Table 2.
Measurement of outcomes, coverage and quality in key Transition-to-Scale projects
| Project name | Transition to scale of an integrated programme of nutritional care and psychosocial stimulation to improved malnourished children’s development. | An integrated intervention targeted at deprived preschool children in rural areas. | Home visiting programmes to improve early child development and maternal mental health. | Saving Brains, Changing Mindsets. |
| Lead institution | International Centre for Diarrhoeal Disease Research. | Universidad de los Andes. | Faculdade de Medicina da Universidade de Sao Paulo. | Mobile Crèches for Working Mothers’ Children. |
| Country | Bangladesh | Colombia | Brazil | India |
| Site | Dhaka area: Narsingdi and Kishoreganj Rural. | Central rural regions: Boyaca, Cundinamarca, Santander, Tolima. | Sao Paulo, urban slums in western area. | Delhi area, Bangalore, Ahmedabad and Chandigarh. |
| Vision/goal/objectives | Integrate RCEL intervention for poor, underweight children into routine government health services. | Improve quality of a pre-existing public parenting programme in a scalable fashion. | Evaluate the efficacy and cost-effectiveness of two alternative platforms for home visiting programmes. | Demonstrate scalability of workplace-based childcare for children of migrant construction workers. |
| No. of participating children | 1597 | 2134 | 206 | 4845 |
| Situational analysis and adaptation to context | Bangladesh government recognises educational and financial benefits of ECD and has incorporated ECD into national plan of action. Existing national infrastructure of government primary healthcare community clinics with supervision structure for clinic staff. Initial concerns regarding workload and motivation. | Building on existing long-standing government Family, Women and Infancy Program for women during pregnancy until their children are 2 years of age, combined clinic and home visits. Focused on several regions in Central Colombia, similar in terms of cultural and socioeconomic context. |
Governmental support. | Pre-existing Mobile Crèches NGO programme, demand from construction companies. |
| Measurement approach | ||||
| Outcome domains measured | Child development outcomes: Cognition. Language. Motor. Socioemotional. Intermediary outcomes: Nutrition. Parental practices. Home environment. Parental mental health. |
Direct: Cognition. Language. Motor. Socioemotional. Indirect: Nutrition. Parental practices. Home environment. |
Direct: Cognition. Language. Motor. Socioemotional. Indirect: Nutrition. Parental practices. Home environment. |
Direct: Cognition. Language. Motor. Socioemotional. |
| Quality | Detailed process evaluation. | Detailed process evaluation (see box 2 for key features measured). | Detailed process evaluation. | Detailed process evaluation (see box 3 for key features measured). Early Childhood Education Quality Assessment Scale. |
| Coverage (risk factor for targeting/method of measurement/population level need) | Underweight children attending community primary healthcare clinics (covered 90 of 13 000 nationally). |
Socioeconomic and geographic (rural location). Population-level data on socioeconomic vulnerability, already collected by national government. Population-level survey (ELCA 2013) including Ages and Stages Questionnaires data. |
Socioeconomic and geographic (urban slum). | National estimates of children of unskilled labourers (n=20 million). |
| References | 49–51 | 51 52 | 51 53 | 51 54 |
| Nurturing Care for Early Child Development Country Profiles – http://nurturing-care.org/resources/country-profiles/. | ||||