Skip to main content

Advertising Disclaimer »

Main menu

  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Open Access
    • Editorial Policies
  • Content
    • Current Issue
    • Online First
    • Archive
    • Blogs
    • Topic/Program Collections
    • AAP Meeting Abstracts
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effects on Pediatric Health
    • More Collections...
  • AAP Policy
  • Supplements
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers
  • Other Publications
    • American Academy of Pediatrics

User menu

  • Log in

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Open Access
    • Editorial Policies
  • Content
    • Current Issue
    • Online First
    • Archive
    • Blogs
    • Topic/Program Collections
    • AAP Meeting Abstracts
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effects on Pediatric Health
    • More Collections...
  • AAP Policy
  • Supplements
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers

Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Group Sessions or Home Visits for Early Childhood Development in India: A Cluster RCT

Sally Grantham-McGregor, Akanksha Adya, Orazio Attanasio, Britta Augsburg, Jere Behrman, Bet Caeyers, Monimalika Day, Pamela Jervis, Reema Kochar, Prerna Makkar, Costas Meghir, Angus Phimister, Marta Rubio-Codina and Karishma Vats
Pediatrics December 2020, 146 (6) e2020002725; DOI: https://doi.org/10.1542/peds.2020-002725
Sally Grantham-McGregor
aInstitute for Global Health, University College London, London, England;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Akanksha Adya
bDepartment of Anthropology, Psychology and Sociology, University of West Georgia, Carrollton, Georgia;
cCentre for Early Childhood Education and Development at Ambedkar University, Delhi, India;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Orazio Attanasio
dDepartment of Economics, Yale University, New Haven, Connecticut;
eInstitute for Fiscal Studies, London, United Kingdom;
fNational Bureau of Economic Research, Cambridge, Massachusetts;
gAbdul Latif Jameel Poverty Action Laboratory, Cambridge, Massachusetts;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Britta Augsburg
eInstitute for Fiscal Studies, London, United Kingdom;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jere Behrman
hDepartment of Economics and Sociology, University of Pennsylvania, Philadelphia, Pennsylvania;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Bet Caeyers
eInstitute for Fiscal Studies, London, United Kingdom;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Monimalika Day
cCentre for Early Childhood Education and Development at Ambedkar University, Delhi, India;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Pamela Jervis
eInstitute for Fiscal Studies, London, United Kingdom;
iDepartment of Industrial Engineering, Universidad de Chile, Chile, South America;
jCenter for Research in Inclusive Education, Chile;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Reema Kochar
cCentre for Early Childhood Education and Development at Ambedkar University, Delhi, India;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Prerna Makkar
kPratham Education Foundation, India; and
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Costas Meghir
dDepartment of Economics, Yale University, New Haven, Connecticut;
eInstitute for Fiscal Studies, London, United Kingdom;
fNational Bureau of Economic Research, Cambridge, Massachusetts;
gAbdul Latif Jameel Poverty Action Laboratory, Cambridge, Massachusetts;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Angus Phimister
eInstitute for Fiscal Studies, London, United Kingdom;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Marta Rubio-Codina
lInter-American Development Bank, Washington, DC
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Karishma Vats
kPratham Education Foundation, India; and
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • Comments
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Download PDF

Abstract

Video Abstract

OBJECTIVES: Poor early childhood development in low- and middle-income countries is a major public health problem. Efficacy trials have shown the potential of early childhood development interventions but scaling up is costly and challenging. Guidance on effective interventions’ delivery is needed. In an open-label cluster-randomized control trial, we compared the effectiveness of weekly home visits and weekly mother-child group sessions. Both included nutritional education, whose effectiveness was tested separately.

METHODS: In Odisha, India, 192 villages were randomly assigned to control, nutritional education, nutritional education and home visiting, or nutritional education and group sessions. Mothers with children aged 7 to 16 months were enrolled (n = 1449). Trained local women ran the two-year interventions, which comprised demonstrations and interactions and targeted improved play and nutrition. Primary outcomes, measured at baseline, midline (12 months), and endline (24 months), were child cognition, language, motor development, growth and morbidity.

