The feasibility, acceptability, cost and benefits of a “communities of practice” model for improving the quality of childcare centres: a mixed-methods study in the informal settlements in Nairobi
BackgroundInformal childcare centres have mushroomed in the informal settlements of Nairobi, Kenya to meet the increasing demand. However, centre providers are untrained and the facilities are below standard putting children at risk of poor health and development. We aimed to co-design and test the...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-08-01
|
| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1194978/full |
| _version_ | 1797768071139557376 |
|---|---|
| author | Margaret Nampijja Nelson Langat Linda Oloo Patrick Amboka Kenneth Okelo Ruth Muendo Sabrina Habib Martin Kiyeng Anna Ray Mary Abboah-Offei Mary Abboah-Offei Patricia Kitsao-Wekulo Elizabeth Kimani-Murage Jinshuo Li Helen Elsey |
| author_facet | Margaret Nampijja Nelson Langat Linda Oloo Patrick Amboka Kenneth Okelo Ruth Muendo Sabrina Habib Martin Kiyeng Anna Ray Mary Abboah-Offei Mary Abboah-Offei Patricia Kitsao-Wekulo Elizabeth Kimani-Murage Jinshuo Li Helen Elsey |
| author_sort | Margaret Nampijja |
| collection | DOAJ |
| description | BackgroundInformal childcare centres have mushroomed in the informal settlements of Nairobi, Kenya to meet the increasing demand. However, centre providers are untrained and the facilities are below standard putting children at risk of poor health and development. We aimed to co-design and test the feasibility, acceptability, cost and potential benefits of a communities of practice (CoP) model where trained community health volunteers (CHVs) provide group training sessions to build skills and improve practices in informal childcare centres.MethodsA CoP model was co-designed with sub-county health teams, centre providers and parents with inputs from Kidogo, government nutritionists and ECD experts and implemented in 68 childcare centres by trained CHVs. Its feasibility and potential benefits were measured quantitatively and qualitatively. Centre provider (n = 68) and CHV (n = 20) knowledge and practice scores before and after the intervention were assessed and compared. Intervention benefits were examined using linear regressions adjusting for potential confounding factors. We conducted in-depth interviews with 10 parents, 10 CHVs, 10 centre providers and 20 local government officials, and two focus groups with CHVs and centre providers. Qualitative data were analysed, focusing on feasibility, acceptability, potential benefits, challenges and ideas for improvement. Cost for delivering and accessing the intervention were examined.ResultsThe intervention was acceptable and feasible to deliver within existing government community health systems; 16 CHVs successfully facilitated CoP sessions to 58 centre providers grouped into 13 groups each with 5–6 centre providers, each group receiving four sessions representing the four modules. There were significant improvements in provider knowledge and practice (effect size = 0.40; p < 0.05) and quality of centre environment (effect size = 0.56; p < 0.01) following the intervention. CHVs’ scores showed no significant changes due to pre-existing high knowledge levels. Qualitative interviews also reported improvements in knowledge and practices and the desire among the different participants for the support to be continued. The total explicit costs were USD 22,598 and the total opportunity costs were USD 3,632 (IQR; USD 3,570, USD 4,049).ConclusionA simple model delivered by CHVs was feasible and has potential to improve the quality of informal childcare centres. Leveraging these teams and integration of the intervention into the health system is likely to enable scale-up and sustainability in Kenya and similar contexts. |
| first_indexed | 2024-03-12T20:49:15Z |
| format | Article |
| id | doaj.art-77a4ad06324247cbb81bbbb0ee42a1b4 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-03-12T20:49:15Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-77a4ad06324247cbb81bbbb0ee42a1b42023-08-01T06:56:12ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-08-011110.3389/fpubh.2023.11949781194978The feasibility, acceptability, cost and benefits of a “communities of practice” model for improving the quality of childcare centres: a mixed-methods study in the informal settlements in NairobiMargaret Nampijja0Nelson Langat1Linda Oloo2Patrick Amboka3Kenneth Okelo4Ruth Muendo5Sabrina Habib6Martin Kiyeng7Anna Ray8Mary Abboah-Offei9Mary Abboah-Offei10Patricia Kitsao-Wekulo11Elizabeth Kimani-Murage12Jinshuo Li13Helen Elsey14African Population and Health Research Center, Nairobi, KenyaAfrican Population and Health Research Center, Nairobi, KenyaAfrican Population and Health Research Center, Nairobi, KenyaAfrican Population and Health Research Center, Nairobi, KenyaAfrican Population and Health Research Center, Nairobi, KenyaAfrican Population and Health Research Center, Nairobi, KenyaKidogo Innovations, Nairobi, KenyaKidogo Innovations, Nairobi, KenyaDepartment of Health Sciences, University of York, Heslington, United KingdomDepartment of Health Sciences, University of York, Heslington, United KingdomSchool of Health and Social Care, Edinburgh Napier University, Edinburgh, United KingdomAfrican Population and Health Research Center, Nairobi, KenyaAfrican Population and Health Research Center, Nairobi, KenyaDepartment of Health Sciences, University of York, Heslington, United KingdomDepartment of Health Sciences, University of York, Heslington, United KingdomBackgroundInformal childcare centres have mushroomed in the informal settlements of Nairobi, Kenya to meet the increasing demand. However, centre providers are untrained and the facilities are below standard putting children at risk of poor health and development. We aimed to co-design and test the feasibility, acceptability, cost and potential benefits of a communities of practice (CoP) model where trained community health volunteers (CHVs) provide group training sessions to build skills and improve practices in informal childcare centres.MethodsA CoP model was co-designed with sub-county health teams, centre providers and parents with inputs from Kidogo, government nutritionists and ECD experts and implemented in 68 childcare