Evaluation of Scaling Up Early Childhood Development in Zambia

Summary

In Zambia, 40% of children under five years of age are stunted and 6% are wasted. While the Zambian government has focused on child nutrition in recent years, more focus on holistically improving early child development (ECD) is needed. Through a previous randomized controlled trial, the investigators developed a community-based parenting intervention and demonstrated that this intervention can improve children's developmental outcomes in Zambia, including nutritional status and their early language development. During fortnightly group meetings, parents learn a diverse curriculum that includes content on: 1) cognitive stimulation and play practices; 2) child nutrition and cooking practices; and 3) self-care for good mental health. This information and learning content is delivered by supervised community volunteers using an interactive theatre-based approach.

In this study, the newly established maternity waiting homes (MWHs) and affiliated Safe Motherhood Action Group leaders (SMAGs) will be used as a novel platform to launch and support community-based parenting groups, embedding this program directly into the existing health system, and making them more feasible for scale-up and sustainability.

Despite the positive impact of the proposed parenting-group model in the pilot trial, this model is not currently operating in Zambia. By integrating this intervention into the existing health system, large populations of rural children exposed to high levels of adversity in the critical early years of life could be reached in a nationally scalable fashion. As part of this project, the investigators propose to implement and rigorously assess the impact of this approach in four districts of Zambia.

Conditions

• Early Childhood Development

Interventions

OTHER

SMAGs trained on ECD curriculum

50 volunteers (primarily SMAGs- Safe Motherhood Action Group members) associated with the health facility will be trained using a training -of-trainers approach on the e ECD (early childhood development) curriculum

OTHER

Head women trained on ECD curriculum

Each of the 50 trained SMAGs will train 10 head women on the ECD curriculum

BEHAVIORAL

Head women led parent groups

Every two weeks 500 trained head women lead parent group meetings on childhood development and nutrition to caregiver-child dyads

OTHER

Usual care of children 0-5 months

The traditional care and education of caregivers/parents for children 0-5 months

Sponsors & Collaborators

• Right to Care Zambia (RTCZ)

  collaborator UNKNOWN

• Swiss Tropical & Public Health Institute

  collaborator OTHER

• United States Agency for International Development (USAID)

  collaborator FED

• Grand Challenges Canada

  collaborator OTHER

• Boston University

  lead OTHER

Principal Investigators

• Nancy A Scott, DrPH MPH · Boston University

• Thandiwe Ngoma · Right to Care - Zambia

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

0 Months

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2019-09-20

Primary Completion

2021-11-30

Completion

2022-01-31

Countries

• Zambia

Study Locations