Increase in maternal employment over the past 25 years has led to an increase in reliance on child care for young children from birth to 5 years of age. Non parental child care is now the norm for young children on a regular basis, with at least 44% of infants in child day care for more than 30 hours a week. Economic deprivation has led mothers especially in low income residential areas in Naivasha to return to work soon after delivery and since they do not have enough money to hire house helps they leave their children in substandard day care centres whose facilities may not be conducive for health. This move has raised questions on the environmental health risks associated with the care of the children. The broad objective of this study was to identify potential environmental risk factors exposed to children within day- care centres in Naivasha Municipality Kenya. The study entailed a cross sectional survey that comprised of 300 children in 10 day care centres. All the children’s anthropometric measurements were taken. Ten children who had been in the day care for more than 2 months were randomly picked from each day care centre making a total of 100 children. Their mothers gave data about their socioeconomic status and the children’s health status while childcare providers in the day care centres gave data on the daycares operation and activities. Primary data was collected using questionnaires and observation schedule. Secondary data from medical reports and demographic health surveys was used to obtain the prevalence of environmental related diseases among children under five in Naivasha area. Data was analysed using descriptive statistics and correlation. Results indicated that 50% of the daycares had an average of 20 children crowded in one room contrary to required standards. 80% of the sampled daycares did not have adequate lighting and ventilation of at least 50 lux of light at each floor level. 50% of the daycares managed their wastes appropriately. 90% used mobile phone for communication; none had a fire extinguisher and First Aid kit. 90% of the day care playgrounds had rubbish, sharp objects, and holes in the play area, 80% had animal and human waste, and 30% had water puddles, while 70% were on the road side and accessible to the driveway. Most (60%) of the children were reported to have had diarrhoea, 59% upper respiratory diseases, 5% malaria and 6% Ringworm. There was a significant correlation between the number of environmental risks in the daycare and the number of diseases experienced by the children. The daycares did not fully comply to required standards, diarrhoea was positively correlated to presence of soap and bowl for washing hands. There are no specific regulations to guide those who want to set up daycare centres. The state should provide laws and regulations to govern day care facilities.

Background Information
Most countries have seen marked increase in maternal employment since the early 1970s. In fact most mothers return to work and remain in the work force, in their child’s first 3-5 months of life (McCartney, 2004). In Kenya the number of women in the paid labour force has continued to grow, from 12.2 % in 1984 to 21% in 1987 (Kenya Development Plan 1989- 1993). The number of female headed households has also continued to increase. It was estimated that 32.1 per cent (3 million) of the households were headed by females in 1979. Most of the women heading households are in their prime working and reproductive ages (25-29 years) therefore, the majority have children requiring care. Most of these women do not live with their parents and so extended family child support is not available. These women and mothers are responsible for caring and socializing their children, and are also the sole bread winners of their families. As a result, the households headed by women form one of the most vulnerable groups not only in Kenya but all over the world (Landers 1992, lea etal 2007).

The dramatic increase of women in the labour force has caused infants and young children to spend much of their early lives in child care arrangements that vary widely in type, setting, and quality. This dramatic shift in child rearing styles has prompted concerns as to whether child care poses any risks to healthy child development. Day care refers to childcare provided by someone else other than the parent which takes place in formal organized facilities. Day care is now an ordinary part of life for children in most western countries. More than half of infants are placed in some form of child care for at least ten hours per day during their first year of life, and more than three-quarters of families with young children depend on child care as a support for maternal employment (McCartney, 2004).

Grave concern has been raised over disadvantaged families whose children attend day care centres perceived to be of low quality. This is due to the alleged greater susceptibility of populations with lower social economic status to environmental threats. The joint report of the European Environment Agency and the WHO Regional Office for Europe (2002), pointed to the growing evidence that the most disadvantaged groups, and children and pregnant women among them, suffer from the worst environmental conditions. The cumulative risk of exposure due to substandard housing and insufficient physical structure and infrastructure of the immediate environment can contribute both directly and indirectly to a variety of adverse health outcomes (Hornberg & Pauli, 2007).

It is estimated that 40% of world deaths can be attributed to various environmental factors (Pimentel et al, 1998). Most of these deaths occur mainly among the poor that live in developing countries (World Bank, 2003). Poor sanitary conditions contribute to approximately 4 million deaths, mostly among infants and young children, every year. Malnutrition, also a major cause of child morbidity and mortality, can be related to environmental degradation (Pimentel & Pimentel, 1996, Pimentel et al, 1998).

The complexity of day care-centres has been due to possible links between environmental pollutants, chemicals, to common infectious diseases, asthma, cancer, autism and other recurring cycles of illness in infants and preschoolers. In addition most child care centres do not conduct a site history, environmental site assessment, or environmental audit before being established. Such an investigation could help prevent a centre from being located on land or in a building that is contaminated (Tarah et al 2010).