RESULTS: Home visiting and group sessions had similar positive average (intention-to-treat) impacts on cognition (home visiting: 0.324 SD, 95% confidence interval [CI]: 0.152 to 0.496, P = .001; group sessions: 0.281 SD, 95% CI: 0.100 to 0.463, P = .007) and language (home visiting: 0.239 SD, 95% CI: 0.072 to 0.407, P = .009; group sessions: 0.302 SD, 95% CI: 0.136 to 0.468, P = .001). Most benefits occurred in the first year. Nutrition-education had no benefit. There were no consistent effects on any other primary outcomes.

CONCLUSIONS: Group sessions cost $38 per child per year and were as effective on average as home visiting, which cost $135, implying an increase by a factor of 3.5 in the returns to investment with group sessions, offering a more scalable model. Impacts materialize in the first year, having important design implications.

  • Accepted September 16, 2020.
  • Copyright © 2020 by the American Academy of Pediatrics

Individual Login

Log in
You will be redirected to aap.org to login or to create your account.

Institutional Login

via Institution

You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.

Log in through your institution

If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

Pay Per Article - You may access this article (from the computer you are currently using) for 2 days for US$25.00

Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.

Offer Reprints

PreviousNext
Back to top

Advertising Disclaimer »

In this issue

Pediatrics
Vol. 146, Issue 6
1 Dec 2020
  • Table of Contents
  • Index by author
View this article with LENS
PreviousNext
Email Article

Thank you for your interest in spreading the word on American Academy of Pediatrics.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Group Sessions or Home Visits for Early Childhood Development in India: A Cluster RCT
(Your Name) has sent you a message from American Academy of Pediatrics
(Your Name) thought you would like to see the American Academy of Pediatrics web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Request Permissions
Article Alerts
Log in
You will be redirected to aap.org to login or to create your account.
Or Sign In to Email Alerts with your Email Address
Citation Tools
Group Sessions or Home Visits for Early Childhood Development in India: A Cluster RCT
Sally Grantham-McGregor, Akanksha Adya, Orazio Attanasio, Britta Augsburg, Jere Behrman, Bet Caeyers, Monimalika Day, Pamela Jervis, Reema Kochar, Prerna Makkar, Costas Meghir, Angus Phimister, Marta Rubio-Codina, Karishma Vats
Pediatrics Dec 2020, 146 (6) e2020002725; DOI: 10.1542/peds.2020-002725

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Group Sessions or Home Visits for Early Childhood Development in India: A Cluster RCT
Sally Grantham-McGregor, Akanksha Adya, Orazio Attanasio, Britta Augsburg, Jere Behrman, Bet Caeyers, Monimalika Day, Pamela Jervis, Reema Kochar, Prerna Makkar, Costas Meghir, Angus Phimister, Marta Rubio-Codina, Karishma Vats
Pediatrics Dec 2020, 146 (6) e2020002725; DOI: 10.1542/peds.2020-002725
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Print
Download PDF
Insight Alerts
  • Table of Contents

Jump to section

  • Article
    • Abstract
    • Methods
    • Results
    • Discussion
    • Footnotes
    • References
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • Comments

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • Promoting Global Early Child Development Through Play: Two Sustainable, Effective Models
  • Google Scholar

More in this TOC Section

  • Predictive Models of Neurodevelopmental Outcomes After Neonatal Hypoxic-Ischemic Encephalopathy
  • A Technology-Assisted Language Intervention for Children Who Are Deaf or Hard of Hearing: A Randomized Clinical Trial
  • Standard Versus Long Peripheral Catheters for Multiday IV Therapy: A Randomized Controlled Trial
Show more Articles

Similar Articles

  • Journal Info
  • Editorial Board
  • Editorial Policies
  • Overview
  • Licensing Information
  • Authors/Reviewers
  • Author Guidelines
  • Submit My Manuscript
  • Open Access
  • Reviewer Guidelines
  • Librarians
  • Institutional Subscriptions
  • Usage Stats
  • Support
  • Contact Us
  • Subscribe
  • Resources
  • Media Kit
  • About
  • International Access
  • Terms of Use
  • Privacy Statement
  • FAQ
  • AAP.org
  • shopAAP
  • Follow American Academy of Pediatrics on Instagram
  • Visit American Academy of Pediatrics on Facebook
  • Follow American Academy of Pediatrics on Twitter
  • Follow American Academy of Pediatrics on Youtube
  • RSS
American Academy of Pediatrics

© 2021 American Academy of Pediatrics