scholarly journals A holistic approach to promoting early child development: a cluster randomised trial of a group-based, multicomponent intervention in rural Bangladesh

2021 ◽  
Vol 6 (3) ◽  
pp. e004307
Author(s):  
Helen O Pitchik ◽  
Fahmida Tofail ◽  
Mahbubur Rahman ◽  
Fahmida Akter ◽  
Jesmin Sultana ◽  
...  
Keyword(s):  
Mental Health ◽  
Child Development ◽  
Dietary Diversity ◽  
Primary Caregivers ◽  
Secondary Outcome ◽  
Early Child Development ◽  
Early Child ◽  
Rural Bangladesh ◽  
Cluster Randomised ◽  
Adjusted Means

IntroductionIn low- and middle-income countries, children experience multiple risks for delayed development. We evaluated a multicomponent, group-based early child development intervention including behavioural recommendations on responsive stimulation, nutrition, water, sanitation, hygiene, mental health and lead exposure prevention.MethodsWe conducted a 9-month, parallel, multiarm, cluster-randomised controlled trial in 31 rural villages in Kishoreganj District, Bangladesh. Villages were randomly allocated to: group sessions (‘group’); alternating groups and home visits (‘combined’); or a passive control arm. Sessions were delivered fortnightly by trained community members. The primary outcome was child stimulation (Family Care Indicators); the secondary outcome was child development (Ages and Stages Questionnaire Inventory, ASQi). Other outcomes included dietary diversity, latrine status, use of a child potty, handwashing infrastructure, caregiver mental health and knowledge of lead. Analyses were intention to treat. Data collectors were independent from implementers.ResultsIn July–August 2017, 621 pregnant women and primary caregivers of children<15 months were enrolled (group n=160, combined n=160, control n=301). At endline, immediately following intervention completion (July–August 2018), 574 participants were assessed (group n=144, combined n=149, control n=281). Primary caregivers in both intervention arms participated in more play activities than control caregivers (age-adjusted means: group 4.22, 95% CI 3.97 to 4.47; combined 4.77, 4.60 to 4.96; control 3.24, 3.05 to 3.39), and provided a larger variety of play materials (age-adjusted means: group 3.63, 3.31 to 3.96; combined 3.81, 3.62 to 3.99; control 2.48, 2.34 to 2.59). Compared with the control arm, children in the group arm had higher total ASQi scores (adjusted mean difference in standardised scores: 0.39, 0.15 to 0.64), while in the combined arm scores were not significantly different from the control (0.25, –0.07 to 0.54).ConclusionOur findings suggest that group-based, multicomponent interventions can be effective at improving child development outcomes in rural Bangladesh, and that they have the potential to be delivered at scale.Trial registration numberThe trial is registered in ISRCTN (ISRCTN16001234).

scholarly journals Maternal mental health modifies the association of food insecurity and early child development

2020 ◽  
Vol 16 (4) ◽  
Author(s):  
Jéssica Pedroso ◽  
Gabriela Buccini ◽  
Sonia Isoyama Venancio ◽  
Rafael Pérez‐Escamilla ◽  
Muriel Bauermann Gubert
Keyword(s):  
Mental Health ◽  
Child Development ◽  
Food Insecurity ◽  
Maternal Mental Health ◽  
Early Child Development ◽  
Early Child

scholarly journals Effects of improved complementary feeding and improved water, sanitation and hygiene on early child development among HIV-exposed children: substudy of a cluster randomised trial in rural Zimbabwe

2020 ◽  
Vol 5 (1) ◽  
pp. e001718 ◽  
Author(s):  
Jaya Chandna ◽  
Robert Ntozini ◽  
Ceri Evans ◽  
Gwendoline Kandawasvika ◽  
Bernard Chasekwa ◽  
...  
Keyword(s):  
Child Development ◽  
Complementary Feeding ◽  
Object Permanence ◽  
Self Control ◽  
Early Child Development ◽  
Early Child ◽  
Link Type ◽  
Cluster Randomised ◽  
Sanitation And Hygiene ◽  
Hiv Exposed

