Timothy L Lash
Heuristic thinking and inference from observational epidemiology
Epidemiology (Cambridge, Mass.)
lack childcare children aged 03 years emerged global crisis accentuated womens increasing workforce participation recognition young children require nurturing care systematic review sought examine associations childcare centre attendance low middleincome countries lmics childrens health growth development generate childcare centre programmatic research recommendations children aged 03 years systematically searched psycinfo medline pubmed cochrane articles centrebased childcare children aged 03 years lmics published 2000 2021 english translated english excluded articles specialised subgroups interventions imported retrieved articles covidence review assessed bias using national institutes health nih quality assessment tool twentytwo articles 24 studies met inclusion criteria encompassing 36 927 children 10 countries across mexico south america n 12 africa n 5 asia n 5 outcomes included health n 12 growthnutrition n 6 development n 6 study quality assessments low 41 exceeded 50 quality criteria 45 adjusted confounders associations childcare attendance outcome measures primarily negative health nn 712 positive growthnutrition nn 56 development nn 46 childcare centre programmatic recommendations children aged 03 years included agespecific policies program quality including safety hygiene nutrition curriculum access affordability parent engagement financial support workforce development research recommendations included study design including enrolment age frequency duration childcare type home childcare sociodemographic cultural environments child caregiver outcomes analytical approaches longitudinal studies implementation research rigorous primary research global childcare young children urgently needed policies programmes investments highquality childcare promote nurturing care young children enabling mothers participate workforce prospero crd42018105576