Delivering Parenting Interventions through Health Services in the Caribbean

Abstract

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“…Integrated programs that combine parent education about nutrition and stimulation with home visits by trained specialists have been shown to improve child development outcomes in LMICs (Grantham-McGregor, Fernald, Kagawa, & Walker, 2014;Spier et al, 2016). However, the cost of "gold standard" home visiting programs can constrain the potential for scale-up; for example, the well-known Jamaica home visiting program was estimated to cost over $100 per child per year (Walker et al, 2015).…”

“…An additional $9.31 per household was spent on adaptation and training, transportation, equipment, text messages and airtime, local guides, and refreshments for participants. Thus, our light touch (single session) intervention can be effectively delivered at substantially lower cost than "gold standard" home visitation programs (Walker et al, 2015). The design of our training (using videos, demonstrations, small group practice and feedback, etc.)…”

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“…For example, consider the parenting program implementing the Jamaican curriculum that involves weekly home visits. A feasible twist on this program is to counsel parents at health clinics during regular medical check-ups (Walker et al, 2015). In this intervention, mothers watch videos and discuss parental strategies with community health workers while waiting to see medical professionals.…”

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“…This inference relies on four studies (Gowani and others 2014; López Boo, Palloni, and Urzua 2014; Walker and others 2015; and a subsequent interpretation by Psacharopoulos 2015 of Vermeersch and Kremer 2004). Because two of these are not or not yet published (Walker and others 2015;Vermeersch and Kremer 2004), and the study designs of the other two have unique features, additional studies are needed to confirm this tendency. Berlinski and Schady (2015) also model the benefi t-cost ratio of day care provision to children ages zero to fi ve years as 1.2 (Guatemala), 1.1 (Colombia), and 1.5 (Chile), also using a modeling exercise and discount rate of 3 percent.…”

“…Two randomized controlled trials for Pakistan and the Caribbean had positive economic evaluations. The benefit-cost ratio for an intervention in Antigua, Jamaica, and St. Lucia that developed videos and showed them to parents waiting in health centers, followed by group discussion, was 5.3 (Walker and others 2015). In Pakistan, a randomized controlled trial compared nutrition alone, responsive stimulation alone, and the two combined against a control receiving usual care (Gowani and others 2014).…”