Effect of early childhood development interventions delivered by healthcare providers to improve cognitive outcomes in children at 0–36 months: a systematic review and meta-analysis

Abstract

ObjectiveTo determine the effect of early childhood development interventions delivered by healthcare providers (HCP-ECD) on child cognition and maternal mental health.DesignSystematic review, meta-analysis.SettingHealthcare setting or home.ParticipantsInfants under 1 month of age.InterventionsHCP-ECD interventions that supported responsive caregiving, early learning and motor stimulation. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Health Technology Assessment Database, Database of Abstracts of Reviews of Effects and Cochrane Database of Systematic Reviews were searched until 15 November 2021. Studies reporting prespecified outcomes were pooled using standard meta-analytical methods.Main outcome measuresCognitive development in children at 0–36 months.ResultsForty-two randomised controlled trials with 15 557 infants were included in the narrative synthesis. Twenty-seven trials were included in the meta-analyses. Pooled data from 13 trials suggest that HCP-ECD interventions may improve cognitive outcomes in children between 0 and 36 months (Bayley Scales of Infant Development version IIII (BSID-III) mean difference (MD) 2.65; 95% CI 0.61 to 4.70; 2482 participants; low certainty of evidence). Pooled data from nine trials suggest improvements in motor development (BSID-III MD 4.01; 95% CI 1.54 to 6.48; 1437 participants; low certainty of evidence). There was no evidence of improvement in maternal mental health (standardised MD −0.13; 95% CI −0.28 to 0.03; 2806 participants; 11 trials; low certainty of evidence).ConclusionsWe report promising evidence, particularly for cognitive and motor outcomes, of the effect of HCP-ECD interventions. However, effect sizes were small, and the certainty of evidence ranged from very low to moderate. Additional high-quality research is required.PROSPERO registration numberCRD42019122021.

Internal consistency and concurrent validity of the Peruvian Infant Development Scale tool in high-altitude rural Andean Peru

“…Various studies have shown that children from disadvantaged backgrounds who received early child development (ECD) interventions are more likely to achieve academic success, be socially and emotionally stable, and be economically productive in adulthood (Gertler et al, 2014; S. Grantham-McGregor, 2015; Woodhead, Ames, & Streuli, 2009). A number of systematic reviews and meta-analysis also confirmed the effectiveness of ECD interventions for improving the developmental status of children in LMICs when implemented by caregivers (Jeong, Franchett, Ramos de Oliveira, Rehmani, & Yousafzai, 2021) and healthcare providers (Hirve et al, 2023). For these reasons, ECD interventions are considered one of the most cost-effective strategies for reducing inequalities in LMIC (Engle et al, 2011; Irwin, Siddiqi, & Hertzman, 2007).…”

“…Grantham-McGregor, 2015;Woodhead, Ames, & Streuli, 2009). A number of systematic reviews and meta-analysis also confirmed the effectiveness of ECD interventions for improving the developmental status of children in LMICs when implemented by caregivers (Jeong, Franchett, Ramos de Oliveira, Rehmani, & Yousafzai, 2021) and healthcare providers (Hirve et al, 2023). For these reasons, ECD interventions are considered one of the most cost-effective strategies for reducing inequalities in LMIC (Engle et al, 2011;Irwin, Siddiqi, & Hertzman, 2007).…”