PROJECT MANAGER: INGVILD ALMÅS 

PROJECT DURATION: 2021-2026 

To address this challenge, this project uses novel longitudinal and experimental data from a nationally-representative sample in Tanzania to yield actionable evidence for policy makers, donors and practitioners about the design of cost effective, scalable, sustainable, integrated ECD parenting programs, from the prenatal period until the child’s 3rd year of life – the "first 1,000 days".

Project details:

Even the best available longitudinal cohort datasets from LMICs contain virtually no information on child development before the age of five, which is likely the most sensitive period, and many of the “gold-standard” measurements of child development outcomes that originated in wealthier countries take a long time to administer and require highly skilled and trained assessors, all of which is not cost-effective in LMICs. Moreover, a lack of knowledge and evidence on how to effectively design and deliver scalable and contextually appropriate early child development (ECD) interventions in LMICs has hindered investment and scale-up in this critical area of development. Gathering rigorous evidence on the impact of innovative service delivery solutions, such as digital tools, to support frontline workers in delivering high quality, respectful and standardized household ECD services and comparing cost-effectiveness relative to that of an unconditional cash transfer (UCT) program would therefore be extremely valuable, especially when considering how to take these programs to scale.

Program activities: 

• a large-scale nationally representative longitudinal study on the lives of children (from pregnancy) across Tanzania
• a multi-arm Randomized Controlled Trial (RCT) in the Dodoma region.

An estimated 200 million children under 5 have: 

• Poor cognitive development
• Lack of health and nutrition
• Inadequate stimulation and care

To address these challenges and fill the existing knowledge gaps, the Institute for International Economic Studies (IIES, Stockholm University), Ifakara Health Institute (IHI), Yale University, FAIR (NHH Norwegian School of Economics), and University of Chile in collaboration with implementing partners D-tree International, Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) and EDI Global, in April 2022 will launch a groundbreaking six-year ECD research program in Tanzania entitled “Kizazi Kijacho” (The Next Generation). This program will use novel longitudinal and experimental data from a nationally-representative sample of 4,620 pregnant women to yield actionable evidence for policy makers, donors and practitioners about the design of cost effective, scalable, sustainable, integrated ECD parenting programs, from the prenatal period until the child’s 3rd year of life – the “first 1,000 days.”

Specifically, this ambitious research program aims to make a major scientific contribution by establishing and analyzing a large and exceptionally rich nationally-representative longitudinal cohort dataset using state-of-the art methods to measure child development and its multi- dimensional inputs from in-utero until the age of 3 - the first research of its kind in an LMIC setting. Moreover, the program will also carry out a randomized controlled trial (RCT) in the Dodoma region to test the cost-effectiveness of a parenting intervention in which Community Health Workers (CHWs) will be guided by an innovative digital application to help provide caregivers with continuous support in all aspects of nurturing care (i.e., health, sanitation, nutrition and early stimulation), relative to the cost-effectiveness of an unconditional cash transfer program.

The rich longitudinal cohort dataset we will generate through this program will help us develop a detailed picture of how children across Tanzania are developing from in- utero until age 3 in this era of massive economic change. The resulting findings on the human development process will enable us to identify critical points in the child’s early life when specific domains develop, when specific inputs (such as nutrition and stimulation) are most impactful, and when their influence wanes. By analyzing material versus non material inducements to ECD and determining those with highest impact and cost-effectiveness, our findings will form a blueprint for ECD programs in Tanzania at a national scale. Supplemented by sizable efforts to disseminate our research findings to ECD stakeholders worldwide, this research has the potential to strengthen ECD policy and programming in LMICs more broadly, thereby helping to break the intergenerational cycle of poverty and contribute to the UN Sustainable Development Goals.