Building Strong Foundations: Large-Scale Early Childhood Human Capital Formation in Nepal

Last registered on April 26, 2023

Pre-Trial

Trial Information

General Information

Title
Building Strong Foundations: Large-Scale Early Childhood Human Capital Formation in Nepal
RCT ID
AEARCTR-0011318
Initial registration date
April 22, 2023

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
April 26, 2023, 5:22 PM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

Region

Primary Investigator

Affiliation
Northeastern University

Other Primary Investigator(s)

PI Affiliation
Allegheny County Department of Human Services
PI Affiliation
Meta Inc.
PI Affiliation
University of Connecticut
PI Affiliation
University of Connecticut
PI Affiliation
World Bank
PI Affiliation
UT Austin

Additional Trial Information

Status
Completed
Start date
2022-06-01
End date
2023-03-03
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
Early Childhood is a crucial phase in the development of a child. Approximately 200 million children under the age of five years in developing nations have development deficits (Engle et al. 2007). Doepke et al. (2019) argues that these development deficits may pass on to the next generation, creating a vicious poverty trap. These early deficits may take the form of stunting or malnutrition, as well as the form of lags in cognitive and non-cognitive behaviors. Since early interaction with parents and teachers are important determinants of cognitive and socio-emotional aspects of children (Shonkoff et al. 2000), it is important that we study the knowledge and skill levels of parent and teachers in the developing economies to improve the nature of interaction between children and their surroundings.

This study is motivated by the idea that yawning gaps remain in the information levels of Early Childhood Development (henceforth, ECD) teachers, and parents, in the developing countries, on the importance of early childhood, especially in the marginalized communities. We intervene at two levels. First, we train the teacher in the ECD classroom on the best practices of early childhood in the treatment arm. Second, we provide an information nudge on these best practices to the primary caregivers of our sample students in the treatment group. By primary caregiver, we mean the parent or guardian who spends the most time with the child in our sample. As part of our intervention, we successfully conduct twenty sessions for caregivers of kids in our sample over a period of six months. These sessions are led by the trained professionals (either teachers or facilitators) covering a range of topics in early childhood development including stimulation, hygiene, nutrition, disability, etc., and were designed by Seto Gurans, a pioneer non-governmental organization working in early childhood development in Nepal. We also vary the treatment by supplementing the trained teacher with contract licensing of trained helpers, in-classroom and out-classroom.

Our study is based in fifteen municipalities in Jhapa district of Nepal. We carried out randomization at the school level, and mapped teachers from these schools to their respective ECD sections’ kids. These kids form the sample points for our study. We have a total of 201 schools in this study with 150 belonging to the treatment, and 51 to the control.
External Link(s)

Registration Citation

Citation
Cohen, Rachel et al. 2023. "Building Strong Foundations: Large-Scale Early Childhood Human Capital Formation in Nepal." AEA RCT Registry. April 26. https://doi.org/10.1257/rct.11318-1.0
Experimental Details

Interventions

Intervention(s)
Early Childhood is a crucial phase in the development of a child. Approximately 200 million children under the age of five years in developing nations have development deficits (Engle et al. 2007). Doepke et al. (2019) argue that these development deficits may pass on to the next generation, creating a vicious poverty trap. These early deficits may take the form of stunting or malnutrition, as well as the form of lags in cognitive and non-cognitive behaviors. Since early interaction with parents and teachers are an important determinant of cognitive and socio-emotional aspects of children (Shonkoff et al. 2000), it is important that we study the knowledge and skill levels of parent and teachers in developing economies to improve the nature of the interaction between children and their surroundings.

This study is motivated by the idea that yawning gaps remain in the information levels of Early Childhood Development (henceforth, ECD) teachers, and parents, in developing countries, on the importance of early childhood, especially in marginalized communities. We intervene at two levels. First, we train the teacher in the ECD classroom on the best practices of early childhood in the treatment arm. Second, we provide an information nudge on these best practices to the primary caregivers of our sample students in the treatment group. By primary caregiver, we mean the parent or guardian who spends the most time with the child in our sample. As part of our intervention, we successfully conduct twenty sessions for caregivers of kids in our sample over a period of six months. These sessions are led by trained professionals (either teachers or facilitators) covering a range of topics in early childhood development including stimulation, hygiene, nutrition, disability, etc., and were designed by Seto Gurans, a pioneer non-governmental organization working in early childhood development in Nepal. We also vary the treatment by supplementing the trained teacher with contract licensing of trained helpers, in-classroom and out-classroom.

