Littérature scientifique sur le sujet « Child care – Government policy – Sweden »

This paper seeks to explain patterns of central government control and local government discretion across nations as well as across policy areas. The argument is that central-local policy is the result of the interaction of three types of actors: ‘Expenditure advocates’, ‘expenditure guardians’, and ‘topocrats’. The argument is based on two assumptions. First, the actors are assumed to pursue self-interests – respectively, sectoral policy goals, macroeconomic control, and local autonomy. Second, the actors' abilities to pursue their self-interests are assumed to be constrained and facilitated by the structure of intergovernmental policy networks. The theoretical propositions are put to a first test in a comparative analysis of three policy areas (economic policy, health policy, and child care policy) in the three Scandinavian countries of Sweden, Norway and Denmark.

There are four important, interrelated issues in child-care policy, on which economists can make contributions. One is the adequacy of the supply of "affordable" child care. A second is the proper role of government, if any, in providing or paying for child care. A third is whether the public could afford to have the government provide child care, assuming that such provision was deemed appropriate and desirable. A fourth is the standards of quality that should be mandated by the government for federal or private-sector child-care facilities. The standard literature tends to be scant on all of these topics.1,2 Economists are seldom unanimous in their opinions, and they certainly do not agree on child-care issues. The now-sizeable school of economists led by Milton Friedman, whose members have staffed the administrations of the last two US presidents, believe that, with very few exceptions, government interventions into the economic functioning of the citizens and their businesses are pernicious. Economists faithful to this tradition argue that parents should buy child care out of their own incomes from nongovernmental providers and that those providers should be regulated minimally if at all. An opposing point of view is that child care is different in important ways from such commodities as shoes and strawberries. Children are the direct consumers of child care, and government intervention in protection of their interests is justified because they lack abilities that can be assumed to reside in the usual participants in the economy. Further, child care provided by or subsidized by government is an indispensable ingredient of any program aimed at bringing about the rescue of the 20% of American children who are officially designated as poor, who are living in conditions that should not be tolerated by a rich and civilized country.1

Sweden has since the start of the pandemic a COVID-19 mortality rate that is 4 to 10 times higher than in the other Nordic countries. Also, measured as age-standardized all-cause excess mortality in the first half of 2020 compared to previous years Sweden failed in comparison with the other Nordic countries, but only among the elderly. Sweden has large socioeconomic and ethnic inequalities in COVID-19 mortality. Geographical, ethnic, and socioeconomic inequalities in mortality can be due to differential exposure to the virus, differential immunity, and differential survival. Most of the country differences are due to differential exposure, but the socioeconomic disparities are mainly driven by differential survival due to an unequal burden of comorbidity. Sweden suffered from an unfortunate timing of tourists returning from virus hotspots in the Alps and Sweden's government response came later and was much more limited than elsewhere. The government had an explicit priority to protect the elderly in nursing and care homes but failed to do so. The staff in elderly care are less qualified and have harder working conditions in Sweden, and they lacked adequate care for the clients. Sweden has in recent years diverged from the Scandinavian welfare model by strong commercialization of primary care and elderly care.

With an area of 450 000 km2, Sweden is one of the largest countries in Western Europe. It is 1500 km from north to south. It has nearly 9 million inhabitants (20 per km2). It is a constitutional, hereditary monarchy with a parliamentary government. Sweden is highly dependent on international trade to maintain its high productivity and good living standards. Many public services are provided by Sweden's 289 municipalities and 21 county councils. Municipal responsibilities include schools, child care and care of the elderly, as well as social support for people with a chronic mental illness. The county councils are mainly responsible for healthcare, including psychiatric care, and public transport at the regional level. Sweden is characterised by an even distribution of incomes and wealth. This is partly a result of the comparatively large role of the public sector.

Election to the parliament was held in Sweden on 9 September 2018. None of the traditional political blocks obtained a majority of the vote. The nationalist Sweden Democrats party increased their share of the vote from 13% in 2014 elections to 17% of the vote in 2018. As no traditional political block wants to collaborate with the Sweden Democrats, no new government has yet been formed, more than 2 months after the election. Health care was a prominent issue in the elections. Health care in Sweden is universal and tax-funded, with a strong emphasis on equity. However, recent reforms have emphasized market-orientation and privatization in order to increase access to care, and may not contribute to equity. In spite of a majority of the population being opposed to profits being made on publicly funded services, privatization of health and social care has increased in the last decades. The background to this is described. Health is improving in Sweden, but inequalities remain and increase. The Swedish Public Health Policy from 2003 has been revised in 2018, on the basis of a national review of inequalities in health. The revised policy further emphasizes reducing inequalities in health.

