The Child-to-Child component of the ECD programme began in Sherpur Upazila, Bogra in January 2003 and was completed in December 2004. A brief and focused KAP survey was done to record benchmark information before the intervention began. This report presents findings from a follow-up survey carried out to assess the effects of intervention, and make recommendations for fine-tuning the programme in future during scaling up.
Materials and methods
For the follow-up survey, the baseline households grouped into three were re-visited and data were collected from the same adolescents, if present at the time of survey. The groups were: a) Treatment Area I: where regular ECD activities as well as ‘child-to-child’ activities were implemented, b) Treatment Area II: where only regular ECD activities were taking place and c) Treatment Area III: this served as Control area where no ECD intervention is taking place. Respondents were unmarried adolescents aged 12-19 years (2 yrs older than the baseline, to allow for the intervention period of two years and re-visit the same adolescents) who have had an under-five child in the household at baseline. The adolescents were traced following the list prepared for the baseline. In 2003, 2000 adolescents out of a targeted 2200 (850 each from two treatment areas and 500 from control area) were interviewed (response rate 91%). There was attrition due to marriage, migration, death etc in 2005 and thus, during follow-up survey, 1600 out of 2000 baseline adolescents could be interviewed and the response rate was 80%. The quantitative survey was supplemented by three focus group discussions with adolescents from the Community Learming Centres (CLCs) and Union Libraries (ULs).
A generalized increase in knowledge about care needed for proper physical growth and mental development of children was noted among adolescents of the treatment areas compared to baseline. Adolescents from Treatment area I were more knowledgeable about feeding practices than their peers from Treatment area II. There was high level of consensus about the importance of adequate nutritious diets among all three groups of adolescents. However, level of knowledge about the effect of harmful practices (such as quarrelling, maltreating others in presence of children etc.) for mental development of children remained low in all groups.
Level of knowledge about the harmful effects of beating and scolding showed improvement from baseline. The knowledge on association of ANC of mother with physical growth and mental development of children, and its importance for the latter, showed improvement from baseline, especially for adolescents of Treatment area I. Also, retention of knowledge on the importance of birth weight for children’s physical growth was noted in the treatment areas, and at a lower level in the control area. All adolescents were more knowledgeable than at baseline about the importance of keeping children under close supervision to prevent injury and drowning.
Adolescents were found to spend time with children more at the weekends than regularly compared to baseline. Inequity in spending time with boys and girls appeared to increase in the treatment areas, but not in the control area. Interaction with children in the form of play, storytelling etc. increased in all areas, but at a much lower level in the control area. Increased participation of adolescents in stimulating the mental development of children through different ways was noted in the treatment areas more frequently than control area since baseline. They were also increasingly active in disciplining children in different ways (such as teaching them not to be rude, quarrel or fight, to obey elders etc.) other than rebuking or scolding.