Using the infrastructure of a conditional cash transfer program to deliver a scalable integrated early child development program in Colombia: cluster randomized controlled trial
By O. Attanasio, C. Fernández, E. Fitzsimons, S. Grantham‐McGregor, C. Meghir, Marta Rubio-Codina. British medical journal, 2014
315 citations recorded by the source corpus.
Objective To assess the effectiveness of an integrated early child development intervention, combining stimulation and micronutrient supplementation and delivered on a large scale in Colombia, for children’s development, growth, and hemoglobin levels. Design Cluster randomized controlled trial, using a 2×2 factorial design, with municipalities assigned to one of four groups: psychosocial stimulation, micronutrient supplementation, combined intervention, or control. Setting 96 municipalities in Colombia, located across eight of its 32 departments. Participants 1420 children aged 12-24 months and their primary carers. Intervention Psychosocial stimulation (weekly home visits with play demonstrations), micronutrient sprinkles given daily, and both combined. All delivered by female community leaders for 18 months. Main outcome measures Cognitive, receptive and expressive language, and fine and gross motor scores on the Bayley scales of infant development-III; height, weight, and hemoglobin levels measured at the baseline and end of intervention. Results Stimulation improved cognitive scores (adjusted for age, sex, testers, and baseline levels of outcomes) by 0.26 of a standard deviation (P=0.002). Stimulation also increased receptive language by 0.22 of a standard deviation (P=0.032). Micronutrient supplementation had no significant effect on any outcome and there was no interaction between the interventions. No intervention affected height, weight, or hemoglobin levels. Conclusions Using the infrastructure of a national welfare program we implemented the integrated early child development intervention on a large scale and showed its potential for improving children’s cognitive development. We found no effect of supplementation on developmental or health outcomes. Moreover, supplementation did not interact with stimulation. The implementation model for delivering stimulation suggests that it may serve as a promising blueprint for future policy on early childhood development. Trial registration Current Controlled trials ISRCTN18991160.
Subfields: Hematology, Nutrition and Dietetics, Pediatrics, Perinatology and Child Health
View Paper: https://www.semanticscholar.org/paper/7fe61d6690f81ef49ea7e952a59a321713d41c34
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In Hematology
In Nutrition and Dietetics
In Pediatrics, Perinatology and Child Health
Citations in the corpus
- THE DETERMINANTS OF HUMAN CAPITAL FORMATION DURING THE EARLY YEARS OF LIFE: THEORY, MEASUREMENT, AND POLICIES (2015, methodology): “One possible approach, for instance, developed in Attanasio et al. (2014b) and used in Attanasio et al. (2015a), is to take draws from the joint distribution estimated into a first step and use these simulated data to estimate the structural relation of interest by standard techniques (such as…”