A community-designed play intervention to enhance early child development in rural Zimbabwe

撒哈拉以南非洲三分之二的儿童没有充分发挥其认知潜力。植根于贫困和脆弱性的一系列潜在因素导致儿童早期发展不理想，使整个人口陷入人力资本减少的困境，其影响贯穿整个生命周期和下一代。虽然在减轻贫困方面存在许多结构性障碍，但改变儿童成长的直接环境可以从根本上影响他们的发展，方法是提供资源和技能，将游戏、早期学习和响应性照料融入家庭。一个在儿童健康、发展心理学、儿童文化、社会科学和社区参与方面具有专业知识的多学科英国-津巴布韦联盟将与哈拉雷的一家儿童博物馆合作，与津巴布韦农村社区共同设计一套游戏、早期学习和响应性照料方案，以促进儿童发展。这将结合多感官刺激，动手玩和早期学习的机会，通过歌曲，讲故事，和社区制作的玩具。社区卫生工作者将根据养育照料框架的原则，通过与社区成员共同设计的讲习班，为家庭提供单独的游戏课程。Discovereum儿童博物馆将利用他们在游戏、教育和以用户为中心的设计方面的专业知识，开发旅行儿童博物馆，这些博物馆将由社区设计和配备，甚至覆盖最偏远的农村家庭，提供包容性的早期学习体验。在联合制作之后，我们将在12周的时间内对舒鲁维县的24户家庭进行干预测试。我们将使用混合方法来评估干预的可行性、可接受性和吸收性，根据共同产生的变化理论来评估机制和结果，并探索意想不到的后果。然后，我们将通过与参与干预的社区卫生工作者和家庭的另一次共同设计讲习班来完善一揽子方案。然后，我们将再招募24个家庭接受改进的干预，并在第12周再次评估可行性、可接受性、吸收性和作用机制。我们将在项目结束时举行最后一次研讨会，以确定干预措施、工具和培训材料，并纳入政策制定者的讨论，以考虑可扩展性和可持续性。在早期通过社区干部提供的低成本、与环境相关的干预措施可以使目前未能充分发挥潜力的三分之二的弱势儿童受益。在儿童早期发展方面即使取得很小的进展，也会转化为人力资本在人口层面上的重大改善，从而增进终身健康、福祉和经济繁荣。

Two-thirds of children in sub-Saharan Africa do not reach their full cognitive potential. A network of underlying factors rooted in poverty and vulnerability lead to suboptimal early childhood development, which traps entire populations into reduced human capital, with impacts across the lifespan and into the next generation. Although there are many structural barriers to poverty alleviation, transforming the immediate environment in which a child grows up could fundamentally shape their development by providing the resources and skills to embed play, early learning and responsive caregiving into households. A multidisciplinary UK-Zimbabwe consortium with expertise in child health, developmental psychology, childhood cultures, social science, and community engagement, in partnership with a children's museum in Harare, will co-design a package of play, early learning and responsive caregiving with a rural Zimbabwean community to promote child development. This will combine multi-sensory stimulation, hands-on play and early learning opportunities through song, storytelling, and community-made toys. Community health workers will deliver individual sessions of play with households, based on the principles of the nurturing care framework, and developed through a co-design workshop with community members. The Discovereum children's museum will leverage their expertise in play, education and user-centred design to develop travelling children's museums, which will be designed and equipped by the community, and reach even the furthest rural households to provide an inclusive early-learning experience. After co-production, we will test the intervention among 24 households in Shurugwi district over a 12-week period. We will use mixed methods to evaluate the feasibility, acceptability, and uptake of the intervention, to evaluate mechanisms and outcomes against the co-produced theory of change, and to explore unintended consequences. We will then refine the package through another co-design workshop with community health workers and families involved in the intervention. We will then enrol a further 24 households to receive the refined intervention, and again evaluate feasibility, acceptability, uptake, and mechanism of action by week 12. We will hold one final workshop at the end of the project, to finalise the intervention, tools and training materials, and incorporate policymaker discussions to consider scalability and sustainability.A low-cost, contextually relevant intervention, delivered through community cadres during the early years could benefit the two-thirds of disadvantaged children who currently fail to reach their full potential. Even small gains in early child development would translate to significant population-level improvements in human capital, which would enhance lifelong health, wellbeing and economic prosperity.