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

Abstract

Background The objective of the study to determine if a nurturing care parenting programme delivered in a humanitarian setting in Rwanda to determine would benefit early development, learning and care outcomes for young children under 5 years and their caregivers compared to standard care. Methodology The parenting programme was implemented in Rwanda’s Mugombwa, Kansi and Kigeme refugee camp and host communities. Via a quasi-experimental research design, the study assessed the effects of intervention delivered as high dose (HD: 12 group sessions and 4 home visits) or low dose (LD: 6 group sessions and 2 home visits) on child and caregiver outcomes compared to the control group from similar settings receiving standard care. Child development outcomes were assessed using the Ages and Stages Questionnaires (ASQ). Parenting practices with respect to early learning and stimulation were assessed using standard questionnaires. Findings A total of 733 children and families were assessed: HD = 314, LD = 240, control = 179. No significant difference on child development scores between intervention and control groups was found. Caregivers exposed to HD and LD packages had significantly higher scores on early learning and stimulation practices compared to the control group respectively with 211(67.2%), 148 (61.7%) vs. 66 (36.9%), p < .001 caregivers engaged in 4 or more activities in the past 3 days. Similarly on responsive feeding items, a higher percentage of HD and LD group caregivers were engaged in positive behaviours compared to control group: 164 (52.2%), 108 (45%) vs 62 (34.6%), p = 0.001. No differences were found in the study arms in regard to caregiver mental health. Conclusion Parenting programmes in humanitarian settings can positively impact on nurturing care practices, even with a low dose, which are essential to strengthening children’s resilience living in at-risk conditions such as refugee settings. Further studies in such context are essential to strengthen the proof of concept from the study findings.