Youth-led early childhood care and education programme (LEAPS)

Date : Jun 2018 - Dec 2021

<div><p>children do not receive adequate nurturing care in health, nutrition, protection, learning, and responsive care, thus</p> <p>jeopardising their healthy development across the life course. Working alongside the health sector, multisectoral</p> <p>actions including social protection and education are necessary to achieve child health and development outcomes.</p> <p>Innovations are needed to expand access to high-quality early childhood care and education (ECCE) for young children</p> <p>and opportunities for youth development. Youth Leaders for Early Childhood Assuring Children are Prepared for</p> <p>School (LEAPS) is a two-generation programme that trains female youth aged 18–24 years to deliver ECCE. We</p> <p>evaluated the effectiveness of LEAPS to improve children’s school readiness when delivered at scale in rural Pakistan.</p> <p>Methods We implemented a stepped-wedge cluster-randomised trial with three steps from Dec 3, 2018, to June 30, 2021.</p> <p>99 villages (clusters) in four districts in rural Sindh, Pakistan, were randomly assigned (1:1:1) to introduce LEAPS</p> <p>across three steps. Eligible clusters were those that had a feeder primary school run by the National Commission for</p> <p>Human Development, a department of the Ministry of Federal Education and Professional Training; were safe; had</p> <p>space for a LEAPS preschool; could identify a female youth to deliver the ECCE service; and had not previously</p> <p>participated in the pilot study. Government partners trained female youth, aged 18–24 years, to provide communitybased</p> <p>ECCE, enrolling up to 20 children, aged 3·5–5·0 years, per class. Population-based cross-sectional surveys were</p> <p>conducted at baseline and after each step for children who were eligible if they resided in the cluster, were aged</p> <p>4·5–5·5 years at the time of the survey, and without any severe clinical health conditions or disability. The primary</p> <p>outcome was children’s school readiness using the International Development and Early Learning Assessment</p> <p>(IDELA) composite score comprising emergent numeracy, emergent literacy, socio-emotional development, and</p> <p>motor skills. An intention-to-treat analysis was conducted, using linear mixed models accounting for clustering and</p> <p>the stepped-wedge design. The trial is registered with ClinicalTrials.gov (NCT03764436).</p> <p>Findings LEAPS was implemented in 91 of 99 villages. In eight clusters, a LEAPS preschool could not be set up. For</p> <p>the intervention programme, the average enrolment of children in a LEAPS preschool was 19 (SD 3, range 12–20).</p> <p>A total of 3858 children (n=3852 with complete IDELA data) were assessed across the four survey rounds conducted</p> <p>between Jan 1, 2019, and March 31, 2021. LEAPS increased school readiness (standardised mean difference: 0·30</p> <p>[95% CI 0·20–0·40]; p</p></div>