Peer-reviewed article
Effects of a Nurturing Care Group behavior change program on child protection outcomes in Ghana: A controlled before and after trial
Bill Forbes, Cynthia Fosuah, Ben Tidwell, Todd Nitkin, Tom Davis ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study tested a behavior change program called Nurturing Care Groups in Ghana to reduce child abuse and corporal punishment among caregivers of young children. The program reached nearly 74,000 caregivers across 41 communities in two ecological zones, compared with 20 control communities. The intervention led to increases in knowledge about stress management, positive parenting practices, and reductions in reported physical and psychological punishment of children.
Key points
- Intervention areas showed statistically significant increases in knowledge of negative impacts of stress on parenting and stress reduction techniques
- Reported physical abuse and corporal punishment decreased significantly in intervention areas
- Positive discipline and parenting practices increased in intervention areas
- The program was designed as low-cost and scalable to reach broad populations
- Changes were measured using a difference-in-difference approach comparing intervention and control areas
Limitations
The study relied on self-reported behavior change rather than observational measures or administrative data, which may not reflect actual changes in child protection practices. The document does not provide specific outcome effect sizes or timeframes for measurement.
Abstract
BACKGROUND: As part of an effort to rigorously apply behavioral science to child protection efforts, a behavior change model called Nurturing Care Groups (NCGs) was tested for effectiveness in changing child abuse and corporal punishment behaviors. OBJECTIVE: The primary research question was to what degree NCGs could change child protection knowledge, attitudes, and practices among caregivers in a low-cost program with broad reach, which could feasibly be scaled. PARTICIPANTS AND SETTING: The NCG project was implemented in two distinct ecological zones in Ghana, reaching 73,959 caregivers of children under 5 across 41 communities; while 20 communities were control sites with no NCG intervention. METHODS: Stratified random sampling was used to select intervention area respondents. Cluster sampling was utilized in control areas, using the Probability Proportional to Size method. Standard measures were used to assess changes in practices of violence and abuse, stress experience and management, parenting techniques, and the household environment. Difference-in-difference linear regression was used to compare intervention and control results. RESULTS: Intervention areas demonstrated statistically-significant and substantial changes in reported knowledge, attitudes and behaviors related to physical abuse and corporal punishment. Knowledge of negative impacts of stress on parenting, as well as stress reduction techniques increased in intervention areas, as did positive discipline and parenting practices. CONCLUSIONS: The NCG model demonstrated important promising results for changing child protection behaviors in this descriptive study. Statistically-significant decreases in reported physical and psychological punishment and corresponding increases in reported positive discipline indicate that this may be an effective and low-cost intervention for child protection behavior change.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Nurturing Care Groups (NCGs) - a behavior change program implemented in communities to change caregiver knowledge, attitudes, and practices regarding child protection
- Population
- 73,959 caregivers of children under 5 in 41 intervention communities across two ecological zones in Ghana; 20 control communities with no intervention
Key finding
Statistically significant increases in knowledge of negative impacts of stress on parenting in intervention areas