Effectiveness of a youth-led early childhood care and education programme in rural Pakistan: A cluster-randomised controlled trial

Aisha K Yousafzai, Muneera A Rasheed, Arjumand Rizvi, Fariha Shaheen, Liliana A Ponguta, Chin R Reyes, Aisha K Yousafzai, Muneera A Rasheed, Arjumand Rizvi, Fariha Shaheen, Liliana A Ponguta, Chin R Reyes

Abstract

Background: The United Nation's Sustainable Development Goals encompass lifelong learning from birth to youth to adulthood (Goal 4) and economic opportunities for young people (Goal 8). The targets include improving access to quality early childhood care and education (ECCE) as well as learning and training opportunities for adolescents and youth. Cross-generational models for young children and youth may offer opportunities to address the interconnections between goals and targets for the next generation. We investigated whether an ECCE programme for young children (3.5-6.5 years) delivered by female youth (18-24 years) in rural Pakistan would be effective on children's school readiness.

Methods: In partnership with the National Commission for Human Development in Pakistan, we implemented the 'Youth Leaders for Early Childhood Assuring Children are Prepared for School' (LEAPS) programme to train female youth to deliver ECCE. The effectiveness of the LEAPS programme on children's school readiness was evaluated in a cluster-randomised controlled trial. We randomly allocated five clusters (villages) to receive the intervention (n = 170 children) and five clusters to control (n = 170 children). Children's school readiness was assessed after nine months of intervention exposure using the International Development and Early Learning Assessment tool. Analyses was by intention-to-treat. The trial is registered with ClinicalTrials.gov, number NCT02645162.

Findings: At endline, the intervention group had significantly higher school readiness scores (n = 166, mean percentage score 59.4, 95% CI 52.7 to 66.2) compared with the control group (n = 168, mean percentage score 45.5, 95% CI 38.8 to 52.3). The effect size (Cohen's d) was 0.3.

Conclusion: Trained female youth delivered an ECCE programme that was effective in benefitting young children's school readiness. The cross-generational model is a promising approach to support early child development; however, further evaluation of the model is needed to assess the specific benefits to youth including their skills and economic development.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Intervention and control clusters.
Fig 1. Intervention and control clusters.
Five clusters were randomly assigned to the intervention arm and five clusters to the control arm for the trial.
Fig 2. Flowchart of clusters, participants, and…
Fig 2. Flowchart of clusters, participants, and timeline.

