Measuring the effect of an early childhood caregiver training on child development outcomes in rural Malawi

• In Event: The equity initiative: building a “solutions menu”: effective interventions for children with disabilities

Proposal

This paper will present the outcomes of a cluster randomized control trial that sought to measure the change in language and socio-emotional development of children aged 2-6 years attending centres with caregivers who received a disability inclusive training package compared to a control group
In Malawi, Early childhood development and education (ECDE) services are provided through community-based childcare centres (CBCCS), which are often run on a voluntary or in-kind payment basis by untrained volunteers. Children with disabilities or developmental delay may require additional or adapted support to reach their potential, and yet are often disproportionately excluded from programmes providing such services. Along with partners, Sightsavers has been testing a training intervention for caregivers at early childhood centres in rural Malawi. The study sought to understand the effect the training package would have on child development measures, caregiver retention and disability-inclusiveness of the centres as a whole. For the purposes of the study, child development was measured using the Malawi Developmental Assessment Tool; caregiver retention was measured through interview with caregivers operational at the time of visit; and disability inclusiveness was measured through composite factors including the number of children with disability enrolled (per the Washington Group/ UNICEF child functioning module) and an adapted version of the ECERS scale. This data was supplemented with qualitative case studies with the parents of children with disabilities attending those CBCCs. Forty-eight centres and over 900 children were randomly selected and assessed at baseline (2017) and enline (2018). At baseline 11.7% of children were identified with suspected developmental delays and 10.7% had functional difficulties. Twenty-nine out of 47 CBCCs (61.7%) reported at least one child with a disability known to caregivers; and in 19 of these CBCCs (65.5%) caregivers made minor modifications to address individual needs of children with disabilities, while in 10 (34.5%) little or no modifications were made.
The study highlights the usefulness of collecting data from ECDE settings using standardised tools. The results of the baseline study show the high prevalence of developmental delay and functional difficulties among young children in low resource settings such as this. Low-cost strategies for including such children meaningfully in ECDE activities are vital for their development.

Author

• Emma Jolley, Sightsavers