What are Swedes like? Recently, this question received a great deal of attention in the Swedish media, because of an article published in the Daily Mail by an English journalist, Geoffrey Levy. He described Swedes as being lazy, sick, and totally unable to enjoy anything nice in life. In addition, Swedish cars are wrecks, Swedes dress sloppily, and, if you do not want to work, you do not need to—but you are still fully paid. Finally, he described family policy in Sweden: "Just imagine a country where mothers as well as fathers can stay at home 12 months, with almost full pay after a baby is born, or a country where the state pays almost 6000 pounds for every child that goes to a day-care center—this would be totally impossible in Britain." How did the Swedish public react to Geoffrey Levy's article? Surprisingly, most people agreed with his description of the Swedes. Yes, we are lazy, too many people are sick, and we are unable to enjoy the good things in life. There was only one major issue where most people disagreed with Geoffrey Levy. Very few were negative about family policy in Sweden. On the contrary, most people took parental leave, the possibility of staying at home with a sick child, and publicly funded day care for granted. In the first part of this presentation, I will describe family policy in Sweden and, in particular, how the society supports and provides care for children under school age (which in Sweden starts at 6-7).

The aim of this article is to give an overview of gender equality policy in Sweden from the 1970s until today. A number of political measures and whether these measures individually, as well as combined, have promoted gender equality and the dual-earner/dual-carer model are described and analyzed. The conclusion is that the right to part-time work, publicly financed child care, parental leave, and tax deductions for domestic services make it easier for mothers to reconcile work and family, but do not challenge the distribution of family responsibilities between women and men. However, the individual right for fathers to 2 months of parental leave does challenge the gender order, to a certain extent, and fathers today participate more in care and domestic work than earlier. The dual-earner/dual-carer family is closer at hand when women have a higher education and earnings and thereby greater bargaining power. Employed work is more conditional among women with a lower education level, i.e., they may be employed but under the constraint that they are still responsible for care and domestic work in the family. Another constraint in this group where many work part-time is the lack of available full-time positions in the labor market.

Abstract The Nordic welfare model is referred to as the dual earner/dual carer model, where the explicit policy goal is to promote the equal sharing of the responsibility of care for children and paid work among men and women. However, how does the dual earner/dual carer model apply to parents who do not live together but who share care, ie, both parents spending substantial time caring for and living with their child? In this article, we compare child maintenance policies in the five Nordic countries – Denmark, Finland, Iceland, Norway, and Sweden – as a means of interrogating how dual earner/carer ideals and realities play out for parents who share care but do not live together. The article makes a unique contribution to the knowledge of how the ideology and practice of shared care is implemented across Nordic countries. Based on vignette data collected in 2017, we show that despite an emphasis on the dual earner/dual carer model, in most cases, Finland and Iceland still refer to a male breadwinner model in their maintenance policies and do not recognise shared care arrangements as matters needing particular policy consideration. Sweden, Norway, and Denmark, on the other hand, recognise shared care in their laws and substantially reduce child maintenance payments in cases of shared care.

