Impact Examples: Early Child Development Communication Programming

The Effect of Sesame Street around the World: A Meta-Analysis from 15 Countries

This meta-analysis of children's learning in 15 countries, published in the Journal of Applied Developmental Psychology, draws upon 24 studies focusing on the impact on learning outcomes of viewing the television series Sesame Street. It is based on studies of the programme's effects, conducted with over 10,000 children outside of the United States.

Selected findings:

Watching Sesame Street was associated with learning about letters, numbers, shapes, and sizes. It was also associated with learning about science, the environment, one's culture, and health- and safety-related practices such as washing one's hands or wearing a bike helmet. Finally, it was associated with more prosocial reasoning about social interactions and more positive attitudes toward various out-groups, including those that were associated with long-standing hostilities or stereotyping. "The fact that over 90% of estimates contained some control for the child's initial performance on that outcome considerably enhances the plausibility that these were causal effects on those children who were selected to participate or who chose to watch." Researchers found an overall effect size of 0.29. This translates into an 11.6 percentile gain (in terms of education). That is, an average child who does not watch Sesame Street is at the 50th percentile, whereas a child who watches is at the 62nd percentile.

Baghch-e-Simsim - Afghanistan

Baghch-e-Simsim, or BSS ("Sesame Garden" in Dari and Pashto) is designed to deliver lessons of literacy, math, and life skills to Afghan children ages 3 to 7 years, with a special emphasis on girls' empowerment, cultural diversity, and mutual respect and understanding.

A 2013 study involving 101 children indicated, in part:

• With regard to phonemic awareness (5 items were measured), at pretest, the control group scored at 4.46 (compared to 2.98 amongst the experimental group. The control group's score increased only slightly (to 4.92), whereas the experimental group showed a greater gain: up to 4.76.
• With regard to gains in counting, the control group at pretest scored 5.90 out of a total of 6 items measured; this score was 5.92 at post-test. The experimental group began at 5.08 and increased to 5.73.
• With regard to gender equity attitudes (8 items were measured), at pretest, the control group scored 5.77 on a scale of 8; this number actually dropped to 5.48 at post-test. In contrast, the experimental group started at 4.55 and increased to 5.86.
• With regard to "gains in emotions", the control group at pretest scored 2.65 out of a total of 4 items measured; this score was 2.75 at post-test. The experimental group began at 2.02 and increased to 2.90.

Communication for Development and Social Change: Influencing Social Norms for an Inclusive Society in Montenegro

UNICEF and the Government of Montenegro implemented a communication strategy, "It's about ability", to challenge the existing, exclusionary practices and promote new, inclusive social norms for children with disability. Drawing on communication for development (C4D) principles and social norms theory, the 2010-2013 nationwide campaign mobilised disability rights non-governmental organisations (NGOs), parents' associations, the media, and the private sector to stimulate inclusive attitudes and practices towards children with disabilities.

According to KAP surveys and qualitative research:

As a result of the campaign, the percentage of citizens who find it acceptable for a child with disability to attend the same class with theirs increased from 35% before the campaign to 80% at the end of it. Similarly, the percentage of Montenegrin citizens who find it acceptable for a child with disability to be the best friend of their child increased from 22% before the campaign to 51% at the end of it. Furthermore, at the end of the campaign, only 7% of citizens thought that the majority of people from their community would oppose the establishment of a day care centre or a small group home for children with disabilities in their neighbourhood (normative expectations).

Sisimpur Community Outreach Project - Bangladesh

Sisimpur is an educational television programme designed for Bangladeshi children between the ages of 3 and 7 years old. Sisimpur's messages are also featured in community outreach materials designed for use in a variety of settings, including early childcare centres, pre-schools, kindergartens, and homes. The kits, which contain books, games, flash cards, and growth charts, are distributed to caregivers from low-income households through a series of 3 workshops conducted by specialised trainers from 12 non-governmental organisations (NGOs).

2006 evaluation showed:

All findings are significant at p < .05:

Compared with non-participants, caregivers who participated in the outreach programme were:

• 8.4 times more likely to own a toothbrush at home
• 5.3 times more likely to own toothpaste at home
• 4.0 times more likely to use a toothpaste to clean teeth
• 3.8 times more likely to use toothbrush to clean teeth
• 2.1 times more likely to have soap in the home
• 2.1 times more likely to have a clean towel in the home
• 4.4 times more likely to wash their hands with soap before having a meal
• 2.1 times more likely to bathe 7 times or more a week
• 3.0 times more likely to bathe with soap 4 times or more a week

Compared with non-participants, children of caregivers who participated were:

