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The impact of an integrated nurturing care intervention to improve early childhood development outcomes in Nampula Province; Mozambique
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DOI：10.1017/S1368980025100554.png)
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Abstract
En 中文
Objective:To estimate the effect of integrating responsive care; early learning and development monitoring into a community-based package of activities on nutrition; sanitation and hygiene; on improvements in early childhood development (ECD) outcomes.Design:This was a quasi-experimental study with nonequivalent comparison groups. The study’s primary outcome; ECD; was measured using the Ages and Stages Questionnaire (ASQ-3) and the Global Scales for Early Development (GSED). We also collected data on the early learning home environment; nutritional practices and caregiver depressive symptoms as secondary outcomes.Setting:This study was conducted across twelve districts in Nampula Province; Mozambique. Half of the districts received holistic nurturing care with responsive care; early learning; nutrition; sanitation and hygiene packages (intervention) and the other half received only nutrition; sanitation and hygiene packages (comparison).Participants:We recruited an age-stratified random sample of 961 caregivers and their children; aged 0–23 months.Results:We found a significantly higher mean caregiver engagement total score (mean difference: 0·36; P ≤ 0·001) and a higher number of activities to support learning (mean difference: 0·30; P = 0·004) in the intervention group than in the control. There were no measurable impacts on the remaining early stimulation activities or the primary outcomes of the ASQ and GSED developmental scores.Conclusions:We discuss the challenges in the integration of nurturing care interventions into existing programmes in high-vulnerability contexts; highlighting the aspects needed to achieve effective caregiver behavioural changes that can translate into improved ECD outcomes.
Keywords:
Nutrition and caregiving interventions
Early childhood development
Nurturing care
Early learning
Early stimulation
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