centres by trained CHVs. Its feasibility and potential benefits were measured quantitatively and qualitatively. Centre provider (n = 68) and CHV (n = 20) knowledge and practice scores before and after the intervention were assessed and compared. Intervention benefits were examined using linear regressions adjusting for potential confounding factors. We conducted in-depth interviews with 10 parents, 10 CHVs, 10 centre providers and 20 local government officials, and two focus groups with CHVs and centre providers. Qualitative data were analysed, focusing on feasibility, acceptability, potential benefits, challenges and ideas for improvement. Cost for delivering and accessing the intervention were examined.ResultsThe intervention was acceptable and feasible to deliver within existing government community health systems; 16 CHVs successfully facilitated CoP sessions to 58 centre providers grouped into 13 groups each with 5–6 centre providers, each group receiving four sessions representing the four modules. There were significant improvements in provider knowledge and practice (effect size = 0.40; p < 0.05) and quality of centre environment (effect size = 0.56; p < 0.01) following the intervention. CHVs’ scores showed no significant changes due to pre-existing high knowledge levels. Qualitative interviews also reported improvements in knowledge and practices and the desire among the different participants for the support to be continued. The total explicit costs were USD 22,598 and the total opportunity costs were USD 3,632 (IQR; USD 3,570, USD 4,049).ConclusionA simple model delivered by CHVs was feasible and has potential to improve the quality of informal childcare centres. Leveraging these teams and integration of the intervention into the health system is likely to enable scale-up and sustainability in Kenya and similar contexts.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1194978/fullcommunities of practicechildcare centrefeasibilitybenefitsquality |
| spellingShingle | Margaret Nampijja Nelson Langat Linda Oloo Patrick Amboka Kenneth Okelo Ruth Muendo Sabrina Habib Martin Kiyeng Anna Ray Mary Abboah-Offei Mary Abboah-Offei Patricia Kitsao-Wekulo Elizabeth Kimani-Murage Jinshuo Li Helen Elsey The feasibility, acceptability, cost and benefits of a “communities of practice” model for improving the quality of childcare centres: a mixed-methods study in the informal settlements in Nairobi Frontiers in Public Health communities of practice childcare centre feasibility benefits quality |
| title | The feasibility, acceptability, cost and benefits of a “communities of practice” model for improving the quality of childcare centres: a mixed-methods study in the informal settlements in Nairobi |
| title_full | The feasibility, acceptability, cost and benefits of a “communities of practice” model for improving the quality of childcare centres: a mixed-methods study in the informal settlements in Nairobi |
| title_fullStr | The feasibility, acceptability, cost and benefits of a “communities of practice” model for improving the quality of childcare centres: a mixed-methods study in the informal settlements in Nairobi |
| title_full_unstemmed | The feasibility, acceptability, cost and benefits of a “communities of practice” model for improving the quality of childcare centres: a mixed-methods study in the informal settlements in Nairobi |
| title_short | The feasibility, acceptability, cost and benefits of a “communities of practice” model for improving the quality of childcare centres: a mixed-methods study in the informal settlements in Nairobi |
| title_sort | feasibility acceptability cost and benefits of a communities of practice model for improving the quality of childcare centres a mixed methods study in the informal settlements in nairobi |
| topic | communities of practice childcare centre feasibility benefits quality |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1194978/full |
| work_keys_str_mv | AT margaretnampijja thefeasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT nelsonlangat thefeasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT lindaoloo thefeasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT patrickamboka thefeasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT kennethokelo thefeasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT ruthmuendo thefeasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT sabrinahabib thefeasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT martinkiyeng thefeasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT annaray thefeasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT maryabboahoffei thefeasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT maryabboahoffei thefeasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT patriciakitsaowekulo thefeasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT elizabethkimanimurage thefeasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT jinshuoli thefeasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT helenelsey thefeasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT margaretnampijja feasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT nelsonlangat feasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT lindaoloo feasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT patrickamboka feasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT kennethokelo feasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT ruthmuendo feasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT sabrinahabib feasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT martinkiyeng feasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT annaray feasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT maryabboahoffei feasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT maryabboahoffei feasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT patriciakitsaowekulo feasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT elizabethkimanimurage feasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT jinshuoli feasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi AT helenelsey feasibilityacceptabilitycostandbenefitsofacommunitiesofpracticemodelforimprovingthequalityofchildcarecentresamixedmethodsstudyintheinformalsettlementsinnairobi |