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The purpose of this study was to (1) explore demands and resources among centre-based and Family, Friend and Neighbor (FFN) early childhood education (ECE) caregivers, and (2) investigate how these factors are associated with the quality of caregiver-child relationships. ECE caregivers (n = 257) completed a survey that assessed demands, resources, and the quality of caregiver-child relationships. Analyses included univariate and bivariate analyses and hierarchical linear regression modelling. Centre-based caregivers (n = 173) reported higher stress, less knowledge related to wellness, and lower confidence related to self-care practices compared to FFN caregivers (n = 84) (all p <.05). Mindfulness was associated with higher reported closeness with children in their care (p <.05). Centre-based caregivers may experience more demands and less resources compared to FFN caregivers which could impact the quality of care. Mindfulness strategies may help to mitigate demands and bolster the well-being of ECE caregivers and healthy early childhood development. [ABSTRACT FROM AUTHOR]

The purpose of this research is to develop a test that measures the cognitive perspective-taking skills of children in early childhood and can be applied directly to children. Cognitive perspective-taking is a type of social skill that refers the ability of an individual to correctly predict what is going through the mind of another person by distinguishing from his/her own thoughts. It is aimed to better understand the cognitive development field by determining the cognitive perspective-taking skill levels of children and thus to contribute to early childhood education. The Early Childhood Cognitive Perspective Taking Test (EBAT) developed in this direction consists of 15 items and 60 pictures. The research group consists of 146 children aged 5-6 years, enrolled in the preschool classes of independent kindergartens and primary schools in the city center of Elazig in the 2020-2021 academic year. Data collected through one-on-one clinical interviews with children were analyzed in SPSS and TAP programs, and the KR-20 reliability coefficient was found to be .902. Explanatory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), item-total correlation, and item analysis were performed, as well as taking expert opinions throughout the research process for test validity. As a result of the research, it has been understood that the Early Childhood Cognitive Perspective Taking Test (EBAT) is a valid and reliable test for children aged 5-6 years. [ABSTRACT FROM AUTHOR]

Background: Systematic or targeted screening for developmental delay (DD) is critical to the early identification of developmental disabilities. With limited available information for urban Rwandan children, this study aimed to determine the prevalence of DD and associated risk factors in infants aged 9 to 16 months living in the urban Rwandan city of Kigali. Methods: A cross-sectional study was conducted in Rwanda from August to November 2019. A convenience sample of 376 Rwandan parents/caregivers and their children attending urban health centers for their routine immunization visits at 9 and 15 months of age was studied. Parents/caregivers completed the official Kinyarwandan version of the Ages and Stages Questionnaire (ASQ-3) and established cutoffs were used to identify DD. Frequency and percentages were used to summarise the data. Logistic regression analysis was used to identify factors associated with DD. Results: Of the 358 children screened using the ASQ-3, the overall prevalence of DD was 24.6%, with a 27.2% prevalence among 9–10-month old children and 22.4% prevalence among 15–16-month old children. Delays in the combined group among the domains of gross motor, communication, fine motor, personal social, and problem solving were 12.8%, 2.5%, 8.4%, 1.7% and 7.5%, respectively. Gestational age at delivery and district of origin were most highly associated with DD, with preterm children at significantly higher risk of having DD compared to term children (Adjusted Odd Ratio AOR = 8.3; 95% CI = 2.5–27.4) and children from Nyarugenge District at high risk of DD compared to children from Gasabo district (AOR = 2.15; 95% CI = 1.2–3.9). Conclusions: The prevalence of ASQ-detectable DD among urban Rwandan children between 9 and 16 months of age was 24.6%, with a high correlation to a history of prematurity and district of origin. This study demonstrates the need for thoughtful health planning regarding integrated developmental surveillance for children, particularly those at high risk, to allow for earlier identification and intervention in the urban area of Kigali, Rwanda. [ABSTRACT FROM AUTHOR]

• Caregiver's language richness plays a supporting role on early child development. • Caregiver's language richness works better for boys and poverty households. • Caregiver language suitability has moderated effects. • Parent-child interaction videos were coded for language richness and suitability. There is rich literature on the predictive role of the caregiver's language richness in child development outcomes during caregiver-child interaction. However, it is unclear whether this is true in rural China, where many young children are still not developing to their fullest potential. Our study supplements the current evidence in rural China by answering three questions. First, is the rural caregiver's language richness associated with child development outcomes? Second, do different child characteristics, caregiver characteristics, and household poverty status affect the relationship between caregiver language richness and early child development outcomes? Third, does the caregiver's language suitability moderate the association between language richness and child development outcomes? We observed and recorded 10-minute-long videos of 591 rural children aged 6–30 months and their primary caregiver dyads in a free toy play session and collected their social-demographic information. Trained coders coded videotaped interactions to obtain measurements of the caregiver's language richness and suitability. Children were assessed for cognitive, language, motor, and social-emotional development. A multivariate linear regression model adjusted for covariates was used to estimate the association between the caregiver's language richness and child development outcomes. Interaction terms were then added to the adjusted model to explore the moderating role of caregivers' language suitability, child characteristics, caregiver characteristics, and household poverty status. The caregiver's language richness is positively associated with the child's cognitive, language, motor, and social-emotional development. The association is more pronounced for children who are boys, in later toddlerhood, or from registered poverty households. In addition, we found that the caregiver's language suitability could enhance the association between language richness and child development outcomes. [ABSTRACT FROM AUTHOR]

Integrated early childhood development (ECD) programs boost child health and developmental outcomes. However, the factors contributing to the successful implementation of such programs in informal urban settlements are not well researched. We conducted 14 focus group discussions and 13 key informant interviews with 125 caregivers of children under the age of 5 years and stakeholders, exploring their views on enablers and barriers to implementing an integrated ECD program in an informal settlement in Kenya. Strategic engagement, capacity building, transparency, fair compensation of ECD workforce, communication skills, and the need to tailor ECD programs to local realities were discussed. An equity-focused implementation approach for integrated ECD programs is timely. [ABSTRACT FROM AUTHOR]

Considering equity in early childhood development (ECD) is important to ensure healthy development for every child. Equity-informative cost-effectiveness analysis can further guide decision makers to maximize outcomes with limited resources while promoting equity. This cost-effectiveness study aimed to examine the equity impacts of a multicomponent ECD intervention in rural Vietnam. We estimated the cost-effectiveness of the intervention with a 30-month time horizon from the service provider and household perspectives with equity considerations. Data were from a cluster-randomized controlled trial comparing the intervention with the local standard of care. The incremental cost-effectiveness ratios (ICERs) per child cognitive development score gained were estimated by household wealth quintile and maternal education level, adjusted for cluster effects and baseline characteristics such as maternal parity and age. A 3% discount rate was applied to costs, and non-parametric cluster bootstrapping was used to examine uncertainty around ICERs. Children in the intervention had higher cognitive development scores than those in the control arm across all subgroups. Based on intervention recurrent cost, the ICER per cognitive development score gained was lower in children from the poorest quintile (−US$6) compared to those from the richest quintile (US$16). Similarly, the ICER per cognitive development score gained was lower in children whose mothers had the lowest education level (−US$0.02) than those with mothers who had the highest education level (US$7). Even though our findings should be interpreted with caution due to the insufficient study power, the findings suggest that the intervention could promote equity while improving child cognitive development with greater cost-effectiveness in disadvantaged groups. [ABSTRACT FROM AUTHOR]

