Project Summary

Globally, more than 200 million children may not reach their full developmental potential due to poverty and adversity. This is most evident in World Bank-classified Low- and Middle-Income Countries (LMICs) struggling with the confluence of war, community violence, poverty and disease. Research across a range of cultures and settings finds that children living in compounded adversity face increased risks of poor child development outcomes and emotional and behavioral problems that can perpetuate a cycle of poverty and violence. Sugira Muryango home-visiting program is an evidence-based intervention that offers active coaching for caregivers by community lay-workers trained to deliver sessions including early stimulation promotion, play, nutrition, hygiene, non-violent discipline and responsive parenting. It is based on the Family Strengthening Intervention (FSI) model originally developed and tested in Rwanda. Sugira Muryango empowers low-income families enrolled in Rwanda's social protection system to support early childhood development and healthy family functioning.

Approach

Sugira Muryango uses a clustered randomized control trial design and mixed models approach with a hybrid type 2 implementation design (i.e., a focus on intervention efficacy and implementation outcomes).

What separates the Sugira Muryango program from similar projects is the methodological rigor, the holistic comprehensiveness of the intervention content, a well-defined theory of change, the emphasis on implementation features, and the methodological rigor. It is rare that programs incorporate elements that aim to enhance Early Childhood Development and violence reduction. In the process of scaling and iterative quality improvements, Sugira Muryango is regarded as a global pioneer for implementation methods, processes, systems, and evaluation.

Measurement & Metrics

A four-arm cluster randomized trial (CRT) will enroll 1,040 VUP-eligible families with children aged 6-36 months to compare outcomes among children and parents in families receiving: (1) Control/Classic VUP, (2) Expanded VUP, (3) Combined Classic VUP plus Sugira Muryango and (4) Combined Expanded VUP plus Sugira Muryango. A cost analysis will provide practical information on the feasibility and cost of integrating Sugira Muryango into VUP programming and a process evaluation will produce useful implementation tools for dissemination and scale-up. Study Aims are to (1) assess effectiveness of Sugira Muryango in promoting responsive parenting, reducing violence and harsh punishment and promoting early child development in families living in poverty; (2) to assess the interaction between Sugira Muryano and classic/expanded VUP programming and (3) to assess costs, barriers and facilitators of integrating the Sugira Muryango package into VUP or other government programming, such as the Ministry of Gender and Family Promotion (MIGEPROF), which holds the early childhood development mandate. This initiative seeks to promote cross sectoral and ministerial collaboration, a key pillar of the Government of Rwanda. Key outcomes include: Physical, cognitive, and language development indicators for children. Parental engagement in ECD activities, parental mental health, the reduction of intimate partner violence and harsh parenting discipline, father engagement, as well as dissemination and implementation measures. Sugira Muryango uses a mixed-methods approach, which includes: observations, surveys, quantitative measurements, longitudinal modeling, focus groups, key stakeholder interviews, among others.

Key Findings

Findings from Sugira Muryango include: 1) increased parental engagement in ECD activities; 2) reduction in both intimate partner violence and harsh parenting; 3) increased father engagement; 4) improved attainment of children's developmental milestones.

Principal Investigator

Project Support

The LEGO Foundation, Grand Challenges Canada, the ELMA foundation, echidna giving, OAK Foundation, USAID, Partnership PLUS

Partnerships

Rwanda National Commission for Children, FXB Rwanda, Rwanda National Child Development Agency

Duration

2016–2022

Facts & Figures

10,000

The current scale up trial includes nearly 10,000 households from the most vulnerable communities in Rwanda.

Publications