Thesis (DPhil (Social Work))--University of Stellenbosch, 2009.
ENGLISH ABSTRACT: The changes in child and youth care policies over the last fifteen years have had profound consequences for the staff at Youth Care and Education Centres (hereafter referred to as YCECs). These changes included systemic changes, philosophical changes, and changes in the way services are rendered to children and youth in their care. It was thus expected of team members to not only change their behaviours but to also make mind shifts. The mandates were that they move from working in silos (educators, residential educators and support team) to working in teams; from rendering generic services to developing individualised plans for children and youth; from following a medical (deficit) approach in service delivery to following a strength based- and developmental approach. Whereas a punitive approach to discipline was followed in the past staff members now have to follow a restorative approach. In addition, the emphasis on children’s rights, in general, and the abolishment of corporal punishment, in particular, brought about changes in the nature of the adultchild relationship. It was required of the team members to learn to use alternatives to this form of punishment. The study explored how the members of the institutional level teams at the four YCECs in the Western Cape were experiencing the implementation of changed child and youth policies. A combined quantitative and qualitative research methodology was followed in obtaining the data from the residential educators, as well as the educators and the support team members comprising of psychologists, school social workers, occupational therapists, and school nurses. The points of departure were the organisational learning model and the phases of team development. Findings derived from the empirical study were that the difference between the way the participants embraced and implemented changed policies and legislation had much to do with the guidance that the principal and senior management provided for them. Where the principal set the tone and conveyed the message that the implementation of the policies were not negotiable and gave staff members the opportunity to thoroughly discuss these changes, they eventually shared the underlying principles of the changed policies. Where the principal provided direction, support and encouragement for the implementation of the changed policies the participants felt secure and empowered. Where this support was not present participants felt uncertain and to some extent let down. When a shared vision was articulated to them the participants were able to align their personal visions thereto, which further led to a greater understanding of their roles within the team. Where participants, however, were not clear on the shared vision they seemed to struggle with role division and status and power issues. When team members were left to their own devices a measure of personal mastery still took place due to the commitment of individuals but team learning was either limited or virtually nonexistent. Systems thinking remained a challenge due to the forming of subgroups within the YCEC and the limited or nonexistent services rendered by external social workers to the families of the children and youth. The most important recommendations resulting from the study indicate that provision must be made for frameworks for the implementation of changes in policy and guidelines for team processes. To ensure that new staff is informed about the policies that guide their services an orientation programme must be in place. Training for principals in effective introduction and implementation of change should also be provided. To ascertain what the staff complement should be to effectively implement changes in the policies, a work-study and a fast track pilot project should be conducted. From this, job descriptions should be developed that make provision for the incumbent’s role within the team. Consideration should also be given to the incentive system that currently only makes provision for individual performance and could hamper teamwork.
AFRIKAANSE OPSOMMING: Die veranderinge in kinder- en jeugsorgbeleide oor die laaste vyftien jaar het diepgaande gevolge ingehou vir personeel by Jeugsorg- en Onderwyssentrums (hierna verwys as JSOS). Hierdie veranderinge het sistemiese en filosofiese veranderings, asook verandering in die wyse waarop dienste gelewer word, aan kinders en jeug in hul sorg, meegebring. Dit word dus van die spanlede verwag om nie net hul gedrag nie, maar ook hul denkwyse te verander. Die mandate vervat in die beleide is dat personeel skuif van werk in silos (opvoeders, residensiële opvoeders en ondersteuningspan) na werk in spanne; van die lewer van generiese dienste tot die ontwikkeling van individuale planne vir kinders en jeug; van die volg van ‘n mediese benadering aangaande dienslewering tot ‘n sterkte-gebaseerde- en ontwikkelingsbenadering. Waar daar in die verlede ‘n strafgerigte benadering gevolg is moet daar nou beweeg word na ‘n helende benadering. Verder het die klem op kinderregte in die algemeen, en die afskaf van lyfstraf in besonder, veranderings meegebring in die aard van die volwasse-kind verhouding. Dit was verwag van die spanlede om te leer om alternatiewes tot die vorm van straf aan te leer. Die studie het ondersoek ingestel na hoe lede van die inrigtingsgebaseerde span by die vier JSOS in die Weskaap die implementering van veranderde kinder- en jeugbeleid ervaar. ‘n Gekombineerde kwantitatiewe en kwalitatiwe navorsing metodologie was gevolg in die insamel van data van die residensiële opvoeders, die opvoeders en die lede van die ondersteuningspan (sielkundiges, skool maatskaplike werkers, arbeidsterapeute en skool verpleegkundiges). Die vertrekpunt was the organisasieleer model en die fases van spanontwikkeling. Bevindings wat gemaak is uit die empiriese studie was dat die verskille tussen die wyse waarop die deelnemers die veranderde beleid aanvaar en implementeer het baie te doen gehad het met die mate van leiding wat die prinsipaal en senior bestuur vir hul gegee het. Waar die prinsipaal die toon aangegee het en die boodskap oorgedra het dat die implementering van die beleide nie onderhandelbaar was nie en personeellede die geleentheid gebied is om die veranderings deeglik te bespreek, het hul geleidelik ingekoop in die veranderde werkswyses. Waar die prinsipaal rigting en ondersteuning vir die implementering van die veranderde beleid gebied het, het die deelnemers veilig en bemagtig gevoel. Waar die ondersteuning egter ontbreek het, het die deelnemers onseker en, tot ’n mate, in die steek gelaat gevoel. Wanneer ‘n gedeelde visie oorgedra is aan hulle was die deelnemers in staat om hul persoonlike visies in lyn te bring daarmee. Dit het verder aanleiding gegee tot beter begrip vir hul rolle binne die span. Waar deelnemers egter nie duidelik was oor die gedeelde visie nie, het dit geblyk dat hulle probleme gehad het met rolverdeling, status en magaangeleenthede in die span. Wanneer spanlede oorgelaat is aan hul eie lot het ‘n mate van persoonlike bemeestering nog plaasgevind as gevolg van die persoonlike toewyding van individue, maar spanleer was óf beperk óf feitlik afwesig. Sisteem denke was steeds ‘n struikelblok as gevolg van die vorming van subgroepe binne die JSOS en die beperkte of afwesige dienslewering deur eksterne maatskaplike wekers aan gesinne van die kinders en jong mense. Die belangrikste aanbevelings, wat voortspruit uit die studie, dui aan dat voorsiening gemaak moet word vir raamwerke vir die implementering van beleidsveranderings en riglyne vir spanprosesse. Om te verseker dat nuwe personeel ingelig is omtrent die beleide wat hul dienslewering rig moet ‘n oriënteringsprogram in plek wees. Opleiding van prinsipale in die effektiewe bekendstelling en implementering van veranderings moet ook voorsien word. Om vas te stel wat die aanvulling vir personeel moet wees om die veranderings in die beleid te implementeer, behoort ‘n werkstudie en ‘n snel loodsprojek onderneem word. Hieruit kan pligstate opgestel word wat voorsiening maak vir die ampsdraer se rol in spanverband. Oorweging moet geskenk word aan die aansporingstelsel wat tans net voorsiening maak vir individuele werksverrigting en wat spanwerk kan strem.

