Cluster-Randomized Clinical Trial and Process Evaluation of the LEAPS Program in Rural Pakistan

• In Event: 2-183 - Youth-Led Early Childhood Care and Education Programs: Characteristics and Potential Impact Across Multiple Global Contexts

Integrative Statement

Introduction: Early childhood (0-8 years) and late adolescence/youth (18- 24 years) are two sensitive periods of brain and human development. Interventions delivered during these periods have been shown to ameliorate exposure to risk factors (i.e. poverty, violence, poor nutrition) as well as help establish foundations for positive learning and wellbeing later in life. Despite this knowledge, access to quality education services globally for young children and youth is low. Cross-generational models for young children and youth may offer opportunities to address the interconnections between global education and development targets.
Hypotheses: Our primary objective was to test the feasibility of 'Youth Leaders for Early Childhood Assuring Children are Prepared for School' (LEAPS), an early childhood care and education (ECCE) program for young children (3.5-6.5 years) delivered by female Community Youth Leaders (CYLs) in a geographic area where access to quality ECCE and professional opportunities for female youth are low. We hypothesized that the youth-led ECCE program would provide a model to strengthen educational and developmental outcomes for young children and youth in low-resource settings.
Study Population: The program was conducted in rural Pakistan, where less than 50% of children 4 years of age are enrolled in an ECCE program. Specifically, the intervention took place in the province of Sindh, where recent statistics show preschool enrollment is around 37%. Children aged 3.5-5.5 years, who resided in the specific villages, and who were not enrolled in primary school, were selected to participate in the study. CYLs had to be 18-24 years of age, have undergone at least 10 years of formal education, and have support from their family to partake in the program.
Methods: The effectiveness of LEAPS was evaluated in a cluster-randomized controlled trial. Five clusters (villages) were randomly allocated to receive the intervention (n= 170 children) and five clusters to control (n= 170 children). Children's school readiness was assessed after nine months of intervention exposure using the International Development and Early Learning Assessment tool. Analyses was by intention-to-treat. The trial is registered with ClinicalTrials.gov, number NCT02645162.
Results: At endline, the intervention group had significantly higher school readiness scores (n= 166, mean percentage score 59.4, 95% CI 52.7 to 66.2) compared with the control group (n=168, mean percentage score 45.5, 95% CI 38.8 to 52.3). The effect size (Cohen's d) was 0.3.
Conclusion: Trained female youth were able to effectively deliver an ECCE program benefitting young children's school readiness. The cross-generational model is a promising approach to support early child development.

Authors

• Aisha Yousafzai, Harvard University
  Presenting Author

• Muneera Rasheed, Aga Khan University
  Non-Presenting Author

• Arjumand Rizvi, Aga Khan University, Karachi
  Non-Presenting Author

• Fariha Shaheen, Aga Khan University
  Non-Presenting Author

• Liliana Angelica Ponguta, The Yale Child Study Center
  Non-Presenting Author

• Chin R. Reyes, Yale Child Study Center
  Non-Presenting Author