"Care for Development" intervention in rural China: a prospective follow-up study

The aim of this study was to test the efficacy and appropriateness of the World Health Organization's Care for Development (CFD) counseling materials, which form part of the Integrated Management of Childhood Illness (IMCI) strategy. The CFD materials are based on the Mother's Card, which contained age-specific messages on how caregivers can better play and communicate with a child.

We enrolled 100 families with a child of younger than 2 years of age from seven randomly selected villages in an impoverished rural county in Anhui Province, China. Two counseling sessions, using the CFD Mother's Card, were provided to 50 families randomly selected from among the study participants. All children were assessed with Gesell Developmental Schedules before counseling and after 6 months. A questionnaire on family situation and knowledge, attitudes, and practices regarding child development was also administered at the start and conclusion of the study.

At baseline assessment, both control and intervention groups were equal, with average developmental scores less than the national norms. Children in families who received counseling had significantly higher development quotient scores in cognitive, social, and linguistic domains. Questionnaire data on child rearing suggested that responsive and rich interactions and consistent caregivers correlated with higher scores. The CFD Mother's Card was found to be feasible and helpful in those families who received counseling.

There is urgent need for further work on promotion of child development in rural China. The World Health Organization's CFD approach and Mother's Card is feasible and effective and should be expanded in use, especially within the national IMCI program.