This thesis examines women's issues and the political agenda. Several factors affect the likelihood of a women's issue getting onto the formal political agenda of government (municipal, provincial, and federal). The nature of the issue (the degree to which it challenges the status quo) affects the political outcome: those issues which have fit into current and historical legislative patterns (such as welfare state guidelines) have been more successful. A patriarchal family ideology places limitations on the proper role of women: women have held primary responsibility for the care of children and family. Women's labour force participation creates parameters for government involvement in issues such as childcare. The lobbying and organizational skills of the political actors involved are prerequisites for gaining access to government decision-makers. While the entry of women into the political arena has not insured the entry of women's issues onto the political agenda, female politicians have been especially important in bringing women's issues forward for debate and action. However, government bureaucracy has often been a barrier in the implementation of legislation concerning women's issues. I present a case study of a particular women's issue (childcare) at the municipal level of government. Five locations are examined in the Greater Vancouver area, using a combination of qualitative methods (personal interviews) and quantitative research techniques (government statistics, official documents, and reports from a variety of community organizations). In spite of the steadily increasing labour force participation of women in all locations, the response of local governments to the childcare issue has varied greatly — childcare is on Vancouver's political agenda but not that of the four district municipalities examined. Vancouver's involvement has been more comprehensive and longterm (more childcare spaces, an involved Social Planning Department, two task forces, a Children's Advocate, and buildings and sites for childcare purposes). The response of municipal councils continues to reflect patriarchal notions of the family (where childcare is a private, family responsibility). Alternatively, Vancouver council has recognized a permanent restructuring of the family and the ongoing involvement of the larger community in childcare. At the same time, the lobbying approach of Vancouver childcare advocates has followed long established patterns concerning childcare and governments -- the argument has been based on child welfare, not the rights or welfare of women.
Arts, Faculty of
Sociology, Department of
Graduate

The government of Malawi established the community based childcare (CBCC) programme with the aim of addressing early childhood problems and achieve national development in the long run. The CBCC programme, as one of the approaches to early childhood development (ECD), is guided by the national early childhood development policy. It promotes some practices that somehow deviate from the traditional childcare ways that communities have always known. Experience has shown that programmes that have elements of conflict with commonly held beliefs are bound to meet with resistance in society. The study employed a mini survey, focus group discussion, observation and document review to understand how the CBCC childcare practices in Malili intersect with commonly held beliefs about childcare as well as how they reflect on the national ECD policy. The study also focused on understanding the perceptions of community members on the CBCC programme. The study revealed that while some aspects of CBCC delivery conform to commonly held beliefs about childcare in the area under study, others diverge from such beliefs. Such convergence and divergence appear to be in line with the propositions of transformalist globalisation theory- one of the perspectives adopted for the study. The study also found that care practices at CBCC are not a true reflection of the national ECD policy as community members’ perceptions, poor community participation, poverty and lack of caregiver training in ECD contribute towards poor quality of care in CBCC, contrary to what is defined in the national ECD policy. The study also found that while both CBCC caregivers and sampled community members perceived the quality of care at the centers as poor, caregivers had a more positive perception towards the CBCC than community members. The study indicated that CBCC are centres of desperation for low economic status communities. Findings from the research have revealed that cultural values and commonly held beliefs, and exposure to new knowledge through globalisation play a role in determining childcare practices as well as perceptions towards them. In this sense the study has indicated that meanings that communities attach to development interventions influence their actions and perceptions towards it.

This study of early years services in India explores the take-up of the government ICDS (Integrated Child Development Services Scheme) and RGNCS (Rajiv Gandhi National Crèche Scheme), and the factors affecting their uptake by working mothers in a Delhi slum. Policy cannot assess programme outcomes effectively without understanding how services are implemented. Existing literature indicates that programme impact is related to programme take-up, with non-take-up being a complex phenomenon affected by factors operating at multiple levels of the policy process. The study makes original contributions by examining user perspectives on early childhood education and care (ECEC) in the Indian context; in being the first to research any aspect of the RGNCS; and in utilizing Critical Realism as the underlying philosophical, theoretical and methodological paradigm for studying programme uptake. It poses five research questions that examine mothers' childcare arrangements and needs/expectations from services, their take-up of government programmes and component services, and the combination of factors affecting uptake. Study findings are based on surveys with 200 working mothers and 37 children's centre workers, and interviews with 15 policy experts. Findings reveal childcare arrangements and needs/expectations to vary by family structure, child's age, and mother's age and employment. ICDS uptake is found to be higher (54.3% of all mothers), than RGNCS (18.6%). An explanatory framework for analysing take-up reveals that low take-up results from a combination of multiple factors, most significantly programme characteristics for the ICDS, and participant characteristics for the RGNCS. Two theoretical frameworks frame this analysis - Wolman's (1981) determinants of programme success and failure, and the 'barriers and bridges' to programme uptake. Critical policy analysis further identifies the effects of the policy meaning-making processes, and the role of local 'street-level bureaucrats' in take-up. Both programmes display 'conflicted policy success' vis-à-vis take-up when categorised using McConnell's (2010) criteria for programme 'success' and 'failure'. Policy implications include strategies for increasing programme uptake, and a policy focus upon service users and women in the informal economy, recognition of the dual role of ECEC, and the importance of evidence-creation for interactive governance.

