Human resources and curricula content for early child development implementation: multicountry mixed methods evaluation

Objective The WHO recommends responsive caregiving and early learning (RCEL) interventions to improve early child development (ECD), and to achieve the Sustainable Development Goals’ vision of a world where all children thrive. Implementation of RCEL programmes in low and middle-income countries (LM...

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Main Authors: Karim Manji, Esther Goh, Kate M Milner, Rob Hughes, Maya Kohli-Lynch, Victoria Ponce Hardy, James Radner, Sonia Sharma, Joy E Lawn, Vanessa Cavallera, Raquel Bernal Salazar, Alexandra Brentani, Karlee L Silver, Sunil S Bhopal, Jena D Hamadani
Format: Article
Language:English
Published: BMJ Publishing Group 2020-04-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/4/e032134.full
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author Karim Manji
Esther Goh
Kate M Milner
Rob Hughes
Maya Kohli-Lynch
Victoria Ponce Hardy
James Radner
Sonia Sharma
Joy E Lawn
Vanessa Cavallera
Raquel Bernal Salazar
Alexandra Brentani
Karlee L Silver
Sunil S Bhopal
Jena D Hamadani
author_facet Karim Manji
Esther Goh
Kate M Milner
Rob Hughes
Maya Kohli-Lynch
Victoria Ponce Hardy
James Radner
Sonia Sharma
Joy E Lawn
Vanessa Cavallera
Raquel Bernal Salazar
Alexandra Brentani
Karlee L Silver
Sunil S Bhopal
Jena D Hamadani
author_sort Karim Manji
collection DOAJ
description Objective The WHO recommends responsive caregiving and early learning (RCEL) interventions to improve early child development (ECD), and to achieve the Sustainable Development Goals’ vision of a world where all children thrive. Implementation of RCEL programmes in low and middle-income countries (LMIC) requires evidence to inform decisions about human resources and curricula content. We aimed to describe human resources and curricula content for implementation of RCEL projects across diverse LMICs, using data from the Grand Challenges Canada Saving Brains ECD portfolio.Setting We evaluated 32 RCEL projects across 17 LMICs on four continents.Participants Overall, 2165 workers delivered ECD interventions to 25 909 families.Intervention Projects were either stand-alone RCEL or RCEL combined with health and nutrition, and/or safety and security.Primary and secondary outcomes We undertook a mixed methods evaluation of RCEL projects within the Saving Brains portfolio. Quantitative data were collected through standardised reporting tools. Qualitative data were collected from ECD experts and stakeholders and analysed using thematic content analysis, informed by literature review.Results Major themes regarding human resources included: worker characteristics, incentivisation, retention, training and supervision, and regarding curricula content: flexible adaptation of content and delivery, fidelity, and intervention duration and dosage. Lack of an agreed standard ECD package contributed to project heterogeneity. Incorporation of ECD into existing services may facilitate scale-up but overburdened workers plus potential reductions in service quality remain challenging. Supportive training and supervision, inducement, worker retention, dosage and delivery modality emerged as key implementation decisions.Conclusions This mixed methods evaluation of a multicountry ECD portfolio identified themes for consideration by policymakers and programme leaders relevant to RCEL implementation in diverse LMICs. Larger studies, which also examine impact, including high-quality process and costing evaluations with comparable data, are required to further inform decisions for implementation of RCEL projects at national and regional scales.
