Examining Early Child Development in Low-Income Countries

10.1596/28107 ◽  
2009 ◽  
Author(s):  
Lia C. H. Fernald ◽  
Patricia Kariger ◽  
Patrice Engle ◽  
Abbie Raikes
Keyword(s):  
Child Development ◽  
Low Income ◽  
Low Income Countries ◽  
Early Child Development ◽  
Early Child

scholarly journals Counting outcomes, coverage and quality for early child development programmes

2019 ◽  
Vol 104 (Suppl 1) ◽  
pp. S13-S21 ◽  
Author(s):  
Kate M Milner ◽  
Sunil Bhopal ◽  
Maureen Black ◽  
Tarun Dua ◽  
Melissa Gladstone ◽  
...  
Keyword(s):  
Child Development ◽  
Low Income ◽  
Outcome Measurement ◽  
Monitoring And Evaluation ◽  
Screening Tools ◽  
Theory Of Change ◽  
Early Child Development ◽  
Middle Income ◽  
Early Child ◽  
Definition Of

Improved measurement in early child development (ECD) is a strategic focus of the WHO, UNICEF and World Bank Nurturing Care Framework. However, evidence-based approaches to monitoring and evaluation (M&E) of ECD projects in low-income and middle-income countries (LMIC) are lacking. The Grand Challenges Canada®-funded Saving Brains® ECD portfolio provides a unique opportunity to explore approaches to M&E of ECD programmes across diverse settings. Focused literature review and participatory mixed-method evaluation of the Saving Brains portfolio was undertaken using an adapted impact framework. Findings related to measurement of quality, coverage and outcomes for scaling ECD were considered. Thirty-nine ECD projects implemented in 23 LMIC were evaluated. Projects used a ‘theory of change’ based M&E approach to measure a range of inputs, outputs and outcomes. Over 29 projects measured cognitive, language, motor and socioemotional outcomes. 18 projects used developmental screening tools to measure outcomes, with a trade-off between feasibility and preferred practice. Environmental inputs such as the home environment were measured in 15 projects. Qualitative data reflected the importance of measurement of project quality and coverage, despite challenges measuring these constructs across contexts. Improved measurement of intervention quality and measurement of coverage, which requires definition of the numerator (ie, intervention) and denominator (ie, population in need/at risk), are needed for scaling ECD programmes. Innovation in outcome measurement, including intermediary outcome measures that are feasible and practical to measure in routine services, is also required, with disaggregation to better target interventions to those most in need and ensure that no child is left behind.

scholarly journals Rating early child development outcome measurement tools for routine health programme use

2019 ◽  
Vol 104 (Suppl 1) ◽  
pp. S22-S33 ◽  
Author(s):  
Dorothy Boggs ◽  
Kate M Milner ◽  
Jaya Chandna ◽  
Maureen Black ◽  
Vanessa Cavallera ◽  
...  
Keyword(s):  
Child Development ◽  
Low Income ◽  
Clinical Relevance ◽  
Outcome Measurement ◽  
Population Level ◽  
Early Child Development ◽  
Early Child ◽  
Individual Level ◽  
Training Requirements ◽  
Measurement Tools

BackgroundIdentification of children at risk of developmental delay and/or impairment requires valid measurement of early child development (ECD). We systematically assess ECD measurement tools for accuracy and feasibility for use in routine services in low-income and middle-income countries (LMIC).MethodsBuilding on World Bank and peer-reviewed literature reviews, we identified available ECD measurement tools for children aged 0–3 years used in ≥1 LMIC and matrixed these according to when (child age) and what (ECD domains) they measure at population or individual level. Tools measuring <2 years and covering ≥3 developmental domains, including cognition, were rated for accuracy and feasibility criteria using a rating approach derived from Grading of Recommendations, Assessment, Development and Evaluations.Results61 tools were initially identified, 8% (n=5) population-level and 92% (n=56) individual-level screening or ability tests. Of these, 27 tools covering ≥3 domains beginning <2 years of age were selected for rating accuracy and feasibility. Recently developed population-level tools (n=2) rated highly overall, particularly in reliability, cultural adaptability, administration time and geographical uptake. Individual-level tool (n=25) ratings were variable, generally highest for reliability and lowest for accessibility, training, clinical relevance and geographical uptake.Conclusions and implicationsAlthough multiple measurement tools exist, few are designed for multidomain ECD measurement in young children, especially in LMIC. No available tools rated strongly across all accuracy and feasibility criteria with accessibility, training requirements, clinical relevance and geographical uptake being poor for most tools. Further research is recommended to explore this gap in fit-for-purpose tools to monitor ECD in routine LMIC health services.

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 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 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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