Table 2.
Description of the Saving Brains responsive care and early learning (RCEL) Transition-To-Scale projects: summary of human resources and curricula content (n=4 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, Bangladesh (ICDDR, B) | Universidad de Los Andes (UDLA) | Faculdade de Medicina da Universidade de São Paulo (USP) | Mobile Crèches for Working Mothers’ Children (MC) |
| Country | Bangladesh | Colombia | Brazil | India |
| Site | Rural Dhaka area: Narsingdi and Kishoreganj | Central rural regions: Boyacá, Cundinamarca, Santander |
São Paulo, urban slums in western area | Delhi area, Bangalore, Ahmedabad, 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 programme | Demonstrate scalability of workplace-based childcare for children of migrant construction workers |
| Participating children, n | 1597 | 2134 | 800 | 4845 |
| Human resources | ||||
| Type | Associate health professional | Lay community member as paraprofessional | Community health workers (CHW) and child development agents (CDA) | Personal care worker |
| Pre-existing/novel cadre | Pre-existing | Pre-existing | CHWs pre-existing, CDAs novel cadre | Pre-existing |
| Incentivisation, including remuneration | Occasional small gifts | Remunerated by government | 30% elevated salary pre-existing CHWs, salary-matched CDAs | Salaried |
| Qualification/skill/competence | Technical qualification | Secondary education | No qualification needed | Primary and secondary education |
| Gender of workers | Majority female | Majority female | Exclusively female | Majority female |
| Length of training | 15 days | 85 hours over 3.5 weeks | 40 hours initial (Reach Up) and 32 hours refresher | 36 days |
| Workers recruited (completing training, delivering project), n | 354 (320, 168) | 171 (171, 171) | 15 (15, 13) | 139 (83, 67) |
| Frequency of supervision | Minimum once per month. | Every 6 weeks | Once per week | Six months rigorous, then monthly |
| Curricula content | ||||
| Group versus individual | 2 or 4–5 dyads | 80% group, 20% individual | All individual | 70% group, 30% individual |
| Duration of intervention | 12 months | 11 months | 12 months | 3 months |
| Average length of sessions | 50 min | 1 hour | 1 hour | 8 hours (full creche day) |
| Sessions, n | 25 | 55 | 24 | 75 |
| Frequency of contacts per month | 2 | 3 | 2 | 25 |
| Materials | Play materials | Books, puzzles, images and toys (recyclable materials) | Books, puzzles, images and toys (recyclable materials) | Play materials, blocks, puzzles, big picture books, toys (low cost) |
| Curriculum | Adaptation of Reach Up | Adaptation of Reach Up | Adaptation of Reach Up | Thematic curriculum on school readiness skills |
| Use of digital media | None | None | None | None |
| Mechanism of behaviour change | ||||
| Mentoring | Yes | Yes | Yes | Yes |
| Problem solving | Yes | Yes | – | – |
| Didactic | – | – | – | – |
| Demonstrations | Yes | Yes | Yes | Yes |
| Service mapping | – | – | – | – |
| Empowerment | Yes | Yes | Yes | Yes |
| Peer support | Yes | Yes | – | – |
| Media | – | – | – | – |
| Materials | Yes | – | Yes | – |
| Published references | 21 48 49 | 21 50 | 21 50 | 21 51 |