Children’s developmental stage and behaviours increase their exposure to environmental toxins as they spend a large portion of their time closer to the ground i.e. on the floor, carpet, grass, and playground surfaces as a result they have more exposure to toxins applied to or settled on these surfaces ( Bearer, 1995) such as formaldehyde and volatile organic chemical vapours from carpets, lead-based paint dust, cleaning product residues, fertilizers, herbicides, and pesticides. Their breathing zones are closer to the ground, it is within these lower breathing zones that heavier chemicals such as mercury settle out and radon accumulates” (Bearer, 1995). Young children explore the world orally by putting things in their mouths. This developmentally appropriate behaviour significantly increases their opportunity for direct ingestion of pollutants in dirt or dust such as lead-based paint dust and pesticide residue. Children also breathe frequently through their mouths, bypassing nasal filtering. All of these characteristics make children more susceptible than adults to air pollutants. Children metabolic rate is higher than that of adults, they therefore breathe more rapidly take in proportionally more pollutants available in the air.

In Kenya, Infants from poor families are more likely to receive relatively low quality care. This is because the day-care centres which are available and economically friendly to them are built in unhealthy communities where there is substantial traffic, lack of safe play areas, unsafe housing with poor indoor air quality. In the study area, where this study was carried out, inadequate data existed on the environmental risks factors in the day care centres and the prevalence of environmental related diseases among the children within these daycares.

Statement of the Problem
Economic deprivation has led mothers in their prime working and reproductive ages especially in low income residential areas in Naivasha Municipality to return to work soon after child delivery. In order to cope with the career and child care roles coped with meagre salaries, and with little money to hire house helps, they leave their children in cheap day care centres whose facilities may not be conducive for health. This move has raised questions on the environmental health risks that these children are exposed to in the day care centres. Little research has been conducted on environmental risks factors associated with day-care centres in low economic societies. This study sought to address this gap on environmental risk factors associated with day care centres that are exposed to children below five years of age in Naivasha Municipality Kenya.

Broad Objective
To identify environmental risk factors that children less than five years are exposed to within the day-care centres in Naivasha Municipality.

Specific Objectives
1. To investigate housing conditions, and facilities/infrastructure in the day-care centres and assess if they comply with the required standards.

2. To document the safety management used in the daycares.

3. To document environmentally related diseases and conditions of children brought to the day care centres.

4. To establish if there is a relationship between the environmental risks factors in the day care centres and the prevalence of environmentally related diseases among the children.

Research Questions
1. Do housing conditions and facilities/infrastructure in the day care centres comply with the required standards?

2. What are the safety management equipment/measures used in the daycare?

3. What are the environmental related diseases and conditions experienced by children brought to the day care centres?

4. Is there a relationship between the environmental risks factors and the prevalence of diseases in children in the day care centres?

Every year, over 5 million children 0–5years of age die, mainly in the developing world, from diseases related to the environment. An estimated 25% of all preventable illness is caused by environmental factors. In Africa, the environmental contribution is even higher, with approximately 35% of the burden of disease due to environmental factors (UNEP, WHO 2002). Prior the study, environmental risk factors exposed to children under five in day-care centres in Naivasha, were not documented and little information was available about the commonly suffered diseases by the children in day-care centres. The inadequate information is a hindrance towards the concerted efforts to achieve the Millennium Development Goal 4 on reducing childhood mortality, and Goal 6 on combating major diseases. Further this deters the effectiveness of environmental pillars which hinge on good health as stated in the 1992 UNCED Rio de Janeiro and WSSD that was the nexus between health, environment and poverty.

In Kenya high mortality rates due to environmentally related diseases have been recorded in children under age five. Pneumonia and diarrhoeal diseases are among the environmental related diseases that account for 60% of the mortality in this age-group (Nyamongo, 2004). Information generated on the environmental risk factors within daycares predisposed to children under five in the study area is necessary to establish whether there’s a relationship between the environmental risks factors and the health of the children as an important step towards achieving MDG 4 & 6, and Vision 2030.
Limitations and Assumptions of Study

The major limitation of this study is that it did not investigate the living conditions of the homes from where the children came from. It was assumed that diseases that the children were suffering from were related to environmental conditions in the day care centres as this children spend the greater part of their time in the day cares.

Scope of Study
The subject of this study was confined to selected 0-5 year old children in day care centres, their mothers and child care providers in Naivasha Municipality. The study covered the socio economic status of the children’s families, and environmental risk factors within day care settings which have a link to the children’s health status. These included those in the buildings housing the day cares and outside where the children play or spend their time when not indoor. Data was collected in the afternoon and evening session to ensure convenience of the informants.

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Item Type: Kenyan Material  |  Attribute: 54 pages  |  Chapters: 1-5
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