The care of young children living in informal settlements in Nairobi during the Covid-19 pandemic

Background: The Covid-19 pandemic disrupted lives globally, bringing the potential for major impacts on the care of young children in urban slums. This study examines these disruptions across the five domains of Nurturing Care (Health, Nutrition, Security and Safety, Responsive Caregiving, and Early Learning) amongst preschool-aged children living in three slums in Nairobi, Kenya, during the pandemic.

Methods: A mixed-methods approach was used, comprising: 1) five rounds of quantitative Computer Assisted Telephone Interview (CATI) surveys; 2) 21 in-depth interviews (IDIs) with parents/carers of young children living in three Nairobi slums. The quantitative surveys measured the pandemic’s impacts across all Nurturing Care domains and in cross-cutting ways, while IDIs provided detailed insights into parental experiences and decision-making regarding childcare before and during the pandemic.

Results: Quantitative findings found consistent negative impacts within all domains of Nurturing Care during the pandemic, including substantial disruptions to healthcare access and the use of paid childcare, and high levels of food insecurity. Only a small fraction of respondents reported direct experience with Covid-19 illness. Qualitative findings showed the complexity and diversity in childcare decision-making by families, both before and during the pandemic, and provided rich descriptions of the vulnerabilities and early childhood adversities that the pandemic exacerbated.

Conclusions: The Covid-19 pandemic, and efforts to control it, were associated with a profound and multi-faceted impact on the Nurturing Care and overall wellbeing of young children in Nairobi slums. There is a critical need for policy interventions and resource allocations tailored to these communities to address these indirect, yet significant, consequences. This includes the need to support childcare systems, ensure healthcare access during crises, and to safeguard food security in order to mitigate the likely long-term adverse effects on early childhood development. In addition, these lessons ought to inform future responses to shocks or crises, including how the rights and needs of young children can be better factored into priority setting and policy making.