Position Statement

35AMarch/April 2001

PHCNEWS

dren or those with special health careneeds (Sterling, 1999). Low wages,inadequate benefits, and other factorslead to the high turnover of child careproviders. There is also a high inci-dence of infectious disease transmis-sion among child care populations (Nif-fenegger, 1997) and inadequate fundingto ensure proper health consultation.

NAPNAP affirms to:1. Provide information to parents and

others regarding types of child carefacilities and the criteria by whichto evaluate the quality of each set-ting. These criteria should include in-formation on licensure, teacher-childratio, health and safety standards,and programs that are appropriate tothe child’s developmental level.

2. Support federal and state legislationof child care issues that aim to raisethe quality of child care. Such legis-lation supports:

A. Standards for child care with inclu-sive provisions for the enforcementof such standards.

B. Licensing standards that protect chil-dren from harm/neglect and opti-mize their developmental potentialthrough high-quality facilities andexperienced, credentialed caregivers.

C. Provision of financial assistance tofamilies in need of child care.

D. Subsidized liability insurance forchild care facilities and providers.

E. Subsidized funding to child carefacilities to provide improved sal-aries and benefits to child care pro-viders.

3. Support the development of qualityassurance programs that monitorhealth and safety components ofchild care programs.

4. Encourage members to provideeducation to child care providers re-garding health issues, such as pre-vention of infectious disease; recog-nition of child abuse/neglect; deter-mination of appropriate options forcare of the sick child; anticipatoryguidance regarding issues of de-velopment, discipline, and commonpediatric problems; and mainstream-ing children with special needs.

5. Support efforts that encourage em-ployers to provide child care pro-grams in or near the workplace.Benefits of such programs includedecreased turnover and absentee-ism, tax savings, and enhanced em-ployee productivity.

6. Encourage members to provide pro-fessional services such as evaluatingthe development, health care, andimmunizations of children attend-ing child care facilities.

7. Support efforts to provide profes-sional support to all child care pro-viders so that wages, benefits and em-ployment status will be enhanced.This must be achieved to recruitand retain optimal caregivers for ourchildren.

8. Encourage pediatric health care pro-viders to develop sick care, episod-ic child care, and special needs carefacilities.

REFERENCESBroom, B. (1998). Parental sensitivity to infants and

toddlers in dual-earning and single-earningfamilies. Nursing Research, 47, 162-170.

Casper, L. M. (1996). Who’s minding our preschoolers.Washington, DC: U.S. Bureau of the Census,Current Population Reports, P-70, 53.

Cohen, P., & Bianchi, S. (1999). Marriage, childrenand women’s employment: What do weknow? Monthly Labor Review, 122, 22-30.

Hayghe, H. (1997). Developments in women’slabor force participation. Monthly Labor Review,120, 41-46.

Niffenegger, J. P. (1997). Proper handwashing pro-motes wellness in child care. Journal of PediatricHealth Care, 11, 26-31.

Scarr, S. (1998). American child care today. Ameri-can Psychology, 54, 95-108.

Sterling, Y. M. (1999). Availability of day care ser-vices for preschool children with special healthcare needs. Journal of Child and Nursing, 2,367-368.

Young, K. T., Marsland, K. W., & Zigler, E. (1997).The regulatory status of center-based infantand toddler child care. American Journal ofOrthopsychiatry, 67, 535-544.

U.S. Department of Health and Human Services,Administration for Children and Families.(1999). Access to child care for low-income workingfamilies [On-line]. Available: www.acf.dhhs.gov/programs/ccb/reports/ccreport.htm.

Approved by the Executive Board:October 31, 1993Revised: November 2000Designation–Priority (2-year review)

CHILD CAREThe National Association of PediatricNurse Associates and Practitioners(NAPNAP) is committed to promotingquality health care for infants, childrenand adolescents. To this end, NAPNAPpromotes the provision of a safe andhealthy environment in which childrencan grow and develop to their greatestpotential. A major barrier to the provi-sion of optimal care for children of par-ents working outside the home is theunavailability of high quality, reliable,affordable child care facilities.

Mothers are working outside thehome in greater numbers than everbefore. Trends reveal dual employmentand a decrease in the number of singlepaycheck families. In addition, work-ing married women in the labor forcehave increased the number of weeksthey work each year (Cohen & Bianchi,1999). Sixty-two and a third percentof American women with childrenyounger than 6 years of age (Casper,1996; Hayghe, 1997) and 77.2% ofmothers with school-aged children areemployed outside the home. There isalso an increased number of mothersreturning to work during their chil-dren’s infancy. Forty percent of allhouseholds are headed by a single par-ent, most often the mother (Broom,1998). Welfare reform has also created asituation of more working mothers andfewer opportunities for family-basedchild care (Scarr, 1998).

Many variables affect the availabili-ty, quality, and affordability of childcare facilities for American children.Lack of a formal National Child CarePolicy in the United States leads toinconsistent and arbitrary state licens-ing standards for child care settingsand caregivers (Young, Marsland, &Zigler, 1997), and limited family leavepolicies that support parental care ofyoung infants and ill children. In addi-tion, there is a scarcity of geographical-ly accessible child care facilities (U.S.Department of Health and Human Ser-vices, 1999), with limited availability ofaffordable infant care or alternative,appropriate care options for sick chil-