Globally, at least 200 million children younger than five years old are falling short of their potential for development and growth. In Bangladesh, 22% of infants have low birth weight and 64% are exclusively breastfed until age six months. Forty-one percent of children under five have stunted growth, and the majority lack appropriate stimulation and early learning opportunities.
There is some evidence that improvements to children’s health, nutrition, and development outcomes can be made through programs that provide direct learning experiences to children and families; are targeted toward younger and disadvantaged children; are of longer duration; and are integrated with family support, health, nutrition, or educational systems and services.
Yet there are serious gaps in knowledge about how to deliver integrated early childhood interventions in cost-effective ways in low-income settings—that particularly focuses on improving growth and child development in the first thousand days of a child’s life. This study will present results for an evaluation of one such intervention in Bangladesh.
AIR and its Bangladesh partners are using a rigorous mixed-methods cluster-randomized controlled trial to determine the impact of Save the Children’s early childhood stimulation program on the cognitive and language development skills of children 0-3 years old in Bangladesh. The program seeks to improve child development outcomes by delivering actionable messages to caregivers, which promotes positive early stimulation practices and maternal responsiveness to the emotional and physical needs of children. The program builds on an existing delivery platform—community clinics—and trains community health care providers to deliver messages on early childhood stimulation practices.
We collected baseline data in 2013 and follow-up data at the end of 2015 for 2,578 households with children. Moreover, we gathered survey data from service providers and community leaders, as well as focus group data from parents. The baseline data validated the study design showing that the randomization process worked successfully in terms of creating equivalent groups before the initiation of the program. During the course of the study, we also implemented a dynamic monitoring strategy that collects monitoring data every two months from a random set of individuals (beneficiaries and suppliers) from both the control and treatment groups. These monitoring surveys allow the impact evaluation team to have a deep understanding of how the program is being implemented and learn what is happening in households and communities as a result of the program activities. The team is currently conducting quantitative and qualitative analyses to develop the Final Report.