Innovation for Poverty Action, Abidjan, Côte d'Ivoire.
Independent Consultant, Abidjan, Côte d'Ivoire.
Front Public Health. 2023 Aug 15;11:1106565. doi: 10.3389/fpubh.2023.1106565. eCollection 2023.
Early Childhood Development is high on the policy agenda in Côte d'Ivoire, where the government has identified it as part of its overall approach to improve human capital outcomes. This paper describes a multi-partner approach to piloting, monitoring, adaption, testing and scaling of parental training for ECD. It discusses the learnings from the pilots, and present early evaluation results from two RCTs, focusing on parental participation in trainings and acceptability of messages, with the objective to inform national scaling strategies. As such, this paper illustrates how "MEL systems contributed to ensuring that positive early childhood development (ECD) outcomes were improved as interventions were seeking to achieve scale," one of the research questions outlined in the call description for the special issue. The paper further provides a real-world example of "How MEL systems can support contributions and buy-in from a variety of stakeholders as ECD interventions (seek to) achieve impacts at scale (e.g., through the public system)?
Five training approaches to improve caregivers' knowledge and practices around nutrition, preventive health, stimulation, and disciplining were piloted at small scale between 2018 and 2020. An intensive process evaluation was embedded to identify strengths and weaknesses, adapt through an iterative phase, and ultimately make recommendations for their scale up against 11 defined criteria. In early 2021, the two most promising approaches were scaled through two clustered randomized control trials to more than 150 villages each. A cost-effectiveness study was designed in consultation with government stakeholders, centered around targeting different caregivers and decision makers in the household and the extended family and on enhancing community interactions around ECD.
The evaluation of the five pilots identified one model recommended to be scaled, and one other model to scale after further adaptations. Monitoring and evaluation data from the two models at scale show high levels of participation and acceptability of core messages. Experimental variations involving community champions and fathers increase participation.
The iterative and multi-partner process led to two models of parenting training that have wide acceptability. Future work will analyze impacts on cognitive and socio-emotional outcomes, together with cost analysis.
科特迪瓦将儿童早期发展置于政策议程的重要位置，政府已将其作为改善人力资本成果的整体方法的一部分。本文描述了一种多方合作伙伴的方法，用于试点、监测、调整、测试和推广儿童早期发展的父母培训。本文讨论了试点的经验教训，并展示了两项随机对照试验的早期评估结果，重点是父母参与培训和对信息的接受程度，旨在为国家推广战略提供信息。因此，本文说明了“监测和评价系统如何确保积极的儿童早期发展（ECD）成果得到改善，因为干预措施试图扩大规模”，这是特刊征稿描述中提出的研究问题之一。本文进一步提供了一个现实世界的例子，说明“监测和评价系统如何支持各种利益相关者的贡献和认同，因为儿童早期发展干预措施（试图）实现大规模影响（例如，通过公共系统）？”
2018 年至 2020 年，五种改善照顾者在营养、预防保健、刺激和纪律方面知识和实践的培训方法进行了小规模试点。嵌入了一项强化的过程评估，以确定优势和劣势，通过迭代阶段进行调整，并最终根据 11 项既定标准提出推广建议。2021 年初，最有前途的两种方法通过两项集群随机对照试验在每个试验中扩展到 150 多个村庄。在与政府利益相关者协商的基础上，设计了一项成本效益研究，以针对家庭和大家庭中的不同照顾者和决策者，并围绕增强围绕儿童早期发展的社区互动为中心。
五项试点的评估确定了一种推荐推广的模式，还有一种模式需要进一步调整后再推广。大规模推广的两种模式的监测和评价数据显示出高水平的参与度和对核心信息的接受度。涉及社区冠军和父亲的实验变化增加了参与度。
迭代和多方合作伙伴的过程导致了两种广泛接受的父母培训模式。未来的工作将分析对认知和社会情感结果的影响，以及成本分析。
