Discussion
Our analysis suggests that the availability of formal, affordable
childcare may have an impact on patterns of school participation in
older siblings, but not through an associated change in caregiving or
other domestic responsibilities. The intervention was associated with a
slight shift in school attendance in the overall sample (when measured
in days of school per week). We did not detect an impact of exposure on
the general probability of enrollment, the probability of being
unenrolled specifically due to domestic responsibilities, or on the
hours spent in school per day. The observed effect of childcare
provision on days of school attendance per week was relatively small,
but given the robustness of these findings it is reasonable to posit
that this is a true effect, and one that may be amplified once data from
all study waves are available for analysis.
To our knowledge, this is the first study to formally examine the impact
of formal care on older siblings using data from a cluster-randomized
study. This study design protects our analyses against several common
sources of bias, but it is still necessary to acknowledge a number of
limitations. Perhaps most importantly, our findings were based on two
waves of data collection; this is a key limitation because there may not
have been a sufficient amount of time between randomization to treatment
and the midline survey to observe the full impact of exposure. Findings
should therefore be viewed as preliminary until the final data are
available. It will also be important to assess balwadi-level factors in
future analyses, including date of first availability and number of days
available/open, as these may be important mediating factors.
A central challenge in compiling this dataset was the amount of missing
birthdate data (particularly month and day). Collecting precise survey
data on date of birth is a widely acknowledged challenge in developing
settings (21), and is a particularly important limitation in the present
analysis as our inclusion criteria were dependent upon age. While the
DHS describes a complex method to handling missingness (21-22), which
essentially imputes values based on other “clues” in the data (ages of
other siblings, etc.), we used a comparatively straightforward approach
by randomly imputing missing dates from a uniform distribution. While
this raises the possibility that certain children were inappropriately
included or excluded from our subsample, we expect any misclassification
to be non-differential given the randomized nature of the study design.
Along similar lines, it is plausible that data completeness is
positively correlated with higher socioeconomic position, which would in
turn be positively correlated with school participation, but this too
should be non-differential.
Finally, our analytical subsample because increasingly restricted over
the course of our analyses, which certainly had an impact on the
precision of our estimates and may have compromised the balance of the
treatment and control groups. Although we demonstrate in Table 1 that
these two groups remained exchangeable following basic restriction,
further modifications of the subsample may have distorted this balance.
Our analyses may have also been underpowered to detect a meaningful
effect of the treatment on our outcomes of interest due to (sometimes
sizable) reductions in sample size; this concern is particularly true
for the sex-stratified per-protocol analyses.
This analysis offers a first glimpse at the causal impact of formal
childcare on educational uptake in older siblings. However, it is
important for future work to more comprehensively explore the nuances of
this relationship. Once the full dataset is available, we plan to more
rigorously test this hypothesis by including a longer period of
follow-up time (which should have a two-fold effect of increasing
compliance and amplifying any benefits of the intervention).