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Measurement of Home Environment: The Family Care Indicators
Patrice EngleCalifornia Polytechnic State University
Yuko Nonoyama-TarumiUNICEF
Why Indicators for Family Care?
Caregiving Practices and
Resources
Quality of Interactions
with the Child
Child Development
Outcomes
Multiple Indicator Cluster Survey (MICS)
• Household Survey• Nationally representative sample• www.childinfo.org• MICS 3 (2005)
• 56 countries• Household module
• household characteristics, education, water and sanitation, nutrition, child labor, support HIV/AIDS orphans, etc.
• Women module• women’s characteristics, child mortality, maternal and newborn
health, marriage/union, HIV/AIDS knowledge, female genital mutilation, sexual behavior, etc.
• Children under five module• children’s characteristics, birth registration, early learning, breast
feeding, immunization, anthropometry, malaria, etc.
Development of Items
• Phase I: Item identification• Literature review• Meeting of global experts (Nov, 2002)
• Phase II: Item evaluation• Field tests in 7 countries (Spring, 2003)
• Qualitative analyses: Focus groups (Content validity)• Quantitative analyses: Frequency analyses (Discrimination)
• Phase III: Item selection• Meeting of global experts (Nov, 2003)
Domains selected
• Caregiving Practices• Quality of verbal
interaction• Learning/stimulating
activities• Limit setting and
discipline techniques• Responsiveness and
acceptance• Responsive feeding
• Caregiving resources• Caregiver stress• Caregiver physical
health• Caregiver knowledge• Alternate caregiver• Father’s involvement• Family cohesion• Social networks• Learning/stimulating
materials
Family Care Items in MICS3 (Core Early Learning Module: 52 countries)
(
Mother Father Other No one
Read books or look at picture books
Tell stories
Sing songs
Take outside the home, compound yard or enclosure
Play
Spend time naming, counting and/or drawing things
Learning/stimulating activities
Engage in any of the activities with the child (in the past 3 days) [multiple responses] (Asked to caretakers of children under 5 years old for each child)
Family Care Items in MICS3(Optional Child Development Module: 33 countries)
Learning/stimulating materials(Asked to caretakers of children under 5 years old once)
• Number of books• Number of children’s books• Play materials that child play with at home
• Household objects; Objects and materials found outside the living quarters; Homemade toys; Toys that come from a store; None
Alternate caregiver (in the last week)
• Number of times the child was left in the care of another child (younger than 10 years old)
• Number of times the child was left alone
Child Discipline Items in MICS3(Child Discipline Optional Module)
Setting Limits (Methods used in the past month)(Asked to caretakers of children 2-14 years old for a randomly selected child)• Non-violent
• Forbade something he/she liked• Explained why something was wrong• Gave him/her something else to do
• Psychological aggression• Shouted, yelled at or screamed at him/her• Called him/her dumb, lazy, etc
• Minor physical assault• Shook him/her• Spanked, hit or slapped him/her on the bottom with bare hand
• Severe physical assault• Hit him/her on the body with something a belt, stick, etc• Hit or slapped him/her on the face, head or ears• Hit or slapped him/her on the hand, arm, or leg• Beat him/her with an implement
• Do you believe that in order to bring up properly, you need to physically punish him/her
ECD Indicators in MICS3
Indicator Definition
Support for learning % of children aged 0-59 months living in households in which an adult has engaged in four or more activities to promote learning and school readiness in the past 3 day
Father’s support for learning
% of children aged 0-59 months whose father has engaged in one or more activities to promote learning and school readiness in the past 3 days
Support for learning: non-children’s books
% of households with three or more non-children’s books
Support for learning: children’s books
% of households with three or more children’s books
Support for learning: materials for play
% of households with three or more materials intended for play
Non-adult care % of children aged 0-59 months left alone or in the care of another child younger than 10 years of age in the past week
Pre-school attendance % of children aged 36-59 months that attend some form of early childhood education programme
School readiness %of children in first grade that attended some form of pre-school the previous year
Preliminary cross-national analyses
• To what extent do countries differ in their level of family care?
• To what extent is positive family care equally distributed within the country?