IntroductionHIV-exposed uninfected children may be at risk of poor neurodevelopment. We aimed to test the impact of improved infant and young child feeding (IYCF) and improved water, sanitation and hygiene (WASH) on early child development (ECD) outcomes.MethodsSanitation Hygiene Infant Nutrition Efficacy was a cluster randomised 2×2 factorial trial in rural Zimbabwe ClinicalTrials.gov NCT01824940). Pregnant women were eligible if they lived in study clusters allocated to standard-of-care (SOC; 52 clusters); IYCF (20 g small-quantity lipid-based nutrient supplement/day from 6 to 18 months, complementary feeding counselling; 53 clusters); WASH (pit latrine, 2 hand-washing stations, liquid soap, chlorine, play space, hygiene counselling; 53 clusters) or IYCF +WASH (53 clusters). Participants and fieldworkers were not blinded. ECD was assessed at 24 months using the Malawi Developmental Assessment Tool (MDAT; assessing motor, cognitive, language and social skills); MacArthur Bates Communication Development Inventories (assessing vocabulary and grammar); A-not-B test (assessing object permanence) and a self-control task. Intention-to-treat analyses were stratified by maternal HIV status.ResultsCompared with SOC, children randomised to combined IYCF +WASH had higher total MDAT scores (mean difference +4.6; 95% CI 1.9 to 7.2) and MacArthur Bates vocabulary scores (+8.5 words; 95% CI 3.7 to 13.3), but there was no evidence of effects from IYCF or WASH alone. There was no evidence that that any intervention impacted object permanence or self-control.ConclusionsCombining IYCF and WASH interventions significantly improved motor, language and cognitive development in HIV-exposed children.Trial registration numberNCT01824940.

scholarly journals Impact of a child stimulation intervention on early child development in rural Peru: a cluster randomised trial using a reciprocal control design

2016 ◽  
Vol 71 (3) ◽  
pp. 217-224 ◽  
Author(s):  
Stella Maria Hartinger ◽  
Claudio Franco Lanata ◽  
Jan Hattendorf ◽  
Jennyfer Wolf ◽  
Ana Isabel Gil ◽  
...  
Keyword(s):  
Child Development ◽  
Randomised Trial ◽  
Control Design ◽  
Cluster Randomised Trial ◽  
Early Child Development ◽  
Early Child ◽  
Cluster Randomised

scholarly journals A factorial cluster-randomised controlled trial combining home-environmental and early child development interventions to improve child health and development: rationale, trial design and baseline findings

2018 ◽  
Author(s):  
Stella M Hartinger ◽  
Nestor Nuño ◽  
Jan Hattendorf ◽  
Hector Verastegui ◽  
Mariela Ortiz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Drinking Water ◽  
Randomised Controlled Trial ◽  
Child Development ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Early Child Development ◽  
Early Child ◽  
Cluster Randomised ◽  
Randomised Controlled

ABSTRACTBackgroundExposure to unhealthy environments and poor cognitive development are the main risk factors that affect children’s health and wellbeing in low- and middle-income countries. Interventions that simultaneously address several risk factors at the household level have great potential to reduce these negative effects. We present the design and baseline findings of a cluster-randomised controlled trial to evaluate the impact of an integrated home-environmental intervention package and an early child development programme to improve diarrhoea, acute respiratory infections and childhood developmental outcomes in children under 36 months of age living in resource-limited rural Andean Peru.MethodsWe collected baseline data on children’s developmental performance, health status and demography as well as microbial contamination in drinking water. In a sub-sample of households, we measured indoor and personal 24-hour air concentration levels of carbon monoxide (CO) and fine particulate matter (PM2.5).ResultsWe recruited and randomised 317 children from 40 community-clusters to four study arms. At baseline, all arms had similar health and demographic characteristics, and the developmental status of children was comparable between arms. The analysis revealed that more than 25% of mothers completed primary education, a large proportion of children were stunted and diarrhoea prevalence was above 18%. Fifty-two percent of drinking water samples tested positive for thermo-tolerant coliforms and the occurrence of E.coli was evenly distributed between arms. The mean levels of kitchen PM2.5 and CO concentrations were 213 μg/m3 and 4.8 ppm, respectively.ConclusionsThe trial arms are balanced with respect to most baseline characteristics, such as household air and water pollution, and child development. These results ensure the possible estimation of the trial effectiveness. This trial will yield valuable information for assessing synergic, rational and cost-effective benefits of the combination of home-based interventions.Trial registrationretrospectively registered on 15th January 2018. SRCTN reference: 26548981

scholarly journals Poor Maternal Mental Health Mediates the Relationship Between Household Food Insecurity and Early Child Development in Brazil

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 280-280
Author(s):  
Jessica Silva ◽  
Fernando José Herkrath ◽  
Gabriela Buccini ◽  
Sonia Isoyama Venancio ◽  
Rafael Pérez-Escamilla ◽  
...  
Keyword(s):  
Mental Health ◽  
Child Development ◽  
Food Insecurity ◽  
Maternal Mental Health ◽  
Unwanted Pregnancy ◽  
Early Child Development ◽  
Household Food Insecurity ◽  
Early Child ◽  
Household Food ◽  
The Relationship

