Parenting programs designed to improve how caregivers engage with their children have had mixed impacts on children’s development and mixed success in sustaining impact. In an earlier SIEF-funded evaluation of a pilot program in Madagascar, an early stimulation program that was integrated with a nutrition program and implemented by community health workers failed to demonstrate any impact on child development. One reason may have been difficulties faced by community health workers, who had to balance existing health and nutrition duties with new tasks related to explaining to parents how to support early childhood development. Using administrative data, GPS data from tablets carried by community health workers, direct observations, and surveys on how they use their time, this evaluation will look at how community health workers allocate their time across different activities while testing the impact of a new home visit and group meetings model to help boost children’s development.
| Country | Madagascar |
| Title | Testing the limits of integrating nutrition and early stimulation |
| Evaluation design | Treatment: Community health workers (CHWs) implement an existing child healthand nutrition program (Projet d’Amélioration des Résultats Nutritionnels or PARN). We offered two 6-month cycles of 12 ECD sessions to eligible caregiver-child dyads (6–30 months) in 25 sites [T]. We added take-home play materials in Cycle 2 to 25 sites [T+]. Control: The status quo. |
| Main outcomes | Attendance at health and nutrition sessions |
| Target groups | Caregivers with children aged 6-30 months |
| Team | Lia Fernald, Emanuela Galasso, Lisy Ratsifandrihamanana, Ann Weber |
| Trial registration link | AEA Social Science Registry (AEARCTR-0004704) and ClinicalTrials.gov (NCT05129696) |