Background: Healthy People 2030 emphasizes personal health literacy (individual skills) and organizational health literacy—the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others. However, research on the latter is in the early stages. Methods: This study describes an organizational health literacy assessment in a U.S. urban academic children's hospital. A variety of evidence-based health literacy assessments were used to assess patient information materials and the environment, including institutional practices, navigation, culture and language, and communication. Trained interviewers and analysts reached consensus for all assessments. Results: Information Items: SMOG scores (n = 9) ranged from 7th- to 14th-grade reading level (average = 11.3). PEMAT-P scores (n = 9) ranged from 43.8% to 93.8% understandability and 0% to 80% actionability. CDC CCI scores (literacy demand) (n = 6) ranged from 18.2% to 58.8% (≥90% = excellent). SAM scores (suitability) (n = 6) fell in the "adequate" range (43.2–58.3%). The PMOSE/IKIRSCH scores (complexity) (n = 3) noted low-moderate difficulty. Apter's Hierarchy (n = 4) revealed three numeracy domains (50% = descriptive purposes and decision-making, 100% = interpreting information). Organization-level: Walking interviews highlighted organizational facilitators and barriers related to the pre-visit and visit environments. HLE2 domain scores ranged from 52% to 68%. Conclusions: Organizational health literacy demands far outweigh the average literacy skills of adults in the U.S. (patients and staff). Findings can be used to hone quality improvement and other processes to focus on structural solutions to increase health equity. [ABSTRACT FROM AUTHOR]

Background: Programs supporting initiatives for children younger than three years are inadequate and not accessible to many families, particularly in resource-limited settings. Many primary caregivers have little knowledge on how to monitor the development of their children or the importance of engaging children in stimulative activities during the course of early development. Health system limitations make it difficult for health workers to educate and demonstrate stimulative engagement to caregivers. The massive use of technology can be used to facilitate access to growth and development programs for children. We developed and implemented a mobile phone technology to help caregivers monitor and stimulate their children's development in real-time. This study explored the influence that this intervention had on the caregivers' early child development (ECD) knowledge, attitudes and practices. Methods: In this qualitative cross-sectional study, we conducted interviews through eight (8) focus group discussions, three (3) key informant interviews and 9 indepth interviews among a total of 111 participants including primary caregivers (n = 87), community health volunteers (CHVs) (n = 21) health managers and workers (n = 3) to determine their attitudes and experience with the intervention with regards to improving their KAP. Interviews were audio-recorded, transcribed, and analyzed thematically. Results: Caregivers and CHVs reported that the intervention had provided them with new knowledge that positively influenced their ECD caregiving attitudes and practices. CHVs and health workers and managers reported that the intervention had provided caregivers with confidence in caring for their children while increasing their knowledge on how to monitor and stimulate their children's development. Conclusion: Mobile phone technology can be effectively used to enhance caregivers' knowledge of ECD and enable them to monitor and support their children's development in real-time. Trial registration: The trial was registered with the Pan African Clinical Trial Registry (www.pactr.org) database (ID number: PACTR201905787868050 Date: 6/05/2019. [ABSTRACT FROM AUTHOR]

Being school-ready when transitioning to the primary school system has been associated with favourable outcomes during schooling and adult life. While children living in socio-economically disadvantaged areas may be at a higher risk of being less school-ready, research in the area has highlighted that not all children experience such a delay. This study examined a range of factors that may account for differences in outcomes across five school readiness domains (physical health and well-being, social competence, emotional maturity, language and cognitive development, and communications skills and general knowledge) within a sample of children living in socio-economically disadvantaged areas. Drawing on data from a sample of five-year-old children involved in the Preparing for Life (PFL) evaluation in Ireland, this study explored the role of child and early environmental factors in facilitating or hindering children's development across these school readiness domains. Statistical analysis identified child's sex, parental involvement and learning materials at home, parent–child interactions, mother's attempt to breastfeed, and mother–child attachment as significant predictors of school readiness after accounting for other factors. Findings contribute to the Irish and international literature on the role of early demographical and environmental factors in shaping school readiness, especially for children from socio-economically disadvantaged areas. [ABSTRACT FROM AUTHOR]

Background. More than 200 million children globally are at risk of not achieving the full developmental potential owing to multiple factors. HIV exposure is of particular concern as evidence suggests that children born to mothers who are HIV-positive are likely to experience developmental delays. Furthermore, the psychosocial and economic impacts of HIV, such as parental illness, poor mental health, poverty and malnutrition, also affect children's development. Objective. To assess and address the developmental challenges faced by children aged 2 - 5 years living in high-HIV prevalence settings through a toy-based rehabilitation intervention and to analyse the prevalence and nature of developmental delays observed in these children using the Ages and Stages Questionnaires (ASQ-3). Methods. In response, the Bright Start programme was developed and implemented to target children living in high HIV-prevalence settings. In 2019, a pilot project was implemented with 90 caregiver-child dyads in Cape Town, South Africa. A baseline survey was conducted to assess developmental progression for all the children (N=141) in the care of the 90 caregivers using the Ages and Stages Questionnaires (ASQ-3) for children aged 24, 36, 48 and 60 months. Results. Findings showed that 64% of children had delays in at least one domain and 37% had multiple delays. More than half of the children had developmental delays in fine motor skills (51%), while gross-motor and problem-solving delays were reported for 30% and 26% of children, respectively. Communication and personal-social domain delays were observed in 17% and 14% of children, respectively. Conclusion. The prevalence of developmental delays among children in the programme was alarmingly high. These findings indicate that developmental delay is a serious concern for children living in high-HIV-prevalence settings. Early identification and timeous referrals of children with developmental delays are critical and may enable children to reach their full developmental potential. [ABSTRACT FROM AUTHOR]

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The aim of this study was to assess the effectiveness of the provision of under-five childcare services taking experiences from marginalized and vulnerable communities in Tanzania. This interpretive study employs phenomenology design to investigate the views of stakeholders based on childcare services. The focus was to determine the childcare interest, needs and requirements of caregivers living in vulnerable and marginalized communities in Tanzania and across the world. This study was grounded by parenting and child-rearing theory which emphasizes in caring for young children from the early stages. The findings indicated that the situation of children and childcare services amongst marginalized and vulnerable communities was not satisfactory. Several NGOs and Networks have been supporting childcare services with minimal support from the government. The Government and the responsible ministries and departments are responsible for reducing the vulnerability of children and their families through accessible, comprehensive, and integrated quality childcare services. This study recommends that to improve the current situation and attain the quality provision of childcare services the government policy planners in collaboration with childcare service providers and practitioners need to establish a strong commitment to the provision of quality childcare services and programs in marginalized and vulnerable communities. [ABSTRACT FROM AUTHOR]

Early childhood science and intervention (ECSI) or simply early childhood development (ECD) is now a multi‐billion‐dollar industry that seeks to export one form of family model, parenting practices, and perspective of child development to the rest of the world. This practice occurs through the efforts of agencies such as the World Health Organization, United Nations Children's Fund, the World Bank Group, and the LEGO Foundation. As a result, Gabriel Scheidecker and colleagues (2023) are justified to characterize ECSI as global ECD that seeks to improve the brains of children in the majority world to break the vicious cycle of poverty. I complement Scheidecker et al.'s (2023) arguments by highlighting a key link that sustains global ECD—the academics and practitioners from the majority world who, knowingly or unknowingly, perpetuate this practice. In this commentary, I discuss why and how such academics and practitioners contribute to the practice of global ECD. [ABSTRACT FROM AUTHOR]

We study whether neonatal health predicts future health and education and test if parents compensate/reinforce early health differences by investing more/fewer resources in their less healthy offspring using a 9-year panel of Mexican siblings. We contribute to the literature, typically focused on birth weight and short-term outcomes, by leveraging a rich set of measures considering weight-by-length-of-birth and offering evidence on how early health influences parents' allocations among siblings from childhood to adulthood. Our rich data also allow us to control for prenatal and postnatal mothers' behavior which is crucial for future children's development. Our results suggest that unhealthy children at birth have worse adult health, a lower height, and fewer years of schooling between ages 5 and 22. Moreover, poorer parents invest nearly 15% fewer economic resources in their less healthy offspring, widening the gap in outcomes between siblings across time. On the contrary, more affluent parents continuously compensate for early disadvantages. [ABSTRACT FROM AUTHOR]

As state and federal policy makers seek to improve mental health, many aim to boost upstream approaches to prevent or mitigate diagnosable conditions. Home visiting offers a wholistic approach for new parents and children at home through health education, parenting support, and other services. Evidence of its benefits has accumulated across a growing number of home visiting models, some of which have demonstrated direct mental health outcomes, such as improved access to mental health services and reductions in family stress and maternal depression. Despite growing federal investments, home visiting reaches only a small fraction of families who might benefit. Public and private grant funding has successfully built and expanded home visiting in every state, but the current landscape of programs remains limited. As the nation's largest single coverage source for children, Medicaid, along with the Children's Health Insurance Program, has unsurpassed reach, to more than 40 million children and millions more families annually. Medicaid offers a natural vehicle to scale home visiting programs to promote early childhood development and address the mental health of both mothers and young children. To scale home visiting and reach far more families across the country who could benefit, federal policy makers should establish home visiting as a required Medicaid benefit and make additional investments to help states build capacity as the approach is scaled. [ABSTRACT FROM AUTHOR]

Abstract Background Nurturing care is necessary for optimal early childhood development. This study aimed to investigate the prevalence of parental risks in rural East China and assess their impacts on early development in children younger than three years old. Methods This community-based cross-sectional survey was conducted among 3852 caregiver-child pairs in Zhejiang Province from December 2019 to January 2020. Children aged 0 to 3 years were recruited from China’s Early Childhood Development Program (ECD). Local child health care providers conducted face-to-face interviews with the primary caregivers. Demographic information of the participants was collected by questionnaire. Each child was screened for parental risk through the Parental Risk Checklist designed by the ECD program. The Ages and Stages Questionnaire (ASQ) was used to identify children with potential developmental delays. Multinomial logistic regression model and linear trend test were applied to assess the association between parental risks and suspected developmental delays. Results Among the 3852 children included in the analyses, 46.70% had at least one parental risk and 9.01% presented suspected developmental delays in any domain of ASQ. Parental risk was statistically associated with the overall suspected developmental delay in young children (Relative Risk Ratio (RRR): 1.36; 95% confidence interval (CI): 1.08, 1.72; P = 0.010) after adjusting potential confounders. Compared with children with no parental risk, children exposed to 3 or more parental risks had 2.59, 5.76, 3.95, and 2.84 times higher risk of the suspected developmental delay in overall ASQ, communication, problem-solving, and personal-social domain, respectively (P values

Early childhood development (ECD) parenting interventions can improve child developmental outcomes in low-resource settings, but information about their implementation lags far behind evidence of their effectiveness, hindering their generalizability. This study presents results from an implementation evaluation of Msingi Bora ("Good Foundation" in Swahili), a group-based responsive stimulation and nutrition education intervention recently tested in a cluster randomized controlled trial across 60 villages in rural western Kenya. Msingi Bora successfully improved child cognitive, receptive language, and socioemotional outcomes, as well as parenting practices. We conducted a mixed methods implementation evaluation of the Msingi Bora trial between April 2018 and November 2019 following the Consolidated Advice for Reporting ECD implementation research (CARE) guidelines. We collected qualitative and quantitative data on program inputs, outputs, and outcomes, with a view to examining how aspects of the program's implementation, such as program acceptance and delivery fidelity, related to observed program impacts on parents and children. We found that study areas had initially very low levels of familiarity or knowledge of ECD among parents, community delivery agents, and even supervisory staff from our partner non-governmental organization (NGO). We increased training and supervision in response, and provided a structured manual to enable local delivery agents to successfully lead the sessions. There was a high level of parental compliance, with median attendance of 13 out of 16 fortnightly sessions over 8 months. For delivery agents, all measures of delivery performance and fidelity increased with program experience. Older, more knowledable delivery agents were associated with larger impacts on parental stimulation and child outcomes, and delivery agents with higher fidelity scores were also related to improved parenting practices. We conclude that a group-based parenting intervention delivered by local delivery agents can improve multiple child and parent outcomes. An upfront investment in training local trainers and delivery agents, and regular supervision of delivery of a manualized program, appear key to our documented success. Our results represent a promising avenue for scaling similar interventions in low-resource rural settings to serve families in need of ECD programming. This trial is registered at ClinicalTrials.gov, NCT03548558, June 7, 2018. https://clinicaltrials.gov/ct2/show/NCT03548558.

The international recognition of the critical importance of the early childhood phase has been firmly established through decades of rigorous research, evidence-based practices, and undeniable evidence of the returns on investment made during this formative period. Consequently, early childhood development has emerged as a top priority on both national and international agendas. This momentum reached a pinnacle in 2015 with the unanimous adoption of the 17 Sustainable Development Goals (SDGs) by the United Nations, which placed a particular emphasis on children under the age of five within the education-focused SDG 4, notably target 4.2, centered on ensuring that all girls and boys are ready for primary education through the provision of accessible “quality early childhood development, care and pre-primary education”. However, the Global South reflects the glaring omission of addressing the needs of children at risk of poor development due to disabilities. This paper underscores the imperative for specialized early childhood intervention tailored to young children with disabilities and their families, commencing as early as possible following birth. It advocates for Early Childhood Intervention (ECI) as a service distinct from general Early Childhood Development (ECD), emphasizing the crucial role of families as active partners from the outset. Furthermore, the paper strengthens the case for Family-Centered Early Childhood Intervention (Fc-ECI) through the integration of evidence-based practices and an in-depth description of one such program in South Africa with specific reference to deaf and hard-of-hearing infants and their families. This model will be guided by core concepts outlined in WHO and UNICEF Early Childhood Intervention frameworks. Through this exploration, the paper aims to shed light on the urgent need for inclusive approaches to early childhood development, particularly for children with disabilities, and to advocate for the adoption of Family-Centered Early Childhood Intervention as a cornerstone of global efforts to ensure the holistic well-being and development of all children.

An estimated 6 million children under the age of five in Nigeria (out of nearly 31 million) risk not reaching their full developmental potential. The dearth of context-relevant measures poses a challenge to the planning and implementation of effective interventions. This study assesses the utility of the Early Childhood Development Index (ECDI) in Nigeria. We used the Multiple Indicator Cluster Surveys to track progress among 3- to 4-year-old children (n = 11,073); 3-year-old, 51%; female, 49%. Using random calibration samples, the results from psychometric tests indicate that while over half of the children were on track in their development based on the ECDI, the instrument had low to average internal consistency and weak face validity, suggesting an inadequacy in capturing ECD information of value. At the outset of the launch of the new ECDI2030, the results of this study point to the need for continued discourse and advocacy for the use of culturally appropriate measures of child development, and a child-centered community engagement approach. This is essential in ensuring accountability and responsive interventions for the children served and their families.

Human helminthiasis, particularly soil-transmitted helminth (STH) infections, is a prevalent health concern in Indonesia, especially among children, often resulting in growth disorders, notably stunting. To examine the link between STH infections and childhood stunting, we conducted a comprehensive review of literature spanning 2012-2023, encompassing 40 selected articles from databases like PubMed, Science Direct, and Google Scholar. Our analysis revealed a substantial association between STH infections and increased stunting risk in children, estimating a 44.407% rise in stunting risk due to STH infection. Stunting, a consequence of chronic malnutrition, profoundly affects a child's physical and cognitive development, with long-lasting repercussions on their future potential and quality of life. This study has significant implications. It underscores the urgent need for robust public health interventions targeting STH infections, especially in high-prevalence areas like Indonesia. Measures such as mass deworming campaigns, improved sanitation and hygiene practices, and health education can significantly alleviate the burden of STH infections and the resulting stunting. Moreover, the research emphasizes the intricate relationship between infectious diseases and malnutrition, highlighting the necessity for a holistic approach to child health. Addressing STH infections necessitates not only medical intervention but also efforts to enhance overall living conditions and nutritional status. Integrating these approaches into a comprehensive public health strategy can yield more effective and sustainable results in the fight against childhood stunting. In conclusion, this study underscores the paramount importance of addressing STH infections in the context of child growth and underscores the urgency of implementing effective public health interventions. This approach can enable children to reach their full physical and cognitive potential, ultimately contributing to the overall well-being and development of societies.

Background: The concept of school readiness is well-defined internationally. However, it is unclear how the concept is defined and used in South Africa or understood by preschool teachers. Aim: The aim of this analysis was to develop a clear and accessible summary of the concept of school readiness in South Africa for preschool teachers. Methods: An eight-step systematic approach, including the use of the preferred reporting items for systematic reviews and meta-analysis guidelines, was followed to identify research conducted in South Africa that defined school readiness, and to complete a concept analysis. A subsequent seven-step process was followed to create a Plain Language Summary (PLS) of the contextual definition of school readiness. Results: Using ATLAS.ti software, we identified 619 quotations related to school readiness. Through inductive thematic analysis we identified 48 unique concept codes followed by eight categories or attributes of school readiness. The contextual definition of school readiness was developed in plain language and is stated as children who are fully prepared for school can engage in meaningful learning, because they have developed the necessary behavioural, intellectual, language, literacy, numeracy, physical, socio-emotional and classroom skills for formal schooling. Conclusion: A South African school readiness definition, that is consistent with the way school readiness is understood internationally, was developed in plain language. Although the concept of school readiness is not unique to South Africa, the ways in which it is promoted is contextually bound. Contribution: This PLS may contribute to sustainable and affordable access to culture-centred preschool teacher training content.

Third sector organisations are effective links between Higher Education Institutions and communities in promoting and expediting Community Engagement programmes tasked with raising awareness, fostering social responsibility and civic mindedness in students and, thus, contributing to the common good. In recognition of this, Durban University of Technology (DUT) pre-emptively enabled collaboration between the institution and a cluster of Civil Society Organisations (CSOs) in 2004. This paper examines one of the partnership programmes between the Gandhi Development Trust and the Durban University of Technology, the Early Childhood Development Values Education Project and the successful Community Engagement partnerships created with three academic departments of DUT. It focuses on the Department of Drama programme based on Bloomgarden’s Preparation, Action, Reflection, Evaluation (PARE) framework integrating experiential and academic learning. The study draws on the theoretical lens of Dewey’s Democracy and Education and Freire’s Critical Pedagogy and uses the case study method to present the data gathered through the PARE phases. Foregrounded in the paper is the impact of democratic education characterised by values such as inclusiveness, participation, reciprocity, and an equality of respect for the knowledge and experience that everyone contributes to education and community building.

The state of early childhood development (ECD) provisioning in South Africa is dire. An onerous regulatory regime is one factor contributing to this crisis. Instead of a developmental and enabling framework, the regulatory landscape is convoluted and overly burdensome. This in turn frustrates the realisation of the rights of children. The author argues that regulatory reform in this context is not only desirable but constitutionally required. The article begins by providing an overview of the evolution of the ECD regulatory landscape in South Africa with a particular focus on health and safety regulation. A shift from under-regulation in the pre-constitutional era to over-regulation in the constitutional era is identified. The author proceeds to argue that South Africa's current state of affairs is animated in part by a failure to articulate the full set of interests that should inform a balanced ECD regulatory regime. Pathways towards a more coherent and coordinated regulatory framework for ECD health and safety standards are suggested. The proposed reforms, albeit limited, have the potential to offer immediate relief to both under-resourced providers and overburdened administrators

