But what happens next? Examining the sustained impacts of a group-based parenting intervention on parenting behaviors and early child development in rural KenyaAdd to Calendar
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Approximately 250 million children (43%) under age 5 from low and middle-income countries (LMICs) have compromised early childhood development (ECD) and are not on track to reach their full developmental potential because of living in poverty. Parents are the main caregivers of young children, and poverty negatively affects parenting behaviors through both financial and psychological constraints. A growing body of evidence shows that responsive parenting interventions can improve ECD, at least in the short term. However, the vast majority have been delivered via home visits, which are prohibitively expensive to implement at scale, and the very few programs that have included longer-term follow-ups show that early impacts tend to fade out over time. Group-based delivery models have been proposed as a more cost-effective alternative to deliver these programs, but evidence on their effectiveness and sustainability is limited.
In this paper, we evaluate the impacts after two years of Msingi Bora (Swahili for “Strong Foundation”), an 8-month group-based parenting intervention tested in a cluster Randomized Control Trial in rural Kenya that was shown to improve children’s developmental outcomes and parenting behaviors in the short-term. After the end of the original 8-month program, in half of the intervention villages, we tested the value-added of offering continued program support with a light-touch “booster” intervention spanning additional two years. However, the global COVID-19 pandemic interrupted the implementation of these extended boosters and forced modifications to their delivery. In a two-year assessment, we find that the original intensive 8-month program achieved sustained impacts on children’s cognitive and socioemotional outcomes, as well as maternal stimulation behaviors, though these medium-term impacts represent declines of 56%-76% from two years prior. Boosters provide small and marginally significant value-added to socioemotional outcomes and parenting behaviors. In an exploratory mediation analysis, we find that impacts on children’s outcomes after two years are strongly mediated by changes in current parenting behaviors and past children’s outcomes, suggesting the presence of dynamic complementarities. Finally, we find suggestive evidence that our program had greater sustainability of impacts among more disadvantaged families and children, and thus helped remediate early deficits across SES groups.