The impact of daycare programs on child health, nutrition and development in developing countries: a systematic review

Publication Details

Leroy, J. L., Gadsden, P. and Guijarro, M., 2012. The impact of daycare programmes on child health, nutrition and development in developing countries: a systematic review, 3ie Systematic Review 7. London: International Initiative for Impact Evaluation (3ie).

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Jef L. Leroy, Paola Gadsden and Maite Guijarro
Latin America and the Caribbean
Early Childhood Development Programs
Equity Focus
None specified
Review Type
Effectiveness review

Main findings

Six studies (all conducted in Latin America) met the authors’ inclusion criteria. Owing to inconsistent results, no conclusions can be drawn with respect to the impact on child health and nutrition. In general, the few studies found large positive effects on measures of short-term and longer-term child development.

The existing studies had limitations:(i) none of the included studies explained the care the children received in the absence of a daycare programme; and (ii) the studies provided insufficient details on factors along the causal pathways. More rigorously conducted studies on the impact of daycare programmes in low- and middle-income countries are needed. The authors recommend that future studies should be conducted in a variety of settings and provide a clear description of the counterfactual care scenarios. Intermediary variables that help to explain the pathways of impact need to be measured and taken into account in the analyses.


Urbanisation and increases in female labour-market participation have increased the demand for non-parental childcare in many low- and middle-income countries. Especially in formal-sector jobs, work and caring for one’s child cannot be combined. Government daycare programmes currently under way in several developing countries seek to promote labour-force participation by relieving one of the most pressing constraints faced by working parents, especially mothers: access to reliable and affordable childcare. While there are a number of impact evaluations of daycare interventions in developing countries, no systematic review of the literature has been conducted to date.

Research objectives

The first objective was to review and summarise the evidence on the impact of daycare on the health, nutrition and development of children under five years of age in low- and middle-income countries. The second objective was to use a programme-impact theory approach to identify the pathways through which daycare may improve child outcomes. The third and final objective was to review the available information on the demand for daycare services.


The authors only included intervention studies evaluating the impact of an exogenous change in daycare provision or utilisation on child outcomes, using experimental or quasi-experimental methods (e.g. propensity score matching), as well as regression-based methods to control for potential self-selection of programme participation.

The authors conducted a comprehensive and systematic search of the unpublished and published literature dating back to 1980. They searched PubMed, EconLit, IDEAS, POPLINE, the British Library for Development Studies (BLDS) and Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS); and the websites of the World Bank and the International Food Policy Research Institute. They also contacted authors and international experts in the field and tracked citations of existing non-systematic reviews. No language restrictions were imposed. Two reviewers conducted the search and assessed studies for inclusion in the review.

Next they used a systematic approach to collect data from the included studies and to assess their quality. The authors then conducted a narrative analysis of the effects on child outcomes by type of outcome and finally summarised information on possible causal pathways through which the intervention might have affected final outcomes.

Quality assessment

This is a high quality systematic review.It is based on comprehensive literature searches and employs appropriate methods to reduce the risk of bias in terms of study selection and analysis.

Read journal article: Jef L. Leroy , Paola Gadsden & Maite Guijarro (2012) The impact of daycare programmes on child health, nutrition and development in developing countries: a systematic review, Journal of Development Effectiveness, 4:3, 472-496, DOI: 10.1080/19439342.2011.639457

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