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Is Early Childhood Development Care at Public Health Facilities in Pakistan Effective? A Cluster Randomized

Nida Khan1, Muhammad Amir Khan2, Muhammad Ahmar Khan2

  • 1Association for Social Development, Islamabad, Pakistan. nidakhan@asd.com.pk.

Global Health, Science and Practice
|October 30, 2023
PubMed

Insights

Integrating early childhood development (ECD) care via lady health visitors (LHVs) significantly reduced developmental delays in children aged 12-24 months in rural Pakistan. This intervention improved ECD outcomes and anthropometric measurements.

Area of Science:

  • Pediatrics
  • Public Health
  • Developmental Psychology

Background:

  • Early brain development (birth to 2 years) is crucial and influenced by environmental factors.
  • Early childhood development (ECD) stimulation interventions are proven effective.
  • Integrating ECD care into existing health systems can enhance child development.

Purpose of the Study:

  • To assess the feasibility and effectiveness of integrating ECD care delivered by lady health visitors (LHVs).
  • To evaluate the impact of this integrated care on early childhood development in rural Pakistan.

Main Methods:

  • A cluster randomized controlled trial involving 22 clusters in Punjab, Pakistan.
  • Intervention group received ECD counseling from LHVs; control group received routine care.
  • 804 mother-child pairs (children aged 11-12 months at enrollment) participated, with outcomes assessed at 24 months.

Main Results:

  • The intervention group showed a significantly lower proportion of children with 2 or more developmental delays (13% vs. 41%).
  • The odds ratio for developmental delays in the intervention arm was 0.21 (95% CI=0.11, 0.42).
  • Children in the intervention arm exhibited significantly better anthropometric measurements at 24 months.

Conclusions:

  • Integrated ECD care delivered by LHVs at public health facilities is effective for children aged 12-24 months.
  • The intervention successfully enhanced ECD and reduced global developmental delays.
  • This model shows promise for improving child development outcomes in resource-limited settings.
Abstract

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