Evaluating Integration of Early Childhood Development Interventions in the m2m Program in Eswatini: Summary of the Results

Author(s): Health Communication Capacity Collaborative

Year: 2019

Abstract:

In 2014–2015 many countries—including Swaziland (now Eswatini)—introduced the World Health Organization’s Option B+ strategy of lifelong antiretroviral therapy (ART) for women diagnosed with HIV to prevent mother-to-child transmission (PMTCT) of the virus during pregnancy and breastfeeding. While PMTCT regimens were known to be highly effective, there was some concern that the growing population of HIV- and ART-exposed but uninfected children could be at risk of poorer outcomes, including developmental ones.

The United States Agency for International Development (USAID), through the United States President’s Emergency Plan for AIDS Relief (PEPFAR), proposed testing whether an early child development (ECD) intervention integrated in antenatal care/PMTCT programs could optimize outcomes in this population. ECD programs designed to promote responsive parenting-and-child early learning opportunities have been shown to have significant effects in improving the cognitive and motor skills of children ages 0–24 months, particularly among those with delayed development and malnutrition in low- and middle-income countries (LMICs).

USAID chose Eswatini as a site to test the effectiveness of such an intervention in the context of a national PMTCT program. It asked mothers2mothers (m2m) to implement the ECD program and the Health Communication Capacity Collaborative (HC3), also funded by USAID, was tasked with conducting an independent evaluation. USAID asked MEASURE Evaluation to edit and format this brief to promote dissemination of the evaluation’s findings, as part of its work developing a USAID-funded regional learning platform for research on orphans and vulnerable children.