Care for Child Development in rural Malawi: a model feasibility and pilot study

Area of Science:

• Child Development
• Public Health Interventions
• Global Health

Background:

• Early stimulation, communication, and nutrition are crucial for child development.
• Real-world feasibility studies of such interventions in Africa are scarce.

Purpose of the Study:

• To pilot the integrated Care for Child Development program for children under two years old in Malawi.
• To assess the feasibility, acceptability, and impact of the intervention delivered by health surveillance assistants (HSAs).

Main Methods:

• A pilot study involving 60 caregivers and children <2 years, delivered by six HSAs.
• Intervention included group and individual sessions.
• Data collected on recruitment, session completion, child development (MDAT), maternal stress (SRQ), and family care indicators (FCIs), with caregiver/HSA interviews for acceptability.

Main Results:

• HSAs achieved only 14.2% coverage of eligible children.
• Session completion rates were 86% for group and 3.6/12 for individual sessions.
• Significant improvements were observed in child development (MDAT language and social Z-scores) and family care indicators (FCIs).

Conclusions:

• Integrated Care for Child Development programs are acceptable to caregivers in Malawi.
• Universal implementation through HSAs is not feasible due to limited coverage.
• Alternative delivery models for early childhood development interventions should be explored.