Planning interventions in Africa that support sustainable rural development, and sustainable rural livelihoods as an extension thereof, are often considered in terms of broad-sweeping central government approaches. However, these homogenous approaches often disregard the differentiation that exists between different rural areas. In this article, the development of Early Childhood Development (ECD) centres as micro-level planning interventions situated within the specific community circumstances of the rural areas of South Africa, are investigated as a change catalyst in sustainable rural livelihood development. This has been done by means of a literature survey and practical research. The main objectives were establishing a theoretical framework through literature studies pertaining to sustainable rural livelihood development, determining whether a community-integrated empowerment approach in this regard was a feasible option, and considering if the development of ECD centres in rural areas aligned with local community priorities and could consequently serve as entry point for sustainable rural livelihood development, and to reflect on the benefits and limitations of this approach as an integral part of sustainable rural livelihood development. In examining the relevance and applicability of the theoretical perspective, the Footprints of Hope ECD centre (a non-governmental organisation) in Griekwastad, Northern Cape (South Africa), was examined as case study. The main findings of this study indicate that the establishment of ECD centres could be an effective change catalyst in sustainable rural livelihood development, especially when approached in an integrated and multidimensional manner. Specific aspects highlighted are the importance of community-driven grassroot initiatives, circumstance-specific approaches towards sustainable rural livelihood development, and the empowerment of local communities through the provision of ECD, employment, skills training, and food security. However, isolated instances of micro-development initiatives cannot effectuate broader sustainable rural livelihood development, and thus, an enabling policy and legal framework as well as the mobilisation of non-governmental organisations is required in this regard. [ABSTRACT FROM AUTHOR]

The aim of this research is to examine how developmental progress and socio-emotional difficulties in early childhood are influenced by family complexity, and how socioeconomic status (SES) and interparental conflict influence these effects. To measure family complexity, full biological families, two-biological-parent families with half- and/or step-siblings, step-parent families, and single-parent families were separated. Dependent variables include the risk of developmental delay (based on ASQ-3) and socio-emotional difficulties (based on SDQ) at age 3. The data come from four waves of the Cohort '18 Growing Up in Hungary longitudinal birth cohort study (n = 5788). Based on the results, children in all non-intact family types have a higher risk of developmental delay than do children from full biological families, when controlled only for the basic socio-demographic characteristics of children and mothers. However, controlling for family SES or interparental conflict as well, only children raised by a step-parent have a higher risk. Considering socio-emotional difficulties, children living with their biological parents but also with half- or step-siblings, or in a single-parent family, were at higher risk, even adjusted for interparental conflict. After controlling for family SES, however, only children in single-parent families have a higher risk. Parental conflict and low family SES have significant negative effects on both child outcomes, even in intact families, and together these seem to explain the adverse effect of non-intact family types. To conclude, children's outcomes in the early years depend not only on whether they live with both their biological parents, but also on whether they are raised with half- and/or step-siblings or by a step-parent. That said, in many cases the negative impacts are due to selection effects, i.e., the fact that children of low-status parents are more likely to live in non-intact families. [ABSTRACT FROM AUTHOR]

Background: Mass media can play critical roles in influencing parents' attitudes and practice toward the healthy upbringing of children. Objective: This study examined the association between the use of five types of mass media among mothers living in rural and urban areas and the early childhood development (ECD) of their children. Methods: We analysed nationally representative and internationally standardized Multiple Indicator Cluster Survey data collected in 2013 and 2019 in Bangladesh. The ECD was calculated using four domains of development: physical health, literacy-numeracy, learning and social-emotional. Mothers' use of newspapers/magazines, radio, television, internet and mobile phones was the study factor. We used Poisson regression with robust variance. The dataset included 27,091 children aged three or four years. Results: Almost 21% of the children were living in urban and 78% in rural areas. Mothers/caretakers of 30% of the children used none, 39% used one, 25% used two, and approximately 6% used three or more of the five types of media. Mobile phones and television were the dominant types of media, both in terms of the number of users and the frequency of use. Overall, 68.87% of the children were on track in terms of their ECD and 31.13% were not. A significantly larger proportion of urban children (74.23%) than rural children (67.47%) were on track in their ECD. The prevalence of children being on track of ECD increases by 4% (aPR 1.04; 95%CI: 1.01–1.06) for each additional media use among women who lived in urban areas and increases by 7% if women live in rural areas. In terms of the individual formats of media, using newspapers, television and internet was found to be significantly associated with the children in rural areas being on track in terms of their ECD. In the urban sample, only radio use was found to be significant. Conclusions: Targeted and well-designed child development campaigns that are delivered through popular media types are likely to help mothers to take better care of their children. [ABSTRACT FROM AUTHOR]

• Quality Rating and Improvement Systems use indicators to define early care and education quality. • Indicators often offer evidence-informed guidance to support and monitor development and foster mental health. • Development and mental health promotion often applies to center-based and family child care. • Opportunities exist to offer more specific guidance in quality indicators. • Future research can assess equity of child development and mental health promotion indicators. In the United States (U.S.), quality rating and improvement systems (QRIS) are used by many states to incentivize quality in ECE and may be a viable lever for promoting early childhood development and mental health on a population level. We conducted a qualitative review of publicly available data on state QRIS indicators to better understand how states incorporate evidence-informed early childhood development and mental health promotion standards in QRIS. We systematically compared QRIS indicators for 41 U.S. states with child development and mental health promotion quality standards from Caring for Our Children National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs, 3rd Edition , as of March/April 2020. Of those, 39 states included at least one indicator consistent with child development or mental health promotion standards, including practices that can lead to early detection of developmental delays such as developmental monitoring, activities or curriculum addressing developmental domains, and regular communication and resource-sharing with parents/guardians. Opportunities exist within states for incorporating more specific guidance within indicators, such as use of childcare health consultants and advocates, validated screening tools, parent/guardian participation or input in developmental monitoring and screening, and staff training on family engagement. We found that in most states QRIS indicators offer guidance for ECE systems to support and monitor early development and foster mental health, with opportunities to enhance guidance. Findings point to QRIS as a viable opportunity for promotion of early childhood development and mental health standards in ECE systems. [ABSTRACT FROM AUTHOR]

• We used a multilevel model to study levels of influence on early childhood development (ECD) outcomes. • We defined ECD outcomes based on select domains of the early childhood development index (ECDI): literacy, cognitive and socioemotional. • Individual and household factors trump macro-factors in their association with child outcomes. • Maternal education remains a most significant factor in child outcomes. This study used multilevel modeling to examine the dynamics between the layers of influence associated with literacy, cognitive, and socioemotional outcomes of 3- to 4-year-old children in Nigeria. The study used data from the fifth round of the Multiple Indicator Cluster Survey (MICS), and adapted the social-ecological model of child development and the social determinants of health framework to investigate the interaction between a child's microsystem, engagement with the mesosystem, the politico-cultural climate, and how they are associated with selected Early Childhood Development Index (ECDI) domains. The final sample of 11,207 mother-child dyads (n=22,414; state mean = 303; ethnicities – Hausa 48%, Yoruba 10%, Igbo 11%, and others combined 31%) comprised three-year-old children (51%), females (49%). Results indicated a 29% variation in child outcomes accounted for by the grouping structure of the states, that diminished with the addition of household-level predictors. On average, a child not attending early education (-1.93), not having books (-1.32), being in the poorer wealth quintiles (-.91), mother having informal or no education (.82), and ethnicity, specifically being Hausa (-.21) were associated with predicted lower child development outcome score. At the state level, low maternal education was the most significant predictor of child development outcomes. Findings will add value to policy interventions as states reconsider their strategy and funding obligations to ECD, addressing poverty at the family level, and promotion of girl/maternal education. [ABSTRACT FROM AUTHOR]

