Improving parenting practices and development for young children in Rwanda: Results from a randomized control trial

Abstract

It is well known that the first 1,000 days of life have long-lasting impact on a child’s cognitive, language, socio-emotional, and physical development, but there is little evidence from Rwanda about how to maximize parent–child interactions during these critical early years. Save the Children piloted the First Steps “Intera za Mbere” early childhood parenting education program in one district of Rwanda to promote healthy development through holistic parenting education. Using a cluster randomized control trial, we assessed outcomes of a 17-week parenting education on parenting skills and child development for families with children aged 6–36 months. Families were randomly allocated into three study groups: light touch ( n = 482), full intervention ( n = 482), and control ( n = 483) groups. We used a Kinyarwanda-adaptation of the validated Ages & Stages Questionnaires (ASQ), a Home Observation Measurement of the Environment-Short Form. Multivariate linear and logistic regression analyses were used for both the intention-to-treat analyses and more robust models controlling for ASQ form received, child gender, maternal education, number of children in the home, and baseline ASQ scores. Findings indicate that children in the light touch and full intervention groups were significantly more likely to meet the ASQ benchmarks than the control group in all developmental domains. The strong positive results from the light touch group are especially relevant to efforts to bring beneficial early childhood stimulation programs to scale in low-income contexts.

Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis

“…In spite of the observational evidence that fathers are critically important for ECD [56], only 7 parenting interventions in this review (7%) engaged fathers to some degree [34][35][36][37][38][39][40], and only 1 study measured paternal outcomes from fathers directly (who only comprised 5% of the respondents in this study) [39]. A prior review has drawn attention to the limited number of parenting interventions with fathers and the program implementation barriers that limit fathers' participation in parenting interventions across global contexts [57].…”

“…Intervention duration ranged from a brief intervention delivered over 1 month to longer interventions delivered across the first 5 years of the child's life. Nearly all interventions (93%) focused on supporting mothers exclusively, with only 7 interventions (7%) additionally engaging fathers to some degree [34][35][36][37][38][39][40].…”

Supporting Child Development Through Parenting Interventions in Low- to Middle-Income Countries: An Updated Systematic Review

“…Of the 21 eligible studies, 16 of them (39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54) were previously captured in four previous reviews (17,(20)(21)(22) assessing the effects of parenting interventions with the components of psychosocial stimulation or responsive care on early child neurodevelopmental outcomes. This present review includes 5 additional studies (55)(56)(57)(58)(59). Common reasons for exclusion include the use of a non-RCT design, study conducted outside a low-and-middle-income country context, a single focus on nutrition supplementation or education, the enrollment of predominantly children over 24 months, and the absence of child developmental outcomes (e.g., a focus on child physical growth or parent-child interactions).…”

“…The study and sample characteristics are summarized in Table 1. Of the 21 eligible studies, seven were conducted in the African region (42,46,49,(55)(56)(57)(58), and their implementation period was between 2013 and 2019. There were four eligible studies from the Caribbean region (41,(50)(51)(52), implemented between 1999 and 2012; however, two of these studies did not report the implementation dates (50,51).…”

Arm-Wrestling in the Classroom: the Non-Monotonic Effects of Monitoring Teachers

“…In turn, the effect size of nudging both parents and teachers is actually negative, and we can reject that it is equal to that of nudging parents alone (at the 5% level; column 3). 32 We include listening to radio as part of the engagement summary measure in face of the evidence that this develops language skills, particularly in the earlier grades (Abimpaye et al, 2019). In fact, only 35% of children in our sample report listening to radio at baseline.…”