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General

Study Overview

Title:

Implementation science for early childhood development in Odisha, India

Study is 3ie funded:

No

Study ID:

RIDIE-STUDY-ID-67342a92ee2cb

Initial Registration Date:

11/12/2024

Last Update Date:

11/08/2024

Study Status:

Ongoing

Location(s):

India

Abstract:

Around 25% of the world’s 250 million children aged 0-5 years identified as being at risk of not meeting their full developmental potential, based on proxy indicators of poverty and stunting, live in India. Among them, an estimated nine million children under five from indigenous communities are particularly at risk: 71% are in the two poorest wealth quintiles and 48% are chronically undernourished. Existing research and policies offer three main options for expanding access to nurturing care for young children in rural areas of India: home visits, parenting groups and creches. Creches are a potentially more comprehensive form of ECD intervention, which provide food, clean water, and safe early learning opportunities for children. However, existing trials of creches in India either did not measure their effects on child development or suffered from limited investment and had no detectable effects on children’s cognitive ability. In this study we aim to assess the effects of existing creches run by civil society organisation Ekjut in Odisha on the development of children aged 0 to 36 months using a quasi-experimental design. 

Registration Citation:

Categories:

Education
Health, Nutrition, and Population

Additional Keywords:

early childhood development, creches

Secondary ID Number(s):

Principal Investigator(s)

Name of First PI:

Audrey Prost

Affiliation:

University College London

Name of Second PI:

Shibanand Rath

Affiliation:

Ekjut

Study Sponsor

Name:

Economic and Social Research Council (ESRC)

Study Sponsor Location:

United Kingdom

Research Partner

Name of Partner Institution:

Ekjut

Type of Organization:

NGO (local) or other civil society organization

Location:

India

Intervention

Intervention Overview

Intervention:

Creches typically accommodate between 10 and 15 children at any given time and provide breakfast, a hot cooked lunch and snacks for children, as well as play activities in a smoke-free environment. Study leads Ekjut have been running creches in Odisha since 2012, funded by District Mineral Foundation.

Theory of Change:

The theory of change for the creche intervention is shown in Figure 2 of the study protocol. 

Multiple Treatment Arms Evaluated?

No

Implementing Agency

Name of Organization:

Ekjut

Type of Organization:

NGO (local)/Community Based Organization/Other civil society organization

Program Funder

Name of Organization:

District Mineral Foundations (DMF)

Type of Organization:

Public Sector, e.g. Government Agency or Ministry

Intervention Timing

Intervention or Program Started at time of Registration?

Yes

Start Date:

01/01/2012

End Date:

Evaluation Method

Evaluation Method Overview

Primary (or First) Evaluation Method:

Difference in difference/fixed effects

Other (not Listed) Method:

Additional Evaluation Method (If Any):

Other (not Listed) Method:

Method Details

Details of Evaluation Approach:

A quasi-experimental, controlled pre-post study design will be used to evaluate the impact of the creche intervention. Impact will be evaluated after 6 months of implementation, based on repeated survey measurements of children and caregivers at two time points (i.e. at study enrolment and 6 months later). The sample will comprise an intervention group of children aged 6-24 months from 30 creches and a control group of an equivalent number of  ‘unexposed’ children of the same age in neighbouring villages without creches.

Intervention areas were selected in Joda Block, which has 166 operational creches across 200 villages. Amongst these, 48 creches were purposively selected for evaluation, to ensure a mixture of older and more recently established creches in the sample. In the intervention arm, each of these creches will be a cluster for the evaluation. Control areas were selected from neighbouring Champua Block, where 65 creches operate across 150 villages. Amongst the 85 villages without creches, a subset of around 60 which were not adjacent to villages with creches were eligible for the control group. Clusters in the control arm therefore correspond to geographical areas or villages. Control villages were matching to the 48 intervention creches based on the proportion of scheduled tribe and scheduled caste population, resulting in 48 clusters in both arms.

The intervention group will be recruited using routine monitoring data on children’s entry into creches to identify eligible children. All children enrolled in creches within the previous three months, or during the three-month period of baseline data collection, will be enrolled in the study. Within eligible pair-matched villages, we will then conduct a population census to identify caregivers of children under two years of age.

Outcomes (Endpoints):

Primary outcome:  Global Scale for Early Development (GSED) combined format 

Secondary outcomes:

• Wasting. A binary indicator of wasting, based on weight-for-height z scores <-2 standard deviation from the median of WHO Child Growth Standards.
• Labour market participation: Binary indicators of whether mothers worked in the previous 7 days and in the previous 12 months.
• Caregiver mental health: Measured using the Kessler Psychological Distress Scale (K10).17
• Caregiver stress: Measured by an 8-item scale developed for this study.
• Quality of the home care environment: Measured through early learning play activity survey questions developed for the Nurturing Care Framework.18
• Caregiver beliefs: Survey item on the importance of early learning developed for this study
• Child immunisation status: Binary indicator of whether child fully vaccinated based on Government of India National Immunization Schedule. Vaccination history captured in Mother and Child Protection card.

Exploratory outcomes:

• Child illness: Binary indicator of whether child was sick in the past two weeks
• Child care-seeking: For those who were sick within the past two weeks, binary indicator of whether care was sought from a qualified provider.
• Caregiver time-use: Questions on caregiver perceptions of how creches have changed their time spent on various ac

Unit of Analysis:

Child/Caregiver

Hypotheses:

(1) Fidelity: Do creches adhere to quality standards and what factors influence creche quality?

(2) Real-world effectiveness: Are creches an effective and cost-effective intervention for improving ECD and caregiver wellbeing?

(3) Equitability: What is the impact of creches on child and caregiver outcomes by socioeconomic status, as well as age and gender of child?

(4) Sustainability: How can quality of creches be maintained over time to support scale up?

Unit of Intervention or Assignment:

Number of Clusters in Sample:

96

Number of Individuals in Sample:

1248

Size of Treatment, Control, or Comparison Subsamples:

48 clusters per evaluaton arm

Supplementary Files

Analysis Plan:

Data

Outcomes Data

Description:

Household survey, qualitative data collection, creche quality checklist

Data Already Collected?

No

Data Previously Used?

Data Access:

Data Obtained by the Study Researchers?

Data Approval Process:

Approval Status:

Treatment Assignment Data

Participation or Assignment Information:

Yes

Description:

Data Obtained by the Study Researchers?

Data Previously Used?

Data Access:

Data Obtained by the Study Researchers?

Data Approval Process:

Approval Status:

Data Analysis

Data Analysis Status:

Study Materials

Upload Study Materials:

Registration Category

Registration Category:

Prospective, Category 1: Data for measuring impacts have not been collected

Completion

Completion Overview

Intervention Completion Date:

Data Collection Completion Date:

Unit of Analysis:

Clusters in Final Sample:

Total Observations in Final Sample:

Size of Treatment, Control, or Comparison Subsamples:

Findings

Preliminary Report:

Preliminary Report URL:

Summary of Findings:

Paper:

Paper Summary:

Paper Citation:

Data Availability

Data Availability (Primary Data):

Date of Data Availability:

Data URL or Contact:

Access procedure:

Other Materials

Survey:

Survey Instrument Links or Contact:

Program Files:

Program Files Links or Contact:

External Link:

External Link Description:

Description of Changes:

Study Stopped

Date:

Reason: