Implementation science for early childhood development in Jharkhand and Odisha, India

在生命的头三年，良好的护理、营养和学习机会对儿童的心理、身体和情感发展至关重要。世界上有四分之一的儿童面临着不能充分发挥其潜力的风险，他们生活在印度。其中，生活在农村地区和土著(部落)家庭的儿童风险最大，因为他们是最贫穷的。三岁以下儿童及其照顾者的托儿所和育儿小组是帮助儿童在早期获得所需营养、护理和刺激的可能战略。不幸的是，在土著家庭众多的农村地区，托儿所和托儿所团体是否、如何以及以什么成本可以使儿童的发展受益的研究很少。我们已经为印度拥有大型土著社区的邦的托儿所和团体确定了一个新的政府资金来源；这些被称为地区矿物基金会。来自地区矿物基金会的资金旨在惠及12个州受采矿影响的社区，其中一半州有大型农村和土著社区。地区矿物基金会的资金可以用于资助托儿所和团体，如果我们的研究表明它们有利于儿童的发展。在这项研究中，我们将修改地区矿物基金会可以资助的现有托儿所模式，使其适用于查尔坎德邦和奥迪萨邦的农村土著社区，这两个邦是印度东部的两个邦，超过一半的土著儿童长期营养不良。我们还将采用在牙买加和孟加拉国进行测试的成功的育儿小组模式，以适用于贾坎德邦和奥迪萨的这些农村土著社区。很少有适合与土著印第安人社区合作来衡量儿童发展的工具，因此我们将翻译和修改六个工具，以能够捕捉照顾者关于儿童发展、他们与儿童的互动以及儿童自身发展知识的变化。最后，我们将测试托儿所，无论是单独的托儿所还是与团体一起托儿所，是否能够改善恰尔肯德邦和奥迪萨的西辛格布胡姆和肯贾尔地区60个村庄的儿童发展。其中20个村庄将只有托儿所，20个村庄将有托儿所和团体，20个村庄将由政府提供正常服务。我们将比较干预后这三组村庄两岁儿童的心理、身体和情感发展。通过这项研究项目，我们将通过现有的倡导网络和我们自己的政府联系，在地区和国家层面与托儿所和育儿团体的倡导者接触，通过10年来在印度不同邦扩大团体干预而获得的联系。我们将致力于在印度五个拥有大型土著社区的邦(查尔坎德邦、奥迪萨邦、中央邦、拉贾斯坦邦、恰蒂斯加尔邦)的农村地区增加由地区矿物基金会资助的托儿所和团体的数量，该项目的研究伙伴已经在这些地区开展工作。

Good care, nutrition and opportunities to learn during first three years of life are crucial for children's mental, physical and emotional development. One in four children in the world at risk of not developing to their full potential live in India. Among them, children living in rural areas and those from indigenous (tribal) families are at greatest risk, because they are the poorest.Creches and parenting groups for children under three and their caregivers are possible strategies to help children get the nutrition, care and stimulation they need in early life. Unfortunately, there is little research on whether, how, and at what cost creches and groups could benefit children's development in rural areas with a large number of indigenous families. We have identified a new source of government funding for creches and groups in Indian states with large indigenous communities; these are called District Mineral Foundations. Funds from District Mineral Foundations are meant to benefit communities affected by mining in 12 states, half of which have large rural and indigenous communities. Funds from District Mineral Foundations could be used to finance creches and groups if our research shows they have benefit for children's development.In this study, we will adapt an existing model of creches fundable by District Mineral Foundations to make it acceptable to rural, indigenous communities of Jharkhand and Odisha, two states of eastern India where over half of indigenous children are chronically undernourished. We will also adapt a successful model of parenting groups tested in Jamaica and Bangladesh for these same rural, indigenous communities in Jharkhand and Odisha. There are very few tools to measure child development adapted for work with indigenous Indian communities, so we will translate and modify six tools to be able to capture changes in caregivers' knowledge about child development, their interactions with children, and children's own development. Finally, we will test whether creches, either on their own or together with groups can improve the development of children in 60 villages of West Singhbhum and Keonjhar districts, in Jharkhand and Odisha. Twenty of these villages will have creches only, 20 will have creches and groups, and 20 will have normal services provided by government. We will compare the mental, physical and emotional development of children aged two years across these three groups of villages after the interventions.Throughout the research project, we will engage with advocates for creches and parenting groups at regional and national levels through an existing advocacy network and our own government contacts gained through 10 years of scaling up group interventions in different Indian states. We will aim to increase the number of creches and groups funded by District Mineral Foundations in rural areas of five Indian states with large indigenous communities (Jharkhand, Odisha, Madhya Pradesh, Rajasthan, Chhattisgarh), and where the project's research partners already work.