Promoting Family Resilience with Father Engagement in Early Child Development: Findings from a Hybrid Type 2 Cluster Randomized Trial in Rwanda

• In Event: The education sector in response, resilience and recovery during and after violent conflicts

Proposal

Background: The first three years of life can have an enormous impact on future child and adult outcomes. Caregivers who provide nurturing care—that is, responsive caregiving and parenting practices that support child health and early learning—can substantially improve their children’s developmental potential. However, many interventions directed at supporting caregiver engagement in Early Child Development (ECD) do not adequately address father engagement. A number of studies have demonstrated that father engagement improves ECD both directly through caregiving and play activities and indirectly through positive interactions with partners, such as co-parenting, shared decision making, and provision of emotional and financial support. In this presentation, we describe how an evidence-based, home-visiting intervention called Sugira Muryango (“Strengthening Families”, SM) engaged fathers during scale out to 10,000 households in rural Rwanda. This study offers a highly unique window into father engagement attitudes, beliefs, and practices in a low-and-middle-income country (LMIC) where access to resources that support ECD (e.g., economic, nutrition, healthcare, and education) are constrained. We examine how father engagement promotes family resilience—that is, how the family adapts to stress, crisis, or trauma—which is an important predictor of stability in a post-conflict setting such as Rwanda.

Method: SM is being scaled out to 10,000 of the poorest families in three districts in Rwanda as part of a Hybrid Type 2 Implementation-Effectiveness study to deploy a multi-level implementation strategy called the PLAY Collaborative. This approach involves engaging stakeholders at multiple levels of the ECD ecosystem to coordinate delivery and strengthen local systems to support and sustain SM. An embedded effectiveness cluster randomized trial evaluated whether SM improved a number of caregiver (e.g., mental health symptoms, intimate partner violence, shared decision-making, and nurturing care) and child (e.g., playful interactions, cognitive development, health) outcomes. We examined whether father engagement promotes family resilience by measuring its impact on several key indicators: caregiver mental health symptoms, family violence, shared decision-making with partners. We then explored whether family resilience independently improves ECD outcomes, over and above effects of caregiver participation in nurturing care.

Results: Preliminary analysis revealed that 30.8% of caregivers in the effectiveness trial were male and 29.4% of biological fathers reported being the primary caregiver. Median male caregiver participation in SM was 11 sessions. Among SM families, male caregivers increased caregiving activities such as feeding, soothing, bathing, and seeking healthcare for the child. Both male and female caregivers reported fewer anxiety and depression symptoms following SM. Findings with regard to specific effects of father engagement on family resilience will be revealed at the conference.

Discussion: The impact of father engagement on ECD is well-documented; yet, many interventions do not adequately address this. SM is an evidence-based, home-visiting program in which father engagement is a core feature and has been designed for delivery in very low resource settings. Our study reveals that father engagement promotes ECD while also cultivating family resilience, a highly important trait for families living in LMICs and post-conflict settings.

Author

• Candace J Black, Boston College