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

撒哈拉以南非洲地区三分之二的儿童没有充分发挥他们的认知潜力。根植于贫困和脆弱性的潜在因素网络导致儿童早期发展不佳，使整个人口陷入人力资本减少的困境，对寿命和下一代产生影响。尽管减贫有许多结构性障碍，但通过提供资源和技能，将游戏、早期学习和顺应形势的照顾融入家庭，改变儿童成长的直接环境可以从根本上影响他们的发展。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英国-津巴布韦多学科联盟，与哈拉雷的一家儿童博物馆合作，将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看方案，以促进儿童发展。这将结合多感官刺激，动手游戏和早期学习机会，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护理框架的原则，通过与社区成员的共同设计研讨会，提供与家庭玩耍的个人课程。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来开发流动儿童博物馆，这些博物馆将由社区设计和配备，甚至可以接触到最远的农村家庭，提供包容的早期学习体验。在联合制作之后，我们将在舒鲁威区的24户家庭中测试为期12周的干预。我们将使用混合方法来评估干预的可行性、可接受性和接受性，对照共同产生的变革理论来评估机制和结果，并探索意想不到的后果。然后，我们将通过另一个与社区卫生工作者和参与干预的家庭共同设计的研讨会来完善一揽子计划。然后，我们将再招募24个家庭接受改进的干预措施，并在第12周之前再次评估可行性、可接受性、接受性和行动机制。我们将在项目结束时举行最后一次研讨会，以最终确定干预措施、工具和培训材料，并纳入政策制定者的讨论，以考虑可伸缩性和可持续性。早期通过社区干部提供的低成本、与背景相关的干预措施可能会使目前未能充分发挥其潜力的三分之二的弱势儿童受益。即使在儿童早期发展方面取得的微小进展也会转化为人口层面的人力资本的显著改善，这将增强终身健康、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.