In Colombia, researchers evaluated the medium-term effects of a home-based early childhood development intervention. The program sought to improve nutrition and development in the first two years of life through home visits to encourage children’s psycho-social development and use of micronutrient supplements. The findings are useful to help policymakers and others understand the extent to which nutrition and parental involvement at an early age can carry lasting effects into the medium term and issues around scaling up such programs effectively for long-term impact.
Research area: |
Early Childhood Nutrition, Development, and Health |
| Country: | Colombia |
Evaluation sample: |
1,429 children |
| Timeline: | 2012 - 2015 (Completed) |
| Intervention: | Psychosocial stimulation, home visits, micronutrient supplementation |
| Researchers: | Orazio Attanasio, University College London and Institute for Fiscal Studies; Emla Fitzsimons, Institute for Fiscal Studies and Institute for Education; Emanuela Galasso, World Bank; Sally Grantham-McGregor, UCL Institute of Child Health; original researcher in the Jamaica study; Costas Meghir, Yale University and Institute for Fiscal Studies; Marta Rubio-Codina, Inter-American Development Bank |
| World Bank Task Team Lead (TTL): | Emanuela Galasso |
Development experts and educators know that stimulation programs for very young children are important to development and school readiness. Verbal interaction boosts vocabulary and mental development; playtime builds important physical and mental skills; and praise from a parent creates confidence and security. As shown by the long-term study of children in Jamaica whose mothers received weekly home visits by trained health workers who showed them how to play and talk to their toddlers (read the Evidence to Policy note on the evaluation), gains go beyond better grades. Nearly 20 years later, the children -- now young adults -- were earning as much as their non-disadvantaged peers. What’s not known is how to structure these programs so that they are cost-effective and still deliver the right impact, and whether linking programs with nutritional supplements or nutritional education is important.
This project, a follow-up evaluation of a pilot intervention that delivered psychosocial stimulation and micronutrient supplements at scale in Colombia, will help policymakers and development experts around the world improve the design of cost-effective and scalable strategies for successful early childhood development programs.
Problem
Development experts and educators know that stimulation programs for very young children are important to development and school readiness. How to deliver these programs in a cost-effective manner is the challenge. In Colombia, researchers wanted to test whether a home visit program for early childhood development could be effective at scale.
Intervention
The 18-month program trained mentors and mother “leaders” – local women who were already volunteering in the conditional cash transfer program -- to deliver psychosocial stimulation and distribute micronutrient supplements during weekly home visits starting in early 2010.
Evaluation design
Cluster randomized control trial. There were three treatment groups and one control group. The treatment groups included municipalities receiving psychosocial stimulation home visits; municipalities receiving micronutrient supplements; and municipalities that received both. The intervention covered a total of 1,429 children living in 96 towns in central Colombia
Eligibility
Children 12-24 months old and their mothers living in poor households that are beneficiaries of the country’s Familias en Accion conditional cash transfer program.
Results
The initial follow-up at the end of the intervention showed significant impact on cognitive and language development and on the amount of time and effort parents put into interacting with their children. The second follow-up, two years later, found no continuing benefits to the child nor in terms of parental behavior.
Next Steps
The research team is working with the government on a number of early childhood initiatives and the results of this evaluation will be used to help inform their discussions.
