Health status of children aged under two years cared for in day-care centres and the home environment in Ibadan, Nigeria

Abstract

Background: As a result of the increasing numbers of Nigerian women in the labour force and also the gradual disintegration of the extended family system, a demand for alternative means of caring for children is being created. Day-care as an alternative source of childcare has now become a necessity rather than an option.
Objectives: To assess and compare the health status of two groups of children under two years old cared for in two different rearing environments, home environment and day-care centres.
Methods: A descriptive comparative study design was used. Two groups of children from comparable low socio-economic backgrounds were recruited into the study. Using simple random sampling, 91 under two-year old children attending day-care centres in a middle-high density area of Ibadan and 91 under two-year old children cared for in the home environment in a settlement in the junior staff quarters of the University of Ibadan were enrolled in the study. Anthropometric data, immunisation status and morbidity patterns for various childhood illnesses were obtained for children in both groups in the study.
Results: Statistically insignificant higher percentages of children cared for in the day-care centres were underweight and wasted, while significantly more children cared for at home were stunted {Relative risk RR=1.46, (95% Confidence Limit CL = 1.10-1.93), p=0.018}. Except for measles immunisation coverage which was lower in the day-care group, there was comparability in the immunisation status of children in both groups. Day-care attendance was found to be a significant risk factor associated with the occurrence of diarrhoea (RR=1.74, (95% CL =1.34-2.26), p=0.0016) and upper respiratory tract infections (RR=2.31, (95% CL = 1.62-3.30), p=0.0000004) in these children. Measles occurred only in children attending day-care centres and there was an outbreak during the study period.
Conclusions: Given the higher risk of infections among children cared for in day-care centres, strategies should be put in place to train the child minders and ensure regular supervision of the