Every Newborn-Reach up Early Education intervention for All CHildren(EN-REACH)

Sustainable Development Goals (SDGs) target 4.2 aims that, by 2030, all children access quality early child development (ECD), pre-primary education and are ready for primary education. However, children most at risk of poor educational outcomes, including those with neuro-developmental delay and disability (NDD/D), are less likely to access school, including pre-school services. 

This study is called EN-REACH (Every Newborn – Reach up Early Education intervention for All CHildren) and builds on a previous observational cohort study EN-SMILING, it will evaluate the impact and implementation of a pre-school parenting program aimed at improving school readiness in Bangladesh, Nepal & Tanzania with three objectives: 

Obj1: INNOVATION: To adapt existing parenting packages and tools to promote school readiness and develop a new school readiness package for children in three diverse low-and middle- income countries (LMIC). This package will be inclusive of those with NDD and disability, co-designed by all three country sites, consist of approximately 10 sessions delivered to parents over 6 months by two facilitators (who will be made up of teachers and non study parents)  

Obj2: IMPACT EVALUATION: To use a cluster randomised control design to measure impact of the designed package on early child development outcomes. In each site approximately 500 participants from the EN-SMILING study have been identified as available for EN-REACH. Each site will have approx. 50 clusters (25 in intervention arm, 25 in non-intervention arm), each cluster will contain 10-12 caregiver-child dyads.  

We will use the Measurement for Early Learning and Quality of Outcomes (MELQO) to measure the primary outcome of school readiness, which includes measures of pre-literacy and pre-numeracy domains. Secondary outcomes will include caregiver quality of life and child behaviour.  

Obj3: IMPLEMENTATION: To undertake process evaluation of implementation, including examining barriers & enablers for uptake of adapted package integrated into routine education systems.  

We will use co-designed guides for focus groups and IDI’s in all three countries with recipients and facilitators and policymakers. 

This study will provide data on effectiveness and acceptability of a disability-inclusive school readiness package delivered to parents and their children. EN-REACH aims to have impact for children and their families, at country level and influence global policy for care of children with disabilities through links with global organisations such as UNICEF and WHO.