abstract: 'The early years are critical and inform the developmental trajectory of

  children. This is justifiably attracting growing policy attention. Much

  of this attention is focused on interventions and policies directed at

  parents, especially mothers. Yet emerging evidence suggests that

  increasing numbers of children in rapidly urbanizing low- and

  middle-income countries are now spending much of their day with other

  formal and informal childcare providers, including largely unregulated

  paid childcare providers. This paper summarizes the limited literature

  about the use of such paid childcare in low- and middle-income countries

  in sub-Saharan Africa, before considering possible reasons behind the

  lack of research evidence. Finally, key research gaps and their

  implications for public health practice are explored, with reference to

  the ongoing British Academy funded Nairobi Early Childcare in Slums

  research programme in Nairobi, Kenya. We argue that improving childcare

  may be an under-explored strategy to help some of the world''s most

  disadvantaged children in the most important period of their lives, and

  that interventions in this largely informal market should be built on a

  rigorous research base.

  This article is part of the theme issue `Multidisciplinary perspectives

  on social support and maternal-child health''.'
affiliation: 'Hughes, RC (Corresponding Author), London Sch Hyg \& Trop Med, Fac Epidemiol
  \& Populat Hlth, Dept Populat Hlth, Keppel St, London WC1E 7HT, England.

  Hughes, Robert C.; Bhopal, Sunil S.; Kirkwood, Betty R., London Sch Hyg \& Trop
  Med, Fac Epidemiol \& Populat Hlth, Dept Populat Hlth, Keppel St, London WC1E 7HT,
  England.

  Kitsao-Wekulo, Patricia; Muendo, Ruth; Kimani-Murage, Elizabeth, African Populat
  \& Hlth Res Ctr, Maternal \& Child Wellbeing Unit, Nairobi, Kenya.

  Bhopal, Sunil S., Newcastle Univ, Populat Hlth Sci Inst, Fac Med Sci, Newcastle
  Upon Tyne, Tyne \& Wear, England.

  Hill, Zelee, UCL, Inst Global Hlth, Epidemiol \& Publ Hlth, London, England.'
article-number: '20200430'
author: Hughes, Robert C. and Kitsao-Wekulo, Patricia and Muendo, Ruth and Bhopal,
  Sunil S. and Kimani-Murage, Elizabeth and Hill, Zelee and Kirkwood, Betty R.
author-email: robert.hughes@lshtm.ac.uk
author_list:
- family: Hughes
  given: Robert C.
- family: Kitsao-Wekulo
  given: Patricia
- family: Muendo
  given: Ruth
- family: Bhopal
  given: Sunil S.
- family: Kimani-Murage
  given: Elizabeth
- family: Hill
  given: Zelee
- family: Kirkwood
  given: Betty R.
da: '2023-09-28'
doi: 10.1098/rstb.2020.0430
eissn: 1471-2970
files: []
issn: 0962-8436
journal: PHILOSOPHICAL TRANSACTIONS OF THE ROYAL SOCIETY B-BIOLOGICAL SCIENCES
keywords: 'early childhood development; urban health; child health; childcare;

  nurturing care'
keywords-plus: HEALTH; ADVERSITY; WORK
language: English
month: JUN 21
number: '1827'
number-of-cited-references: '50'
orcid-numbers: 'Hughes, Robert/0000-0002-1345-3063

  Kitsao-Wekulo, Patricia/0000-0003-4206-9746

  Bhopal, Sunil/0000-0003-1229-781X

  Kirkwood, Betty/0000-0001-5274-6072'
papis_id: a0c47bc4ac268ea131a88fa0b1ff8f52
ref: Hughes2021whoactually
researcherid-numbers: 'Kimani-Murage, Elizabeth/HGB-3312-2022

  '
times-cited: '8'
title: Who actually cares for children in slums? Why we need to think, and do, more
  about paid childcare in urbanizing sub-Saharan Africa
type: Editorial Material
unique-id: WOS:000646856500006
usage-count-last-180-days: '0'
usage-count-since-2013: '2'
volume: '376'
web-of-science-categories: Biology
year: '2021'