Peer-reviewed article
Effect of a home-visiting parenting program to promote early childhood development and prevent violence: a cluster-randomized trial in Rwanda
Sarah K. G. Jensen, Matias Placencio‐Castro, Shauna M. Murray, Robert T. Brennan, Simo Goshev et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study tested Sugira Muryango, a home-visiting parenting program delivered through Rwanda's social protection system, with 541 intervention and 508 control families with young children. The program improved children's gross motor, communication, problem-solving and personal-social development, increased father engagement, and reduced harsh discipline and intimate partner violence. However, there were no improvements in development scores on the Malawi tool or in child growth.
Key points
- Children in the intervention group showed improvements in gross motor development (d=0.162), communication (d=0.081), problem-solving (d=0.101) and personal-social skills (d=0.096) on the Ages and Stages Questionnaire
- Intervention families had 1.6 times higher odds of father engagement compared to control families
- Harsh discipline decreased by 26% in intervention families and intimate partner violence decreased by 38%
- No intervention-related improvements were found on the Malawi Development Assessment Tool or child anthropometric measures
- Study attrition was very low (2% of children, 9.6% of caregivers) and addressed through imputation
Limitations
The study used cluster randomisation in Rwanda only, so findings may not generalise to other countries or contexts. The lack of improvements on the MDAT and growth measures suggests effects may be modest or context-specific.
Abstract
INTRODUCTION: Families living in extreme poverty require interventions to support early-childhood development (ECD) due to broad risks. This longitudinal cluster randomised trial examines the effectiveness of Sugira Muryango (SM), a home-visiting intervention linked to Rwanda's social protection system to promote ECD and reduce violence compared with usual care (UC). METHODS: Families with children aged 6-36 months were recruited in 284 geographical clusters across three districts. Cluster-level randomisation (allocated 1:1 SM:UC) was used to prevent diffusion. SM was hypothesised to improve child development, reduce violence and increase father engagement. Developmental outcomes were assessed using the Ages and Stages Questionnaire (ASQ-3) and the Malawi Development Assessment Tool (MDAT) and anthropometric assessments of growth. Violence was assessed using questions from UNICEF Multiple Indicators Cluster Survey (MICS) and Rwanda Demographic and Health Surveys (DHS). Father engagement was assessed using the Home Observation for Measurement of the Environment. Blinded enumerators conducted interviews and developmental assessments. RESULTS: A total of 541 SM families and 508 UC families were enrolled and included in the analyses. Study attrition (2.0% children; 9.6% caregivers) was addressed by hot deck imputation. Children in SM families improved more on gross motor (d=0.162, 95% CI 0.065 to 0.260), communication (d=0.081, 95% CI 0.005 to 0.156), problem solving (d=0.101, 95% CI 0.002 to 0.179) and personal-social development (d=0.096, 95% CI -0.015 to 0.177) on the ASQ-3. SM families showed increased father engagement (OR=1.592, 95% CI 1.069 to 2.368), decreased harsh discipline (incidence rate ratio, IRR=0.741, 95% CI 0.657 to 0.835) and intimate partner violence (IRR=0.616, 95% CI:0.458 to 0.828). There were no intervention-related improvements on MDAT or child growth. CONCLUSION: Social protection programmes provide a means to deliver ECD intervention. TRIAL REGISTRATION NUMBER: NCT02510313.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
Problem
Early childhood development gaps and violence in families living in extreme poverty in Rwanda
- Intervention
- Sugira Muryango (SM), a home-visiting parenting program linked to Rwanda's social protection system
- Population
- Families with children aged 6-36 months in three districts of Rwanda (541 intervention, 508 control families across 284 geographical clusters)
Key finding
Gross motor development improved with effect size d=0.162 (95% CI 0.065 to 0.260)
Jensen et al. · OpenAlex - Early Childhood · 1 Jan 2021