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Promoting parent child relationships and preventing violence via home visiting: A pre-post cluster randomised trial among Rwandan families linked to social protection programs

Article scientifique 2019 Anglais

Résumé

Abstract Background: Sugira Muryango ​ (SM) is an early child development and violence-prevention home-visiting program delivered by trained lay workers. This cluster-randomised trial evaluates whether families living in extreme poverty who receive SM in combination with government-provided social protection demonstrate greater responsive and positive caregiving, nutrition, care seeking, hygiene, and father involvement compared with control families receiving usual care (UC).Methods: Sugira Muryango (SM) was delivered to families with children aged 6–36 months living in extreme poverty. We assessed changes in outcomes in intervention and UC control families using structured surveys and observation. Analyses were intent to treat using mixed models.Results: Families receiving SM improved significantly on responsive caregiving using the Home Observation for Measurement of the Environment (Cohen’s d= 0.78; p< 0.001) and the Observation of Mother-Child Interaction (Cohen’s d= 0.29; p< 0.001) and showed decreased violent discipline (OR:0.34: 95% CI: 0.22, 0.51) compared with UC. Children in families receiving SM also had a 0.44 higher increase in food groups consumed in the past 24 hours (Cohen’s d= 0.34, p< 0.001), increased care seeking for diarrhoea (OR=2.2, 95% CI: 1.5, 3.1) and fever (OR: 3.3, 95% CI: 2.3, 4.8), and improved hygiene behaviours such as proper treatment of water (OR: 3.6; 95% CI: 2.4, 5.5) compared with UC. SM was also associated with a decreased intimate partner violence (OR=0.67, 95% CI: 0.33, 1.3) and caregiver depression and anxiety (OR=0.9, 95% 0.58, 1.4).Conclusions: Sugira Muryango led to improvements in family functioning and caregiver behaviours linked to child development and health.

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Betancourt, T., Jensen, S., Barnhart, D., Brennan, R., Murray, S., Yousafzai, A., Farrar, J., Godfroid, K., Bazubagira, S., Rawlings, L., Wilson, B., Sezibera, V., Kamurase, A. (2019). Promoting parent child relationships and preventing violence via home visiting: A pre-post cluster randomised trial among Rwandan families linked to social protection programs. https://doi.org/10.21203/rs.2.13621/v1

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Auteur(s)

Theresa S. Betancourt Sarah K. G. Jensen Dale A. Barnhart Robert T. Brennan Shauna M. Murray Aisha K. Yousafzai Jordan Farrar Kalisa Godfroid Stephanie M. Bazubagira Laura B. Rawlings Briana Wilson Vincent Sezibera Alex Kamurase

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