Our study is based on fifteen municipalities in the Jhapa district of Nepal. We carried out randomization at the school level and mapped teachers from these schools to their respective ECD sections’ kids. These kids form the sample points for our study. We have a total of 201 schools in this study with 150 belonging to the treatment and 51 to the control.
Intervention Start Date
2022-07-09
Intervention End Date
2023-01-07

Primary Outcomes

Primary Outcomes (end points)
(i) Ages and Stages Questionnaire scores of the children in our sample
(ii) Caregivers (Parents) stress index
(iii) Caregivers participation in the early stimulation and learning exercise with their children (Practice of early stimulation and learning (Index))
Primary Outcomes (explanation)
Our first primary outcome of the study is the aggregate ASQ score which is the sum of scores in all five subsections of the ASQ: Communication, Gross Motor, Fine Motor, Problem-solving, and Personal-social.

Parent (Caregivers) Stress Index is calculated by adding the coded values of the responses to the seven questions as mentioned in the pre-analysis document.

Caregivers' participation in the early stimulation and learning exercise with their children is measured by an index which basically records the frequency with which caregivers engage in the practice of early stimulation and learning exercise with their children. This outcome is calculated as an additive sum of the six components as mentioned in the pre-analysis plan document.

Important Note: Please observe that the three indices above would be obtained after the additive sum of their components are normalised with respect to the control group.

Secondary Outcomes

Secondary Outcomes (end points)
(i) Quality of our ECD centers measured by (a) observation of teacher-student interaction at the endline, and (b) checklist of required facilities and infrastructure in these ECD classrooms.
(ii) Caregivers attitude to child discipline
(iii) Caregivers understanding of disability
(iv) Caregivers’ intensity of stimulation activities with their children
Based on the ASQ scores (primary outcome of our study), we shall also compare the fraction of kids scoring in the risk-range of the ASQ in the treatment and the control.
Secondary Outcomes (explanation)
All the secondary outcomes are duly explained in the pre-analysis document. The relevant tables are Table 3, Table 4, and Table 5.

Experimental Design

Experimental Design
We randomize the study sample of 201 schools into the following four arms:

Training Only (T1): The 50 schools in this arm receive treatment in the form of a trained teacher. This teacher conducts 20 parental-educational sessions with the caregivers of kids from their respective schools over a period of six months. The teacher educates the caregivers on various facets and best practices of early childhood. These sessions cover a range of topics on health, hygiene, disability, stimulation, and understanding the needs and importance of early childhood.

Training plus Outside Classroom Helper (T2): The 50 schools in the arm receive a trained teacher plus an additional outside classroom helper (henceforth, facilitator). This arm differs from T1 in the sense that the facilitator, rather than the trained teacher, conducts the parental-educational sessions as part of the intervention. We hired the facilitator on a contractual basis and trained them on conducting the parents-education sessions on early childhood. These sessions are similar to those conducted in the treatment arm T1.

Training plus Inside Classroom Helper (T3): The 50 schools in this arm receive a trained teacher plus an additional inside classroom helper (henceforth, helper). The teacher is responsible for conducting the 20 parental-educational sessions with caregivers of kids from our sample. The helper helps the teacher efficiently carry out the day-to-day activities in the classroom. Like the facilitator, the helper is hired on contract for a period of seven months. The helpers assist our ECD teachers in managing and carrying out the class activities. These sessions are similar to those conducted in the treatment arm T1.

Control(T4): The 51 schools in this arm received nothing from the perspective of teacher-training or parental-educational sessions.
Experimental Design Details
Randomization Method
randomization done in office by a computer
Randomization Unit
school
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
201 schools
Sample size: planned number of observations
3213 kids
Sample size (or number of clusters) by treatment arms
50 schools teacher training, 50 schools teacher training plus an in-classroom helper, 50 schools with teacher training plus an outside-classroom helper, and 51 control schools.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Supporting Documents and Materials

Documents

Document Name
ECD_Endline_Questionnaire (IRB)
Document Type
survey_instrument
Document Description
File
ECD_Endline_Questionnaire (IRB)

MD5: a667382e1389505dae2d06bd245db294

SHA1: 44b83d70a44672620550ec63763bd0a72fe91bee

Uploaded At: April 22, 2023

IRB

Institutional Review Boards (IRBs)

IRB Name
Nepal Health Research Council
IRB Approval Date
2022-03-14
IRB Approval Number
862/2020
IRB Name
University of Connecticut
IRB Approval Date
2021-02-19
IRB Approval Number
H20-0070
Analysis Plan

Analysis Plan Documents

Building Strong Foundations: Large-Scale Early Childhood Human Capital Formation in Nepal

MD5: d306d7229f425c3f5b544e7cffc42111

SHA1: 71da34721cc531c311bf3d86d1f8dd1d1dce6172

Uploaded At: April 21, 2023

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
No
Data Collection Complete
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials