Evaluating an early childhood care and education program brought to scale in Ghana

INTERVENTION: The intervention in this trial is the government implementation of the International NGO's Lively Minds Early Child Care and Education program, with the sequence in which different districts start receiving the program randomly allocated by the research team. The program involves child playgroups for pre‐school‐aged children, the installation of "Tippy Tap" water sources for hand‐washing, pre‐school teacher training, and a parenting program, and was previously evaluated by the PI in an earlier study (see https://ifs.org.uk/publications/14922 for details). While the program is scaled to all districts in Northern Ghana, this study focuses on 54 districts (grouped into 9 district groups (DG)) and two cohorts of children, combined into 60 district‐cohort pairs. District groups will be enrolled in the study from January 2021 to September 2024 in 5 tranches. In each tranche, one DG is allocated at random into the treatment group and one allocated to the control. District group six is used with different cohorts of children as both a control and treatment district group ‐ control with the first cohort of children, treatment with the second. The control DG in each tranche will begin to receive the program 2 to 3 terms after being enrolled into the study after all data collection has been completed. CONDITION: Child health and cognitive and socio‐emotional development. ; Not Applicable PRIMARY OUTCOME: Measured 2 to 3 academic terms (6 ‐ 9 months approximately) after treatment commences:; 1. Child cognition as measured using the emergent numeracy, emergent literacy and executive functioning tasks in the IDELA as well as items relating to the same domains from the Harvard Laboratory for Development Studies; 2. Child health, as measured using height/weight for age and height for weight Z score; 3. Child socio‐emotional development, as measured by the externalizing, internalizing and pro‐social domains of the Strengths and Difficulty questionnaire and the the socio‐emotional items in the IDELA SECONDARY OUTCOME: Measured 2 to 3 academic terms (6 ‐ 9 months approximately) after treatment commences:; 1. Maternal mental health (Kessler‐10 and WEMWBS) and knowledge of ECCE; 2. Teacher knowledge, motivation and teaching quality (measured through classroom observations); 3. Parent‐child investment, as measured by quality of the home environment (FCI and HOME) and the parent‐child relationship (CPRS); 4. WASH practices in the home; 5. Acute Malnutrition measured by MUAC INCLUSION CRITERIA: 1. Aged between 3 and 5 years 2. Enrolled in the 1st year of preschool or planning to enrol in a sample preschool in the coming term (i.e. they must be in the preschool for the whole duration of the treatment).