While this study is partly theoretical it includes an exploratory case study in which theoretical insights are applied. In the theoretical part of this study, criteria for a successful poverty alleviation project were developed, guided by sustainability theory and complexity theory. It was proposed that researchers could assess existing projects according to these criteria to show where they were successful and where they could improve. The second part of this research consists of a case study, where an actual poverty alleviation project (The Nomzamo Special Care Centre, Peddie, Eastern Cape) was assessed according to the criteria developed in the first part. For this exploratory case study a non-random sample of 9 participants was drawn from the Nomzamo Special Care Centre and other stakeholders in the Ngqushwa Local Municipality in the Eastern Cape. Data was collected using questionnaires, observation and interviews. The results obtained from analysis indicate that project members particularly experience challenges pertaining to financial resources, infrastructure and maintenance. It is recommended that project members receive assistance from the government departments in order for the project to remain sustainable.

The research undertaken represents an in-depth study of gender and economics from a multi-disciplinary perspective. By drawing on economic, social policy and political science literature it makes an original contribution to the disciplines of economics and feminist economics by advancing ideas on a feminist theory of policy change and institutional design. Equally, the study develops a framework for a multi-method approach to feminist research with applied policy focus by establishing a pragmatic feminist research paradigm. By espousing multiple research philosophies, it extends understanding of gender differences in policy outcomes by connecting theories from feminist economics, feminist historical institutionalism and ideational processes. Jointly funded by the Economic and Social Research Council UK and the Scottish Government, this project attempts to answer three key questions: What is the relative position of men and women in the Scottish economy and how do childcare responsibilities influence these? Which institutions, structures and processes have been instrumental in embedding gender in Scottish economic policy? To what extent and how is the Scottish Government’s approach to economic policy gendered? Quantitative analysis reveals persistently disproportionate differences in men and women’s position in the labour market. Women remain over-represented in part-time employment and in the public sector in the 10years under investigation. Using panel data, the multinomial logistic regression estimation of patterns in labour market transitions equally reveal disproportionate gendered patterns, with families with dependent children 0-4years at a disadvantage to those without. Qualitative analysis indicates that these differences are partly explained by the fact that the unpaid economy still remains invisible to policymakers despite changes in the institutional design, policy processes and the approach to equality policymaking undertaken in Scotland. Unpaid childcare work is not represented as policy relevant and the way gender, equality and gender equality are conceptualised within institutional sites and on political agendas pose various challenges for policy development on unpaid childcare work and gender equality in general. Additionally, policymakers in Scotland do not integrate both the paid and unpaid economies in economic policy formulation since social policy and economic policy are designed separately. The study also establishes that the range of institutions and actors that make-up the institutional setting for regulating and promoting equality, influence how equality issues are treated within a national context. In Scotland, equality regulating institutions such as parliament, the Scottish Government, equality commission and the law are instrumental variables in determining the range of equality issues that are embedded in an equality infrastructure and the extent to which equality issues, including gender, are consequently embedded in public policy and government budgets. Significantly despite meeting all the attributes of an equality issue, unpaid care is not classified as a protected characteristic in the Equality legislation. These institutions can ameliorate, sustain or perpetuate the delivery of unequitable policy outcomes for men and women in the mutually dependent paid and unpaid economy. Thus, economic, social and political institutions are not independent from one another but are interrelated in complex ways that subsequently have material consequences on men and women in society. In summary, there are interlinkages between the law, labour market, the unpaid economy, the welfare state and gendered political institutions such that policy or institutional change in one will be dependent on or trigger change in another. These institutions are gendered, but are also interlinked and underpin the gender structure of other institutions to the extent that the gendered norms and ideas embedded in one institution, for example legislation or political institutions, structure the gendered dimensions of the labour market, welfare state, and the unpaid economy. By shedding light on institutional and political forces that regulate equality in addition to macroeconomic forces, the analysis reveals the important role of institutions, policy actors and their ideas as instrumental forces which constantly define, redefine and reconstruct the labour market experiences of men and women with significant material consequences.

Defence date: 2 October 2006
Examining board: Prof. Klaus Eder (Humboldt-University, Berlin) ; Prof. Birgit Pfau-Effinger (University Hamburg) ; Prof. Bo Stråth (European University Institute) ; Prof. Colin Crouch (The University of Warwick)
PDF of thesis uploaded from the Library digitised archive of EUI PhD theses completed between 2013 and 2017

Today in Canada, child care is not perceived by the government, nor its citizenry, as a public good. Despite numerous reports from economic, health, social and psychological experts, Canadians remain complacent about the inadequate child care provisions in our country. As a society, we do not demand, or even anticipate, the public provision of universal, affordable, accessible child care. Instead, Canadians consider the care of children to be a predominantly private issue; unworthy of significant government intervention or assistance. Consequently, parents and children must improvise within a privatized, ad hoc, market-oriented patchwork of individualized child care arrangements. While it is true that certain "special" cases are acknowledged to deserve the government's support, - for example Aboriginal children and children with special needs, as well as the children of "welfare moms" - their exceptional status serves to reinforce the notion that the care of children is primarily a private parental responsibility. The purpose of this paper is to analyze and critique the current child care system (or lack thereof) in Canada. In addition, I intend to show that existing child care arrangements are unsatisfactory not only because of the immediate consequences for parents, children, and child care workers, but because of the way in which the privatized purchasing of child care reinforces other systemic shortcomings in our patriarchal, racialized, capitalist society. I will argue that current attitudes toward child care in Canada, as part of a patriarchal capitalist and racialized paradigm, rely on and perpetuate detrimental notions of class, gender and race, to the disadvantage of all citizens. Finally, I will discuss the possibilities for meaningful reform of the Canadian approach to child care.

