A community-designed play intervention to enhance early child development in rural Zimbabwe
Lead Research Organisation:
Queen Mary University of London
Department Name: Blizard Institute of Cell and Molecular
Abstract
Two-thirds of children in sub-Saharan Africa do not reach their full cognitive potential. A network of underlying factors rooted in poverty and vulnerability lead to suboptimal early childhood development, which traps entire populations into reduced human capital, with impacts across the lifespan and into the next generation.
Although there are many structural barriers to poverty alleviation, transforming the immediate environment in which a child grows up could fundamentally shape their development by providing the resources and skills to embed play, early learning and responsive caregiving into households.
A multidisciplinary UK-Zimbabwe consortium with expertise in child health, developmental psychology, childhood cultures, social science, and community engagement, in partnership with a children's museum in Harare, will co-design a package of play, early learning and responsive caregiving with a rural Zimbabwean community to promote child development. This will combine multi-sensory stimulation, hands-on play and early learning opportunities through song, storytelling, and community-made toys. Community health workers will deliver individual sessions of play with households, based on the principles of the nurturing care framework, and developed through a co-design workshop with community members. The Discovereum children's museum will leverage their expertise in play, education and user-centred design to develop travelling children's museums, which will be designed and equipped by the community, and reach even the furthest rural households to provide an inclusive early-learning experience.
After co-production, we will test the intervention among 24 households in Shurugwi district over a 12-week period. We will use mixed methods to evaluate the feasibility, acceptability, and uptake of the intervention, to evaluate mechanisms and outcomes against the co-produced theory of change, and to explore unintended consequences. We will then refine the package through another co-design workshop with community health workers and families involved in the intervention. We will then enrol a further 24 households to receive the refined intervention, and again evaluate feasibility, acceptability, uptake, and mechanism of action by week 12. We will hold one final workshop at the end of the project, to finalise the intervention, tools and training materials, and incorporate policymaker discussions to consider scalability and sustainability.
A low-cost, contextually relevant intervention, delivered through community cadres during the early years could benefit the two-thirds of disadvantaged children who currently fail to reach their full potential. Even small gains in early child development would translate to significant population-level improvements in human capital, which would enhance lifelong health, wellbeing and economic prosperity.
Although there are many structural barriers to poverty alleviation, transforming the immediate environment in which a child grows up could fundamentally shape their development by providing the resources and skills to embed play, early learning and responsive caregiving into households.
A multidisciplinary UK-Zimbabwe consortium with expertise in child health, developmental psychology, childhood cultures, social science, and community engagement, in partnership with a children's museum in Harare, will co-design a package of play, early learning and responsive caregiving with a rural Zimbabwean community to promote child development. This will combine multi-sensory stimulation, hands-on play and early learning opportunities through song, storytelling, and community-made toys. Community health workers will deliver individual sessions of play with households, based on the principles of the nurturing care framework, and developed through a co-design workshop with community members. The Discovereum children's museum will leverage their expertise in play, education and user-centred design to develop travelling children's museums, which will be designed and equipped by the community, and reach even the furthest rural households to provide an inclusive early-learning experience.
After co-production, we will test the intervention among 24 households in Shurugwi district over a 12-week period. We will use mixed methods to evaluate the feasibility, acceptability, and uptake of the intervention, to evaluate mechanisms and outcomes against the co-produced theory of change, and to explore unintended consequences. We will then refine the package through another co-design workshop with community health workers and families involved in the intervention. We will then enrol a further 24 households to receive the refined intervention, and again evaluate feasibility, acceptability, uptake, and mechanism of action by week 12. We will hold one final workshop at the end of the project, to finalise the intervention, tools and training materials, and incorporate policymaker discussions to consider scalability and sustainability.
A low-cost, contextually relevant intervention, delivered through community cadres during the early years could benefit the two-thirds of disadvantaged children who currently fail to reach their full potential. Even small gains in early child development would translate to significant population-level improvements in human capital, which would enhance lifelong health, wellbeing and economic prosperity.
Technical Summary
Early child development forms the foundation of human capital. However, two-thirds of children in sub-Saharan Africa do not currently reach their full potential. Our goal is to improve cognitive and socioemotional development among children aged 0-3 years through a co-produced package of play, early learning and responsive caregiving.
The intervention will be co-produced in rural Zimbabwe through an iterative approach, using the principles of human-centred design. We will enrol eligible households with a child below 3 years, and collect baseline data, then community health workers will deliver the intervention over 12 weeks, and our partner, the Discovereum, will deploy a travelling children's museum to communities using a converted vehicle. A researcher will visit the household at endline to repeat data collection. Mixed methods process evaluation will help interpret the results and improve understanding of the intervention mechanisms of action.
A second workshop will share the findings of the pilot, and refine the intervention. The second pilot study will enrol another 24 households with children below 3 years, and use the same implementation and evaluation approach. A final workshop will be convened with caregivers and policymakers to review acceptability, feasibility, uptake and retention, and determine if the intended mechanisms and outcomes of the theory of change were achieved. We will also evaluate potential unintended negative consequences, such as time burden for caregivers and community health workers, household conflicts, and environmental impact of local toy production; and positive consequences such as new caregiver-produced toys and materials, engagement of siblings, interest from non-study families in the travelling museum, and broader valorisation of rural culture. The same steps will be followed to finalise the intervention, including development of training materials for deployment in a larger trial.
The intervention will be co-produced in rural Zimbabwe through an iterative approach, using the principles of human-centred design. We will enrol eligible households with a child below 3 years, and collect baseline data, then community health workers will deliver the intervention over 12 weeks, and our partner, the Discovereum, will deploy a travelling children's museum to communities using a converted vehicle. A researcher will visit the household at endline to repeat data collection. Mixed methods process evaluation will help interpret the results and improve understanding of the intervention mechanisms of action.
A second workshop will share the findings of the pilot, and refine the intervention. The second pilot study will enrol another 24 households with children below 3 years, and use the same implementation and evaluation approach. A final workshop will be convened with caregivers and policymakers to review acceptability, feasibility, uptake and retention, and determine if the intended mechanisms and outcomes of the theory of change were achieved. We will also evaluate potential unintended negative consequences, such as time burden for caregivers and community health workers, household conflicts, and environmental impact of local toy production; and positive consequences such as new caregiver-produced toys and materials, engagement of siblings, interest from non-study families in the travelling museum, and broader valorisation of rural culture. The same steps will be followed to finalise the intervention, including development of training materials for deployment in a larger trial.
