Early Childhood Newborn Responsive Parenting Education Program at Maternal Primary Healthcare Facilities of Pakistan...

Responsive caregiving is one of the most fundamental pillars of early childhood development. In the newborn stage, the parents are undergoing transitions and require support to understand the nuances of interacting with the young baby. The role of healthcare facilities in this becomes vital as a hub for conducting parenting education sessions that may yield thriving outcomes for young children and their future development. This study aims to explore the impact of the early childhood newborn parenting program on parental confidence and newborn responsive interaction and to explore the perceptions of healthcare providers regarding the intervention implemented in healthcare settings.

An implementation research design will be used in this study. A total of 500 participants will be included in the study, 400 from Pakistan and 100 from Afghanistan. There are two sites: each site will be randomly assigned as a control or an intervention. The rationale was to ensure that both sites are in different geographical locations. Participants from each side will be chosen using a convenience sampling technique. Cohort 1 (control group) will only be provided with a self-study, one consolidated handout on responsive caregiving, and one-time bed teaching, and will be requested to visit the center after six months (child age) for an endline. While cohort 2 (intervention group) will be provided a six-module intervention consisting of one session at birth with a self-study handout on responsive caregiving, and five monthly sessions (once a month till the infant turns six months) will be conducted. Outcomes measured at the baseline and endline (at six months) include differences in responsive interactions and parenting confidence scores between the control and intervention groups using tools such as Karitine parenting confidence, responsive interaction scale, Caregiver Reported Early Development Instruments (CREDI), WHO QoL, and Patient Health Questionnaire (PHQ).

This is an ongoing study protocol, and the analysis of the results is expected in December 2025.

The study will be one of its kind to have been implemented from a healthcare setting, whereby the formal newborn responsive parenting intervention is used, particularly in remote areas of Pakistan and Afghanistan, using a primary healthcare facility for implementation. The study will establish the feasibility of a novel intervention and provide a model of utilization of healthcare settings as hubs for early childhood (ECD)-responsive parenting education. Evidence from this study will be largely applicable to countries with limited resources and countries that are striving to make early childhood parenting education more accessible to the communities.