Summary of programme decisions in Saving Brains Responsive Caregiving and Early Learning (RCEL) Transition to Scale grants (n=4). (Please note, an additional TTS grant related to Kangaroo Mother Care is described separately in the Cameroon and Mali case study (box 1))
| Name | Modified Reach Up (Bangladesh) | Enhanced FAMI | Modified Reach Up (Brazil) | Mobile Crèches |
| Lead institution | International Centre for Diarrhoeal Disease Research Bangladesh (ICDDR, B) | Universidad de los Andes (UDLA) | Faculdade de Medicina da Universidade de Sao Paulo (USP) | Mobile Crèches for Working Mothers’ Children (MC) |
| Country | Bangladesh | Colombia | Brazil | India |
| Site | Narayanganj and Narsingdi districts (rural) | Boyaca, Cundinamarca, Santander, Tolima (rural, periurban) | Sao Paulo (urban slum area) | Delhi National Capital Region (urban construction sites) |
| What is being scaled? | An integrated RCEL and nutrition intervention | An improved pre-existing integrated RCEL and nutrition intervention | An RCEL intervention delivered by pre-existing and novel cadres of workers | An RCEL intervention, with development and strengthening of early learning services |
| Leadership and partnership | Government health services, local families and communities | Government social services, academic | Government health services, academic, private child focused foundation (Maria Cecilia Vidigal Foundation) | Community, Mobile Crèches and other early learning non-government organisation, construction industry |
| Situational analysis (context and need) | Government recognises the educational and financial benefits of ECD and has incorporated ECD into the national plan of action. Existing national infrastructure of government primary healthcare community clinics with supervision structure for clinic staff. Initial concerns regarding workload, motivation for front-line workers. | Building on existing long-standing government Family, Women and Infancy Program (FAMI) for women during pregnancy until their children are 2 years of age, combined clinic and home visits. Focused on several regions in central Colombia which were considered to be socioeconomically deprived. | Increased government support for ECD but major gaps in programmes, especially public services for young children. Shift towards mandatory early learning provided a favourable policy environment. | This built on long-standing relationships between Mobile Crèches and partner organisations to provide for basic and early learning needs of children of migrant workers who would otherwise typically be left unaccompanied while their parents were working. |
| Sector (primary) | Health | Social services | Health | Informal/private |
| Targeted/universal/ indicated | Targeted to undernourished children | Targeted according to socioeconomic vulnerability (national data available) | Targeted to urban slum populations | Target to children of migrant construction workers |
| Focal nurturing care domain | RCEL (and health and nutrition) | RCEL (and nutrition) | RCEL | RCEL |
| Participating children (n) | 1597 | 2134 | 206 | 4845 |
| Research question | Feasibility and effectiveness | Feasibility and effectiveness | Feasibility, impact and cost-effectiveness | Feasibility, effectiveness and scalability |
| Findings | Implemented in 90 clinics, feasible and acceptable |
| Adapted programme was acceptable to caregivers and families. | Child care programme delivered through partnerships with 11 non-government organisations, 24 builders at 40 crèches. Crèches scored well on standard early learning quality assessment measures. |
| References | 18 34 | 21 | 35 | 36 |
| Nurturing Care for Early Child Development Country Profiles, accessible at http://nurturing-care.org/resources/country-profiles/ | ||||
ECD, early child development; TTS, Transition to Scale.