Using the infrastructure of a conditional cash transfer program to deliver a scalable integrated early child development program in Colombia: cluster randomized controlled trial

Attanasio, Orazio; Fernández, Camila; Fitzsimons, Emla; Grantham‐McGregor, Sally; Meghir, Costas; Codina, Marta Rubio

doi:10.1136/bmj.g5785

“…The size of the cognitive benefit was comparable to other more intensive programs elsewhere (Attanasio et al, 2014;Hamadani et al, 2006) although it was smaller than previous Jamaican home visiting interventions (GranthamMcGregor et al, 1991;Powell et al, 2004) and benefits were limited to cognition, with no benefits to the children's language or fine motor development. There was only one intervention contact after 12 months, which is a time of rapid expansion in language.…”

Section: Discussionmentioning

confidence: 59%

“…Firstly, we cost the intervention as 6 We use 0.20SD based on the literature of larger scale home visits. Attanasio et al, (2014) if it was taken to scale within the clinic (columns 3 and 4) and secondly, we estimated the BC ratios considering an attenuation of the benefits at scale.…”

Section: Sensitivity Analysismentioning

confidence: 99%

Delivering Parenting Interventions through Health Services in the Caribbean

Walker¹,

Powell²,

Chang³

et al. 2015

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work is licensed under a Creative Commons IGO 3.0 AttributionNonCommercial-NoDerivatives (CC-IGO BY-NC-ND 3.0 IGO) license (http://creativecommons.org/licenses/by-nc-nd/3.0/igo/ legalcode) and may be reproduced with attribution to the IDB and for any non-commercial purpose, as provided below. No derivative work is allowed.Any dispute related to the use of the works of the IDB that cannot be settled amicably shall be submitted to arbitration pursuant to the UNCITRAL rules. The use of the IDB's name for any purpose other than for attribution, and the use of IDB's logo shall be subject to a separate written license agreement between the IDB and the user and is not authorized as part of this CC-IGO license.Following a peer review process, and with previous written consent by the Inter-American Development Bank (IDB), a revised version of this work may also be reproduced in any academic journal, including those indexed by the American Economic Association's EconLit, provided that the IDB is credited and that the author(s) receive no income from the publication. Therefore, the restriction to receive income from such publication shall only extend to the publication's author(s). With regard to such restriction, in case of any inconsistency between the Creative Commons IGO 3.0 Attribution-NonCommercial-NoDerivatives license and these statements, the latter shall prevail.Note that link provided above includes additional terms and conditions of the license.The opinions expressed in this publication are those of the authors and do not necessarily reflect the views of the Inter-American Development Bank, its Board of Directors, or the countries they represent. AbstractIntegrating early childhood interventions with health and nutrition services has been recommended, however there is limited information on interventions that are effective and feasible for delivery through health services. In this trial we developed and evaluated a parenting program that could be integrated into primary health center visits. The intervention used group delivery at five routine visits from age 3-18 months, and comprised: short films of child development messages, shown in the waiting area; discussion and demonstration led by community health workers; and mothers' practice of activities. Nurses gave out and reviewed message cards with mothers, together with a few play materials. A cluster randomized trial was conducted in the Caribbean (Jamaica, Antigua and St Lucia) in 29 health centers. Centers, stratified by the 3 countries, were randomized to control (n=15) or health center intervention (n=14).We also adapted the Jamaica home visit intervention to increase feasibility at scale, and evaluated this together with the group intervention in Jamaica only. Participants were recruited at the 6-8 week child health visit. Primary outcomes were child cognition, language and hand-eye coordination, and secondary outcomes caregiver knowledge, practices, maternal depression, and child growth, measured after the 18 month visit. Multilevel analyses comparing...

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“…The range of programs to improve child cognitive development in LMICs during the period between birth and the initiation of primary schooling is reviewed in Engle and others (2007) and in Engle and others (2011) and includes programs to promote better parenting and mother-child interaction through home visits by community health workers or by means of group sessions with mothers. Consistent evidence from several countries indicates that interventions that improve parent-child interaction and stimulation benefit children's development; the most current evidence is from interventions delivered through home visits by trained community health workers (Attanasio and others 2014;Hamadani and others 2006;Powell and others 2004;Yousafzai and others 2014). Some evidence indicates that these early interventions have sustained benefits for cognitive ability and behavior around the age of school entry (Grantham-McGregor and others 1997; Walker and others 2010) and adulthood (Gertler and others 2014;Walker, Chang, and others 2011).…”

Section: Overview Of Programs and Interventionsmentioning

confidence: 99%

Evidence of Impact of Interventions on Growth and Development during Early and Middle Childhood

Alderman¹,

Behrman²,

Glewwe³

et al. 2017

Disease Control Priorities, Third Edition (Volume 8): Child and Adolescent Health and Development

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“…Importantly, this test has shown sensitivity to differences in ECD outcomes due to interventions in diverse contexts (Hamadani et al 2006;Nahar et al 2009;Attanasio et al 2014). However, test administration is time consuming and requires highly trained professionals working in controlled environments; test kits and test administration fees are expensive; and identifying professional testers who can administer it in local languages is challenging.…”

Section: Introductionmentioning

confidence: 99%

Concurrent Validity and Feasibility of Short Tests Currently Used to Measure Early Childhood Development in Large Scale Studies: Methodology and Results

Rubio‐Codina¹,

Araujo²,

Attanasio³

et al. 2016

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work is licensed under a Creative Commons IGO 3.0 AttributionNonCommercial-NoDerivatives (CC-IGO BY-NC-ND 3.0 IGO) license (http://creativecommons.org/licenses/by-nc-nd/3.0/igo/ legalcode) and may be reproduced with attribution to the IDB and for any non-commercial purpose, as provided below. No derivative work is allowed.Any dispute related to the use of the works of the IDB that cannot be settled amicably shall be submitted to arbitration pursuant to the UNCITRAL rules. The use of the IDB's name for any purpose other than for attribution, and the use of IDB's logo shall be subject to a separate written license agreement between the IDB and the user and is not authorized as part of this CC-IGO license.Following a peer review process, and with previous written consent by the Inter-American Development Bank (IDB), a revised version of this work may also be reproduced in any academic journal, including those indexed by the American Economic Association's EconLit, provided that the IDB is credited and that the author(s) receive no income from the publication. Therefore, the restriction to receive income from such publication shall only extend to the publication's author(s). With regard to such restriction, in case of any inconsistency between the Creative Commons IGO 3.0 Attribution-NonCommercial-NoDerivatives license and these statements, the latter shall prevail.Note that link provided above includes additional terms and conditions of the license.The opinions expressed in this publication are those of the authors and do not necessarily reflect the views of the Inter-American Development Bank, its Board of Directors, or the countries they represent.

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Using the infrastructure of a conditional cash transfer program to deliver a scalable integrated early child development program in Colombia: cluster randomized controlled trial

Abstract: Objective To assess the effectiveness of an integrated early child development intervention, combining stimulation and micronutrient supplementation and delivered on a large scale in Colombia, for children's development, growth, and hemoglobin levels.

Cited by 293 publications

References 32 publications

Delivering Parenting Interventions through Health Services in the Caribbean

Delivering Parenting Interventions through Health Services in the Caribbean

Evidence of Impact of Interventions on Growth and Development during Early and Middle Childhood

Concurrent Validity and Feasibility of Short Tests Currently Used to Measure Early Childhood Development in Large Scale Studies: Methodology and Results

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