ľ¹ÏÓ°Ôº

Nutrition, health and development during the first three years of life are at the foundation of human capital formation. Yet children growing up in poverty often experience low levels of stimulation and low quality of nutrition. Interventions that promote child stimulation and emphasize parent-child interactions providing opportunities to play and learn such as home visits and community groups have been identified as having great potential but there is little evidence of cost-effective interventions that can be implemented at scale in very poor environments. This study in India will develop evidence on the relative effectiveness of using home visits and group visits to help caregivers, usually mothers, support their children¡¯s healthy development.

Problem

More than half of India¡¯s population is poor, and children growing up in poor households have a higher chance of being malnourished and a lower chance of enrolling in school and graduating. The situation is more extreme in the Indian state of Odisha, where some 64 percent of the population is poor and more than 50 percent of children between the ages of 24 and 26 months were moderately or severely stunted, according to national statistics from 2005-2006. Programs to help stimulate healthy children¡¯s development ¨C a key challenge for those raised in poor environments ¨C have shown to work on a small scale. But how to apply these across a large area, and how to do this cost-effectively, remains a challenge.

Intervention

The evaluation team tested three different approaches for working with mothers to help them improve their children¡¯s development through better nutrition and through play activities that can stimulate cognitive and social-emotional development. One group of mothers received weekly home visits focused on nutrition, child health, and food preparation and storage. The second group received the same weekly visits but these also included a focus on how to use play and learning to boost children¡¯s development. The third group included the same weekly home visits on nutrition, but the child stimulation information was provided at weekly group meetings in the villages for mothers and their children instead of during home visits. All three groups, and a control group, received a one-time explanation of existing community services,  separate from the interventions. The curriculum used to encourage positive interactions between mothers and their children is based on that developed for a small program in Jamaica that showed very strong results on children¡¯s development.

Evaluation Design

Clustered-randomized controlled trial. About 200 communities in Odisha were randomly assigned to either be in one of three treatment groups or in the control group. Households with children between the ages of six and 18 months were eligible to take part.

Eligibility

Mothers and other caregivers in poor families with children between the ages of 6 and 18 months at the start of the program.

Data Collection

Midline data was collected between November 2016 and July 2017, about 10-12 months into the implementation of each intervention arm.

Results

(Pending)