The benefits of nurturing care interventions on early child development and care: findings from a quasi-experimental study in a humanitarian setting

Abstract

Background The study objective was to determine if a nurturing care parenting intervention delivered in a humanitarian setting in Rwanda would benefit early development, learning, and care outcomes for young children under five years and their caregivers compared to standard care. Methodology Rwanda’s Mugombwa, Kansi, and Kigeme refugee camps and host communities implemented the parenting program. Via a quasi-experimental research design, the study assessed the effects of intervention delivered as a high dose (HD: 12 group sessions and four home visits) or low dose (LD: 6 group sessions and two home visits) on child and caregiver outcomes compared to the control group from similar settings receiving standard care. The Ages and Stages Questionnaires-3 (ASQ-3) assessed child development outcomes. The Multiple Indicator Cluster Survey questionnaire assessed parenting practices concerning early learning and stimulation. Findings The assessment included 733 children and families in total: HD = 314, LD = 240, control = 179. The researchers found no significant difference in child development scores between the intervention and control groups. Significantly higher proportion of caregivers exposed to HD and LD packages had engaged in early learning and stimulation practices compared to the control group, respectively, with 211(67.2%), 148 (61.7%) vs. 66 (36.9%), p < 0.001 caregivers engaged in 4 or more activities in the past three days. Similarly, on responsive feeding items, a higher percentage of HD and LD group caregivers were engaged in positive behaviours compared to the control group: 164 (52.2%), 108 (45%) vs. 62 (34.6%), p = 0.001. The study found no difference between the study arms regarding caregiver mental health. Conclusion Parenting programmes in humanitarian settings can improve nurturing care practices, even with a low dose, which is essential to strengthening children’s resilience in at-risk conditions. Further studies in humanitarian contexts are crucial to understand the implementation needs in sensitive contexts.

Implementation evaluation of a nurturing care intervention in a humanitarian setting in Rwanda

“…The objective of the study was to present the implementation evaluation ndings of an intervention delivered in a humanitarian setting in Rwanda, in high and low dose. A prior evaluation of 3C, assessing its impact, had shown the intervention's effectiveness in promoting early learning practices, responsive feeding and attitude towards corporal punishment [7]. Data about adoption of practices in this study aligns with the previous ndings.…”

“…A signi cant barrier has been the lack of evidence regarding the implementation of programs, speci cally addressing the 'why' and 'how,' and the settings and contexts in which these interventions can be effective [6]. To support resilience building in early childhood within refugee settings, World Vision Rwanda (WVR) employed an innovative, evidencebased, child-focused parenting program designed to reach 3,000 caregivers with children under the age of 5 in underserved populations residing in camps and host communities, including the Mugombwa Congolese Refugee Camp and three nearby Sector Host Communities (Kansi, Kigembe, Mugombwa) [7].…”

Complementary feeding practices for children aged 6–23 months in early childhood education institutions in urban China: A cross-sectional study

“…In addition, as the children's first teacher, nurturer and protector, primary caregivers play a crucial role in providing nurturing care for infants and young children [17,18]. The most basic experiences in early life come from the nurturing care and protection of parents and families, which have lifelong benefits for health and well-being and enhance the ability to learn and earn [19]. Despite numerous studies on infant feeding, the current status of early childhood feeding in urban ECE institutions remains unknown.…”