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spelling doaj-art-d09d25c237d4453bb9b53dfec9bfc7722025-08-20T02:19:51ZengBMJ Publishing GroupBMJ Open2044-60552020-04-0110410.1136/bmjopen-2019-032134Human resources and curricula content for early child development implementation: multicountry mixed methods evaluationKarim Manji0Esther Goh1Kate M Milner2Rob Hughes3Maya Kohli-Lynch4Victoria Ponce Hardy5James Radner6Sonia Sharma7Joy E Lawn8Vanessa Cavallera9Raquel Bernal Salazar10Alexandra Brentani11Karlee L Silver12Sunil S Bhopal13Jena D Hamadani1415 Department of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania3 Bernard van Leer Foundation, The Hague, The NetherlandsMaternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene and Tropical Medicine, London, UK4 Maternal & Child Health Intervention Research Group, Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK1 Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene and Tropical Medicine, London, UKMaternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene and Tropical Medicine, London, UKCenter on the Developing Child, Harvard University, Cambridge, Massachusetts, USA8 La Jolla Institute for Allergy and Immunology, La Jolla, California, USAMaternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene and Tropical Medicine, London, UK3Brain Health Unit in Department of Mental Health and Substance Use, World Health Organization3 Economics Department, Universidad de los Andes, Bogota, ColombiaDepartment of Pediatrics, University of São Paulo Medical School, São Paulo, Brazilvice president, programmesMaternal & Child Health Intervention Research Group, London School of Hygiene & Tropical Medicine, London, UKMaternal and Child Health Division, ICDDR,B, Dhaka, BangladeshObjective The WHO recommends responsive caregiving and early learning (RCEL) interventions to improve early child development (ECD), and to achieve the Sustainable Development Goals’ vision of a world where all children thrive. Implementation of RCEL programmes in low and middle-income countries (LMIC) requires evidence to inform decisions about human resources and curricula content. We aimed to describe human resources and curricula content for implementation of RCEL projects across diverse LMICs, using data from the Grand Challenges Canada Saving Brains ECD portfolio.Setting We evaluated 32 RCEL projects across 17 LMICs on four continents.Participants Overall, 2165 workers delivered ECD interventions to 25 909 families.Intervention Projects were either stand-alone RCEL or RCEL combined with health and nutrition, and/or safety and security.Primary and secondary outcomes We undertook a mixed methods evaluation of RCEL projects within the Saving Brains portfolio. Quantitative data were collected through standardised reporting tools. Qualitative data were collected from ECD experts and stakeholders and analysed using thematic content analysis, informed by literature review.Results Major themes regarding human resources included: worker characteristics, incentivisation, retention, training and supervision, and regarding curricula content: flexible adaptation of content and delivery, fidelity, and intervention duration and dosage. Lack of an agreed standard ECD package contributed to project heterogeneity. Incorporation of ECD into existing services may facilitate scale-up but overburdened workers plus potential reductions in service quality remain challenging. Supportive training and supervision, inducement, worker retention, dosage and delivery modality emerged as key implementation decisions.Conclusions This mixed methods evaluation of a multicountry ECD portfolio identified themes for consideration by policymakers and programme leaders relevant to RCEL implementation in diverse LMICs. Larger studies, which also examine impact, including high-quality process and costing evaluations with comparable data, are required to further inform decisions for implementation of RCEL projects at national and regional scales.https://bmjopen.bmj.com/content/10/4/e032134.full
spellingShingle Karim Manji
Esther Goh
Kate M Milner
Rob Hughes
Maya Kohli-Lynch
Victoria Ponce Hardy
James Radner
Sonia Sharma
Joy E Lawn
Vanessa Cavallera
Raquel Bernal Salazar
Alexandra Brentani
Karlee L Silver
Sunil S Bhopal
Jena D Hamadani
Human resources and curricula content for early child development implementation: multicountry mixed methods evaluation
BMJ Open
title Human resources and curricula content for early child development implementation: multicountry mixed methods evaluation
title_full Human resources and curricula content for early child development implementation: multicountry mixed methods evaluation
title_fullStr Human resources and curricula content for early child development implementation: multicountry mixed methods evaluation
title_full_unstemmed Human resources and curricula content for early child development implementation: multicountry mixed methods evaluation
title_short Human resources and curricula content for early child development implementation: multicountry mixed methods evaluation
title_sort human resources and curricula content for early child development implementation multicountry mixed methods evaluation
url https://bmjopen.bmj.com/content/10/4/e032134.full
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