Table 1

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))

NameModified Reach Up (Bangladesh)Enhanced FAMIModified Reach Up (Brazil)Mobile Crèches
Lead institutionInternational 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)
SiteNarayanganj 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 interventionAn improved pre-existing integrated RCEL and nutrition interventionAn RCEL intervention delivered by pre-existing and novel cadres of workersAn RCEL intervention, with development and strengthening of early learning services
Leadership and partnershipGovernment health services, local families and communitiesGovernment social services, academicGovernment 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)HealthSocial servicesHealthInformal/private
Targeted to undernourished childrenTargeted according to socioeconomic vulnerability (national data available)Targeted to urban slum populationsTarget to children of migrant construction workers
Focal nurturing care domainRCEL (and health and nutrition)RCEL (and nutrition)RCELRCEL
Participating children (n)159721342064845
Research questionFeasibility and effectivenessFeasibility and effectivenessFeasibility, impact and cost-effectivenessFeasibility, effectiveness and scalability
FindingsImplemented in 90 clinics, feasible and acceptable
  • Positive impact on child development: cognition (~+0.15 SD), receptive language (0.11 SD), expressive language (0.14 SD) and gross motor scores (0.14 SD) compared with active controls using Bayley-III.

  • Reductions in stunting (0.13 SD).

  • Improvement in parental practices and caregiving environment were also noted.

  • The cost of the quality enhancement of the programme was estimated to be US$320/child/year (66% corresponds to the nutritional supplementation) and the total cost of the unenhanced version of the programme US$310/child/year.

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
  • ECD, early child development; TTS, Transition to Scale.