Effects of an integrated early childhood parenting programme on child development and growth of children 6-24 months in Sri Lanka: a pragmatic cluster randomized trial.

INTERVENTION: Study setting: Participants of the study will be drawn from three Area programmes (AP) of World Vision Lanka. They are Ridigama AP in the Kurunegala district of North Western province, Chankanei AP in Jaffna district of Northern Province, and Karachchi AP, Kilinochchi district of Northern Province. Both control and intervention arms will be located in all three APs. Randomization: Randomization will be based on GN areas. From each area, there will be 5 intervention and 5 control areas. Intervention: The intervention arm will consist of the “Go Baby Goâ€? intervention and The Child Health and Nutrition Package (CH&N) developed based on the guidelines of the Ministry of Health , delivered by World Vision Lanka under the supervision of the Medical Officer of Health. Go Baby Go: The Go Baby Go! (GBG) parenting programme is developed to strengthen the confidence and competence of mothers (starting in pregnancy), fathers, and other primary caregivers of children 0 to 3 years old, thereby, promoting caregiver‐child relationships that foster children’s growth, learning and lifelong development. GBG’s ultimate goal is to empower parents and caregivers with the skills to create positive change within their families, to foster holistic, early childhood development (ECD) in practical ways, and establish the strongest foundation possible for their children’s futures. The Go Baby Go intervention will comprise 10‐12 group sessions (each about 45 to 90 minutes) involving approximately 30 caregivers, conducted every 2 weeks over the 6‐month intervention period. This will be further supported by approximately 3‐4 home visits every month during the first 3‐4 months of the intervention. The group sessions will cover areas such as holistic child development, nurturing development in domains such as cognitive, language, physical and socio emotional, play and communication, home environment, family affairs and community action planning. Child Health CONDITION: Child Development SECONDARY OUTCOME: None [None]; INCLUSION CRITERIA: 1. Resident in the last year in the selected areas and provide consent to take part in the trial; 2. Have a child 6 to 24 months as of 1st January 2019. The younger of two children will be selected. 3. Has agreed for home visits by facilitators and will visit the intervention sites (community centers) during intervention. PRIMARY OUTCOME: 1. Child anthropometric measurements – height/length and weight at baseline and endline (after 6 months) to derive anthropometric indices (weight‐for‐age, weight‐height and height‐for‐age) using instruments (Seca brand), with the support of trained data collectors; WHO Anthro software will be used to compute standard z‐scores of weight for age, height for age and weight for height versus WHO 2007 reference population; ; ; 2.Child age‐appropriate development of language, cognitive, social‐emotional and motor development; ; ‐ Caregiver reported early childhood development Instrument (CREDI) to measure child age‐appropriate development for language, cognitive, social‐emotional and motor development. ; ; ‐ Bayley‐III, screening of child development in four domains (language, cognitive, social‐emotional and motor), will be applied to a nested sample of children from control and intervention sites, by trained psychometricians or paediatricians. ; ; [Base line and after 6 months];