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Child Care, Maternal Employment, and Children's School Outcomes. An Analysis of Italian Data.

ABSTRACT: In this paper we analyse the impact of mothers' employment status and formal child care attendance during early childhood on children's school grades later in life, controlling for socio-demographic factors. We use the year 2008 of the Italian ISFOL-PLUS dataset. The dataset provides information on each respondent's demographic characteristics, as well as a set of retrospective information on the individual's school grades at the end of junior high school, high school, and university, along with (in the 2008 wave only) information about the respondent's formal child care attendance and mother's employment status when he or she was under age of three. We estimate the effects of maternal employment and child care attendance on the probability that the respondent would have high grades at the end of high school. Since maternal employment and child care attendance are likely to be endogenously determined, we use an instrumental variable approach. Our empirical results show that while having a mother who was working (during early childhood) had no significant effect on an individual's high school grades, child care attendance had a positive and significant effect. These results have potential policy implications. As maternal employment does not seem to negatively affect the development process of children, while child care attendance appears to have a positive impact on academic achievement, policy makers should consider expanding the availability of child care and promoting women's participation in the labour market.

SUBMITTER: Del Boca D

PROVIDER: S-EPMC6241099 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundMany low- and middle-income countries (LMICs) prioritise minimising maternal, neonatal, and infant mortality. To improve maternal and child health, various evidence-based interventions have been introduced. Quality of care is pertinent while strengthening service utilisations. Achieving optimal-quality care is often marred with difficulties, such as inadequate skills and knowledge of health workers, poor fidelity to protocols, and poor user acceptance. Angola is a LMIC facing these problems. This study aimed to demonstrate the influence of health facilities' quality of care at antenatal care (ANC) on subsequent maternal, newborn and child health (MNCH) service utilisation in Angolan pregnant women.MethodsPopulation-based cohort data from the Maternal and Child Health Handbook (MCH-HB) effectiveness study were analysed. The original study was conducted among women who became pregnant between March and April 2019 in Benguela Province, Angola. Socioeconomic and MNCH service utilisation indicators were collected through interviewer-administered structured questionnaires. The indicator of quality of care was a composite measure that assessed the implementation of the MCH-HB based on the RE-AIM framework, mostly consisted of common factors related to delivery and management of MNCH services. A multivariate logistic regression analysis was performed between quality of care, socioeconomic factors, and service utilisation indicators among the intervention group participants who had at least one ANC visit.ResultsOf the 3351 pregnant women who visited ANC at least once, 2911 without missing values among explanatory or dependent variables were included in the analysis. Among them, 2032 (69.8%) were exposed to optimal-quality ANC, and 2058 (70.7%), 1573 (54.0%), and 941 (32.3%) achieved ANC target, facility delivery, and vaccination target for six-month-old infants, respectively. Exposure to suboptimal-quality care at ANC was associated with lower odds for facility delivery (adjusted odds ratio (AOR) = 0.60, 95% CI = 0.49-0.73) and the achievement of the vaccination target (AOR = 0.43, 95% CI = 0.33-0.55). A low socioeconomic status was inversely associated with health service utilisation indicators.ConclusionsHealth facilities' quality of care influences subsequent MNCH service utilisation. Therefore, simultaneous efforts to improve quality of care and the mobilisation of pregnant women and communities are essential for enhancing maternal and child health.

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Child Care, Maternal Employment, and Children's School Outcomes. An Analysis of Italian Data.

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