1067-Kenya-Implementing a community-based intervention programme in Kisumu West to improve caregiver co-regulation and child neurodevelopment

Early child development (ECD), especially the first 1,000 days of life, is a critical period for intervention that supports brain growth, thinking and motor function, social emotional development, school readiness and school outcomes, lifelong learning, and improved health (and mental health) across the lifespan. Children from all backgrounds, and especially those from low-income families, benefit from high-quality early childhood care. Designing and implementing these ECD programs is complex. A systems approach that aligns community-based systems, community health promoters (CHPs) who are familiar with the communities and families, with primary caregiver training, skills development, and coaching is critical. Effective ECD intervention programs must engage and empower mothers of young children, other primary caregivers in the home, and community care workers. Self-regulation – the act of managing thoughts and feelings to enable goal-directed actions – is the foundational cognitive skill that enables all other cognitive skills such as fine and gross motor coordination, numeracy, literacy, verbal communication, and setting and attaining goals. There is strong evidence that children who demonstrate self-regulation go on to succeed in school and show improved socioeconomic and health outcomes later in life. Children learn to self-regulate through co-regulation with adult caregivers who have developed the skill of self-regulation themselves. This co- regulation requires social emotional connection between the caregiver and the child. It is thus critical to support primary caregivers in developing self-regulation within themselves and maximizing the skill of establishing social emotional connections with the children in their care.

The aim of the community-based intervention programme in Kisumu West is to train 35 CHPs and three CHP Supervisors from pre-selected Health Centers to deliver the intervention to 585 families/households across 3 community health units. The intervention involves caregivers of children aged 23 months and under within the 585 households, who will learn the intervention from the 35 trained CHPs and will implement the practices in their everyday lives at home. Before the intervention is disseminated by the CHPs, 20 trained research assistants will conduct pre-intervention (baseline) assessments on 1,170 households (585 intervention, 585 waitlist control). These assessments include measures of child neurodevelopment, the home environment, and parent well-being. The CHPs will also be assessed on their protocol adherence and fidelity to the intervention model and their well-being. The intervention will take place for 30-40 weeks after which there will be a post intervention assessment identical to the pre-intervention assessment to measure the impact of the intervention on neurodevelopment among the target children in the households who were under 23 months of age when the study began. Caregiver uptake of knowledge and skills and child neurodevelopmental in the intervention households will be compared to the waitlist control households.

Learning the intervention model and assisting CHPs in delivering training and coaching to households in select intervention communities in Kisumu West County. The intervention is provided to groups of 5-8 caregivers at a time in community settings. Students will also work with the Research Assistants to collect target outcomes assessment data to track the uptake and implementation of intervention knowledge and skills and track target outcomes among the caregivers, their households, and the children. Students will assist with data collection via electronic devices, data checking, data analysis, writing results, and preparing presentations of key results for public health officials in Kenya and scientific/academic presentations both within Kenya and internationally. This will include the collection and analysis of qualitative data. Students will receive guidance from supervisors on quantitative and qualitative data analysis.

...collaborative. The student will interact with other team members with expertise across various fields: public health, community-based intervention, maternal-child health, ECD, cognitive neuroscience, mental illness and building resilience, epidemiology, and data analysis. There are opportunities for office and field work, and students will be encouraged to lead on sub-project data analysis and reporting of results. 

...is interested in ECD, maternal-child health, empowering women of child-bearing age and mothers, community-based assessment and intervention, work in low resource settings, work in tropical areas, integrating methodologies and data from multiple fields to tackle a specific and concrete public health problem, mental illness and its connection to chronic disease 

Familiarity with qualitative research methods and survey research methods; Familiarity with quantitative research methods, data checking, databasing, and data analysis; Strong interpersonal and writing skills and willingness to work collaboratively with research partners; Knowledge or experience in ECD and maternal-child health preferred but not required; Interest in applied public health problems that require deep intersectoral collaboration. 

Name: Anita Shankar, anita.shankar@jhu.edu 

I would describe my communication and mentorship styles as... 

Open and direct; Willing to work with student in relation to the GHEFP project as well on larger career goals.

A complementary student would have a working style and mentorship expectations that are..

Interested in personal and career development; open and direct discussions; willing to work outside their comfort zone.

Estimated Costs:

Housing $0 (covered by project), Food $500/month, Local transport $150/month (project transport covered by project), Internet SIM card $50/month Total: $700/month

Additional support from PI:

 no additional support is available from the project side but housing and utilities and house internet (WiFi) while onsite is covered and all work-related travel is covered