Improving early childhood care and development, HIV-testing, treatment and support, and nutrition in Mokhotlong, Lesotho : study protocol for a cluster randomized controlled trial
Date
2016-11-09
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Background: Since 1990, the lives of 48 million children under the age of 5 years have been saved because of
increased investments in reducing child mortality. However, despite these unprecedented gains, 250 million children
younger than 5 years in low- and middle-income countries (LMIC) cannot meet their developmental potential due to
poverty, poor health and nutrition, and lack of necessary stimulation and care. Lesotho has high levels of poverty, HIV,
and malnutrition, all of which affect child development outcomes. There is a unique opportunity to address these
complex issues through the widespread network of informal preschools in rural villages in the country, which provide a
setting for inclusive, integrated Early Childhood Care and Development (ECCD) and HIV and nutrition interventions.
Methods: We are conducting a cluster randomised controlled trial in Mokhotlong district, Lesotho, to evaluate a newly
developed community-based intervention program to integrate HIV-testing and treatment services, ECCD, and nutrition
education for caregivers with children aged 1–5 years living in rural villages. Caregivers and their children are randomly
assigned by village to intervention or control condition. We select, train, and supervise community health workers
recruited to implement the intervention, which consists of nine group-based sessions with caregivers and children over
12 weeks (eight weekly sessions, and a ninth top-up session 1 month later), followed by a locally hosted community
health outreach day event. Group-based sessions focus on using early dialogic book-sharing to promote cognitive
development and caregiver-child interaction, health-related messages, including motivation for HIV-testing and
treatment uptake for young children, and locally appropriate nutrition education. All children aged 1–5 years and their
primary caregivers living in study villages are eligible for participation. Caregivers and their children will be interviewed
and assessed at baseline, after completion of the intervention, and 12 months post intervention.
Discussion: This study provides a unique opportunity to assess the potential of an integrated early childhood
development intervention to prevent or mitigate developmental delays in children living in a context of extreme
poverty and high HIV rates in rural Lesotho. This paper presents the intervention content and research protocol
for the study.
Description
CITATION: Tomlinson, M., et al. 2016. Improving early childhood care and development, HIV-testing, treatment and support, and nutrition in Mokhotlong, Lesotho : study protocol for a cluster randomized controlled trial. Trials, 17:538, doi:10.1186/s13063-016-1658-9.
The original publication is available at http://trialsjournal.biomedcentral.com
The original publication is available at http://trialsjournal.biomedcentral.com
Keywords
Child development -- Case studies, Care of children, Cognitive-developmental theory, HIV infections -- Treatment, HIV infections -- Care
Citation
Tomlinson, M., et al. 2016. Improving early childhood care and development, HIV-testing, treatment and support, and nutrition in Mokhotlong, Lesotho : study protocol for a cluster randomized controlled trial. Trials, 17:538, doi:10.1186/s13063-016-1658-9