Promoting parent-child relationships and preventing violence via home-visiting: a pre-post cluster randomised trial among Rwandan families linked to social protection programmes

Media type: E-Article
Title: Promoting parent-child relationships and preventing violence via home-visiting: a pre-post cluster randomised trial among Rwandan families linked to social protection programmes
Contributor: Betancourt, Theresa S.; Jensen, Sarah K. G.; Barnhart, Dale A.; Brennan, Robert T.; Murray, Shauna M.; Yousafzai, Aisha K.; Farrar, Jordan; Godfroid, Kalisa; Bazubagira, Stephanie M.; Rawlings, Laura B.; Wilson, Briana; Sezibera, Vincent; Kamurase, Alex
imprint: Springer Science and Business Media LLC, 2020
Published in: BMC Public Health, 20 (2020) 1
Language: English
DOI: 10.1186/s12889-020-08693-7
ISSN: 1471-2458
Origination:
Footnote:
Description: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p><jats:italic>Sugira Muryango</jats:italic> is a father-engaged early child development and violence-prevention home-visiting programme delivered by trained lay workers. This cluster-randomised trial evaluates whether families living in extreme poverty (<jats:italic>Ubudehe</jats:italic> 1, the poorest category in the Government of Rwanda’s wealth ranking) who receive <jats:italic>Sugira Muryango</jats:italic> in combination with a government-provided social protection programme demonstrate greater responsive, positive caregiving, nutrition, care seeking, hygiene, and father involvement compared with control families receiving usual care (UC).</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Using detailed maps, we grouped closely spaced villages into 284 geographic clusters stratified by the type of social protection programmes operating in the village clusters; 198 clusters met all enrolment criteria. <jats:italic>Sugira Muryango</jats:italic> was delivered to <jats:italic>n</jats:italic> = 541 families in 100 treatment clusters with children aged 6–36 months living in extreme poverty. We assessed changes in outcomes in intervention and <jats:italic>n</jats:italic> = 508 UC control families using structured surveys and observation. Analyses were intent to treat using mixed models to accommodate clustering.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Families receiving <jats:italic>Sugira Muryango</jats:italic> improved on core outcomes of parent-child relationships assessed using the Home Observation for Measurement of the Environment (Cohen’s <jats:italic>d</jats:italic> = 0.87, 95% CI: 0.74, 0.99) and the Observation of Mother-Child Interaction (Cohen’s <jats:italic>d</jats:italic> = 0.29, 95% CI: 0.17, 0.41). We also saw reductions in harsh discipline on items from the UNICEF MICS (OR = 0.30: 95% CI: 0.19, 0.47) and in violent victimisation of female caregivers by their partners (OR = 0.49, 95% CI: 0.24, 1.00) compared with UC. Moreover, children in families receiving SM had a 0.45 higher increase in food groups consumed in the past 24 h (Cohen’s <jats:italic>d</jats:italic> = 0.35, 95% CI: 0.22, 0.47), increased care seeking for diarrhoea (OR = 4.43, 95% CI: 1.95, 10.10) and fever (OR = 3.28, 95% CI: 1.82, 5.89), and improved hygiene behaviours such as proper treatment of water (OR = 3.39, 95% CI: 2.16, 5.30) compared with UC. Finally, <jats:italic>Sugira Muryango</jats:italic> was associated with decreased caregiver depression and anxiety (OR = 0.58, 95% CI: 0.38, 0.88).</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p><jats:italic>Sugira Muryango</jats:italic> led to improvements in caregiver behaviours linked to child development and health as well as reductions in violence.</jats:p> </jats:sec><jats:sec> <jats:title>Trial registration</jats:title> <jats:p>ClinicalTrials.gov number <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/show/NCT02510313">NCT02510313</jats:ext-link>.</jats:p> </jats:sec>
Access State: Open Access

Search in field:

Recently searched for: