Human resources and curricula content for early child development implementation: multicountry mixed methods evaluation.
child health
early child development
evaluation
health systems
implementation
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
26 04 2020
26 04 2020
Historique:
entrez:
29
4
2020
pubmed:
29
4
2020
medline:
16
2
2021
Statut:
epublish
Résumé
The WHO recommends responsive caregiving and early learning (RCEL) interventions to improve early child development (ECD), and to achieve the Sustainable Development Goals' vision of a world where all children thrive. Implementation of RCEL programmes in low and middle-income countries (LMIC) requires evidence to inform decisions about human resources and curricula content. We aimed to describe human resources and curricula content for implementation of RCEL projects across diverse LMICs, using data from the Grand Challenges Canada Saving Brains ECD portfolio. We evaluated 32 RCEL projects across 17 LMICs on four continents. Overall, 2165 workers delivered ECD interventions to 25 909 families. Projects were either stand-alone RCEL or RCEL combined with health and nutrition, and/or safety and security. We undertook a mixed methods evaluation of RCEL projects within the Saving Brains portfolio. Quantitative data were collected through standardised reporting tools. Qualitative data were collected from ECD experts and stakeholders and analysed using thematic content analysis, informed by literature review. Major themes regarding human resources included: worker characteristics, incentivisation, retention, training and supervision, and regarding curricula content: flexible adaptation of content and delivery, fidelity, and intervention duration and dosage. Lack of an agreed standard ECD package contributed to project heterogeneity. Incorporation of ECD into existing services may facilitate scale-up but overburdened workers plus potential reductions in service quality remain challenging. Supportive training and supervision, inducement, worker retention, dosage and delivery modality emerged as key implementation decisions. This mixed methods evaluation of a multicountry ECD portfolio identified themes for consideration by policymakers and programme leaders relevant to RCEL implementation in diverse LMICs. Larger studies, which also examine impact, including high-quality process and costing evaluations with comparable data, are required to further inform decisions for implementation of RCEL projects at national and regional scales.
Identifiants
pubmed: 32341042
pii: bmjopen-2019-032134
doi: 10.1136/bmjopen-2019-032134
pmc: PMC7204990
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e032134Subventions
Organisme : World Health Organization
ID : 001
Pays : International
Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Health Policy Plan. 2017 Oct 1;32(suppl_1):i6-i20
pubmed: 28981766
Ann N Y Acad Sci. 2018 May;1419(1):120-140
pubmed: 29791729
Ann N Y Acad Sci. 2014 Jan;1308:172-82
pubmed: 24571217
Int J Environ Res Public Health. 2018 Mar 14;15(3):
pubmed: 29538291
Lancet Glob Health. 2016 Aug;4(8):e548-58
pubmed: 27342433
Cochrane Database Syst Rev. 2013 Apr 30;(4):CD009035
pubmed: 23633365
Ann N Y Acad Sci. 2014 Jan;1308:33-45
pubmed: 24372510
Arch Dis Child. 2019 Apr;104(Suppl 1):S3-S12
pubmed: 30885961
BMJ Open. 2018 Jun 22;8(6):e021186
pubmed: 29934387
Soc Sci Med. 2014 Oct;118:33-42
pubmed: 25089962
Annu Rev Psychol. 2015 Jan 3;66:433-57
pubmed: 25196276
Ann N Y Acad Sci. 2018 May;1419(1):264-271
pubmed: 29791728
Lancet. 2017 Jan 7;389(10064):77-90
pubmed: 27717614
Arch Dis Child. 2019 Apr;104(Suppl 1):S43-S50
pubmed: 30885965
Ann N Y Acad Sci. 2014 Jan;1308:68-88
pubmed: 24372533
PLoS Med. 2012;9(12):e1001359
pubmed: 23300387
Lancet. 2007 Jan 20;369(9557):229-42
pubmed: 17240290
PLoS Med. 2018 Apr 24;15(4):e1002556
pubmed: 29689057
BMJ. 2015 Mar 19;350:h1258
pubmed: 25791983
Arch Dis Child. 2019 Apr;104(Suppl 1):S34-S42
pubmed: 30885964
Arch Dis Child. 2019 Apr;104(Suppl 1):S22-S33
pubmed: 30885963
Lancet. 2011 Oct 8;378(9799):1339-53
pubmed: 21944378
J Glob Health. 2017 Jun;7(1):010908
pubmed: 28685046
Health Policy Plan. 2017 Oct 1;32(suppl_1):i1-i5
pubmed: 28981767
Lancet Glob Health. 2019 Mar;7(3):e366-e375
pubmed: 30784637
PLoS Med. 2013 Dec;10(12):e1001572; discussion e1001572
pubmed: 24358029
Ann N Y Acad Sci. 2018 May;1419(1):230-248
pubmed: 29791735
Arch Dis Child. 2019 Apr;104(Suppl 1):S13-S21
pubmed: 30885962
Ann N Y Acad Sci. 2018 May;1419(1):218-229
pubmed: 29791741
Child Care Health Dev. 2019 Jan;45(1):45-53
pubmed: 30259548
Health Policy Plan. 2017 Oct 1;32(suppl_1):i53-i63
pubmed: 28981764
Ann N Y Acad Sci. 2014 Jan;1308:192-203
pubmed: 24571219
Lancet. 2017 Jan 7;389(10064):9-11
pubmed: 27717607
Ann N Y Acad Sci. 2018 May;1419(1):160-178
pubmed: 29791730
Lancet. 2017 Jan 7;389(10064):91-102
pubmed: 27717615
Arch Dis Child. 2014 Sep;99(9):840-8
pubmed: 24647995
BMJ. 2015 Sep 14;351:h4029
pubmed: 26371213