BRIEF

Effects of Quality Improvement Strategies on Early Childhood Development in Community-Based Childcare Centers in Malawi: A Randomized Trial

October 3, 2016



" When you own the results because you are part of the process you know exactly what has transpired. The impact evaluation is one strong piece of evidence that will help us to tell our story. "

McKnight Kalanda

Director of Children’s Affairs, Ministry of Gender, Children and Social Welfare, Malawi

Research area: Early Childhood Nutrition, Development, and Health
Country:  Malawi
Evaluation Sample:  199 child community centers
Timeline: Completed
Intervention: Incentives, training, parental involvement
Researchers: Lia C. H. Fernald, University of California, Berkeley; Patricia Kariger, University of California, Berkeley; Christin McConnell, World Bank; Michelle Neuman, University of Pennsylvania; Berk Özler, World Bank
Partners: Save the ChildrenGovernment of MalawiRapid Social Response Multi-Donor Trust Fund; Early Learning Partnership

 

Problem
Around 50 percent of young children in Malawi suffer from chronic malnutrition, which stunts physical growth and is associated with poor brain development and lasting health problems. The government, with donor assistance, established Community-Based Childcare Centers in the 1990s to promote children’s development. These centers now enroll about a third of the country’s children aged three to five. The quality of the centers, however, is mixed. Most caregivers are young, part-time volunteers without any formal training in early childhood development and turnover is high.

Intervention
A team supported by the Strategic Impact Evaluation Fund joined forces with the Government of Malawi to evaluate the impact of providing play materials and teacher training to community-run childcare centers, and child development classes for local parents.

Evaluation
The control group received only a special UNICEF play and learning kit for use with children. The three treatment groups received the play and learning kit and one of the following interventions: teacher training and mentoring for community center caregivers; teacher training and mentoring along with small monthly cash payments; teacher training and mentoring along with 12 education group sessions for parents on early childhood development.

Evaluation design
Cluster randomized control trial. The evaluation included 199 childcare centers, 310 teachers, 2,009 primary caregivers and 2,120 children.

Results
The evaluation found that after one year, some children showed gains on measures of skills development; but by the time they reached primary school, the gains disappeared. It may be that the centers need additional assistance, or that children can’t continue to thrive in primary schools that may have more than 100 children in a classroom with just one teacher.

Future steps
The evaluation results underscore that there is a lot more to be done to monitor centers and improve them, and that improving primary school education may need to be part of the solution.

Impacts

  • Baseline survey: The results of the baseline survey showed that the number of childhood centers that were functioning was much less than what the government had initially thought. This led to a revision in government figures.
  • While recognizing that the results of this intervention didn’t show lasting gains, the evaluation showed policymakers the potential benefits of trying to improve quality.

 

Country: Malawi

Evaluation Sample: 199 child community centers

Timeline: Completed

Intervention: Incentives, training, parental involvement

Researchers: Lia C. H. Fernald, University of California, Berkeley; Patricia Kariger, University of California, Berkeley; Christin McConnell, World Bank; Michelle Neuman, University of Pennsylvania; Berk Özler, World Bank

Partners: Save the ChildrenGovernment of MalawiRapid Social Response Multi-Donor Trust Fund; Early Learning Partnership

 

Context

Malawi is struggling to meet the development needs of its children. About half the children under five years old are stunted and almost 20 percent are underweight. In addition, almost one in five children is an orphan, in many cases because parents have died from HIV/AIDS. High food and fuel prices, a devastating earthquake in 2009 and localized droughts exasperate the difficulties faced by poor families.

The government, with donor assistance, established Community-Based Childcare Centers in the 1990s to promote children’s development. These centers now enroll about a third of the country’s children aged three to five. The quality of the centers, however, is mixed. Most caregivers are young, part-time volunteers without any formal training in early childhood development and turnover is high.

As part of Malawi’s Protecting Early Child Development Project, which is supported by the World Bank and the Rapid Social Response Multi-Donor Trust Fund, the Government of Malawi is testing four different low-cost approaches for improving the quality of the childcare centers. The results will help inform plans for a scale up.

Research area: Early Childhood Nutrition, Development, and Health

 

Country: Malawi

Evaluation Sample: 199 child community centers

Timeline: Completed

Intervention: Incentives, training, parental involvement

Researchers: Lia C. H. Fernald, University of California, Berkeley; Patricia Kariger, University of California, Berkeley; Christin McConnell, World Bank; Michelle Neuman, University of Pennsylvania; Berk Özler, World Bank

Partners: Save the ChildrenGovernment of MalawiRapid Social Response Multi-Donor Trust Fund; Early Learning Partnership

 

Context

Malawi is struggling to meet the development needs of its children. About half the children under five years old are stunted and almost 20 percent are underweight. In addition, almost one in five children is an orphan, in many cases because parents have died from HIV/AIDS. High food and fuel prices, a devastating earthquake in 2009 and localized droughts exasperate the difficulties faced by poor families.

The government, with donor assistance, established Community-Based Childcare Centers in the 1990s to promote children’s development. These centers now enroll about a third of the country’s children aged three to five. The quality of the centers, however, is mixed. Most caregivers are young, part-time volunteers without any formal training in early childhood development and turnover is high.

As part of Malawi’s Protecting Early Child Development Project, which is supported by the World Bank and the Rapid Social Response Multi-Donor Trust Fund, the Government of Malawi is testing four different low-cost approaches for improving the quality of the childcare centers. The results will help inform plans for a scale up.


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World Bank

Intervention and Evaluation Details

Intervention

The program was implemented in 199 childcare centers in four of Malawi’s 28 districts. Centers were divided into four groups – one control and three treatment groups – in order to evaluate what worked best to improve how teachers and families interact with the children. The program ran from May 2012 through November 2012.

Evaluation

After a baseline survey, the centers were randomly assigned to one of three treatment groups or to the control group, with about 50 centers in each group. The control group received only a special UNICEF play and learning kit for use with children. The three treatment groups received the play and learning kit and one of three following interventions:

Caregiver training and mentoring: Five weeks of on-site training program, supported by mentors, were offered to improve caregiver knowledge, skills and practices. Topics covered include health, nutrition, childhood learning processes and activities that support development.

Caregiver training and mentoring PLUS caregiver incentives: Caregivers were offered small monthly cash incentives tied to their regular attendance at the childcare center.

Caregiver training and mentoring PLUS parental education: Parents of children in the centers were invited to 12 group sessions that provided information on activities that can be done at home to improve early development. They also learned about childhood health, nutrition, development milestones and the importance of responding to the needs of children.

The evaluation was a cluster-randomized trial. The research team ued surveys and direct observation of the centers and parents, along with child measurements and assessments to identify the impacts of the interventions on the centers and classrooms, on parenting practices, and on early childhood development outcomes. Data collected included child growth, health, and development, caregiver knowledge, parents’ knowledge, behaviors and stress levels, childcare center quality and staff retention.