Piloting a text-based intervention in Northern Ghana aimed at improving caregiver engagement

• In Event: Equity through Innovation: Closing the Gaps Using Phone-based Interventions to Reach Caregivers–Evidence from Bangladesh, Palestine, and Northern Ghana.

Proposal

Background: The evidence shows that infants and young children living in a fragile context such as the West Bank in Palestine under constant security threats are very vulnerable to development outcomes. According to a ORG survey (2020), only a small percentage of caregivers (in the West Bank) were providing positive, safe and stimulating care practices such as playing, singing with children, or positive discipline, making toys, reading books and stories, and going to safe playing areas outdoors. Almost 37% of children under 3 had delays in development according to their age. This was coupled with poor access to and quality of healthcare services, and exacerbated by COVID 19.
Methodology: PROGRAM, also known as the PROGRAM team within the early childhood development model, adapted a virtual communication approach to reach 22,000 caregivers and children using virtual social networking platforms such as Facebook, messenger, WhatsApp. Mothers who did not have any internet access were reached by phone. Caregivers were recruited using clinics, village councils’ records and community representatives.
Community Health Workers “CHW” were responsible for providing monthly sessions to support caregivers to be able to adopt an age-appropriate play, communication and responsiveness including psychological first aid, posting daily posts via social platforms to raise awareness on health topics, and encouraging caregivers to support children’s development through home-based activities; play and communication; importance of home environment and well-being as a family affair, assisting mothers daily by offering advice, support and consultation.
Increasing access to primary health care facilities through connecting 1,823 mothers with nurses to ensure mothers and children receive services. Quantitative and qualitative methods assessing 1,823 children and their caregivers measured the effect of integrated online and direct parenting program on caregiver and child outcomes.
Findings: The final evaluation compared to baseline showed significant improvements in caregivers’ nurturing care practices – early learning, responsive caregiving and safe home environment to their children. The results from FY21 show considerable improvements: increase by 16% over the baseline data in the proportion of primary caregivers providing a positive, safe, healthy, and stimulating home environment to children 0-3. 14% at baseline, 30% at end line. Data measures caregivers who engage with their children in activities such as reading, singing, playing, and providing books and toys when feasible. There is an increase by 16% over the baseline in the percentage of the caregiver knowledge, attitudes, behaviors and practices related to child nurturing care (57% at baseline, 73% at end line) such as promoting child physical, cognitive, language social, and emotional development; play and communication; and finally, the importance of home environment. Regarding the data reflecting the progress related to the indicator “Children (male & female) who are developmentally on track” collected from ages and stages “ASQ” for six months and twelve months, the results show significant improvement (95% “6 months”, 86% “12 month) which confirms successful implementation of interventions.
Measuring the effect of only online support is important to build evidence on its effectiveness and support the quick and low-cost scale up to reach more beneficiaries.

Author

• Autumn Brown