Measurement of Home Environment: The Family Care Indicators

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Measurement of Home Environment The Family Care
Indicators

• Patrice Engle
• California Polytechnic State University
• Yuko Nonoyama-Tarumi
• UNICEF

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Why Indicators for Family Care?
Caregiving Practices and Resources
Quality of Interactions with the Child
Child Development Outcomes
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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
• womens characteristics, child mortality,
  maternal and newborn health, marriage/union,
  HIV/AIDS knowledge, female genital mutilation,
  sexual behavior, etc.
• Children under five module
• childrens characteristics, birth registration,
  early learning, breast feeding, immunization,
  anthropometry, malaria, etc.

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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)

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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
• Fathers involvement
• Family cohesion
• Social networks
• Learning/stimulating materials

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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)

• (

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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 childrens 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

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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

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ECD Indicators in MICS3
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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?

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Learning/stimulating activities (four or more) by
wealth
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Non-children's books (three or more) by wealth
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Children's books (three or more) by wealth
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Inadequate care (left in the care of another
child or left alone) by wealth
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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

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Descriptive data on activities by country

• Selected three countries with publicly available
  data from different parts of the world
• Kyrgyzstan (n2987) Bangladesh (n34710) and
  Sierra Leone (n5904)
• Examined activities separately to see which have
  reasonable variability and if they vary as
  expected

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Activities anyone did Percent of households
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Sources of toys percent of households
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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).

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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
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Measures

• 6 activity items
• Play play with toys rather than play
• Sources of toys
• Variety of toys
• Books
• Childcare situation

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Reliability
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Associations of Activity Index with Outcome
Measures (n798)
Controlling for maternal education, wealth,
family size, birthweight, gestational age,
paternal education, income, age, gender, other
family care measures
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Means of MDI by Number of Family Activities
controlling for age (N800 18 months)
ANOVA significant at plt.001
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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)

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Validity assessment with MICS data Bangladesh
(N34,710)

• 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 childs intelligence
• Value of individual activity questions

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Which items are related to age? Bangladesh, N
about 34,000
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Internal consistency of Index Alpha .734
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Correlations of items with SES measures
controlling for age
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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

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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