• 8.6 times more likely to use a toothbrush to clean teeth
• 5.0 times more likely to use toothpaste to clean teeth
• 7.8 times more likely to clean teeth more than once a day
• 2.8 times more likely to clean teeth after a meal
• 10.9 times more likely to clean teeth at night
• 8.0 times more likely to use soap to wash hands before a meal
• 4.6 times more likely to use soap to wash hands after defecation
• 3.0 times more likely to comb hair more than once a day
• 3.0 times more likely to eat eggs daily
• 3.0 times more likely to drink milk at least once a week

Sisimpur [2013 results]

This study was conducted among 3 participant groups: children (boys and girls aged 3 to 7 years), caregivers/parents, and Ministry of Primary and Mass Education (MOPME) school teachers who received training on Sisimpur were assigned to 3 groups: a group that received Sisimpur print materials (Exp 1), a group that received print materials and DVDs (Exp 2), and a control group that did not receive Sisimpur materials. Teachers participating in the intervention received training in implementing the curriculum and using the materials and activities in their classrooms.

Overall:

• Analyses found that the Sisimpur intervention had a positive impact on: (i) school readiness (SRI), (ii) numeracy, (iii) knowledge of shapes, and (iv) knowledge of the environment. These effects were over and above the effects of child age, child gender, caregiver education, family income, and children's prior knowledge.
• For SRI, numeracy, and environment knowledge, children in Exp 1 (print only) scored higher than those in the control schools at post-test, whereas children in Exp 2 (print + DVD) performed similarly to those in the control group. For instance, at post-test on learning outcomes:
  • With regard to SRI (range of 0-40), control group scored 31.6, compared to 33.9 amongst the intervention group that received print only (Exp 1) and 31.7 amongst the intervention group that received print + DVD (Exp 2).
  • With regard to numeracy, the numbers (range of 0-22) were 18.6 for control, 20.1 for Exp 1, and 19.0 for Exp 2.
  • With regard to shapes (range of 0-3), the scores were 2.3 for the control and 2.8 for both the Exp 1 and Exp 2 groups.

Cambodia Mass Media Campaign

This was a multifaceted mass media campaign in 2003 that was an effort to help stop the spread of HIV and AIDS, improve care and support for people living with HIV, and improve the health of Cambodia's mothers and children. The coordinated campaign consisted of a television soap opera, 3 radio phone-in and discussion programmes, television and radio public service announcements (PSAs), and a print magazine.

• 100 episodes of a soap opera ('Taste of Life') were broadcast.
• 666,000 copies of a photo-strip magazine were produced each month and distributed to the public.
  A youth radio phone-in programme ('Really?') was broadcast weekly.
• A radio discussion programme ('Real Men') was broadcast weekly.
• 99 shows of the maternal and child health radio phone-in programme 'First Steps' were broadcast.
• 23 television and 22 radio public service announcements (PSAs) about child and maternal health. In the space of a year, the radio PSAs were broadcast more than 35,000 times across 11 radio stations.

2006 evaluation showed:

• Knowledge of the benefits of breastfeeding immediately after birth rose from 38% to 67%; and parents' awareness of acute respiratory illnesses in children rose from 20% to 80% during the campaign.
• The number of people who said they washed their hands to avoid diarrhoea increased from 10% to 25%.
• The number of children who were taken to health centres with signs of acute respiratory illness rose from 51% to 70%.
• The prevalence of those reporting a child in their care with diarrhoea in the last month decreased from 17% to 13%.

Tanzania Essential Health Interventions Project (TEHIP)

TEHIP was established to test innovations in planning, priority setting, and resource allocation at the district level, in the context of the reform and decentralisation of Tanzania's health care system. The project's goal is to determine the feasibility of an "evidence-based" approach to health planning - an approach whereby decisions on how to allocate scarce health care resources are made based on information obtained locally - and measure its impact. TEHIP uses participatory research and implementation strategies to give local people a say in the causes of child and adult mortality, drawing on personal contact, radio, and computers as tools to strengthen health systems' capacity to improve health.

2005 evaluation showed:

• Average clinic visits per child increased from 2.8 to 5.8 a year. More children were treated for malaria, more early cases of worms were spotted, more eye infections were caught, more AIDS messages were shared, and more mothers had exposure to family planning information.
• Child mortality fell in the 2 districts by more than 40% over the 5 years of implementation. Adult mortality dropped by about 20%, even as AIDS was beginning to spread. During this period, districts not using the TEHIP plan experienced virtually no change in their death rates.
• In accomplishing the above, the districts were able to use just 30 cents out of TEHIP's promised $2 increase the first year. (The figure increased to 89 cents in the second year, and $1.37 in the third.)

