An evaluation of the effectiveness of a community-based parenting empowerment program to improve nurturing care of young children in Kenya and Zambia
Keywords:Child development, Early childhood, Nurturing care, Stimulation, Parenting empowerment
Background: Investing in parents and children during the critical period between birth and five years of a child’s life can have long-lasting benefits in the life of the child. Recently, the 2016 Lancet Series estimated that 250 million children aged less than five years in low- and middle-income countries (LMICs) are at risk of not reaching their developmental potential. Over 66 % of these, who live in sub-Saharan Africa and are at risk due to poor nutrition, exposure to poverty, high HIV prevalence as well as under stimulation in the home environment.
Methods: The study will employ a cluster-randomized control trial design and will use a mixed-methods approach combining quantitative and qualitative methodologies (Concurrent Triangulation Design). This will be a two-arm study, where the first arm will participate in the parenting empowerment program implemented by the faith-based organizations, while the second (control) will not receive the parenting interventions. A total of 510 mother/primary caregiver-child dyads will be recruited into this study. We will estimate the causal effect of the intervention using mixed linear models and the Difference-in-Differences (DID) estimator.
Conclusions: This implementation research will provide greater scientific rigor and a deeper process and outcome evaluation including measurement of child development outcomes. The findings will be useful for early childhood practitioners, multilateral stakeholders and funders as they provide information on the factors to consider in the implementation of high quality ECD interventions.
Trial Registration: Ethical approval: ESRC P467/2018 and IRB No.00005948).
Black MM, Walker SP, Fernald LCH, Andersen CT, DiGirolamo AM, Lu C, et al. Early childhood development coming of age: science through the life course. Lancet. 2017;389:77-90.
Britto PR, Lye SJ, Proulx K, Yousafzai AK, Matthews SG, Vaivada T, et al. Nurturing care: promoting early childhood development. Lancet. 2017;389:91–102.
Kimani-Murage EW, Kimiywe J, Kabue M, Wekesah F, Matiri E, Muhia N, et al. Feasibility and effectiveness of the baby friendly community initiative in rural Kenya: Study protocol for a randomized controlled trial. Trials. 2015;16(1).
Ambey R, Gaur A, Gupta R, Patel G. Urban poor children. Australas Med J. 2013;6(6):341–3.
Richter L, Daelmans B, Lombardi J, Heymann J. Investing in the foundation of sustainable development: pathways to scale up for early childhood development. Lancet. 2017;389(10064):103-18.
Engle PL, Fernald LCH, Alderman H, Behrman J, O’Gara C, Yousafzai A, et al. Strategies for reducing inequalities and improving developmental outcomes for young children in low-income and middle-income countries. Lancet. 2011;378(9799):1339–53.
Walker SP, Powell CA, Grantham-McGregor SM, Himes JH, Chang SM. Nutritional supplementation, psychosocial stimulation, and growth of stunted children: The Jamaican study. Am J Clin Nutr. 1991;54(4):642–8.
Yousafzai AK, Aboud F. Review of implementation processes for integrated nutrition and psychosocial stimulation interventions. Ann N Y Acad Sci. 2014;1308(1):33–45.
Engle PL. Parenting Programme for Child Development. Source J Heal Popul Nutr. 2007;2525(1l):1–2.
Engle PL, Black MM, Behrman JR, Cabral de Mello M, Gertler PJ, Kapiriri L, et al. Strategies to avoid the loss of developmental potential in more than 200 million children in the developing world. Lancet. 2007;369:229–42.
Engle P, Menon P, Haddad L. Care and nutrition: concepts and measurement. World Dev. 1999;27(8):1309-37.
Digirolamo AM, Stansbery P, Lung’aho M. Advantages and challenges of integration: Opportunities for integrating early childhood development and nutrition programming. Ann N Y Acad Sci. 2014;1308(1):46–53.
Gowani S, Yousafzai A, Armstrong R. Cost effectiveness of responsive stimulation and nutrition interventions on early child development outcomes in Pakistan. Ann N Y Acad Sci. 2014;1308:149-61.
Ministry of Health. Kisumu County Health at a Glance. 2015;(2014):2015.
Kenya National Bureau of Statistics (KNBS); ICF Macro. Kenya Demographic and Health Survey 2014. Heal San Fr. 2014;1–314.
County K. First county integrated development plan 2013-2017; 2013.
Hsiao C, Richter L, Makusha T, Matafwali B, van Heerden A, Mabaso M. Use of the ages and stages questionnaire adapted for South Africa and Zambia. Child Care Health Dev. 2017;43(1):59–66.
Squires J, Bricker D. Ages & Stages Questionnaires. Third Edition. (ASQ-3): A Parent-Completed Child-Monitoring System. Paul Brookes Publication Co; 2009.