Learning/stimulating activities (four or more) by wealth
0
10
20
30
40
50
60
70
80
90
100
Gu
inia
Bis
sau
Bu
rkin
a F
aso
Bu
run
di
Mau
rita
nia
To
go
Co
te d
'Ivo
ire
Gh
an
a
Cam
ero
un
Iraq
Gam
bia
Ban
gla
de
sh
CA
R
Syr
ia
Mo
ng
olia
Vie
tnam
Ta
jikis
tan
Alg
eri
a
Pal
est
inia
ns
in
Nig
eri
a
Sie
rra
Leo
ne
So
mal
ia
Pal
est
inia
ns
in S
yri
a
Alb
an
ia
Su
rin
ame
Kyr
gys
tan
Uzb
eki
sta
n
Bo
sn
ia&
Her
zeg
ov
ina
Th
aila
nd
Kas
akh
stan
Gu
yan
a
Geo
rgia
Bel
aru
s
Ser
bia
Mac
edo
nia
Bel
ize
Jam
aic
a
Mo
nte
neg
ro
Tri
nid
ad
an
d T
ob
ag
o
Countries
Per
cen
tag
e
Poorest (%) Richest (%) Average
Average=61%Median= 64.6%Average Ratio (poorest/richest)= 0.76Correlation (prevalence, inequality)=.46
Non-children's books (three or more) by wealth
0
10
20
30
40
50
60
70
80
90
100
Pal
est
inia
ns
inL
eb
ano
n CA
R
To
go
Sie
rra
Leo
ne
Co
te d
'Ivo
ire
*
Nig
eri
a
Kyr
gys
tan
Gh
an
a
Ta
jikis
tan
Cam
ero
un
Mac
edo
nia
Mo
ng
olia
Gu
yan
a
Alb
an
ia
Pal
est
inia
ns
in S
yri
a
Su
rin
ame
Vie
tnam
Alg
eri
a
Syr
ia
Th
aila
nd
Bel
ize
Bo
snia
&H
erze
go
vin
a
Ser
bia
Uzb
eki
sta
n
Mo
nte
neg
ro
Geo
rgia
Jam
aic
a
Kas
akh
sta
n
Tri
nid
ad
an
d T
ob
ag
o
Ukr
ain
e
Country
Per
cen
tag
e
Poorest (%) Richest (%) Average
Average=58.1%Median=59.6%Average Ratio (poorest/richest)=0.54Correlation (prevalence, inequality)=.69
Children's books (three or more) by wealth
0
10
20
30
40
50
60
70
80
90
100
Co
te d
'Ivo
ire
To
go
CA
R
Cam
ero
un
Sie
rra
Leo
ne
Gh
ana
Nig
eria
Taj
ikis
tan
Pal
esti
nia
ns
inL
eban
on
Vie
tnam
Mo
ng
olia
Alg
eria
Syr
ia
Alb
ania
Pal
esti
nia
ns
in S
yria
Uzb
ekis
tan
Th
aila
nd
Su
rin
ame
Mac
edo
nia
Gu
yan
a
Jam
aica
Bel
ize
Kas
akh
stan
Bo
snia
&H
erze
go
vin
a
Geo
rgia
Kyr
gys
tan
Mo
nte
neg
ro
Ser
bia
Tri
nid
ad a
nd
To
bag
o
Ukr
ain
e
Country
Per
cen
tag
e
Poorest (%) Richest (%) Average
Average=41.6%Median=42.3%Average Ratio (poorest/richest)=0.36Correlation (prevalence, inequality)=.83
Inadequate care (left in the care of another child or left alone) by wealth
0
10
20
30
40
50
60
70
Tri
nid
ad
an
d T
ob
ag
o
Jam
aic
a
Bel
ize
Uzb
eki
sta
n
Mo
nte
neg
ro
Bo
sn
ia&
Her
zeg
ov
ina
Su
rin
ame
Geo
rgia
Alg
eri
a
Ser
bia
Mac
edo
nia
Kas
akh
stan
Ukr
ain
e
Kyr
gys
tan
Gu
yan
a
Ta
jikis
tan
Alb
an
ia
Mo
ng
olia
Th
aila
nd
Pal
est
inia
ns
in S
yri
a
Syr
ia
Gam
bia
Vie
tnam
Pal
est
inia
ns
inL
eb
ano
nS
ierr
a L
eon
e
Gh
an
a
To
go
Cam
ero
un
Nig
eri
a
CA
R
Co
te d
'Ivo
ire
Country
Per
enta
ge
Poorest (%) Richest (%) Average
Average=16.1%Median=12.6%Average Ratio (Poorest/Richest)=2.2Correlation (prevalence, inequality)=-.18
How well do these scales work?
