Measurement of Home Environment: The Family Care Indicators

1. Measurement of Home Environment: The Family Care Indicators Patrice Engle California Polytechnic State University Yuko Nonoyama-Tarumi UNICEF

2. Why Indicators for Family Care? Caregiving Practices and Resources Quality of Interactions with the Child Child Development Outcomes

3. 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.

4. 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)

5. 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 Domains selected

6. Family Care Items in MICS3 (Core Early Learning Module: 52 countries) 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) (

7. 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

8. 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

9. ECD Indicators in MICS3

10. 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?

11. Learning/stimulating activities (four or more) by wealth

12. Non-children's books (three or more) by wealth

13. Children's books (three or more) by wealth

14. Inadequate care (left in the care of another child or left alone) by wealth

15. 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

16. 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

17. Activities anyone did: Percent of households

18. Sources of toys: percent of households

19. 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).

20. 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

21. Measures • 6 activity items • Play – “play with toys” rather than “play” • Sources of toys • Variety of toys • Books • Childcare situation

22. Reliability

23. Associations of Activity Index with Outcome Measures (n=798) +Controlling for maternal education, wealth, family size, birthweight, gestational age, paternal education, income, age, gender, other family care measures

24. Means of MDI by Number of Family Activities controlling for age (N=800; 18 months) ANOVA significant at p<.001

25. 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)

26. 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

27. Which items are related to age? Bangladesh, N= about 34,000

28. Internal consistency of Index: Alpha = .734

29. Correlations of items with SES measures controlling for age

30. 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

31. 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