Assessing the effect of an educational intervention on early childhood development among Mexican preschool children in the state of Oaxaca: a study protocol of a cluster randomized stepped-wedge trial

Abstract

Background Early childhood development (ECD) is essential in human capacity building and a critical element in the intergenerational process of human development. In some countries, social programs targeted at improving ECD have proven to be successful. Oaxaca is one of the States with the greatest social inequities in Mexico. Therefore, children in Oaxaca are at a high risk of suboptimal ECD. In 2014, the non-governmental organization (NGO) Un Kilo de Ayuda started to implement the Neurological and Psycho-affective Early Childhood Development Program in eighty marginalized communities of Oaxaca. In this article, we present the impact evaluation design to estimate the effect of this program on ECD. Methods We will use a cluster randomized stepped-wedge design with an allocation ratio of 1:1. Communities will be randomly assigned to each study group: four groups of twenty communities each. We expect that children from intervened communities will show better ECD outcomes. Discussion This study is one of the few rigorous assessments of the effect of an ECD program on the neurodevelopment of Mexican children recruited in their first 3 years of life from communities of high social vulnerability. Our study design is recommended when the way in which outcomes are measured and assessed depends on age, self-selection is present, and assignment is performed at an aggregate level. Implementation research will be conducted prior to study launch and quality control measures will be in place to maximize the fidelity of study design implementation. Trial registration ClinicalTrials.gov NCT04210362

Proximal determinants of suboptimal early child development during the first three years of life in socially deprived Mexican contexts

“…The individuals analyzed in this study participated in the baseline measurement impact evaluation of the Neurological and Psycho-affective Development Program (PDNyP by its Spanish initials) on child neurodevelopment (in progress) [ 29 ], designed and implemented by the Mexican non-governmental organization Un Kilo de Ayuda A.C. Details concerning the sample design and the PDNyP itself have been presented elsewhere [ 29 ].…”

Early neurological development and nutritional status in Mexican socially deprived contexts

“…The children analyzed had participated in a baseline measurement exercise performed during an impact assessment of the Neurological and Psycho-affective Development Program (PDNyP by its initials in Spanish). This Program was designed and implemented by the civil society organization Un Kilo de Ayuda, A.C. A detailed description of the assessment study has been published elsewhere [ 25 ].…”

“…Anthropometric measurements of the children were taken and their ranking in childhood development scales was determined. The contents of the questionnaire have been detailed elsewhere [ 25 ].…”