Group-Based Parenting Programs Help Early Childhood Development in Kenya

By Carolyn Crist

January 19, 2021

NEW YORK (Reuters Health) - Parenting programs in Kenya with peer groups of mothers and children improved cognitive, language and socioemotional development among young children, according to a new report.

These programs can address early disadvantages that nearly half of children under age 5 face in low-income and middle-income countries, researchers write in The Lancet Global Health.

"About 43% of children under 5 years around the world do not meet their 'developmental potential' - they won't grow up as smart or as capable as they otherwise could, which can inhibit their life's trajectory right from the start," said lead author Dr. Jill Luoto of the RAND Corporation.

The early disparities stem from nutritional deficiencies, poverty and inadequate psychosocial stimulation. Early childhood development programs that integrate nutrition education and responsive parenting tactics can minimize some of the disadvantages.

"These programs can help parents to become excited about their children's potential to achieve a better life," Dr. Luoto told Reuters Health by email. "When we think about a country's development, these little daily changes can potentially lay the foundation for a brighter tomorrow."

She and her colleagues tested two programs among 1,070 families in 60 villages across western Kenya - a group-based delivery with 16 sessions and a mixed delivery with 12 group sessions and four home visits. They also ran a comparison group with no intervention.

The programs, led by trained community health volunteers at local community centers or churches, included nutrition education, encouraged parents to talk and play with their children more and at earlier ages, fostered responsive communication to children's cues and promoted love and respect in the family. The sessions emphasized learning new practices through demonstration and practice, group-based problem solving and peer support.

Some groups included both mothers and fathers, and some only included mothers. Several father-only sessions emphasized topics such as respectful communication, father involvement in childcare and emotional support between spouses. Trained supervisors supported the community health volunteers, provided feedback after each session and ran the assessments of child language, cognition and socioemotional development.

Overall, children in the 16-session group-only villages showed significant improvements over the comparison group in cognitive, receptive language and socioemotional scores. Children in the mixed-delivery villages showed smaller but still significant improvements in cognitive and socioemotional scores.

Both groups showed improvements in maternal knowledge of child development but not maternal well-being. Higher attendance led to greater gains, and mothers commented that both they and their children liked interacting with others in their group. Mothers also benefited from problem-solving with others and learning how to play games and talk with their child by watching others.

"The findings were the best we could hope for. Children got smarter and more verbal, and the group sessions taught them how to play and share with others," Dr. Luoto said. "This was a surprise and very exciting because group visits are also less costly to deliver and only low-cost programs are possible to bring to scale in low-resource settings such as ours in Kenya."

Dr. Luoto and colleagues encourage governments in low-income countries to commit to investing in and scaling group programs to help child development and urge officials in wealthy countries to support global child health and development funding.

In addition, future studies should investigate whether involving fathers provides additional benefits, the authors write. Although the research team invited fathers to participate in some sessions, the attendance was low.

"Although childcare duties in Kenya have largely been a preserve of women, the country is rapidly urbanising and traditional structures that endorsed a separation of duties are unravelling," said Dr. Pamela Wadende of Kisii University in Kisii, Kenya, who wrote a commentary accompanying the study.

Programs could also include non-parental caregivers such as babysitters, friends, relatives and children who are commonly put in charge of younger children, she said.

"It is equally important to devise ways to improve the participation of fathers in such interventions, despite social norms, and to account for other childcare givers in the community such as pre-adolescent children and other relatives," she said.

SOURCE: The Lancet Global Health, online December 17, 2020.