Objective: With the developments in the world, a significant decrease in the death rates of chronic or fatal diseases causes the problems that affect the development of children to be seen more frequently. Physicians must be aware of the basic developmental stages and information of children during medical education for early diagnosis and intervention. This study aimed to determine the knowledge of medical students about child development. Material and Methods: A total of 482 3rd and 4th-year medical faculty students who did not take the Developmental Pediatrics lecture in the Department of Pediatrics of İnönü University Faculty of Medicine between 2018 and 2019 were included in the study. Our study included socio-demographic information and questions on "Caregiver Knowledge of Child Development Inventory". Results: 227 (47.09%) 3rd year and 255 (52.90%) 4th-year students were included in the study. The mean Caregiver Knowledge of Child Development Inventory total score was 14.44±5.89 for 3rd-year students and 16.10 ± 5.90 for 4thyear students. More than 50% of the third and fourth year students answered 5 of the 10 questions in the developmental skills component section correctly. It was observed that the developmental skills and stimulation component knowledge of the third and fourth year medical students were not sufficient. It was also understood that the general pediatrics courses given in the third year did not increase the knowledge of the fourth year students about child development. Conclusion: Evaluating the child development knowledge of medical students is important for interventions and studies to ensure that medical students are familiar with and detect developmental delays in infancy and early childhood. [ABSTRACT FROM AUTHOR]

Research over the last thirty years has provided empirical evidence of similarities between language and music in terms of structure, sound, and neural processing. In addition, the positive effects of musical experience and training on working memory, reading and writing skills, and various parameters of language acquisition in children and adults have been demonstrated. However, the extent to which children can benefit from these transfer effects with regard to language development remains largely unexplored. This article compares the development of musical and linguistic parameters in early childhood and derives opportunities that may result from the transfer effects of the two domains for unimpaired language acquisition. Based on a differentiated analysis of relevant research, opportunities are formulated to show how an early encounter with music can be used profitably in children's language acquisition. It is shown that the presentation of musical input in a high-frequency and specific form has the most effective effect on undisturbed language acquisition. [ABSTRACT FROM AUTHOR]

Purpose of Review: To examine the impacts of gun violence on early childhood development including early childhood mental health, cognitive development, and the assessment and treatment of survivors. Recent Findings: The literature reflects that gun violence exposure is often associated with significant mental health outcomes including anxiety, post-traumatic stress, and depression in older youth. Historically, studies have focused on adolescents and their exposures to gun violence through proximity to gun violence within their communities, neighborhoods, and schools. However, the impacts of gun violence on young children are less known. Summary: Gun violence has significant impacts on mental health outcomes of youth aged 0–18. Few studies focus specifically on how gun violence impacts early childhood development. In light of the increase in youth gun violence over the past three decades with a significant uptick since the onset of the COVID-19 pandemic, continued efforts are needed to better understand how gun violence impacts early childhood development. [ABSTRACT FROM AUTHOR]

For culturally and linguistically diverse children, early second language (L2) development is important for school achievement and social inclusion. These children face challenges in acquiring L2, especially in Hong Kong, where the dominant Chinese language contrasts strongly with their home languages. Studies that compared the language abilities of first language (L1) and L2 students in English-speaking contexts have reported young L2 learners' disadvantage in using the dominant language in oral language and comprehension at school entry. The findings raise the question of whether L2 learners who fall behind their L1 peers in language abilities will be further disadvantaged, showing a weaker development gradient. This study used the Chinese Character Acquisition Assessment (CCAA) to compare character acquisition of 491 L2 children aged from 3 to 6 years against that of 240 of their L1 peers from Hong Kong kindergartens. The CCAA is comprised of six subtests and assesses children's abilities to make associations among character written form (orthography), sound, and meaning. Results showed that L2 learners had greater development in meaning and sound associations across class levels, implying that they may first develop oral language related abilities. In addition, results indicate that diverging gaps between L1 and L2 learners' Chinese character acquisition existed across class levels for the associations involving written character form, but not in regard to associations between character meaning and sound. This study highlights the Chinese learning needs of L2 preschoolers and provides understanding of their abilities in mapping among character written forms, sounds, and meanings. The findings suggest the importance of supporting L2 children's oral language at earlier stages of Chinese learning, and the need to provide instructional support to compensate for their relative weakness in literacy at school entry. [ABSTRACT FROM AUTHOR]

This conceptual discourse interrogates the contributions and challenges faced by parents in supporting the supplementary feeding programme at the Early Childhood Development (ECD) level in rural Southern Africa. This conceptual paper is a literature review study that relies on secondary data to draw the findings. The research hinges on Maslow's hierarchy of needs and Epstein's theory of overlapping spheres of influence. The study notes that parents play an important role in supporting the programme through activities such as the construction of cooking sheds, providing relish, fetching firewood, cleaning, and serving meals. Factors such as lack of knowledge, financial constraints, lack of cooperation, poor communication, and time constraints hinder their ability to make a sustained and effective contribution to the programme. The study recommends that parents be educated about the benefits of the supplementary feeding programme, empowered with various projects to improve their economic status, and encouraged to contribute to the programme. Another recommendation is that the school should build strong relationships with the corporate world, government, and non-governmental organisations so that they can work with parents to participate fully in the programme. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to examine how equity is integrated into economic evaluations of early childhood development interventions in low-and middle-income countries (LMICs), and to narratively synthesize the study characteristics and findings. Methods: We conducted a scoping review by searching three electronic databases with terms including equity, early childhood development intervention, economic evaluation, and LMICs. Interventions that aimed to improve child cognitive, physical, language, motor, or social and emotional development through health, nutrition, security and safety, responsive caregiving, and early learning interventions between conception and age 8 years were considered. Studies published in English peer-reviewed journals in the year 2000 and later were included. Results: The review included 24 cost-effectiveness studies out of 1460 identified articles based on eligibility criteria. The included studies addressed health, nutrition, social protection, and water, sanitation and hygiene interventions for child development. The common type of intervention was immunization. Mostly, equity was measured using household wealth or geographic areas, and the study findings were presented through subgroup analyses. The study settings were LMICs, but most studies were conducted by research teams from high-income countries. Overall, 63% of included studies reported that early childhood development interventions improved equity with greater intervention benefits observed in disadvantaged groups. Conclusions: Consideration of equity in evaluations of early childhood interventions provides a more complete picture of cost-effectiveness, and can improve equity. Greater focus on promoting equity consideration, multi-sectoral interventions, and researchers in LMICs would support evidence-based interventions and policies to achieve equity in child development. Significance: The review found that existing studies mostly measured equity by wealth groups or geographic areas, and presented their findings through subgroup analyses. The most common type of intervention was childhood immunization. The study settings were LMICs, but most studies were conducted by research teams from high-income countries. More than half of studies reported that early childhood development interventions improved equity with greater intervention benefits observed in disadvantaged groups. The small number of relevant studies in the review highlights that more emphasis on equity integration into economic evaluation, coordinated work across multiple sectors, and strong involvement of researchers based in LMICs, are necessary to improve child development. [ABSTRACT FROM AUTHOR]

