ArticleAnnals of the New York Academy of Sciences2021
Scaling up of Brazil's Criança Feliz early childhood development program: an implementation science analysis.
Article in Annals of the New York Academy of Sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Strengthening Early Childhood Development Programs and Interventions in Low- and Middle-Income Countries: Systematic Review of Interventions.Maternal & child nutrition · 2026Pooled it
- Exploring the barriers and facilitators of implementing family-focused child development programmes in real-world settings: a scoping review.BMJ paediatrics open · 2026Article
- Nurturing Care Systems Underlying Early Childhood Food Insecurity in Brazil: A Causal Loop Diagram Approach.Maternal & child nutrition · 2026Article
- [Assessment of the implementation of a national intersectoral strategy for the prevention of childhood obesity in Brazil].Cadernos de saude publica · 2026Article
- Implementation matters: program impact pathway analysis of four sectoral nutrition-sensitive interventions in Anambra and Kebbi states, Nigeria.Global health action · 2025Article
- Socioeconomic and maternal mental health factors associated with the parenting and development of children in an early childhood promotion program: analysis via structural equation modeling.BMC public health · 2025Article
- Do Playful Parenting Programs Implemented at Scale Improve Caregiver Practices and Child Development?Children (Basel, Switzerland) · 2025Article
- Scaling parenting programs for early child development in four low- and middle-income countries.Frontiers in public health · 2025Article
- Blueprint for Enhancing Implementation Quality ofGlobal implementation research and applications · 2025Article
- Article
- Predictors of early child development for screening pregnant women most in need of support in Brazil.Journal of global health · 2024Article
- Using Implementation Research to Inform Scaling of Parenting Programs: Independently Conducted Case Studies from Zambia and Bhutan.Children (Basel, Switzerland) · 2024Article
- Scaling up a home-visiting program for child development in Brazil: a comparative case studies analysis.Lancet regional health. Americas · 2024Article
- Nurturing care: perceptions and practices of caregivers for children under five in the Ecuadorian highlands - a qualitative study.Frontiers in public health · 2024Article
- Determining RE-AIM indicators for evaluating the Estratégia Amamenta e Alimenta Brasil (EAAB - Brazilian Breastfeeding and Complementary Feeding Strategy).Revista de saude publica · 2024Article
- Analysis of the elaboration and proposal of a Brazilian intersectoral strategy for the prevention and care of childhood obesity.Cadernos de saude publica · 2023Article
- Pathways to scale up early childhood programs: A scoping review of Reach Up and Care for Child Development.PLOS global public health · 2023Article
- A qualitative analysis of the nurturing care environment of families participating in Brazil's Criança Feliz early childhood program.PloS one · 2023Article
- Effect of the SPRING home visits intervention on early child development and growth in rural India and Pakistan: parallel cluster randomised controlled trials.Frontiers in nutrition · 2023Article
- Can home visits for early child development be implemented with sufficient coverage and quality at scale? Evidence from the SPRING program in India and Pakistan.Frontiers in nutrition · 2023Article
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Authors and funding
3 authors.
Funding
Abstract
To address inequities that prevent socioeconomically vulnerable young children from reaching their full developmental potential, Brazil implemented Programa Criança Feliz (PCF) ("Happy Child" early childhood development program) in 2934 of its 5570 municipalities. A qualitative case study was carried out on the basis of in-depth interviews with 22 key informants, employing purposive sampling, from past or current national and state coordination teams. Thematic analysis followed the RE-AIM framework, and complex adaptive system constructs mapped how barriers and enablers influenced scale-up. One overarching theme related to PCF emergence, and 18 subthemes were identified within the RE-AIM. An enabling national political environment favored PCF emergence through a top-down approach that led to governance challenges. Changes in the enrollment criteria for families facilitated reach, and evidence-based methodology favored the designing of the home visits. However, operationalizing the intersectoral actions remains a barrier for effectiveness, while intrasectoral resistance across levels delayed adoption. WhatsApp facilitated networking, capacity building, and adoption. Rushed scale-up generated barriers for quality delivery and led to different implementation pathways across municipalities. Legal institutionalization is critical to assure permanent funding and maintenance. PCF has enhanced early childhood services in Brazil, but strong negative feedback loops need to be addressed for effective sustainability.
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