Promoting Family Integrated Early Childhood Development During the First 1000 Days in Urban Slums of Delhi: Feasibility and Early Implementation Experience.

The first 1000 days are critical for human development. Children residing in urban slums are at higher risk of suboptimal development. This article reports the feasibility and early implementation experiences of child stimulation directed counselling integrated with nutrition and health services by community functionaries in Delhi slums. This implementation research with cohort study design has two groups. The intervention group includes: pregnant women; infants and children in second year. The comparison group (without intervention) includes: recently delivered women, children aged 13-25 months. The feedback from the community functionaries and parents of children were also obtained. 44 videos with Hindi voiceover, demonstration of tools/toys/props, and 9 calendars depicting age-appropriate child stimulation activities were prepared and packaged with health and nutrition services for delivery by the frontline functionaries. These functionaries are coaching the families on child stimulation using these audio-visual messages using Tablets and demonstration tools/toys/props twice every three months. Monitoring and feedback data on service delivery are being collected. The data from the intervention cohort shall be compared with that from the comparison group to document the impact. From 63 anganwadi centres, 130 pregnant women, 142 infants and 136 children have been recruited for the intervention. 82.9% of the families received the intervention within 2 weeks and average time taken was 15 minutes. The initial feedback from the community functionaries and parents are very encouraging. The integrated child development package is acceptable and feasible for implementation through community functionaries and possible integration into the existing programs at scale.