Improving health and development through play - Evaluation of a comprehensive ECCE programme at scale in Ghana

通过玩耍改善健康和发展 - 对加纳大规模综合幼儿保育和教育项目的评估

• 批准号: MR/V035312/2
• 负责人: Sofya Krutikova
• 金额: $ 129.94万
• 依托单位: University of Manchester
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FV035312%2F2
• 关键词: Improving; health; development; through; play

Children who receive quality ECCE are proven to be healthier, do better and stay longer in school, and thereby have better economic trajectories in adult life. Improving ECCE is therefore critical, especially in remote and vulnerable areas, such as northern Ghana, where most families live on less than US$2 per day, 20% of children under the age of 5 are stunted and 39% 3-4 years olds are off-track cognitively. Previous research by members of this research team has shown that an intervention by the NGO Lively Minds (LMNGO), designed to combat the twin problem of low kindergarten quality and poor parenting practices/mindsets, significantly improved children's health, cognitive skills and socio-emotional development in remote, poor, rural areas of northern Ghana. These promising findings were a key driver of the decision by the Ministry of Education (MoE) to work with LMNGO to scale up the programme in 60 of Ghana's 228 districts to reach 4,000 pre-schools and up to 1.3 million children over the next four years.However, from previous studies we know that programmes that are impactful at smaller scale may not maintain their effectiveness once adapted for and implemented at the scale necessary to reach those in need of them. In this project we, therefore, aim to find out whether the promising effect of the Lively Minds programme can be sustained as coverage is expanded and ownership of the programme is handed from LMNGO to the MoE. We will also study the causal pathway between the programme and child developmental outcomes. Analysis of the efficacy trial results conducted by this research team revealed some of these pathways (especially for impacts on socio-emotional development), drivers of the substantial health effects that were identified remain unexplained. To achieve these research aims, we have brought together a multidisciplinary research team, consisting of in-country and international economists, epidemiologists, WASH experts and developmental psychologists. Working in close partnership with LMNGO and the three ministries which oversee ECCE provision in Ghana (MoE, Ministry of Health and Ministry of Gender, Children and Social Protection) this team will embed a randomised controlled trial in the scale-up, collecting data on child development and pathways through which the Lively Minds programme could affect it after 4 terms of exposure. We will also collect routine data in schools to assess how well the programme is being implemented. The Lively Minds programme is unusual. ECCE programs are often one-dimensional, targeting either parents or pre-schools, and/or focusing on one area of child development. LMNGO developed a hybrid ECCE program, designed with scalability in mind, that simultaneously improves the home and pre-school environments, as well as children's health alongside cognitive and socio-emotional development at a projected cost of $7 per child per year when scaled, using only locally available resources and infrastructure and empowering marginalised and isolated mothers in rural communities. From starting in a few villages in Ghana and Uganda ten years ago it will now be taken over by the government of Ghana and will reach over a million children in the next 5 years. We will evaluate whether it maintains its effectiveness through this process of substantial scaling and transmission of ownership and whether there are ways in which it could be improved. This will first and foremost provide important evidence for the MoE on effectiveness of its policies. However, it will also help the wider community of stakeholders in LMICs seeking cost-effective, innovative, cross-sectoral and scalable ways to intervene in order to meet Sustainable Development Goals 3 and 4 ensuring that all children, including those in the most marginalised and vulnerable populations, receive nurturing care and opportunities for early learning.

事实证明，接受高质量教育的儿童更健康，表现更好，在校时间更长，因此成年后的经济发展轨迹更好。因此，改善幼儿教育至关重要，特别是在偏远和脆弱地区，如加纳北部，那里大多数家庭每天的生活费不足2美元，20%的5岁以下儿童发育迟缓，39%的3-4岁儿童认知障碍。该研究小组成员以前的研究表明，非政府组织Lively Minds （LMNGO）的干预措施，旨在解决幼儿园质量低和父母做法/心态差的双重问题，显著改善了加纳北部偏远、贫困农村地区儿童的健康、认知技能和社会情感发展。这些有希望的发现是教育部决定与非政府组织合作，在加纳228个地区中的60个地区扩大该项目规模的关键驱动力，在未来4年内覆盖4000所幼儿园和多达130万名儿童。然而，从以前的研究中我们知道，在较小规模上具有影响力的规划，一旦经过调整并在达到需要它们的人所需的规模上实施，就可能无法保持其有效性。因此，在这个项目中，我们的目标是发现，随着覆盖范围的扩大，以及计划的所有权从非政府组织移交给教育部，“活泼心灵”计划的良好效果能否持续下去。我们还将研究该计划与儿童发展结果之间的因果关系。该研究小组对疗效试验结果的分析揭示了其中一些途径（特别是对社会情感发展的影响），已确定的重大健康影响的驱动因素仍未得到解释。为了实现这些研究目标，我们汇集了一个多学科研究小组，由国内和国际经济学家、流行病学家、讲卫生运动专家和发展心理学家组成。该小组与LMNGO和负责加纳ECCE提供的三个部委（教育部、卫生部和性别、儿童和社会保障部）密切合作，将在扩大规模的过程中纳入一项随机对照试验，收集有关儿童发展的数据，以及“活泼心灵”项目在接触4个阶段后可能对儿童发展产生影响的途径。我们亦会收集学校的日常数据，以评估计划的执行情况。活泼的头脑节目是不同寻常的。ECCE项目通常是单向度的，针对家长或学前教育，并且/或者专注于儿童发展的一个领域。LMNGO制定了一项混合幼儿教育方案，在设计时考虑到可扩展性，可同时改善家庭和学前环境，以及儿童的健康以及认知和社会情感发展，按规模计算，每名儿童每年的预计成本为7美元，仅使用当地可用的资源和基础设施，并赋予农村社区边缘化和孤立的母亲权力。从十年前在加纳和乌干达的几个村庄开始，现在将由加纳政府接管，并将在未来五年内惠及100多万儿童。我们将评估它是否通过大规模扩展和所有权转移的过程保持其有效性，以及是否有办法改进它。这首先将为教育部政策的有效性提供重要证据。然而，它还将帮助中低收入国家更广泛的利益攸关方寻求具有成本效益、创新、跨部门和可扩展的干预方式，以实现可持续发展目标3和4，确保所有儿童，包括最边缘化和最弱势群体的儿童，都能得到养育和早期学习的机会。