Developmental health in the context of an early childhood program in Brazil

The "Primeira Infância Melhor" experience

Dados Bibliográficos

ID5165646
AutoresTonantzin Ribeiro Gonçalves (0000-0003-0249-3358, Universidade do Vale do Rio dos Sinos), Eric Duku (0000-0003-3599-3527, McMaster University), Magdalena Janus (0000-0001-7806-1696, McMaster University)
Ano2019
Volume35
Fascículo3
Páginase00224317-e00224317
Data de publicação2019-01-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoCadernos de Saude Publica (JOURNAL)
Identificadores do periódicoISSN: 0102-311X • E-ISSN: 1678-4464
EditoraFapUNIFESP (SciELO) (PUBLISHER)
DOI10.1590/0102-311x00224317
PMID30864615
OpenAlexW2920940282
SCIELO_PIDS0102-311X2019000305001
IdiomaEN
Citações recebidas4
Referências citadas22

Design and evaluation of early child development (ECD) programs are poorly documented in low- or middle-income countries. The study aimed to identify family and child characteristics associated with developmental health outcomes among children aged from 4 to 6 years who participated in the "Primeira Infância Melhor" - PIM (Better Early Childhood), a home visiting program in Rio Grande do Sul State, Brazil. We also evaluated the impact of PIM on developmental vulnerability at school entry using a comparison group. Multistage sampling was first used to select cities, then families, in different regions of the state, resulting in a sample of eight cities and 571 children (364 PIM; 207 comparison). We used a sociodemographic questionnaire, completed by parents, and the Early Development Instrument (EDI), completed by teachers. Among PIM children, lower family income, time of exit from the program, city, and younger age were associated with higher risk of developmental vulnerability and/or with lower mean scores in EDI domains. Multivariate analysis controlling for covariates found no differences between the study groups in EDI outcomes even though the gaps in equity of the outcomes were smaller in the PIM group. These results are discussed in the context of challenges faced by home visiting programs in addressing complex social conditions of high-risk families and difficulties in finding an adequate comparison group in communities where an ECD program is universally accessible. We also note the importance of setting structured and longitudinal monitoring systems together with the implementation of ECD policies

Child development · Context (archaeology) · Developmental psychology · Early childhood · Equity (law) · Geography · Longitudinal study · Multivariate analysis · Political science · Psychiatry · Social vulnerability · Sociology · Vulnerability (computing) · Child Nutrition and Water Access · Demography · Global Maternal and Child Health · Medicine · Poverty, Education, and Child Welfare · Psychology · Gerontology