Peer-reviewed article
The benefits of nurturing care interventions on early child development and care: findings from a quasi-experimental study in a humanitarian setting
Viktoria Sargsyan, Ana Tenorio, Mediatrice Uwera, Andre Gasirikare, Jean Aime Habyarimana et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study tested whether a parenting program focused on nurturing care would improve early child development in refugee camps and host communities in Rwanda. The program was delivered in two doses: high (12 group sessions plus home visits) and low (6 group sessions plus home visits) compared to standard care. While child development scores did not differ between groups, caregivers who received the program were significantly more likely to engage in early learning activities and responsive feeding practices. The findings suggest parenting programs can strengthen caregiving practices in humanitarian settings even with modest intensity.
Key points
- 733 children and families were assessed across high-dose, low-dose, and control groups
- No significant difference found in child development scores (ASQ-3) between intervention and control groups
- 67.2% of high-dose and 61.7% of low-dose caregivers engaged in 4+ early learning activities versus 36.9% in control group (p<0.001)
- 52.2% of high-dose and 45% of low-dose caregivers engaged in positive responsive feeding practices versus 34.6% in control group (p=0.001)
- No difference found in caregiver mental health between study arms
Limitations
The study did not find improvements in child development outcomes themselves, only in caregiver behaviors, so the long-term impact on children's development remains unclear. The lack of difference in caregiver mental health outcomes and the absence of data on implementation fidelity or contextual factors specific to humanitarian settings limits understanding of how these programs function in crisis contexts.
Abstract
BACKGROUND: The study objective was to determine if a nurturing care parenting intervention delivered in a humanitarian setting in Rwanda would benefit early development, learning, and care outcomes for young children under five years and their caregivers compared to standard care. METHODOLOGY: Rwanda's Mugombwa, Kansi, and Kigeme refugee camps and host communities implemented the parenting program. Via a quasi-experimental research design, the study assessed the effects of intervention delivered as a high dose (HD: 12 group sessions and four home visits) or low dose (LD: 6 group sessions and two home visits) on child and caregiver outcomes compared to the control group from similar settings receiving standard care. The Ages and Stages Questionnaires-3 (ASQ-3) assessed child development outcomes. The Multiple Indicator Cluster Survey questionnaire assessed parenting practices concerning early learning and stimulation. FINDINGS: The assessment included 733 children and families in total: HD = 314, LD = 240, control = 179. The researchers found no significant difference in child development scores between the intervention and control groups. Significantly higher proportion of caregivers exposed to HD and LD packages had engaged in early learning and stimulation practices compared to the control group, respectively, with 211(67.2%), 148 (61.7%) vs. 66 (36.9%), p < 0.001 caregivers engaged in 4 or more activities in the past three days. Similarly, on responsive feeding items, a higher percentage of HD and LD group caregivers were engaged in positive behaviours compared to the control group: 164 (52.2%), 108 (45%) vs. 62 (34.6%), p = 0.001. The study found no difference between the study arms regarding caregiver mental health. CONCLUSION: Parenting programmes in humanitarian settings can improve nurturing care practices, even with a low dose, which is essential to strengthening children's resilience in at-risk conditions. Further studies in humanitarian contexts are crucial to understand the implementation needs in sensitive contexts.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Parenting program with two dose levels: high-dose (12 group sessions and 4 home visits) and low-dose (6 group sessions and 2 home visits) focused on early learning, stimulation, and responsive feeding practices
- Population
- 733 children under five years and their caregivers in Rwandan refugee camps (Mugombwa, Kansi, Kigeme) and host communities
Key finding
Child development scores (ASQ-3) showed no significant difference between intervention and control groups