The care and education of pre-school children presents a perfect storm of conflicts among the needs of women, children, and states, particularly in societies that maintain a sharp barrier between the private and public spheres such as the United States and Britain. American and British policymakers attempted to address these tensions in the early 1970s by proposing universal child care programs. In the U.S., the Comprehensive Child Development Act (CDA) of 1971 passed both the House and Senate by overwhelming majorities but was vetoed by President Richard Nixon. Going further than any proposal before or since to establish a national public child care program, it would have made public child care centers universally available on a sliding-scale basis: free for children of the poor but available for a fee to middle and upper class children. The British Department of Education and Science, led by Secretary Margaret Thatcher, published a White Paper in 1972 calling for nursery expansion, but it was never fully implemented. It proposed a dramatic expansion of public nursery education, so that it might be available within a decade to all families with three and four year old children who chose to utilize it, with funds being made available first to local areas designated as most in need. My dissertation presents an in-depth account of the political bargaining that occurred during this period in both countries, and addresses the factors that contributed to the failure of these universal child care proposals. Although neither child care program was implemented (or fully implemented, in the British case), the proposals raise important questions about the relationship between the state and the family. It also analyzes the aftermath of these policies’ failure through to the end of Thatcher and Reagan administrations. It then turns to the mid-1990s which represent a key divergence in the two nations’ paths, as Britain returned to its earlier nursery education initiatives for all children and the United States further entrenched its reliance on the private market for the provision of care. The passage in 1997 of the British National Child Care Strategy, a central component of New Labour’s War on Child Poverty, included a free and universal preschool provision for all three and four year old children. In the U.S., by contrast, the 1996 Personal Responsibility and Work Opportunity Reconciliation Act expanded child care subsidies only for eligible low income children below the age of five, thus continuing the American reliance on the free market to provide this necessary service for most families. I argue that conflicting visions of child care as an educational intervention versus a welfare service—and as a universal provision benefitting all children and families versus a means-tested program targeted to low-income families—explain the differences between these two countries’ policy developments in the 1990s. Specifically, my dissertation examines how British and American conceptions of motherhood and child-rearing compare, and how policymakers viewed the role of the state in intervening with parental responsibilities. In the United States, Republicans balked at the idea of public child care provision for the nonpoor, yet British politicians of both major parties supported universal public interventions in the early years at various points across the period.

AbstractThe positive view of child migration held by UK Government officials in the inter-war period was not based on any regular system of inspections of the institutions in Australia to which children were sent. During the Second World War, UK Government officials became more of reported problems at several of these institutions, relating to standards of accommodation, management, care, training and after-care. This chapter traces the growing awareness of these problems and the UK Government’s response to them. Whilst policy-makers’ positive assumptions about child migration were challenged, and specific issues and institutions were known to require significant improvement, overall confidence in the value of child migration remained. Despite evidence of organisational failings in Australia, Australian welfare professionals were trusted to address these problems, and suggestions about the need for greater control from the United Kingdom were seen as a backward-looking attempt to limit the autonomy of Britain’s Dominions.

AbstractThis chapter examines the policy context and administrative systems associated with the resumption of assisted child migration from the United Kingdom to Australia in 1947. During the Second World War, the Australian Commonwealth Government came to see child migration as an increasingly important element in its wider plans for post-war population growth. Whilst initially developing a plan to receive up to 50,000 ‘war orphans’ shortly after the war in new government-run cottage homes, the Commonwealth Government subsequently abandoned this, partly for financial reasons. A more cost-effective strategy of working with voluntary societies, and their residential institutions, was adopted instead. Monitoring systems of these initial migration parties by the UK Government were weak. Whilst the Home Office began to formulate policies about appropriate standards of care for child migrants overseas, this work was hampered by tensions between the Home Office and the Commonwealth Relations Office about the extent to control over organisations in Australia was possible.

The Swedish government policy on extended working life has since its introduction in the mid-1990s aimed to lower the costs of the public pension system and to reduce the financial burden for workers. By focusing on an idealised category of those who are "willing and able to work longer", the policy has neglected the obstacles faced by those with physically demanding jobs or with a big responsibility to care for a close relative. This mainly affects women and upholds a neoliberal view of older people. By only problematizing gender perspective on the challenges to gender equality in working life, a narrow understanding of gender equality is created which deviates from other national gender equality policies. The policy debate thereby contributes also to excluding older women and men from the Swedish gender equality project. Despite the argument that an extended working life is needed to ensure the value of pensions, this does not apply to those who are unable to continue working - they are instead expected to rely on the social security scheme.

Abstract This study examines why Denmark is considered the leader among the Nordic countries and globally when it comes to childcare. In terms of programmatic success, Denmark is a pioneer in nationwide ECEC (early childhood education and care), including social investment, which focuses on learning capabilities and skills of children. The implementation of ECEC nationwide is well organized, and the take-up of ECEC is evenly spread geographically and across social classes. Danish ECEC is also a clear political success, as political parties from the left to the right of the political spectrum, and at central and local levels of government, have supported ECEC, from the 1970s onwards; furthermore, stakeholders have been involved in setting agendas for continued high-quality ECEC as part of Danish family-, childcare- and labour market policy. Linked to the political success, Danish ECEC has also been a clear process success, with incremental reforms by broad-based coalitions, which have been carried out without major obstacles. The Danish system of ECEC has endured over several decades, despite changes at the margin due to challenges, including financial crises. The endurance is likely to continue well into the future, because of the cap on parental own contribution to the costs of ECEC, and because there has been a political decision to have a minimum threshold for quality of care in 2019. Across both sides of the Atlantic, in the EU context and in the US, childcare in Denmark is considered as a poster-child.

This chapter examines different interpretations and objectives of in-home child care in Australia, the UK and Canada, and the ways in which these diverging interpretations are reflected in the policy mechanisms of ECEC that facilitate, or do not facilitate, different forms of regulated and unregulated in-home child care. It brings together scholarship on early education and women’s workforce participation to present different reasons and rationales for government investment and spending on ECEC. National governments and advocates, and international organisations, increasingly emphasise a human capital approach to social policy. This frames ECEC around children’s ‘early learning and development’ and concerns about child poverty, which often extends to include parents’ workforce participation. The chapter is based on analysis of primary policy documents and interviews conducted with key policy stakeholders across the three countries. The final section discusses tensions and contradictions across and within countries in relation to two dichotomies.

This chapter discusses the ecosystems that support children and families in early care and education, that lead to the transition into K-12 schools. Since America's inception, child rearing and development have been considerations for families, but as the nation industrialized and racially and socially integrated the need for public systems of care and education emerged. In recent times, state governments have established various accountability systems to create more “cohesive, equitable, and effective early childhood systems.” These systems gatekeep the conditions for early care and education. However, government is not the sole early childhood stakeholder. Parents, providers, teachers, community members, and researchers are all stakeholders in the research, policy, practice, and governance of early care and education. This chapter delves into the why behind policy and governance—who supports children's earliest years and what are the considerations to do so equitably and efficiently to provide a smooth transition to elementary education?

Abstract This chapter details the progression of Spanish residential care through a period of civil war followed by 40 years of dictatorship, when large institutions prevailed. The arrival of a democratic government in the late 1970s marked the beginning of a period of transformation in child welfare, including the introduction of family foster care and the expansion of family support services, the evolution of standards for residential care, and the development of research alliances with Spanish universities to identify effective strategies for residential staff training. Spain’s residential care population includes a high percentage of unaccompanied minors who, along with youth who present with severe behavioral and emotional problems, are a present focus of concern. The chapter concludes with the matrix used throughout the book, which provides information about the current policy context, key trends and initiatives, characteristics of children and youth served, preparation of residential care personnel, promising programmatic innovations, and present strengths and challenges.

China becomes an aging society in a pace much faster than other countries because of its one-child policy implemented since 1980. This chapter examines the current situation of population aging in China, the government policies and regulations surrounding elderly care, and the experiences of other Asian and Oceanian countries in dealing with population aging. The rapid population aging poses severe challenges for the elderly care in China, which has not established an adequate social security system, but it also provides abundant opportunities for enterprises and entrepreneurs in the aging industry from other Asian and Oceanian countries as well as China. China can learn from the experiences of industrialized Asian and Oceanian countries and regions in developing its elderly care industry.

China becomes an aging society in a pace much faster than other countries because of its one-child policy implemented since 1980. This chapter examines the current situation of population aging in China, the government policies and regulations surrounding elderly care, and the experiences of other Asian and Oceanian countries in dealing with population aging. The rapid population aging poses severe challenges for the elderly care in China, which has not established an adequate social security system, but it also provides abundant opportunities for enterprises and entrepreneurs in the aging industry from other Asian and Oceanian countries as well as China. China can learn from the experiences of industrialized Asian and Oceanian countries and regions in developing its elderly care industry.

The provision of healthcare should be in relation to the need of care, but this is not always the case, as examples given in this chapter illustrate. The impact on equity in the utilization of care of need-based resource allocation versus recent market-oriented choice reforms and changes in reimbursement systems in primary care in Sweden are discussed. Examples are given of alternative ways of providing services in primary care in disadvantaged areas. Further, the chapter describes an applied example of the concept of proportionate universalism in child healthcare services, where extra postnatal home visits are provided in a disadvantaged area of Stockholm. Finally, the emerging needs of integrated care in an ageing population are contrasted against current health policy reform, which emphasizes freedom of choice of providers, and discussed.

