Implementing an early childhood development intervention with routine immunization visits in India: a feasibility
Reshma Shah1, Veena Herekar2, Deepa Metgud2
1Departments of Pediatrics, University of Illinois at Chicago, Chicago, United States. reshmamd@uic.edu.
European Journal of Pediatrics
|May 4, 2022
Summary
Integrating early childhood development (ECD) interventions into routine healthcare visits is feasible in India. The adapted Sit Down and Play (SDP) intervention showed promise for improving home stimulation quality in low-income communities.
Area of Science:
- Public Health
- Developmental Pediatrics
- Global Health
Background:
- Millions of children in low- and middle-income countries (LMICs) do not reach their developmental potential.
- Responsive caregiving and learning opportunities are crucial for early childhood development (ECD).
- A gap exists between effective ECD interventions and their delivery in routine care for low-income communities.
Purpose of the Study:
- To assess the feasibility of integrating an adapted ECD intervention (Sit Down and Play - SDP) into primary health centers (PHCs) in rural India.
- To evaluate the potential of the SDP intervention to support key components for improving ECD, such as learning opportunities.
- To explore the intervention's impact on the quality of home stimulation and learning opportunities.
Main Methods:
- A prospective cluster nonrandomized pilot and feasibility trial was conducted in two PHCs in Karnataka, India.
- Caregivers of infants aged 6-10 weeks were recruited: one group received the SDP intervention during immunization visits (n=25), and a control group received usual care (n=28).
- Feasibility was assessed via implementation, practicality, acceptability, demand, and limited efficacy. Quality of home stimulation was measured using UNICEF Multiple Cluster Index Survey items.
Main Results:
- The Sit Down and Play (SDP) intervention was feasible for delivery during routine immunization visits.
- High caregiver satisfaction was reported with the adapted intervention content, training, and fidelity measures.
- Exploratory analyses indicated greater improvements in the quality of home stimulation over time in the intervention group compared to the control group.
Conclusions:
- Integrating an ECD intervention into routine healthcare visits is a feasible and promising strategy for supporting early childhood development in India.
- The adapted Sit Down and Play intervention demonstrates potential for improving parenting behaviors that promote ECD.
- Further research is necessary to confirm the effectiveness of the SDP intervention on children's developmental outcomes.
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