ArticleBMJ open2022
Integrating an early child development intervention into an existing primary healthcare platform in rural Lesotho: a prospective case-control study.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 14 citations in OpenAlex.
- Integrating early child development into an existing health and nutrition program: evidence from a cluster-randomized controlled trial.BMC public health · 2024Trial
- Health worker support for early learning, responsive caregiving, and safety and security: a scoping review.BMC health services research · 2026Article
- Stress biomarkers and child development in young children in Bangladesh.Psychoneuroendocrinology · 2024Article
- Article
- Using digital chatbots to close gaps in healthcare access during the COVID-19 pandemic.Public health action · 2022Article
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Authors and funding
14 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study evaluated a novel early childhood development (ECD) programme integrated it into the primary healthcare system.
settingThe intervention was implemented in a rural district of Lesotho from 2017 to 2018.
participantsIt targeted primary caregivers during routine postnatal care visits and through village health worker home visits.
interventionThe hybrid care delivery model was adapted from a successful programme in Lima, Peru and focused on parent coaching for knowledge about child development, practicing contingent interaction with the child, parent social support and encouragement. PRIMARY AND SECONDARY OUTCOMES MEASURES: We compared developmental outcomes and caregiving practices in a cohort of 130 caregiver-infant (ages 7-11 months old) dyads who received the ECD intervention, to a control group that did not receive the intervention (n=125) using a case-control study design. Developmental outcomes were evaluated using the Extended Ages and Stages Questionnaire (EASQ), and caregiving practices using two measure sets (ie, UNICEF Multiple Indicator Cluster Survey (MICS), Parent Ladder). Group comparisons were made using multivariable regression analyses, adjusting for caregiver-level, infant-level and household-level demographic characteristics.
resultsAt completion, children in the intervention group scored meaningfully higher across all EASQ domains, compared with children in the control group: communication (δ=0.21, 95% CI 0.07 to 0.26), social development (δ=0.27, 95% CI 0.11 to 0.8) and motor development (δ=0.33, 95% CI 0.14 to 0.31). Caregivers in the intervention group also reported significantly higher adjusted odds of engaging in positive caregiving practices in four of six MICS domains, compared with caregivers in the control group-including book reading (adjusted OR (AOR): 3.77, 95% CI 1.94 to 7.29) and naming/counting (AOR: 2.05; 95% CI 1.24 to 3.71).
conclusionsThese results suggest that integrating an ECD intervention into a rural primary care platform, such as in the Lesothoan context, may be an effective and efficient way to promote ECD outcomes.
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