Testing the Responsive Care and Early Learning Addendum to Improve Early Childhood Outcomes in Ghana and the Kyrgyz Republic

• In Event: Promoting Nurturing Care to Improve Early Childhood Development through Health and Nutrition Services

Proposal

Background: Research shows that children who receive a combination of nutritional and nurturing care interventions have improved nutrition and early childhood development outcomes. Therefore, USAID Advancing Nutrition is pilot testing the integration of a new responsive care and early learning [RCEL] Addendum package (two components of nurturing care) with the widely used nutrition package—UNICEF Community-Based Infant and Young Child Feeding (C-IYCF) Counseling Package—in Northern Ghana and the Kyrgyz Republic to assess the feasibility, acceptability, and effectiveness of the RCEL Addendum to promote optimal early childhood outcomes.

Methods: USAID Advancing Nutrition is using a mixed method design to conduct implementation research. A household survey of N=478 caregivers of children ages 0 up to 24 months was collected in March–July 2022 (baseline) and endline data will be between January–March 2023. The study includes multiple data collection components—including a pre-post survey design, focus group discussions, individual interviews, and pre-post training evaluations—to answer six research questions in Ghana and five research questions in the Kyrgyz Republic related to the feasibility, acceptability, and effectiveness of the package. The pre-post household survey assessed nurturing care practices including responsive care and early learning using newly developed tools, as well as parenting stress using the Parent Stress Index Short Form, and infant and young child feeding practices.

Results: A household survey of N=478 caregivers of children ages 0 to 24 months was collected in March–July 2022 (baseline) and endline data will be between January–March 2023. While results of the studies are pending, they are expected to illustrate the feasibility of adapting a generic reference material to different country contexts, highlighting key points where adaptation was necessary. Results will also provide evidence on the efficacy of the training program, following the cascade of the training to the community level, to enable frontline workers to deliver the Addendum context. Results will also provide insights into the feasibility of delivering the package, examining barriers and enablers to its effective implementation, such as the value of on-the-job coaching through supportive supervision. Last, endline results will provide evidence on the effectiveness of the package to support behavioral changes related to RCEL practices among the study population (caregivers of children under two) and ultimately contribute to improving children’s development.

Conclusions: Overall, the study will provide evidence on the feasibility, acceptability, and effectiveness of implementing the Addendum in two unique contexts, though existing government systems, and will offer insights into how such an integrated package may impact ECD outcomes.

Author

• Malia Uyehara, USAID Advancing Nutrition