Abstract Objectives The aim of the study was to evaluate whether maternal mental health and infant's diet mediate the association between Household Food Insecurity (HFI) and Early Child Development (ECD) using Structural Equation Modeling (SEM). We hypothesized a priori that both maternal mental health and infant's diet would mediate the association between HFI and ECD. Methods A cross-sectional study was carried out with 474 mother-infant dyads at Primary Health Centers in the Federal District, Brazil. Mothers answered a questionnaire that evaluated variables through validated instruments. SEM analyses were conducted including the following observed variables: HFI, ECD, consumption of a healthy and diverse diet, presence of a partner in the household, wanted pregnancy and current breastfeeding. Latent variables were included to evaluate mental health (created from maternal depression, trait anxiety and state anxiety), poverty (created from maternal educational level, household per capita income and participation in the Brazilian cash transfer program) and infant health (created from preterm birth, hospitalization after birth and Neonatal Intensive Care Unit needed after birth). Results Poor maternal mental health mediated the relationship between HFI and ECD (β = –0.05), but a healthy and diverse diet was not a mediator in this relationship. Poverty was related to lower ECD scores directly (β = 0.21) and indirectly (β = 0.02). Not having a partner (β = 0.05) and having an unwanted pregnancy (β = 0.02) predicted indirectly lower ECD scores. Conclusions Poor maternal mental health mediates the relationship between HFI and ECD, and ECD is influenced by poverty, single motherhood and unwanted pregnancy through different pathways. Therefore, it is necessary that public policies and interventions that aim to promote an optimal ECD also approach these aspects. Longitudinal cohort studies are needed to determine causality and identify promising approaches to improve parenting skills and ECD outcomes in the context of HFI. Funding Sources This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) (Finance Code 001, CAPES scholarship Programa Doutorado Sanduíche no Exterior Process number 88,881.189710/2018–01).

Perceived Knowledge of Early Child Development Among New and Expecting Fathers

2009 ◽  
Author(s):  
Heather A. Keefe ◽  
Sharnail D. Bazemore ◽  
Kate Farr ◽  
James F. Paulson
Keyword(s):  
Child Development ◽  
Early Child Development ◽  
Perceived Knowledge ◽  
Early Child

scholarly journals Nutritional Status of Children 24–60 Months Attending Early Child Development Centres in a Semi-Rural Community in South Africa

2020 ◽  
Vol 18 (1) ◽  
pp. 261
Author(s):  
Onwaba Makanjana ◽  
Ashika Naicker
Keyword(s):  
South Africa ◽  
Child Development ◽  
Nutritional Status ◽  
Energy Intake ◽  
Vegetable Consumption ◽  
Childhood Development ◽  
Early Child Development ◽  
Serum Retinol ◽  
Early Child ◽  
Nutritional Status Of Children

Despite the numerous efforts to improve the nutritional status of children, a high prevalence of malnutrition still exists in South Africa. This study aimed to determine the nutritional status of children attending Early Child Development centres in South Africa. In this baseline study, we randomly selected two Early Child Development centres comprising 116 children aged 24–60 months, separated into two cohorts, of 24–47 months and 48–60 months. Dietary intake was measured through the 24 hDR and analysed using Food Finder software. The food frequency questionnaire was used to calculate the food variety and food group diversity scores. Anthropometric measurements were taken and the WHO Anthro software was used to convert it to nutritional data indices. Blood samples were collected through dried blood spot cards in order to determine serum retinol and haemoglobin levels and they were assessed using WHO indicators. The findings showed that participants between 24 and 47 months had a high mean energy intake (4906.2 kJ and 4997.9 kJ for girls and boys, respectively). For the 48–60 months age group, energy intake was lower than the EER (5936.4 kJ and 5621.2 kJ; p = 0.038). There was low fruit and vegetable consumption (24–47 months; 63.8 g and 69.5 g (p = 0.037), 48–60 months; 68.3 g and 74.4 g (p = 0.038) and the top five foods consumed were carbohydrate rich foods for girls and boys, respectively. Stunting was noted in 7% and 20% (48–60 months) (p = 0.012) and overweight in 8% and 17% (24–47 months) and 17% and 13% (48–60 months) (p = 0.041) in girls and boys, respectively. Low serum retinol levels (<0.070 µmol/L) were found in 9.1% of boys (24–47 months), and 8% and 7.4% of girls and boys (48–60 months), respectively. Low haemoglobin levels (<11.0 g/dL) were found in 50.0% and 30.4% (24–47 months) and 8.6% and 39.3% (48–60 months) of girls and boys, respectively. Malnutrition, despite many national and provincial initiatives, still exists in Early Childhood Development centres in South Africa, calling for the application of contextualized nutrition interventions to suit resource-poor settings.

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