The purpose of this study is to evaluate whether the integration of an early child 'stimulation and care for development' intervention, either alone or in combination with an 'enhanced care for nutrition' intervention, delivered by Lady Health Workers to families with infants and young children aged 0-24 months living in rural Sindh in Pakistan, has beneficial outcomes on child development (cognitive, language, motor and social emotional development) and child growth.
In Pakistan, the "National Program for Family Planning and Primary Healthcare" delivers maternal and child health and nutrition services in rural and remote areas of Pakistan through community-based Lady Health Workers. The strengths of the programme include provision of services at grassroots levels, reinforcement of health and basic nutrition messages and community acceptability. Given, the growing recognition that optimal early child development (ECD) also requires the integration of psychosocial care; the PEDS-Trial has been proposed to evaluate the benefits of the addition of 'stimulation and care for development' interventions and the feasibility of scaling up an ECD strategy within the community healthcare system of Pakistan.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
1,489
Project Office, Dept of Paediatrics and Child Health, AKU
Naushero Feroze, Sindh, Pakistan
Early Child Development
Cognitive, Language, Motor, Social-Emotional development
Time frame: 24 months of child age
Child Growth
Length/Height, Weight, Mid Arm Circumference, Head Circumference
Time frame: 24 months of child age
Caregiving Mediators: Maternal Psychological Distress (Depression)
Self-Reporting Questionnaire (SRQ)-20
Time frame: Baseline, 6 months, 12 months, 18 months and 24 months of child age
Caregiving mediators: Caregiving Environment
Home Observation and Measurement of the Environment (HOME) Inventory
Time frame: 6 months and 18 months of child age
Caregiving Mediator: Mother/Child Interaction
Live observation
Time frame: 12 months and 24 months of child age
Caregiving Mediator: Care for Development
Knowledge and Practices Questionnaire (Maternal Report)
Time frame: Baseline, 12 months and 24 months of child age
Caregiving Mediator: Feeding Practices
Maternal report of infant and young child feeding practices
Time frame: Baseline, 6 months, 12 months, 18 months and 24 months of child age
Morbidity
Maternal recall
Time frame: Monthly report
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Anaemia Status
Haemoglobin assessment using HemoCue Assay
Time frame: 24 months child age