care availability in Italy in mothers' working status and children's scholastic achievements. We use a newly available dataset containing individual standardized test scores of pupils attending the second grade of primary school in 2009-10 in conjunction with data on public child care availability. Our estimates indicate a positive and significant effects of child care availability on both mothers' working status and children's Language test scores. We find that a percentage change in public child care coverage increases mothers' probability to work by 1.3 percentage points and children's Language test scores by 0.85 percent of one standard deviation; we do not find any effect on Math test scores. Moreover, the impact of a percentage change in public child care on mothers' employment and children's Language test scores is greater in provinces where child care availability is more limited.

BACKGROUND: Disentangling the effects of maternal depression in toddlerhood from concurrent maternal depression on child behavior is difficult from previous research. Child care may modify any effects of maternal depression on subsequent child behavior, but this has not been widely investigated. METHODS: We examined the influence of maternal depressive symptoms during toddlerhood on children's behavior at the age of 5 years and investigated if formal or informal child care during toddlerhood modified any relationship observed. RESULTS: Data were available from 438 mothers and their children (227 girls and 211 boys); the mothers who completed questionnaires during the children's infancy, in toddlerhood, and at the age of 5 years. Recurrent maternal depressive symptoms in toddlerhood (when study children were aged 2 and 3½ years) was a significant risk factor for internalizing, externalizing, and total behavior problems when children were aged 5 years. Intermittent maternal depressive symptoms (study child age 2 or 3½ years) did not significantly affect child behavior problems. Formal child care at the age of 2 years modified the effect of recurrent maternal depressive symptoms on total behavior problems at age 5 years. Informal child care in toddlerhood did not significantly affect child behavior problems. CONCLUSIONS: Recurrent...

The authors model the household demand for child care, the mother's participation in the labor force, and her working hours in Romania. Their model estimates the effects of the price of child care, the mother's wage, and household income on household behavior relating to child care and mothers working outside the home. They find that: Both the maternal decision to take a job and the decision to use out-of-home care are sensitive to the price of child care. A decrease in the price of child care can increase the number of mothers who work and thus reduce poverty in some households. The potential market wage of the mother has a significant positive effect on the decision to purchase market care and the decision to engage in paid employment. The level of household nonwage income has little effect on maternal employment and the demand for child care. In addition to facilitating women's work, kindergartens and creches appear to provide educational and social benefits for children. Close to half the children in these facilities have mothers who do not work. Further research is needed to assess the cost and nature of these benefits and to determine the appropriate roles for the private and public sectors in providing, financing, and regulating such services for working and nonworking mothers.

Formal child care services can expand women's economic opportunities and promote equity through early childhood development. However, academics and policy makers often overlook the role of relatives as child care providers. This note discusses how grandparent-provided child care can be factored into child care policies in the context of Organization for Economic Co-operation and Development (OECD) countries, omitting the role of relatives when estimating costs and benefits of child care programs can give biased and incomplete results that might even reverse certain programs. The focus of this note is on the opportunity cost of relatives particularly grandparents who care for children. Not just governments spend on child care programs grandparents spend considerable time caring for grandchildren. Depending on their labor market status and work history, grandparents' opportunity cost could be high or low; governments should factor in such costs when evaluating programs. The Netherlands and the United Kingdom are experimenting with policies that formally support grandparent-provided child care.

This thesis aims to uncover the dynamics, causes and outcomes of women's reliance on unregulated home-based child care in Ontario, Canada, and the implications ofthis form of care for women's equality. Drawing on a longitudinal qualitative study, I examine the diverse experience of 14 women using home-based child care and engaged in both paid work/training and care work for children under the age of six, and draw comparisons with users of other forms of child care. I argue that home-based child care involves high levels of instability for continuity of care and is chosen largely as a default position based on economic considerations. It represents a compromise between the demands of social reproduction and paid work/training that entangles mothers in relations of exploitation with care providers. Doing so leaves both mothers and care providers socially and economically vulnerable and relying on social networks to fill in the gaps.

This thesis examines the impact of universal child care on child development outcomes. Through the case of the Quebec Family Policy, one of the largest and most comprehensive child care policies enacted in North America, the six papers making up this thesis investigate the impact of universal child care on a variety of child outcomes, including cognitive, health, and behavioural, and demonstrate that the effects of this policy are complicated along a number of dimensions. Moving beyond average effects, this research instead considers heterogeneity to produce a more nuanced analysis of the effects of universal child care. This research contributes significantly to debates surrounding best practices in child care policies, and the ways in which child care fits into trends such as gender gaps in education and increasing rates of childhood obesity. The first paper analyzes reporting of negative impacts of the Quebec Family Policy, confirming the notion that universal child care programs weaken individual and family outcomes but suggesting that substantial heterogeneity exists in response to child care attendance. The next paper examines these heterogeneous effects of universal child care through a consideration of differential impact according to child ability levels. Analysis reveals that formal child care can indeed boost developmental outcomes for some children...

Child care subsidies play an important role in stabilizing parental employment and helping low-income families access quality and affordable child care options. However, low-income families on average only maintain subsidies for short periods of time, commonly known as spells. While there are several reasons a family may stop using subsidies, some policymakers and researchers have expressed concerns that program policies may create barriers to subsidy maintenance. With limited federal requirements under the Child Care and Development Block Grant, states have developed divergent policies for their state-based child care subsidy programs. To date, research on child care subsidies has mainly focused on the demographics differences between subsidy recipients and low-income families who do not use subsidies. Very little is known about the effects of states’ policies on whether families’ maintain subsidy coverage. Using data from the Urban Institute’s CCDF Policies Database and the Administration for Children and Families’ CCDF Administrative Dataset this paper analyzes the effects of polices on average spell length and stability of child care spells from October 1, 2007 to September 30, 2010. In particular, the study focuses on policies related to whether families can count job search as an eligibility activity...