I am a Child But I Have My Rights Too! - Benin, Burkina Faso, Guinea, Guinea Bissau, Senegal, Togo

I am a Child But I Have My Rights Too! is an awareness campaign initiated and coordinated by Plan's West Africa Regional Office (WARO) on the rights of the child. Broadcast since 1999 on radio stations in Burkina Faso, Togo, Guinea, Senegal, Mali, Benin and Guinea Bissau, the campaign focuses on the application of children's rights in the day-to-day lives of young people in West Africa. The 29 5-minute stories of the radio campaign promote child rights issues such as health, good environment, education, and gender equity. Other activities such as listening clubs, theatre productions, and training have supported the campaign. Children play active roles at all stages of the implementation of the project.

2004 evaluation showed:

• Children gained new self-confidence in speaking to adults, and adults became aware of children's rights, which led to increased parent-child dialogue. As children discussed what they learned on the radio, they began to explore issues affecting them in their homes, schools, and communities. For example, the programme helped get people talking about girls' rights to education and excision, which helped to increase the rate of girls' school enrollment and decrease the rate of excision.
• According to radio journalists participating in the evaluation, "This had a great influence on people. They have started talking about excision - something that we never did before."
• Where there used to be only a few girls in each class, the enrollment of girls in primary school 2003-2004 (one year after the first broadcasts) rose to almost the same as for boys (340 boys to 304 girls). "There was a lot of debate about the importance of girls’ education. It all started with the radio programme", says one of the teachers.
• Several radio stations confirm that they have had to create new children’s programmes after the campaign because of the strong demand from listeners.

Better Parenting Project - Jordan

This project sought to address the needs of parents of very young children for basic information and for support in their tasks of childrearing, particularly in the areas of health, nutrition, and social-emotional development. The campaign included: 4 video presentations, 4 accompanying parent booklets, and 3 facilitator guides to the use of these materials.

2000 evaluation showed:

For the 112 mothers who attended every one of the 8 sessions (out of the 214 who attended some), "the findings demonstrated that the program had a statistically significant effect on creating differences in the performance of mothers, as measured against the pre- and post-participation evaluation tools. Improvement was observed in the level of the mothers' knowledge in the areas of child growth and development....The program also contributed towards improving the mothers' patterns of parenting. No differences were found in the performance of literate or illiterate mothers. The results also demonstrated that the program was both effective and suitable, that it led to raising the level of mothers' awareness in the area of early childhood upbringing..."

Immunization Promotion Activities: Are They Effective in Encouraging Mothers to Immunize Their Children?

This study was conducted to evaluate the effectiveness of the Mexican National Vaccination Council's (CONAVA) communication activities for the Second National Health Week (SNHW) in Mexico City. The study sought to determine whether the messages communicated were effective in providing information to mothers and in motivating them to have their children vaccinated.

Key findings (1999):

Overall, 83% were aware of the campaign and 63% were impacted by its messages. The net increase in immunisation between the "aware" and "unaware" groups was 14.8%, though it must be recognised that a relatively large proportion of the "unaware" mothers also took their children for vaccinations, a feature the authors attribute to long-term momentum gained by successive vaccination campaigns.

Immunisation Communication - Burkina Faso

This campaign used interpersonal communication, radio programmes, songs, print materials, flipcharts, stickers, and posters to improve the number of children with full immunisation (a series of five immunisation contacts) before age 1. The local population was mobilised to actively participate in the programme through discussions and provision of information about immunisation.

1994 evaluation showed:

• Over 70% of the mothers mentioned vaccination when describing what the interactive sticker and form had taught them. Mothers mentioned numerous benefits when asked how these materials helped them, including: remembering to get vaccinations, understanding and protecting children, acquiring good health, and dealing with side effects.
• More of the exposed mothers (87-96%, depending on type of exposure) knew that 5 visits were required to complete the immunisation compared to those who had not been exposed (71-80%). Similarly, more exposed mothers (60-75%) than unexposed (38-48%) knew that a child should be vaccinated against measles at 9 months. An increase in the number of materials that the mothers were exposed to correlated to an increase in the knowledge of the mothers with respect to the questions asked.

Mass Media and Health Practices Project - Honduras

The programme began by providing 900 health care workers with four to eight hours of Oral Rehydration Therapy (ORT) training. A supportive media campaign was developed based on print materials and radio advertisements to issue basic messages related to ORT and the associated training programme.

1981 evaluation showed:

• 93% of the mothers surveyed in rural Honduras knew that the programme's radio campaign was promoting Litrosol, the brand name of the locally packaged oral rehydration salts (ORS) used to treat diarrhoea.
• Of the mothers sampled in the study, 42% knew that the use of Litrosol prevented dehydration.
• 49% of the mothers surveyed had used the ORS Litrosol. Of these women, 94% accurately described the correct mixing volume and 96% knew that the entire package of ORS was to be used in treatment.
• 16 months after the programme's start, 39% of all of the cases of diarrhoea within the prior two weeks among the sampled families had been treated using Litrosol.
• Between 1981 and 1982 mortality rates for children under five years of age had decreased from 47.5% to 25%.