Scaling Early Childhood Development – what to read this month | July 2025

Scaling Early Childhood Development – what to read this month is curated by Bet Caeyers (Lead Editor, Chr. Michelsen Institute), Meghan Taylor (Editor, Oxford Policy Management) and Daniel Munday (Editor, Oxford Policy Management).

Kicking off this month’s newsletter, we have Priyanka and Sara’s study on the intergenerational effects of Bangladesh’s Female Secondary School Stipend Program (FSSSP), active since 1994. The programme provides cash stipends and tuition support based on school attendance, exam scores and marital status. Findings show that women who received five years of FSSSP support have children at age 4 with a 0.27 standard deviation (SD) boost in development, including increases of 0.23 in cognitive and 0.24 in motor skills. These benefits persist up to age 14, especially in reading. Additionally, participating mothers are more engaged in child development, enrol their children in school more often, and experience improved wellbeing and decision-making leverage. The study highlights that programmes like FSSSP can generate lasting, intergenerational benefits, underscoring the importance of expanding maternal education initiatives.

Jensen et al. have shared new findings from a four-year follow-up on the Sugira Muryango programme in Rwanda – a creative effort to reduce domestic violence and boost early childhood development in families facing extreme poverty and post-conflict challenges. Since 2018, trained community workers have been visiting homes to coach parents on caregiving, encourage fathers to get involved and promote strategies to cut down on harsh punishment. They have also been providing essential advice on nutrition and hygiene. So, what did the 2022 data reveal? The programme shows promising results: parents report more stimulating interaction, dads are more involved in play, and families are using more engaging learning materials. Harsh discipline has decreased too. However, there were not any significant changes in child cognition or behaviour, suggesting these areas need more attention and investment.

Next up, Kim et al. provide an important addition to the discussion on the impact of non-primary caregiving in early childhood development and cognitive development. The authors argue that too often, parenting programmes have focused on providing mothers with support and caregiving knowledge, while failing to adequately address and support the wider circle of non-primary caregivers, such as grandparents, aunts and older siblings. The team use data from ChildFund International on caregiving in Kenya and Uganda to demonstrate that a significant proportion of under 5s spend 3 days or more being cared for by non-primary caregivers. The authors stress that this fact should translate into programmatic changes; that parenting and caregiving programmes should in future adopt a holistic approach, and focus on supporting not just mothers, but the wider community of non-primary caregivers.

Pyne-Mercier et al. offer key insights into improving service delivery of community health worker initiatives, particularly through payment. They highlight that mobile money systems – common methods for payment – often suffer from issues like poor connectivity, payment errors and unhelpful support. In Zanzibar’s Jamii ni Afya project, the team adapted the open-source Community Health Toolkit to display payment schedules, track successful transactions and work even with limited internet. Community health workers responded positively, feeling more informed and in control of their pay. While a follow-up study is planned for more comprehensive results, this initial work shows how strong administrative systems are essential for scaling effective community health programmes

Larson et al. review the potential of using growth monitoring and promotion platforms to enhance early childhood development in LMICs. They find that while growth indicators like height-for-age relate to developmental outcomes at a population level, they are not reliable for predicting individual development. Short, simple screening tools like the Ages and Stages Questionnaire (ASQ), Survey of Wellbeing of Young Children (SWYC), and Parents’ Evaluation of Development Status (PEDS) are better predictors of individual development and are practical for frontline health workers during growth monitoring and promotion visits. The study also highlighted light-touch early childhood development interventions in Peru, Mozambique and India that incorporate responsive caregiving and play into health and nutrition services. Results show that programmes promoting responsive caregiving have four times greater impact on parenting practices than those without this focus. Larson et al. advocate for universal caregiving interventions and call for further research to identify optimal delivery models, workforce needs, and contact frequency to improve developmental outcomes.

A new Lancet systematic analysis from the Global Burden of Disease Study 2023 tracks childhood vaccination trends in 204 countries from 1980 to 2023, projecting to 2030. Global coverage for core vaccines – diphtheria, tetanus, and pertussis (first dose [DTP1] and third dose [DTP3]), measles (MCV1), polio (Pol3), and tuberculosis (BCG) – has nearly doubled since 1980, but progress stalled after 2010, and high-income countries saw declines. The COVID-19 pandemic further disrupted efforts, reversing gains and lowering rates below pre-pandemic levels. Regions such as sub-Saharan Africa and South Asia are lagging, with peak zero-dose children reaching 18.6 million in 2021 and 2023, mainly in Nigeria, India, Democratic Republic of the Congo, Ethiopia, Sudan, Somalia, Brazil and Indonesia. To meet Immunization Agenda 2030 goals – halving zero-dose children and reaching 90% coverage – countries must intensify efforts with tailored strategies, stronger health systems, addressing hesitancy and catch-up campaigns. Without urgent action, only DTP3 may meet targets, leaving zero-dose children mainly in under-resourced, fragile areas.

Lountain, Cooper and Crase’s new paper introduces the Women’s Empowerment and Labour (WEaL) scale – a new tool designed to capture women’s property rights over labour – offering a practical proxy for broader empowerment across Bangladesh, Nepal and India. Building on Scott’s property rights framework, the authors use exploratory factor analysis to develop a scale that reflects meaningful control over labour. The resulting WEaL scale factors encompass temporal, spatial, legacy and financial elements. Each represents distinct aspects of how individuals perceive and engage with their labour and the underlying factors that influence their perspectives, contributing to their overall empowerment. The WEaL scale’s simplicity and adaptability make it suitable across different contexts. For policymakers and practitioners, WEaL could offer a sharper lens for targeting labour autonomy, and in doing so, help centre women’s rights and agency in economic empowerment efforts.

A new Global Health Feature in Pediatrics by Bulterys et al. explores the critical, yet under-addressed, role of fathers in maternal and child health (MCH) and HIV outcomes across sub-Saharan Africa. Despite paternal involvement being associated with better child development, maternal mental health and HIV treatment outcomes, engagement remains low – constrained by stigma, gender norms and systemic barriers in healthcare access. The article outlines a conceptual model linking paternal engagement with reductions in intimate partner violence and improvements in parenting, care retention and child wellbeing. It also calls for existing father-focused interventions – such as Sugira Muryango (Rwanda) and REAL Fathers (Uganda) – to incorporate families affected by HIV. The authors conclude by advocating for a greater shift towards father-responsive care, noting that meaningful male engagement is a key entry point to improving outcomes across HIV and MCH.

Finally, we end this month’s newsletter with an interesting recent Lancet Correspondence in response to the launch of the Lancet Series on Early Childhood Development and the Next 1000 Days, which highlighted the urgent need to support young children aged 2–5. In response to this series, a group of researchers raise concerns that the series relies on a deficit model that risks reinforcing negative stereotypes about families in poverty. They argue that measures of psychosocial care, such as the presence of toys or formal learning, reflect cultural bias and overlook rich, context-specific caregiving practices. In response to this critique, the authors in turn agree on the importance of considering local context but defend the cultural appropriateness of the nurturing care index, clarifying that their early learning indicator considered access to both learning materials and organised programmes. They emphasise that their definition of responsive caregiving includes various early stimulation behaviours to be culturally inclusive. In response to the deficit model critique, they argue that the index was designed not to blame caregivers but to identify areas where support can enable caregivers to provide suitable care tailored to their context. They emphasise the necessity of systemic changes to address inequities and support early childhood development, especially in LMICs.

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