Delivering Parenting Interventions Through Health Services in the Caribbean

42 Pages Posted: 21 May 2019

See all articles by Susan Walker

Susan Walker

University of the West Indies (Mona)

Christine Powell

University of the West Indies (Mona)

Susan Chang

University of the West Indies (Mona)

Helen Baker-Henningham

Bangor University - Bangor University

Sally Grantham-McGregor

University College London

Marcos Vera-Hernandez

University College London; Institute for Fiscal Studies (IFS)

Florencia López Bóo

Inter-American Development Bank (IDB); Young Lives, Department of International Development, University of Oxford; IZA

Abstract

There is limited information on whether integrating childhood interventions with health and nutrition services interventions is effective and feasible. In this trial we used group delivery at five routine visits from age 3-18 months, and comprised: short films of child development messages, shown in the waiting area; discussion and demonstration led by community health workers; and mothers' practice of activities. Nurses gave out and reviewed message cards with mothers, together with a few play materials. A cluster randomized trial was conducted in the Caribbean (Jamaica, Antigua and St Lucia) in 29 health centers. Centers were randomized to control (n=15) or health center intervention (n=14).We also adapted the Jamaica home visit intervention to increase feasibility at scale. Primary outcomes were child cognition, language and hand-eye coordination, and secondary outcomes caregiver knowledge, practices, maternal depression, and child growth, measured after the 18 month visit. Multilevel analyses comparing health center only with control in all 3 countries showed significant benefits for cognitive development from the health center intervention with effect size of 0.3 SD and benefits to parenting knowledge with effect size 0·4.In analyses of the two interventions in Jamaica, both benefited cognitive development with effect sizes of 0.34 SD (home visit) and 0.38 SD (health center). The most conservative analyses found benefit cost ratios of 5.3 for the health center intervention and 3.8 for home visits. Integrating parenting interventions into health services has the potential to reach a large number of children with benefits substantially higher than required investments.

Keywords: child development, parenting interventions, home visits, primary care health service, cost-benefit, Caribbean

JEL Classification: I10, I15, I30, I38, J13

Suggested Citation

Walker, Susan and Powell, Christine and Chang, Susan and Baker-Henningham, Helen and Grantham-McGregor, Sally and Vera-Hernandez, Marcos and López Bóo, Florencia, Delivering Parenting Interventions Through Health Services in the Caribbean. IZA Discussion Paper No. 12106, Available at SSRN: https://ssrn.com/abstract=3390094

Susan Walker (Contact Author)

University of the West Indies (Mona) ( email )

Kingston
Kingston 7
Mona, Mona Kingston 7
Jamaica

Christine Powell

University of the West Indies (Mona)

Kingston
Kingston 7
Mona, Mona Kingston 7
Jamaica

Susan Chang

University of the West Indies (Mona) ( email )

Kingston
Kingston 7
Mona, Mona Kingston 7
Jamaica

Helen Baker-Henningham

Bangor University - Bangor University ( email )

Sally Grantham-McGregor

University College London ( email )

Gower Street
London, WC1E 6BT
United Kingdom

Marcos Vera-Hernandez

University College London ( email )

Economics Dept.
Gower Street
London, WC1E 6BT
United Kingdom
+442076791007 (Phone)

HOME PAGE: http://www.homepages.ucl.ac.uk/~uctpamv

Institute for Fiscal Studies (IFS) ( email )

7 Ridgmount Street
London, WC1E 7AE
United Kingdom

Florencia López Bóo

Inter-American Development Bank (IDB) ( email )

1300 New York Avenue NW
Washington, DC 20577
United States

Young Lives, Department of International Development, University of Oxford ( email )

Queen Elizabeth House
3 Mansfield Road
Oxford, OX1 3TB
United Kingdom

IZA ( email )

P.O. Box 7240
Bonn, D-53072
Germany

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