Due to the lack of tools that can be easily used by practitioners, there is a need to develop acceptable embedded ways to assess children's fine motor skill development within early childhood education and care settings. This study examined the validity and reliability of a brief and ecologically valid fine motor assessment tool for preschool-aged children; the fine motor growth assessment (i.e., FINGA). Children's fine motor performance on FINGA was compared with widely-used and validated performance-based (Peabody Developmental Motor Scales 2nd edition) and informant-based (Ages and Stages Questionnaire 3rd edition) fine motor assessments. Ninety-one children [mean age (y) ± SD = 4.50y ± 0.68] were assessed within seven early childhood education and care services in New South Wales, Australia. Exploratory factor analyses (EFA) and linear regression analyses showed that FINGA had good internal consistency (EFA of 73%) and age sensitivity (Bstd = 0.69, p < 0.001), and bivariate correlation analyses demonstrated good concurrent validity (rs from 0.69 to 0.84, ps < 0.001) against the two comparison assessments. Because of its brevity and ecological validity, the FINGA tool should be further examined as a routine fine motor skills assessment administered within the context of universal early childhood education and care service provision. [ABSTRACT FROM AUTHOR]

Implementation fidelity is the degree of compliance with which the core elements of program or intervention practices are used as intended. The scientific literature reveals gaps in defining and assessing implementation fidelity in early intervention: lack of common definitions and conceptual framework as well as their lack of application. Through a critical review of the scientific literature, this article aims to identify information that can be used to develop a common language and guidelines for assessing implementation fidelity. An analysis of 46 theoretical and empirical papers about early intervention implementation, published between 1998 and 2018, identified four conceptual frameworks, in addition to that of Dane and Schneider. Following analysis of the conceptual frameworks, a four-component conceptualization of implementation fidelity (adherence, dosage, quality and participant responsiveness) is proposed. [ABSTRACT FROM AUTHOR]

Understanding how parents, and other primary caregivers, perceive and experience early childhood programs and services is essential for identifying family-centered facilitators and barriers to service utilization. Therefore, this paper aims to explore parent knowledge of and experiences with community efforts of an early childhood system in Illinois: the All Our Kids Early Childhood Networks (AOK Networks). Our research team conducted focus group interviews with 20 parents across four Illinois counties. A semi-structured interview guide was used to examine parent perceptions of an early childhood system's community efforts in promoting the health and well-being of children aged from birth to five. Thematic network analysis was used to analyze all focus group data. Parents indicated three salient themes, including: (1) comprehensive information sharing practices, (2) diverse service engagement, and (3) barriers to service access. Overall, parents reported general satisfaction with the quality of available services and provided feedback regarding identified areas of need to increase the accessibility and utilization of local services. Engaging parents as partners is essential to the effective implementation of family-centered early childhood services. Families are the experts of their lived experiences, and incorporating their voices in program development and evaluation efforts works to increase positive child and family outcomes. [ABSTRACT FROM AUTHOR]

Supporting caregivers' mental wellbeing and ability to provide psychosocial stimulation may promote early childhood development. This paper describes the systematic approach of developing an integrated stimulation intervention, identifying the feasibility and challenges faced throughout the period. We developed an integrated curriculum by culturally adapting three interventions (Reach Up, Thinking Healthy, and general nutrition advice) and piloted this curriculum (Mar-April 2017) in courtyard groups sessions and individual home visits with pregnant women (n = 11) and lactating mothers (of children

Malaria is a leading cause of morbidity and mortality among children under five years of age, with most cases occurring in Sub-Saharan Africa. Children in this age group in Africa are at greatest risk worldwide for developmental deficits. There are research gaps in quantifying the risks of mild malaria cases, understanding the pathways linking malaria infection and poor child development, and evaluating the impact of malaria on the development of children under five years. We analyzed the association between malaria infection and gross motor, communication, and personal social development in 592 children age 24 months in rural, western Kenya as part of the WASH Benefits environmental enteric dysfunction sub-study. Eighteen percent of children had malaria, 20% were at risk for gross motor delay, 21% were at risk for communication delay, and 23% were at risk for personal social delay. Having a positive malaria test was associated with increased risk for gross motor, communication, and personal social delay while adjusting for child characteristics, household demographics, study cluster, and intervention treatment arm. Mediation analyses suggested that anemia was a significant mediator in the pathway between malaria infection and risk for gross motor, communication, and personal social development delays. The proportion of the total effect of malaria on the risk of developmental delay that is mediated by anemia across the subscales was small (ranging from 9% of the effect on gross motor development to 16% of the effect on communication development mediated by anemia). Overall, malaria may be associated with short-term developmental delays during a vulnerable period of early life. Therefore, preventative malaria measures and immediate treatment are imperative for children's optimal development, particularly in light of projections of continued high malaria transmission in Kenya and Africa.

Abstract Background Preschool children in low resource settings are at higher risk of missing developmental potential due to the lack of standardized and validated methods for the timely detection of children with developmental delays or neurodevelopmental disorders. The preschool teacher is a non-specialist resourceful link within the community to detect and offer interventions early. This paper discusses the preliminary iteration of designing and testing the psychometric properties of a developmental assessment for children aged 24 to 60 months in Sri Lanka. This assessment is designed to be conducted by preschool teachers in their preschool setting. Methods Three processes followed: 1. Designing and development of the Ragama Early Assessment for Children (REACh) complete preschool developmental assessment and a tool kit 2. Testing and training teachers on conducting the REACh assessment 3. Preliminary assessment of the psychometric properties including content validity, internal consistency, interrater reliability and concurrent validity. Results A literature search identified 11 assessments and 542 items representing cognitive, social-emotional and adaptive, language and motor domains. Content validity was assessed to select and adapt items. A complete assessment tool was designed to be administered in four settings within the preschool. This was further improved during pre and pilot testing and teacher training. Cronbach's alpha measuring internal consistency was > 0.70 for cognitive, language, social-emotional and adaptive domains across all three age groups in 1809 children. Interrater reliability was > 65% for age groups 36–47 and 47- 60 months. Concurrent validity using a clinical gold standard demonstrated sensitivity of more than 0.75 for all age groups with variable specificities (24–35 months: 0.71, 36- 47 months: 0.43 and 48–60 months: 0.67) assessed in 75 children. Conclusions This culturally and linguistically adapted tool was tested nationally in Sri Lanka. The inte-rrater reliability between teachers and research assistants was higher than 65% for all domains in children more than 36 months. The preliminary iteration confirms it as an acceptable screening assessment for all age groups but with significantly lower specificity in the 36-47 month age group. Further improvement in certain domains together with intense teacher training is likely to enhance the validity and reliability of the assessment. Trial registration Ethics clearance for the procedure was granted prospectively from the Ethics Review Committee, Faculty of Medicine, University of Kelaniya (ERC no. P 131/06/2018).

