An Evaluation Study on Promoting Holistic Nurturing Care into Nutrition Delivery Systems to Improve Early Childhood Outcomes in Mozambique

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

Proposal

Background:
The Nurturing Care Country Profile data for Mozambique show that less than half (41 percent) of infants under 6 months of age are exclusively breastfeed, only 11 percent of children have a minimum acceptable diet, 33 percent are engaged in activities that promote early learning, and only 3 percent have playthings at home. Thus, in Mozambique, caregivers need support to provide nurturing care for young children, particularly around adequate nutrition, responsive care, and early learning. USAID Advancing Nutrition is addressing this gap by supporting the local consortium, Transform Nutrition (TN) to improve early childhood development (ECD) by integrating responsive care and early learning in community-based sanitation and hygiene (SH) and nutrition services delivered through peer groups and home visits.

Methods: The study employs a mixed-methods design to estimate program impact on children’s ECD outcomes and will use qualitative and quantitative data to understand the implementation fidelity and quality. A random sample of 961 caregiver-child dyads (children 0 to 2 years at baseline) from 12 districts in Nampula Province will participate in caregiver surveys, interviews, focus groups, child anthropometric assessments, and child assessments. The Ages and Stages Questionnaire (ASQ 3), and the Global Scale for Early Development (GSED) Short Form, Long Form, and Psychosocial Form were administered at baseline (February–April 2022) and will be administrated at end line (early 2023). This study will also provide data to validate the GSED measure.

Results: The baseline included 961 caregiver-child dyads, and 73 percent of children were identified as at-risk for developmental delay on the ASQ-3. Study findings will indicate if the integration of responsive care and early learning, particularly through caregiver counseling, has a greater effect on ECD outcomes compared to the nutrition/SH intervention alone. Results will also provide evidence on the feasibility, acceptability, and experience of integration. Finally, this study will provide evidence on validation of the GSED measure.

Conclusions: Findings from this study have the potential to be used in Mozambique and by other stakeholders who are considering integrated approaches to improve children’s development outcomes and contribute to the global evidence base on measuring child outcomes for children zero–two years.

Author

• Catherine Kirk, USAID