Integrated Early Childhood Development in Cambodia: Initial data from a cluster stepped-wedge trial

• In Event: Data Use in Early Childhood

Proposal

Limited evidence is available on mechanisms linking integrated, multisector interventions with early childhood development. The Integrated Early Childhood Development program aims to improve children’s development by promoting targeted caregiving behaviors beginning prenatally through age 5 years, in partnership with the Royal Government of Cambodia.

In this presentation, I will present results from two waves of a data collection in a longitudinal study of caregiving practices and children’s outcomes. This cluster stepped-wedge trial is being conducted in Cambodia among 3 cohorts, encompassing 339 villages and 1790 caregivers who are pregnant or caring for a child aged <5 years. The 12- to 15-month intervention is delivered to each cohort using a staggered stepped-wedge design. After initial enrollment, we intend to conduct three additional waves of data collection, through 2025. The program intervention provides targeted caregiving interventions through community, group, and home-visiting platforms. Child development is measured using the Caregiver Reported Early Development Instrument and the Early Childhood Development Index (ECDI) 2030. The evaluation assesses mediation through targeted caregiving behaviors: responsive caregiving, nutrition, health and hygiene, and household stability and support; as well as moderation by household wealth, caregiver education, and birth weight.

Initial data suggest that caregiving behaviors targeted by the IECD program are associated with child outcomes as measured by the ECDI, and that the relationship between caregiving behaviors and child outcomes is moderated by household wealth, caregiver education and the birth weight of the child. The presentation will explore whether the intervention has resulted in a change in caregiving practices, as well as any impact on children’s developmental outcomes. I will discuss implications of the results, both for the Cambodian context and for ECD global evidence.

This paper is relevant for CIES 2024 because it outlines a longitudinal study to evaluate an integrated,
multicomponent, multiplatform intervention developed in collaboration with government partners to enhance children’s development through caregiving activities, beginning prenatally through age 5 years. Building on evidence that caregiving practices are modifiable with well-structured support, the IECD intervention is designed to help families adopt nurturing care practices throughout their daily activities. The project trains and engages village-level volunteers to implement multicomponent caregiving activities through community-, group-, and home-based sessions, with the goal of building capacity for sustainable interventions. Partnership with the Royal Government of Cambodia and involvement of RGC representatives increase the likelihood of ongoing governmental engagement and support for these activities. This study design enables the government to use data to consider policy objectives according to distinct population needs, such as universal coverage with a pro-poor, equity enhancing investment in children and families most in need.

Author

• Katherine Merseth King, RTI International