Abstract Background A rich language environment is an important element of a nurturing home environment. Despite their proven importance, vocabulary and conversation have been shown to vary widely across households—even within the same socio-economic class. One significant gap in the existing literature is its nearly exclusive geographic focus on Western and developed settings, with little attention given to poorer communities in lower/middle income countries. The purpose of this study was to empirically illustrate the characteristics of the home language environment in the low SES, non-Western cultural setting of rural China. Methods Using Language Environment Analysis (LENA) automated language-analysis system, this study measured the home language environment of 38 children aged 20-27 months in Northwest rural China. Our primary measures of the home language environment were Adult Word Count (AWC), Conversational Turn Count (CTC) and Child Vocalization Count (CVC). Multivariate linear regression models were used to examine the association between home language environment and family/child characteristics, and language skills (Measured by MacArthur-Bates Communicative Developmental Inventory score). Results In this paper, by comparison, we found that the home language environment of our rural sample fell far behind that of urban households. We also identify significant, positive correlations between language skills and both AWC and CTC. Our analysis finds no significant correlations between home language environment and family/child characteristics. Conclusion In this paper, we present the first ever findings using the LENA system to measure the home language environment of young children from poor rural communities in China. We found that the home language environment of lower-SES household was significantly worse than high-SES households, and demonstrated the importance of the home language environment to language skills, pointing to a need for more high-quality studies of the home language environment in rural China to better understand possible mechanisms behind low levels of parent-child language engagement and ways to improve the home language environment.

Abstract Background In March 2020, the COVID-19 outbreak was declared a pandemic by the World Health Organization (WHO), generating stark economic and social repercussions that directly or indirectly affected families’ wellbeing and health status. Aims This review aims at mapping the existing evidence on the impact of the COVID-19 pandemic on maternal mental health, early childhood development, and parental practices, worldwide, to identify evidence gaps and better inform future delivery of care and health policy measures. Methods Following the protocol defined by PRISMA-ScR, this scoping review has searched for relevant studies published between January 2020 and June 2021, selecting evidence sources based on pre-established criteria. From a total of 2,308 articles, data were extracted from 537 publications from 35 countries on all three health domains. Results The combined stressors brought forth by the pandemic have exerted a heavy burden on the mental health of mothers and the development of young children, partly mediated by its impact on parental practices. Conclusions Despite remaining gaps, we have identified sufficient evidence pointing to an urgent need for more concerted global research efforts and rapid policy responses to timely address severe and pervasive negative impacts to the mental health of mothers and children at a key developmental stage.

The lockdown in Serbia imposed major challenges for parents to take on a 24/7 shift in caretaking, educating, and entertaining their children, while managing to complete the demands of their professional roles and everyday household functioning, along with the constant fear of the virus spreading and potential job loss. This study examines parenting practices (enriching activities, harsh parenting, daily structure, screen time and perception of the increase in screen time) during the COVID-19 lockdown in relation to the perceived parenting stress, parents' socioeconomic status and their working conditions (i.e., without work obligation, working online, working from the workplace). The sample consisted of 1510 mothers of preschool children. Four socioeconomic clusters were identified using the relevant variables (education level, economic status and impact of the pandemic on the financial situation). The results showed that highly educated mothers who worked remotely during the lockdown experienced significantly higher stress of balancing working and parenting than other parents. Mothers who did not work during the pandemic spent more time in enriching activities (p

This paper examines how parents’ early childhood exposure to a refugee crisis impacts their children’s health status. Based on Demographic and Health Survey data from Tanzania with the migration history of mothers and fathers, the analysis exploits geographical, time, and cohort variations using shock intensity and distance from refugee camps to instrument treatment. The findings show that children who were born to parents who were living closer to refugee camps during their early childhood have lower height for their age and are more likely to be stunted. The results are robust to alternative functional forms of the distance from camps, alternative specifications of the treatment and control groups, alternative cohorts of mothers, and several placebo tests.

BackgroundForty-three percent of children under five in low and middle-income countries (LMICs) experience compromised cognitive and psychosocial development. Early childhood development (ECD) interventions that promote parent-child psychosocial stimulation and nutrition activities can help remediate early disadvantages in child development and health outcomes, but are difficult to scale. Key questions are: 1) how to maximize the reach and cost-effectiveness of ECD interventions; 2) what pathways connect interventions to parental behavioral changes and child outcomes; and 3) how to sustain impacts long-term.MethodsMsingi Bora ("good foundation" in Swahili) is a multi-arm cluster randomized controlled trial across 60 villages and 1200 households in rural Western Kenya that tests different, potentially cost-effective and scalable models to deliver an ECD intervention in biweekly sessions lasting 7 months. The curriculum integrates child psychosocial stimulation with hygiene and nutrition education. The multi-arm study will test the cost-effectiveness of two models of delivery: a group-based model versus a mixed model combining group sessions with personalized home visits. Households in a third study arm will serve as a control group. Each arm will have 20 villages and 400 households with a child aged 6-24 months at baseline. Primary outcomes are child cognitive and socioemotional development and home stimulation practices. In a 2 × 2 design among the 40 treatment villages, we will also test the role of including fathers in the intervention. We will estimate intention-to-treat and local average treatment effects, and examine mediating pathways using Mediation Analysis. One treatment arm will receive quarterly booster visits for 6 months following the end of the sessions. A follow-up survey 2 years after the end of the main intervention period will examine sustainability of outcomes and any spillover impacts onto younger siblings. Study protocols have been approved by the Maseno Ethics Review Committee (MUERC) in Kenya (00539/18) and by RAND's institutional review board. This study is funded by the National Institute for Child Health and Human Development (R01HD090045).DiscussionResults can provide policymakers with rigorous evidence of how best to design ECD interventions in low-resource rural settings.Trial registrationClinical Trial NCT03548558 registered June 7, 2018 at clinicaltrials.gov; AEA-RCT registry AEARCTR-0002913.