The Impact of Nursery Quality, Empowerment, and Nutrition Interventions on Early Childhood Development and Women’s Employment in Egypt

2024-05-15

2027-05-31

Outcome 1: Nursery quality index

Outcome 2: Nutrition (anthropometrics, dietary diversity, and food security)

Outcome 3: Gender role attitudes (women and husband) and empowerment and agency indices (women)

Outcomes 4: Enrollment and attendance of nurseries

Outcomes 5: Parental involvement in caregiving (mother and father)

Outcomes 6: Children’s development indices

Outcomes 7: Well-being of women and households -- female labor force participation, earnings, and subjective well-being

Outcome 1: Nursery Quality Index (baseline, endline)
Measured using validated nursery quality data tools, based on the Brief Early Childhood Quality Inventory (BEQI) and Measuring Early Learning Environment (MELE). An additive index of quality measures will be created from all the tool items, reverse-coding negative indicators (e.g. hazards).

Outcome 2: Nutrition (Anthropometrics (baseline, endline), Dietary Diversity (baseline, endline) and Food Security (baseline, midlines, endline))
Weight and height for age will be measured at the child level and transformed into z-scores. We use the FAO's Household Dietary Diversity Score (HDDS). For children, the dietary intake questions from the MICS6 survey will be used, and an index of dietary diversity used. For households, the Food Insecurity Experience Scale (FIES) will be used to measure food security.

Outcome 3: Gender Role Attitudes and Empowerment and Agency Indices (baseline, midlines, and endline)
Women’s and husbands’ gender norms will be measured by a series of Likert-Scale questions (strongly agree through strongly disagree), as well as yes/no questions. Items that indicate less gender-equitable attitudes will be reverse coded. Factor analysis will be used to create a single index from all the norms items. Likewise, empowerment will be measured, based on questions for ability to set goals, self-efficacy, decision-making and mobility. An additive index of involvement in decision making, an additive index of mobility, an additive index of ability to set goals, and an additive index of self-efficacy will be used.

Outcomes 4: Enrollment and Attendance (baseline, midlines, and endline)
Children’s current enrollment in any nursery and the intervention nursery will be measured, along with the number of days attended in the past five weeks. Outcomes will be assessed for all children ages 0-6 and specifically ages 2-4 who are the target of the interventions.

Outcomes 5: Parental involvement in caregiving (baseline and endline)
Minutes per day for each of the husband and wife in caregiving activities will be measured. Overall caregiving will be measured as well as its components of direct caregiving, indirect caregiving (e.g. household chores), and instruction of children.

Outcome 6: Children’s development Indices (baseline and endline)
Measured using two tools: Caregiver Reported Early Development Instruments (CREDI) for children under 3 and Measure of Development and Early Learning (MODEL) for ages 3-6. The CREDI is an additive index and the MODEL creates an overall school readiness factor. The two measures will be standardized and combined into a single standardized variable.

Outcome 7: Well being of women and households (baseline, midlines, and endline)
Women’s employment in the past 7 days will be measured, along with unemployment (not employed in the past 7 days; wanting to work; being available to start within two weeks; and engaging in search behavior in the past 3 months, including specifically steps towards creating a business). Together these metrics are female labor force participation. Additionally, women’s and households’ earnings (wage and non-wage) will be measured on a monthly basis. Furthermore, we will measure subjective well-being using the WHO-5 indicators and life satisfaction for women.

The intervention will focus on the villages of the Hayah Karima national project in rural Upper Egypt. MoSS will identify eligible nurseries and share lists with the research team, who will create catchment areas of 0.5 km around nurseries (distance based on qualitative fieldwork). Nurseries will be randomly assigned to treatment and control. We then randomly sample 20 households in each nursery catchment area to partake in the study. The sample will consist of a total of 240 nurseries, split equally among treatment and control.
There will be multiple rounds of data collection. A census to identify eligible participants, collected by social workers on the village level, an in-person baseline, two midlines by phone and an in-person endline survey, collected by a data collection agency. The household sample will be stratified at baseline into: (1) households that are already enrolled in our sample nurseries (2) households that are not enrolled in our sample nurseries to ensure that each sub-group is equitably represented.

Not available

Randomization done in office by a computer

Cluster (catchment areas of 0.5 km around nursery)

Yes

240 nurseries (and surrounding catchment areas)

4,800 households (4,800 mothers, 4,800 husbands, approximately 9,600 children)

120 treatment nurseries (and surrounding catchment areas)
120 control nurseries (and surrounding catchment areas)