The policy review is part of the project EQualCare: Alone but connected? Digital (in)equalities in care work and generational relationships among older people living alone, a three-year international project involving four countries: Finland, Germany, Latvia and Sweden. EQualCare interrogates inequalities by gender, cultural and socio-economic background between countries, with their different demographics and policy backgrounds. As a first step into empirical analysis, the policy review aims to set the stage for a better understanding of, and policy development on, the intersections of digitalisation with intergenerational care work and care relationships of older people living alone in Germany. The policy review follows a critical approach, in which the problems policy documents address are not considered objective entities, but rather discursively produced knowledge that renders visible some parts of the problem which is to be solved as other possible perspectives are simultaneously excluded. Twenty publicly available documents were studied to analyse the processes in which definitions of care work and digital (in)equalities are circulated, translated and negotiated between the different levels of national government, regional governments and municipalities as well as other agencies in Germany. The policy review consists of two parts: a background chapter providing information on the social structure of Germany, including the historical development of Germany after the Second World War, its political structure, information on the demographic situation with a focus on the 60+ age group, and the income of this age group. In addition, the background presents the structure of work and welfare, the organisation of care for old people, and the state of digitalisation in Germany. The analysis chapter includes a description of the method used as well as an overview of the documents chosen and analysed. The focus of this chapter is on the analysis of official documents that deal with the interplay of living alone in old age, care, and digitalisation. The analysis identified four themes: firstly, ageing is framed largely as a challenge to society, whereas digitalisation is framed as a potential way to tackle social challenges, such as an ageing society. Secondly, challenges of ageing, such as need of care, are set at the individual level, requiring people to organise their care within their own families and immediate social networks, with state support following a principle of subsidiarity. Thirdly, voluntary peer support provides the basis for addressing digital support needs and strategies. Publications by lobby organisations highlight the important work done by voluntary peer support for digital training and the benefits this approach has; they also draw attention to the over-reliance on this form of unpaid support and call for an increase in professional support in ensuring all older people are supported in digital life. Fourthly, ageing as a hinderance to participation in digital life is seen as an interim challenge among younger old people already online.

Following the International Population and Development Conference in Cairo, there has been widespread consensus in the international community that family planning (FP) programs must be people-centered and focus not just on contraception, but on the reproductive health (RH) of men and women throughout their lives. This policy brief reviews the research and policy implications of promoting the Lactational Amenorrhea Method (LAM) as a component of FP counseling in India. The Government of India and the Population Council are using a pregnancy-based approach in Uttar Pradesh to improve the delivery of FP services through the rural primary health care system. Introducing pregnant women and their families to LAM offers a number of health benefits for mother and child. It promotes breastfeeding, which benefits the mother by reducing risk of postpartum hemorrhage and lowering risk of breast and ovarian cancers. The benefits to the fully breastfed infant include protection from hypothermia, neonatal hypoglycemia, and infections, in addition to nutritional advantages. Breastfeeding reduces postpartum fertility, thus delaying the need to use other contraceptive methods. LAM introduces couples to the concept of nonpermanent contraception and child spacing in a culturally acceptable way.

The Government of India has adopted a Reproductive and Child Health (RCH) approach as the basis of its new family welfare policy. One component of RCH is management of reproductive tract infections (RTIs). The Population Council's Asia and the Near East Operations Research and Technical Assistance (ANE OR/TA) Project, in collaboration with the State of Uttar Pradesh, Ministry of Health and Family Welfare, is conducting a study on the feasibility and cost of providing RTI case management at the primary-care level. The estimated annual cost of RTI case management at the district level would be about US$64,000. From the analysis, it is clear that the average annual drug budget of a Primary Health Care Centre in India is inadequate even if used only for subsidized RTI case management. Policymakers and program managers are examining the initial and continuing costs of RTI case management within the overall RCH package in India, with a focus on quality and sustainability. As noted in this paper, alternatives for controlling costs include better efforts at primary prevention, partner participation to reduce reinfection, user fees, and more private-sector involvement in reproductive health care.

Over the last 30 years, Bangladesh’s national family planning (FP) program has mainly concentrated its promotional efforts on women’s adoption of FP. While the government policy has been effective in influencing women to accept contraceptive methods, men’s role in FP has been completely neglected. Similarly, male RH services are hardly available at Health and Family Welfare Centres (HFWCs). This report describes a project aimed at integrating male RH services within the existing government female-focused health-care-delivery system. The study was implemented by NIPORT in collaboration with the Directorate of Family Planning and the Population Council. Interventions resulted in a substantial rise of male clients in the clinics, however nearly all came for the treatment of general health problems. Only a small number of male RTI/STI clients sought services from the clinics. Although unexpected, there was a substantial rise in the number of female clients. The study concluded that RH services for men could be easily integrated into HFWCs without affecting the female and child focus of the clinics and that augmentation of the total number of patients at HFWCs will lead to more effective use of resources and decreased cost of treatment.