Effectiveness of an integrated multilevel early child development intervention on caregiver knowledge and behavior: a quasi-experimental evaluation of the Malezi program in Tanzania

BMC Public Health

Research

Pieter Remes¹  Teopista Komba²  Roland van de Ven²  Josephine Ferla²  Ola Jahanpour²  Gretchen Antelman²  Michelle M. Gill³  Amina Abubakar⁴  Mary A. Mang’enya⁵  Martha Mariki⁶  Heather J. Hoffman⁷ 

[1] Development Media International, Mwanza, Tanzania;Elizabeth Glaser Pediatric AIDS Foundation, Dar es Salaam, Tanzania;Elizabeth Glaser Pediatric AIDS Foundation, Washington DC, USA;Institute for Human Development Aga Khan University (South-Central Asia, East Africa, UK), Nairobi, Kenya;Ministry of Health, Dodoma, Tanzania;President’s Office Regional and Local Government, Dodoma, Tanzania;The George Washington University, Milken Institute School of Public Health Washington DC, Washington DC, USA;

关键词: Early child development;    Parenting;    Media intervention;    Community health workers;    Program evaluation;    Caregiver;   

DOI  :  10.1186/s12889-022-14956-2

 received in 2022-02-19, accepted in 2022-12-28,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundThe quality of caregiving and the parent-child relationship is critical for early child development (ECD) and has been shown to be modifiable. This study evaluated an ECD project in Tanzania, assessing the effectiveness of radio messaging (RM) alone and a combined radio messaging/video job aids/ECD (RMV-ECD) intervention.MethodsThis two-arm pre-post evaluation study enrolled a cohort of caregivers of children 0–24 months in four districts of Tabora region, following them for 9 months. ECD radio messages were broadcast on popular stations at least 10 times/day reaching all study districts. In two districts, community health workers (CHW), trained in UNICEF’s Care for Child Development package, used ECD videos in home- and facility-based sessions with caregivers. We used McNemar’s testing (pre-post pairs) within intervention group to describe how the intervention was associated with change in five outcomes: ECD knowledge, early stimulation, father engagement, responsive care, and environment safety. Logistic regression was used to describe the relative benefits of the combined intervention package (RMV-ECD) compared to radio messaging (RM).ResultsIn the RMV-ECD arm, all outcomes at endline except environment safety significantly improved after the intervention with the largest change seen in ECD knowledge (35.8% increase, p < .0001) and the smallest in father engagement (6.7%, p = .015). In the RM arm, ECD knowledge (5.7%, p = .031) and environment safety (18.1%, p = <.0001) improved. High measures of parenting stress were associated with lower likelihood of having good ECD knowledge (AOR 0.50, 95%CI: 0.35, 0.71), father engagement (AOR 0.72, 95%CI: 0.52, 0.99) and responsive care (AOR 0.31, 95%CI: 0.18, 0.54).ConclusionsAn intervention that includes mass media, educational video content and CHWs who counsel caregivers in their homes and health facilities was associated with significant improvements in ECD parenting knowledge and behaviors but a relationship with responsive care could not be established. The less costly mass media-only intervention was associated with improved parenting knowledge and household environment safety. Parenting interventions targeting young children could be improved by incorporating more messaging and caregiver coaching in managing parental stress.Trial registrationNCT05244161 (17/02/2022); retrospectively registered with the US National Institutes of Health ClinicalTrials.gov.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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