The Impact of an Integrated Nurturing Care Intervention to Improve Early Childhood Development Outcomes in Nampula Province, Mozambique
Abstract Objective: To estimate the effect of integrating responsive care, early learning, and development monitoring into a community-based package of activities on nutrition, sanitation, and hygiene, on improvements in early childhood development outcomes. Design: This was a quasi-experimental...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
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| Series: | Public Health Nutrition |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S1368980025100554/type/journal_article |
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| author | Filipa de Castro Katija Momade Jennifer Yourkavitch Charles D. Arnold Alberto Manhiça Filipe Zano Higino André Edmilson Ismail Kristen Cashin Catherine M. Kirk |
| author_facet | Filipa de Castro Katija Momade Jennifer Yourkavitch Charles D. Arnold Alberto Manhiça Filipe Zano Higino André Edmilson Ismail Kristen Cashin Catherine M. Kirk |
| author_sort | Filipa de Castro |
| collection | DOAJ |
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Abstract
Objective:
To estimate the effect of integrating responsive care, early learning, and development monitoring into a community-based package of activities on nutrition, sanitation, and hygiene, on improvements in early childhood development outcomes.
Design:
This was a quasi-experimental study with nonequivalent comparison groups. The study primary outcome, early childhood development, was measured using the Ages and Stages Questionnaire (ASQ-3) and the Global Scales for Early Development (GSED). We also collected data on the early learning home environment, nutritional practices, and caregiver depressive symptoms as secondary outcomes.
Setting:
This study was conducted across 12 districts in Nampula Province, Mozambique. Half of the districts received holistic nurturing care with responsive care, early learning, nutrition, sanitation, and hygiene packages (intervention), and the other half received only nutrition, sanitation, and hygiene packages (comparison).
Participants:
We recruited an age-stratified random sample of 961 caregivers and their children, aged 0–23 months.
Results:
We found a significantly higher mean caregiver engagement total score (mean difference: 0.36; P ≤ .001) and higher number of activities to support learning (mean difference: 0.30, P = 0.004) in the intervention group than in the control. There were no measurable impacts on the remaining early stimulation activities or on the primary outcomes of the ASQ and GSED developmental scores.
Conclusions:
We discuss the challenges in the integration of nurturing care interventions into existing programs in high-vulnerability contexts, highlighting the aspects needed to achieve effective caregiver behavioral changes that can translate into improved early childhood development outcomes.
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| format | Article |
| id | doaj-art-fa4ec89f30974ed392fc3619f166d676 |
| institution | OA Journals |
| issn | 1368-9800 1475-2727 |
| language | English |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Public Health Nutrition |
| spelling | doaj-art-fa4ec89f30974ed392fc3619f166d6762025-08-20T02:31:27ZengCambridge University PressPublic Health Nutrition1368-98001475-272713410.1017/S1368980025100554The Impact of an Integrated Nurturing Care Intervention to Improve Early Childhood Development Outcomes in Nampula Province, MozambiqueFilipa de Castro0https://orcid.org/0000-0002-6710-6315Katija Momade1Jennifer Yourkavitch2https://orcid.org/0000-0002-7701-1918Charles D. Arnold3Alberto Manhiça4Filipe Zano5Higino André6Edmilson Ismail7Kristen Cashin8Catherine M. Kirk9Save the Children US, Fairfield, CT, USAUSAID Advancing Nutrition Mozambique, Nampula, Mozambique Save the Children Mozambique, Nampula, MozambiqueUSAID Advancing Nutrition, Arlington, VA USA Results for Development, Washington, DC USAResults for Development, Washington, DC USA University of California Davis, Davis, CA, USASave the Children US, Fairfield, CT, USA USAID Advancing Nutrition Mozambique, Nampula, MozambiqueSave the Children US, Fairfield, CT, USA USAID Advancing Nutrition Mozambique, Nampula, MozambiqueAjuda de Desenvolvimento de Povo para Povo (ADPP), Nampula, Mozambique Transform Nutrition, Nampula, MozambiqueSave the Children US, Fairfield, CT, USA USAID Advancing Nutrition Mozambique, Nampula, MozambiqueSave the Children Mozambique, Nampula, Mozambique USAID Advancing Nutrition, Arlington, VA USAZemiTek LLC, USAID’s Global Solution Ventures, Washington, DC USA Abstract Objective: To estimate the effect of integrating responsive care, early learning, and development monitoring into a community-based package of activities on nutrition, sanitation, and hygiene, on improvements in early childhood development outcomes. Design: This was a quasi-experimental study with nonequivalent comparison groups. The study primary outcome, early childhood development, was measured using the Ages and Stages Questionnaire (ASQ-3) and the Global Scales for Early Development (GSED). We also collected data on the early learning home environment, nutritional practices, and caregiver depressive symptoms as secondary outcomes. Setting: This study was conducted across 12 districts in Nampula Province, Mozambique. Half of the districts received holistic nurturing care with responsive care, early learning, nutrition, sanitation, and hygiene packages (intervention), and the other half received only nutrition, sanitation, and hygiene packages (comparison). Participants: We recruited an age-stratified random sample of 961 caregivers and their children, aged 0–23 months. Results: We found a significantly higher mean caregiver engagement total score (mean difference: 0.36; P ≤ .001) and higher number of activities to support learning (mean difference: 0.30, P = 0.004) in the intervention group than in the control. There were no measurable impacts on the remaining early stimulation activities or on the primary outcomes of the ASQ and GSED developmental scores. Conclusions: We discuss the challenges in the integration of nurturing care interventions into existing programs in high-vulnerability contexts, highlighting the aspects needed to achieve effective caregiver behavioral changes that can translate into improved early childhood development outcomes. https://www.cambridge.org/core/product/identifier/S1368980025100554/type/journal_articleNutrition and Caregiving InterventionsEarly Childhood DevelopmentNurturing CareEarly LearningEarly Stimulation |
| spellingShingle | Filipa de Castro Katija Momade Jennifer Yourkavitch Charles D. Arnold Alberto Manhiça Filipe Zano Higino André Edmilson Ismail Kristen Cashin Catherine M. Kirk The Impact of an Integrated Nurturing Care Intervention to Improve Early Childhood Development Outcomes in Nampula Province, Mozambique Public Health Nutrition Nutrition and Caregiving Interventions Early Childhood Development Nurturing Care Early Learning Early Stimulation |
| title | The Impact of an Integrated Nurturing Care Intervention to Improve Early Childhood Development Outcomes in Nampula Province, Mozambique |
| title_full | The Impact of an Integrated Nurturing Care Intervention to Improve Early Childhood Development Outcomes in Nampula Province, Mozambique |
| title_fullStr | The Impact of an Integrated Nurturing Care Intervention to Improve Early Childhood Development Outcomes in Nampula Province, Mozambique |
| title_full_unstemmed | The Impact of an Integrated Nurturing Care Intervention to Improve Early Childhood Development Outcomes in Nampula Province, Mozambique |
| title_short | The Impact of an Integrated Nurturing Care Intervention to Improve Early Childhood Development Outcomes in Nampula Province, Mozambique |
| title_sort | impact of an integrated nurturing care intervention to improve early childhood development outcomes in nampula province mozambique |
| topic | Nutrition and Caregiving Interventions Early Childhood Development Nurturing Care Early Learning Early Stimulation |
| url | https://www.cambridge.org/core/product/identifier/S1368980025100554/type/journal_article |
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