Wendy Janssens
Cristina Rosemberg
Publication Date
July 1, 2012

Amsterdam Institute for International Development (Janssens, Rosemberg); VU University Amsterdam (Janssens)

This is a study of the impact of the Roving Care Givers programme of St. Lucia, a home visiting programme for vulnerable families of very young children.

The Amsterdam Institute for International Development [AIID] is conducting a longitudinal impact evaluation of the Roving Caregivers Programme (RCP) in the Caribbean island of St. Lucia. RCP is a home visiting programme designed for vulnerable families with children in the age group from birth to three years old. Its main objective is the introduction of appropriate child rearing practices in order to support the healthy development of young children. The study is funded by the Bernard Van Leer Foundation. Its research objective is to measure the impact of the programme on children's cognitive and socio-emotional development, as well as parenting practices.

The evaluation is designed as a quasi-experimental study, consisting of a baseline survey, conducted in 2006 and 2007, and follow-up survey rounds of children enroled in the programme, as well as a matched control group. Eight villages were included in the RCP programme after the baseline, and 7 are control or non-RCP villages. The study consists of a survey among more than 400 children living in the study area who were aged between birth and two years at the start of the baseline in the summer of 2006. Each survey round consists of two components: 1) a structured interview with the child's caregiver, based on a household and a parent questionnaire, conducted by interviewers from the St. Lucian Statistical Office; and 2) a child assessment at the local health centre, including cognitive and socio-emotional development assessments as well as measurement of anthropometrics (the distribution of body dimensions), conducted by trained nurses who recently graduated from the Health Faculty of the Sir Arthur Lewis Community College in St. Lucia.

Using the data collected in 2008 and compared to the 2006 baseline, this impact study provides an econometric analysis based on a differences-in-differences estimation of average intention-to-treat effects. This first short-impact evaluation pointed out that, after one year of programme implementation, the programme has had a significant and sizeable effect on the cognitive development of the younger age cohort, but not the older children. The study finds "strong and significant effects on the cognitive development of children aged between 6 and 18 months at program start, but not for the older birth cohort aged 18 to 30 months. In particular, their scores on the Visual Reception and Fine Motor Skills scales show substantial increases that are almost half a standard deviation higher than changes over time in the control group." Findings on socio-emotional impact were inconclusive.

These results suggest that there are windows of opportunity for improving child development at an early age. A home-visiting intervention that aims to enhance appropriate parenting practices in this respect may therefore opt to enrol caregivers as soon as possible after birth of their child and potentially even earlier during the prenatal stage.

The study identifies a number of risk factors, in particular poverty and low maternal education, which are strongly correlated with low developmental outcomes, and researchers suggest the desirability of focusing on these children. In addition, a surge in employment during the implementation of the RCP programme negatively affected the enrolment; however, the subsequent economic downturn may have increased the need for a cost-effective home-visiting programme, suggesting a closer look at the institutional environment of operating this kind of programme.

Click here to read this 16-page document in PDF format.

The Impact of a Caribbean Home-Visiting Child Development Program on Cognitive S

AIID website, August 20 2012, and emails from Wendy Janssens to The Communication Initiative on December 5 2012 and February 27 2014. Image credit: G Robinson