Centre-based day care for children younger than five years of age in low- and middle-income countries

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Review question

This review evaluated the effects of centre-based day care for children younger than five years of age in low- and middle-income countries (as defined by the World Bank 2011). We considered the following outcomes: children’s cognitive and psychosocial development, prevalence and incidence of infectious diseases among them and the economic situation of parents. We defined ‘centre-based day care’ as the supervision of children in a publicly accessible location.

Background

In low- and middle-income countries, a significant proportion of children younger than five years of age experience non-parental day care in formal and informal settings. Centre-based day care services may influence the development of children and the economic situation of parents.

Study characteristics

We included studies that assessed the effects of centre-based day care for children younger than five years of age in low- and middle-countries. To isolate the effects of day care, we excluded interventions that involved medical, psychological or non–child-focused co-interventions. Of the 34,902 citations identified through electronic searches, we found only one study that met our inclusion criteria. This study was based in Kenya, Uganda and Tanzania/Zanzibar and included 256 children. Evidence is current to April 2014.

Key results

The one included study reported positive effects of centre-based day care on the cognitive development of children. It did not report the effects of centre-based day care on children’s psychosocial development, the incidence or prevalence of infectious diseases, parental employment or household income.

Quality of the evidence

This review includes only one trial. This study did not assign participants to the intervention by chance, so the comparison groups may have differed in important ways. Therefore results must be interpreted with caution. Although current studies do not now allow for conclusive judgements regarding the effects of centre-based day care on the development of children and the economic situation of parents, this does not imply that these services are not important in low- and middle-income countries. Effectiveness studies of centre-based day care without co-interventions are few, and the need for such studies is significant.

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