Exploring use of digital technology for optimizing, tracking and responding to children's developmental progress: case of informal settlement in Nairobi, Kenya

• In Event: Digital technologies in ECD

Proposal

Background: More than 95% of people globally have mobile network coverage, significantly impacting communication, especially in developing countries like Kenya. Increased mobile phone use presents an opportunity to enhance child development, particularly in areas where support programs are inadequate. In Kenya, particularly in informal urban settlements, children face significant developmental risks due to poverty, poor nutrition, and insufficient stimulation. Many parents, often young and less educated, struggle to provide adequate care and identify developmental delays due to a lack of information and resources. This study aimed to develop and test the feasibility of using a mobile phone technology for optimizing, tracking, and responding to children's developmental progress in informal settlements in Nairobi.
Methods: This was a two-arm quasi-experimental study conducted in Korogocho informal settlements in Nairobi. A total of 227 mother-child (0-3 years) dyads were recruited into the study. The intervention focused on improving caregiver’s knowledge and practices on children’s growth and development through training and use of mobile phone messaging platform to track and stimulate their children’s growth and development, identifying developmental delays, mentorship visits by community health volunteers (CHVs) and referral/linkages to the health facility to address the identified developmental delays. Mothers and CHVs in the intervention arm were trained on the use of a mobile phone application to assess their children’s growth and development, while the control arm only received the standard of care provided by CHVs. Data were collected by interviewers using digitized structured questionnaires in tablets and transmitted to SurveyCTO server from where they were accessed by the research team. We estimated the causal effect of the intervention using the analysis of covariance (ANCOVA) model.
Results: At baseline, the median age of mothers in the control arm was 30 while in the intervention arm, it was 28 (p=0.589). The children were aged between six and 24 months at enrollment to the study. The intervention showed a significant positive impact on the caregiver ECD practices and child development. At endline, ECD practices score of mothers and the children’s developmental score (based on ASQ-3) in the intervention were 0.4 SD (95% CI: 0.11, 0.69) and 0.28SD (95% CI:0.03, 0.53) respectively higher than in the control arm after controlling for the baseline outcomes and other covariates. There was no significant impact on the caregiver ECD knowledge. The intervention was seen to be feasible and acceptable among caregivers as well as CHVs in whom knowledge in the area of staged child development and stimulation was previously lacking.
Conclusion: Use of a mobile messaging platform increased care practices around child development among caregivers and had a positive impact on child developmental outcomes. Improved care practices increase child-care giver interactions as well as responsive care-giving leading to better child development. The intervention proved both acceptable and feasible due to its simplicity and extensive access to phones among mothers throughout the study These findings highlight the potential of mobile applications to deliver information to caregivers pertaining to the health and development of their children, filling the gap left by the limited time health workers have for individual counseling.

Authors

• Nelson Kipkoech Langat, African Population and Health Research Center (APHRC)

• Patricia K Kitsao-Wekulo, African Population and Health Research Center

• Margaret Nampijja, African Population and Health Reserach Center, Nairobi