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。植根于贫穷和脆弱性的一系列根本因素导致幼儿发展欠佳，使整个人口陷入人力资本减少的困境，影响到整个生命周期，并影响到下一代。虽然在减贫方面存在许多结构性障碍，但改变儿童成长的直接环境，通过提供资源和技能，将游戏、早期学习和适应性教育纳入家庭，可以从根本上塑造儿童的发展。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门知识的多学科英国-津巴布韦联合会将与哈拉雷的一个儿童博物馆合作，与津巴布韦农村社区共同设计一套游戏、早期学习和响应式教育，以促进儿童发展。这将结合联合收割机多感官刺激，动手游戏和早期学习的机会，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护理框架的原则，通过与社区成员共同设计的研讨会，与家庭进行单独的游戏。Discovereum儿童博物馆将利用其在游戏、教育和以用户为中心的设计方面的专业知识，开发流动儿童博物馆，这些博物馆将由社区设计和装备，甚至覆盖最偏远的农村家庭，提供包容性的早期学习体验。在合作生产之后，我们将在Shurugwi区的24个家庭中测试干预措施，为期12周。我们将使用混合的方法来评估干预的可行性，可接受性和吸收，评估机制和结果对共同产生的变化理论，并探讨意外的后果。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该方案。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周前再次评估可行性，可接受性，吸收和作用机制。我们将在项目结束时举办最后一次研讨会，最终确定干预措施、工具和培训材料，并与政策制定者讨论，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、与背景相关的干预措施可以使三分之二目前未能充分发挥潜力的弱势儿童受益。即使在幼儿发展方面取得很小的进展，也会转化为人口一级人力资本的显著改善，从而增强终身健康、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.