In post-conflict Sierra Leone, the Intergenerational Study of War-Affected Youth (ISWAY), a 22-year longitudinal study on war-affected youth and their families, has demonstrated that exposure to war violence may be related to poor parental mental health and harsh parenting practices, both of which pose risks to healthy child development. We will leverage our Thrive-funded additional round of data collection for this longitudinal study (see the ISWAY Thrive project) to adapt and test an evidence-based, home-visiting intervention to promote responsive, nurturing care for caregivers of children aged 0-3 and reduce family violence.
The Family Strengthening Intervention for Early Childhood Development (FSI-ECD), originally developed for delivery in Rwanda, previously demonstrated effectiveness in a cluster randomised trial – for improving caregivers’ early stimulation activities and increasing their provision of stimulating home environments; increasing the quality of child-caregiver interactions; increasing children’s dietary diversity; improving care-seeking behaviour for health conditions; reducing harsh child discipline; and improving household WASH (water, sanitation, and hygiene) behaviours (Betancourt et al., 2020). FSI-ECD has also demonstrated effectiveness for reducing intimate partner violence among caregivers and improving caregiver mental health. Furthermore, one-year follow-up results have demonstrated improvements in child development milestones, such as problem-solving, communication, and motor skills (Jensen et al., 2021). Recently, the FSI-ECD was scaled to approximately 10,000 households in Rwanda.
As part of Thrive, we will now adapt this intervention for use in Sierra Leone, and conduct a randomised pilot of the adapted FSI-ECD intervention among families with children aged 0-36 months to observe impact on parental outcomes.