• Item comparison across countries
• Validation on the HOME and Bayley Scales
• Validation within country data
• Recommendations for next steps
Descriptive data on activities by country
• Selected three countries with publicly available data from different parts of the world• Kyrgyzstan (n=2987) Bangladesh (n=34710)
and Sierra Leone (n=5904)
• Examined activities separately to see which have reasonable variability and if they vary as expected
Activities anyone did: Percent of households
0
10
20
30
40
50
60
70
80
90
100
Readbooks
Stories Songs Outside Play Naming
Kyrgyzstan Sierra Leone Bangladesh
Sources of toys: percent of households
0
10
20
30
40
50
60
70
80
90
household outside handmade purchased none
Kyrgyzstan Sierra Leone
Conclusions based on descriptive data
• Differences by country are reasonable
• All families do something
• Some questions have little variability (e.g., taking child outside, play with child).
Validity study: Bangladesh
• 800 children at 18 months• HOME • Bayley MDI and PDI• Language Comprehension and Expression
• 129 of them also measured at 12 months on same measures
• 40 given 7-14 week test-retest on Activities and Toys
Grantham-McGregor, Hamadani, and Engle, 2008
Measures
• 6 activity items• Play – “play with toys” rather than “play”
• Sources of toys
• Variety of toys
• Books
• Childcare situation
Reliability
Measure 1 week (18 months)
12 to 18 months
Family Activity Score
.64** .57**
Number of sources of toys
.91** .09
N 40 129
Associations of Activity Index with Outcome Measures (n=798)
FCI FCI regr+
Source of toys
Source regr
HOME .72** ** .39** ns
MDI .29** * ns ns
PDI .19** ns .09* ns
Language .44** ** .23** ns
+Controlling for maternal education, wealth, family size, birthweight, gestational age, paternal education, income, age, gender, other family care measures
Means of MDI by Number of Family Activities
controlling for age (N=800; 18 months)
6668707274767880828486
1 2 3 4 5 6
Mean MDI
ANOVA significant at p<.001
Conclusion
• Family Activity Index appears to be reliable and valid
• Increases with MDI in a linear fashion – no clear cut-off
• Sources of toys is not so strong
• Variety of toys much stronger (not reported here)
Validity assessment with MICS data: Bangladesh (N=34,710)
• Internal consistency• Association of items with age• Associations with maternal education, household
wealth, gender• Associations with two parent report measures:
Do you do anything to prepare your child for school (3 and 4 only); and do you do things to develop your child’s intelligence
• Value of individual activity questions
Which items are related to age? Bangladesh, N= about 34,000
Total activities .34**
Read books .47**
Tell stories .24**
Sing Songs .01
Take outside .08*
Play .02
Naming, counting, drawing .40**
Do something to develop intelligence .17**
Prepare for school .15**
Internal consistency of Index: Alpha = .734
Measure Item-total correlation
Read books .54
Tell stories .60
Sing Songs .48
Take Outside .29
Play .38
Names, counts, draw .52
Correlations of items with SES measures controlling for age
M Ed Wealth Develop IQ
Prepare school
Total .34 .25 .31 .29
Read Books .35 .23 .24 .35
Tell stories .25 .23 .19 .16
Sing songs .21 .17 .19 .12
Outside .07 .05 .12 .06
Play .15 .13 .15 .09
Name, count. .25 .16 .24 .02
Conclusions
• Family Activities Scale works quite well
• Sources of toys functions less well
• Need more work to define a cut-off point – four or more activities may not be the best
Recommendations
• Analyze role of fathers separately• Make a separate code for some activities
such as “read books” • May revise wording on some questions
• Could replace “take outside”• Might use “play with toys” rather than “play”
• Complete analyses with the rest of the countries
• Apply and use for Advocacy