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Abstract：
Rapid urbanization and increased women\'s involvement in paid work have contributed to the upsurge of informal childcare centers, especially in low-income settings where quality is a major issue. However, there are limited data on the factors associated with the quality of childcare centers in informal settlements in Africa.
We conducted a quantitative observation and questionnaire survey of 66 childcare centers to identify the factors associated with the quality of childcare services in two informal settlements (Korogocho and Viwandani) in Nairobi. The quality of the centers (outcome variable) was assessed using a locally developed tool. Data on center characteristics including type, size, location, length of operation, charges, and number of staff were collected. Center providers\' knowledge, attitude, and practices (KAP) in childcare were assessed through a questionnaire, focusing on nurturing care and business management. Data were described using means and standard deviation or frequencies and percentages. Associations between quality center score (outcome variable) and other variables were examined using multivariable linear regression to identify potential predictors of the quality of the center environment.
A total of 129 childcare centers were identified and categorized as home-based (n = 45), center-based (n = 14), school-based (n = 61), and church-based (n = 9). The number of home-based centers was particularly high in Viwandani (n = 40; 52%). Only 9% of home-based centers reported any external support and 20% had any training on early childhood development. Of the 129 centers, 66 had complete detailed assessment of predictors of quality reported here. Unadjusted linear regressions revealed associations between quality of childcare center and center providers\' education level, type of center, support received, caregiver-child ratio, number of children in the center, and center providers\' KAP score (p < 0.05). However, in the multivariable regression, only higher levels of center provider KAP (β = 0.51; 95% CI: 0.18, 0.84; p = 0.003) and center type (β = 8.68; 95% CI: 2.32, 15.04; p = 0.008) were significantly associated with center quality score.
Our results show that center providers\' knowledge and practices are a major driver of the quality of childcare centers in informal settlements in Nairobi. Interventions for improving the quality of childcare services in such settings should invest in equipping center providers with the necessary knowledge and skills through training and supportive supervision.
We conducted a quantitative observation and questionnaire survey of 66 childcare centers to identify the factors associated with the quality of childcare services in two informal settlements (Korogocho and Viwandani) in Nairobi. The quality of the centers (outcome variable) was assessed using a locally developed tool. Data on center characteristics including type, size, location, length of operation, charges, and number of staff were collected. Center providers\' knowledge, attitude, and practices (KAP) in childcare were assessed through a questionnaire, focusing on nurturing care and business management. Data were described using means and standard deviation or frequencies and percentages. Associations between quality center score (outcome variable) and other variables were examined using multivariable linear regression to identify potential predictors of the quality of the center environment.
A total of 129 childcare centers were identified and categorized as home-based (n = 45), center-based (n = 14), school-based (n = 61), and church-based (n = 9). The number of home-based centers was particularly high in Viwandani (n = 40; 52%). Only 9% of home-based centers reported any external support and 20% had any training on early childhood development. Of the 129 centers, 66 had complete detailed assessment of predictors of quality reported here. Unadjusted linear regressions revealed associations between quality of childcare center and center providers\' education level, type of center, support received, caregiver-child ratio, number of children in the center, and center providers\' KAP score (p < 0.05). However, in the multivariable regression, only higher levels of center provider KAP (β = 0.51; 95% CI: 0.18, 0.84; p = 0.003) and center type (β = 8.68; 95% CI: 2.32, 15.04; p = 0.008) were significantly associated with center quality score.
Our results show that center providers\' knowledge and practices are a major driver of the quality of childcare centers in informal settlements in Nairobi. Interventions for improving the quality of childcare services in such settings should invest in equipping center providers with the necessary knowledge and skills through training and supportive supervision.
摘要：
快速的城市化进程和更多的妇女参与有偿工作，导致非正式托儿中心的兴起，特别是在低收入环境中，质量是一个主要问题。然而,关于非洲非正规住区儿童保育中心质量相关因素的数据有限.
■我们对66个儿童保育中心进行了定量观察和问卷调查，以确定与内罗毕两个非正式定居点（科罗戈乔和维万达尼）的儿童保育服务质量相关的因素。使用本地开发的工具评估中心的质量（结果变量）。有关中心特征的数据，包括类型，尺寸,location,操作长度,charges,并收集了工作人员的数量。中心提供者\'知识，态度,儿童保育实践(KAP)通过问卷进行评估，专注于培育护理和企业管理。使用平均值和标准偏差或频率和百分比来描述数据。使用多变量线性回归检查质量中心评分（结果变量）与其他变量之间的关联，以确定中心环境质量的潜在预测因子。
■总共有129个托儿中心被确定为以家庭为基础的（n=45），以中心为基础(n=14)，校本(n=61)，和教堂为基础（n=9）。Viwandani的家庭中心数量特别多（n=40；52％）。只有9％的家庭中心报告了任何外部支持，而20％的家庭中心接受了有关幼儿发展的任何培训。在129个中心中,66对此处报告的质量预测因子进行了完整的详细评估。未调整的线性回归揭示了儿童保育中心的质量和中心提供者的教育水平之间的关联，中心的类型,得到的支持,照顾者-儿童比例，中心的儿童人数，和中心提供者的KAP评分(p<0.05)。然而,在多变量回归中，只有较高水平的中心提供者KAP(β=0.51;95%CI:0.18,0.84;p=0.003)和中心类型(β=8.68;95%CI:2.32,15.04;p=0.008)与中心质量评分显著相关.
■我们的结果表明，中心提供者\'的知识和实践是内罗毕非正式定居点托儿中心质量的主要驱动因素。在这种情况下提高托儿服务质量的干预措施应投资于通过培训和支持性监督为中心提供者提供必要的知识和技能。
■我们对66个儿童保育中心进行了定量观察和问卷调查，以确定与内罗毕两个非正式定居点（科罗戈乔和维万达尼）的儿童保育服务质量相关的因素。使用本地开发的工具评估中心的质量（结果变量）。有关中心特征的数据，包括类型，尺寸,location,操作长度,charges,并收集了工作人员的数量。中心提供者\'知识，态度,儿童保育实践(KAP)通过问卷进行评估，专注于培育护理和企业管理。使用平均值和标准偏差或频率和百分比来描述数据。使用多变量线性回归检查质量中心评分（结果变量）与其他变量之间的关联，以确定中心环境质量的潜在预测因子。
■总共有129个托儿中心被确定为以家庭为基础的（n=45），以中心为基础(n=14)，校本(n=61)，和教堂为基础（n=9）。Viwandani的家庭中心数量特别多（n=40；52％）。只有9％的家庭中心报告了任何外部支持，而20％的家庭中心接受了有关幼儿发展的任何培训。在129个中心中,66对此处报告的质量预测因子进行了完整的详细评估。未调整的线性回归揭示了儿童保育中心的质量和中心提供者的教育水平之间的关联，中心的类型,得到的支持,照顾者-儿童比例，中心的儿童人数，和中心提供者的KAP评分(p<0.05)。然而,在多变量回归中，只有较高水平的中心提供者KAP(β=0.51;95%CI:0.18,0.84;p=0.003)和中心类型(β=8.68;95%CI:2.32,15.04;p=0.008)与中心质量评分显著相关.
■我们的结果表明，中心提供者\'的知识和实践是内罗毕非正式定居点托儿中心质量的主要驱动因素。在这种情况下提高托儿服务质量的干预措施应投资于通过培训和支持性监督为中心提供者提供必要的知识和技能。