Background. Diarrheal infections are common in children who attend child care, and preventing transmission of disease in this setting depends on actions by child care staff. We set out to discover whether transmission of gastrointestinal infections in child care could be reduced by improved infection control procedures. Methods. We performed a cluster randomized, controlled trial of an infection control intervention conducted in child care centers for 1 city in Australia. The intervention was training of child care staff about transmission of infection and handwashing and focused on both staff and child behavior. Implementation of the intervention was recorded by an observer. Illness was measured by parent report in telephone interviews every 2 weeks. Results. There were 311 child-years of surveillance for diarrheal episodes. The rate of episodes of diarrhea was 1.9 per child-year in intervention centers and 2.7 per child-year in control centers. Multivariate analysis showed that diarrheal episodes were significantly reduced in intervention center children by 50%. However, the impact of the intervention was confined to children over 24 months of age. For those centers in which children's compliance with handwashing was high, diarrheal episodes were reduced by 66%. Conclusions. This trial supports education about infection control...

Background. Acute upper respiratory infections are common in children who attend child care, and preventing transmission of disease in this setting depends on actions by child care staff. We set out to discover whether transmission of respiratory infections in child care could be reduced by improved infection control procedures. Methods. We performed a cluster, randomized, controlled trial of an infection control intervention conducted in child care centers in 1 city in Australia. The intervention was training of child care staff about transmission of infection, handwashing, and aseptic nose-wiping technique. Implementation of the intervention was recorded by an observer. Illness was measured by parent report in telephone interviews every 2 weeks. Results. There were 311 child-years of surveillance for respiratory symptoms. By multivariable analysis, there was no significant reduction in colds in intervention center children across the full age range. However, a significant reduction in respiratory illness was present in children 24 months of age and younger. When compliance with infection control practices was high, colds in these children were reduced by 17%. Conclusions. This trial supports the role of direct transmission of colds in young children in child care. The ability of infection control techniques to reduce episodes of colds in children in child care was limited to children 24 months of age and under.

OBJETIVO: Quantificar a associação entre o tipo de cuidados infantis e a ocorrência de diarréia aguda, sendo dada especial atenção aos diferentes tipos de cuidados infantis prestados a grupos de crianças. MÉTODOS: De outubro de 1998 a janeiro de 1999, foram avaliadas 292 crianças, com idades entre 24 e 36 meses, recrutadas com base numa coorte de recém-nascidos previamente constituída. Foi obtida informação acerca do tipo de cuidados infantis e da ocorrência de diarréia no ano anterior ao estudo por meio de entrevista telefônica aos pais das crianças participantes. Foram utilizadas as provas do X² e de Kruskal-Wallis para comparar proporções e variáveis quantitativas, respectivamente. O risco de diarréia foi estimado pelo cálculo de odds ratios (OR) incidentes e respectivos intervalos de confiança a 95% (IC 95%), brutos e ajustados por regressão logística não condicional. RESULTADOS: Utilizando como classe de referência as crianças cuidadas sozinhas na própria casa, o OR para a ocorrência de diarréia foi 3,18, IC 95% [1,49-6,77] para as crianças cuidadas na própria casa mas em grupo, 2,28, IC 95% [0,92-5,67] para as cuidadas em casas de amas, em grupo, e 2,54, IC 95% [1,21-5,33] para as cuidadas em creches (instituições de prestação de cuidados infantis...

This article closes the special issue of this journal about an international review of out-of-home child care, principally family foster care and residential care, tough several aspects related to adoption were included as well. Although a comparison on some data about residential and foster care, or kinship and non-kinship care, is carried out, the article tries above all to make a reflection on the implications of several themes that have emerged as more interesting or important. Matters such as the use of residential care and its role in the current child care system, the overrepresentation of ethnic minorities in foster care in several countries, the situation of unaccompanied young people asylum seeking, the use of adoption as a permanent solution, the challenges of the transition to the adulthood from care, the relevance of the professionalization and models based on social pedagogy, the evaluation and planning based on data, and the current financial crisis and its impact on child care systems are some of the remarkable topics that will be reviewed.

OBJECTIVE: To quantify the influence of the type of child-care on the occurrence of acute diarrhea with special emphasis on the effect of children grouping during care. METHODS: From October 1998 to January 1999 292 children, aged 24 to 36 months, recruited using a previously assembled cohort of newborns, were evaluated. Information on the type of care and occurrence of diarrhea in the previous year was obtained from parents by telephone interview. The X² and Kruskal-Wallis tests were used to compare proportions and quantitative variables, respectively. The risk of diarrhea was estimated through the calculation of incident odds ratios (OR) and their respective 95% confidence intervals (95% CI), crude and adjusted by unconditional logistic regression. RESULTS: Using as reference category children cared individually at home, the adjusted ORs for diarrhea occurrence were 3.18, 95% CI [1.49, 6.77] for children cared in group at home, 2.28, 95% CI [0.92, 5.67] for children cared in group in day-care homes and 2.54, 95% CI [1.21, 5.33] for children cared in day-care centers. Children that changed from any other type of child-care setting to child-care centers in the year preceding the study showed a risk even higher (OR 7.65, 95% CI [3.25...