References

    1. Richter LM, Daelmans B, Lombardi J, Heymann J, Boo FL, Behrman JR, et al. Investing in the foundation of sustainable development: pathways to scale up for early childhood development. The Lancet. 2016.
    1. Lu C, Black MM, Richter LM. Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level. The Lancet Global Health. 2016;4(12):e916–e22. 10.1016/S2214-109X(16)30266-2
    1. Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R, Allen NB, et al. Our future: a Lancet commission on adolescent health and wellbeing. The Lancet. 2016;387(10036):2423–78.
    1. Nilsson M, Griggs D, Visbeck M. Map the interactions between sustainable development goals: Mans Nilsson, Dave Griggs and Martin Visbeck present a simple way of rating relationships between the targets to highlight priorities for integrated policy. Nature. 2016;534(7607):320–3. 10.1038/534320a
    1. Nelson CA. The neurobiological bases of early intervention. Handbook of early childhood intervention. 2000;2:204–27.
    1. Konrad K, Firk C, Uhlhaas PJ. Brain development during adolescence: neuroscientific insights into this developmental period. Deutsches Ärzteblatt International. 2013;110(25):425 10.3238/arztebl.2013.0425
    1. Moisala M, Salmela V, Carlson S, Salmela-Aro K, Loka K, Hakkarainen K, Alho K. Neural activity patters between different executive tasks are more similar in adulthood than in adolescence. Brain and behavior. 2018; 8e01063.
    1. Casey B, Tottenham N, Liston C, Durston S. Imaging the developing brain: what have we learned about cognitive development? Trends in cognitive sciences. 2005;9(3):104–10. 10.1016/j.tics.2005.01.011
    1. Shonkoff JP, Fisher PA. Rethinking evidence-based practice and two-generation programs to create the future of early childhood policy. Development and psychopathology. 2013;25(4pt2):1635–53.
    1. Tran T, Luchters S, Fisher J. Early childhood development: impact of national human development, family poverty, parenting practices and access to early childhood education. Child: care, health and development. 2017;43(3):415–26.
    1. Britto PR, Yoshikawa H, Boller K. Quality of Early Childhood Development Programs in Global Contexts: Rationale for Investment, Conceptual Framework and Implications for Equity. Social Policy Report. 2011;25(2).
    1. Yoshikawa H, Leyva D, Snow CE, Treviño E, Barata M, Weiland C, et al. Experimental impacts of a teacher professional development program in Chile on preschool classroom quality and child outcomes. Developmental psychology. 2015;51(3):309 10.1037/a0038785
    1. Ponguta LA, Rasheed MA, Reyes CR, Yousafzai AK. A Conceptual Model for Youth‐Led Programs as a Promising Approach to Early Childhood Care and Education. New directions for child and adolescent development. 2018;2018(159):71–89. 10.1002/cad.20233
    1. Mahmood N. The Demographic Dividend: Effects of Population Change on School Education in Pakistan. Working Papers & Research Reports. 2011;2011.
    1. Go Pakistan. National Education Policy. Education Mo; 2009.
    1. UNICEF. Out-of-school children in the Balochistan, Khyber Pakhtunkhwa, Punjab and Sindh provinces of Pakistan. Islamabad, Pakistan: UNICEF Pakistan; 2013.
    1. Bartlett S. Learning about Learning: Reflections on Studies from 10 Countries: Aga Khan Foundation; 2013.
    1. Britto PR, Lye SJ, Proulx K, Yousafzai AK, Matthews SG, Vaivada T, et al. Nurturing care: promoting early childhood development. Lancet (London, England). 2017;389(10064):91–102. 10.1016/S0140-6736(16)31390-3
    1. Fernald LC, Kariger P, Engle P, Raikes A. Examining early child development in low-income countries Washington DC: The World Bank; 2009.
    1. Yousafzai AK, Obradovic J, Rasheed MA, Rizvi A, Portilla XA, Tirado-Strayer N, et al. Effects of responsive stimulation and nutrition interventions on children's development and growth at age 4 years in a disadvantaged population in Pakistan: a longitudinal follow-up of a cluster-randomised factorial effectiveness trial. The Lancet Global health. 2016;4(8):e548–58. 10.1016/S2214-109X(16)30100-0
    1. Carlson SM. Developmentally sensitive measures of executive function in preschool children. Developmental neuropsychology. 2005;28(2):595–616. 10.1207/s15326942dn2802_3
    1. Molfese VJ, Molfese PJ, Molfese DL, Rudasill KM, Armstrong N, Starkey G. Executive function skills of 6–8 year olds: Brain and behavioral evidence and implications for school achievement. Contemporary educational psychology. 2010;35(2):116–25. 10.1016/j.cedpsych.2010.03.004
    1. Noël M-P. Counting on working memory when learning to count and to add: A preschool study. Developmental Psychology. 2009;45(6):1630 10.1037/a0016224
    1. Wesher D. Weshler Preschool and Primary Scale of Intelligence-III San Anttonio: Pearson; 2002.
    1. Rasheed MA, Pham S, Memon U, Siyal S, Obradović J, Yousafzai AK. Adaptation of the Wechsler Preschool and Primary Scale of Intelligence-III and lessons learned for evaluating intelligence in low-income settings. International Journal of School & Educational Psychology. 2017:1–11.
    1. Cogill B. Anthropometric indicators measurement guide. 2003.
    1. Aboud FE, Hossain K. The impact of preprimary school on primary school achievement in Bangladesh. Early Childhood Research Quarterly. 2011;26(2):237–46.
    1. Moore AC, Akhter S, Aboud FE. Evaluating an improved quality preschool program in rural Bangladesh. International Journal of Educational Development. 2008;28(2):118–31.
    1. Yousafzai AK, Rasheed MA, Rizvi A, Armstrong R, Bhutta ZA. Effect of integrated responsive stimulation and nutrition interventions in the Lady Health Worker programme in Pakistan on child development, growth, and health outcomes: a cluster-randomised factorial effectiveness trial. The Lancet. 2014;384(9950):1282–93.
    1. Rao N, Koong M, Kwong M, Wong M. Predictors of preschool process quality in a Chinese context. Early Childhood Research Quarterly. 2003;18(3):331–50.
    1. Arnold C, Bartlett K, Gowani S, Merali R. Is Everybody Ready? Readiness, Transition and Continuity: Reflections and Moving Forward. Working Papers in Early Childhood Development, Number 41: ERIC; 2007.
    1. Nores M, Fernandez C. Builing capacity in health and education systems to deliver interventions that stregnthen early child development. Annals of the New York Academy of Scences 2018; 1489: 57–73.

Source: PubMed

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