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August 17, 2025Open Access

Analysis of Determinant Factors and Mechanisms in Early Childhood Care Services: A Qualitative Study in the Asturian Context (Spain)

Key Points

Barriers to equitable early childhood intervention are prevalent in rural areas, including geographic isolation and lack of specialists.
A qualitative analysis of 24 stakeholders identified key themes like the need for standardized management and improved family support.
Data analysis utilized a phenomenological approach with inductive and deductive coding methods to reveal significant patterns.
The findings emphasize the necessity for fair territorial planning and enhanced coordination in early childhood services.

Abstract

Diverse realities challenge the management capacity of public and private systems to ensure equitable quality and efficient access to resources, in line with the 2030 Agenda and the Sustainable Development Goals, which aim to close gaps in essential services and ensure quality of life. The reality in Spain, and more specifically in the Principality of Asturias, is that most resources are concentrated in urban areas rather than rural ones, partly due to the region’s geography. Background/Objectives: This study aimed to explore the perspectives of various stakeholders on the early childhood care system in the Principality of Asturias (Spain), with the purpose of analyzing the mechanisms and determinants involved in its functioning and identifying opportunities for improvement. Methods: A qualitative study was conducted using the theoretical framework of the National Institute on Minority Health and Health Disparities (NIMHD) as a conceptual basis. Semi-structured interviews were carried out with 24 participants selected based on their relationship with early childhood care systems, encompassing different levels of responsibility and operational roles. Data were analyzed using a phenomenological approach, employing inductive and deductive coding to identify recurring patterns and code co-occurrences within ATLAS.ti software. Conclusions: This study reveals major barriers to equitable early childhood intervention (ECI) in rural areas, such as geographic isolation, lack of specialists, long waiting times, and poor transport. Six key themes emerged, including the need for standardized system management, better family support, and digital tools like centralized electronic health records. Rural areas are directly limited regarding their access to services, highlighting the need for fair territorial planning and a holistic, inclusive care model. Improving coordination, accessibility, and technology is vital.

Analysis of Determinant Factors and Mechanisms in Early Childhood Care Services: A Qualitative Study in the Asturian Context (Spain)

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