Effects of integrated psychosocial stimulation (PS) and Unconditional Cash Transfer (UCT) on Children's development in rural Bangladesh: A cluster randomized controlled trial

Sheikh Jamal Hossain; Bharaty Rani Roy; Hasan Mahmud Sujon; Thach Tran; Jane Fisher; Fahmida Tofail; Shams El Arifeen; Jena Derakhshani Hamadani

doi:10.1016/j.socscimed.2021.114657

Effects of integrated psychosocial stimulation (PS) and Unconditional Cash Transfer (UCT) on Children's development in rural Bangladesh: A cluster randomized controlled trial

Soc Sci Med. 2022 Jan:293:114657. doi: 10.1016/j.socscimed.2021.114657. Epub 2021 Dec 15.

Authors

Sheikh Jamal Hossain¹, Bharaty Rani Roy², Hasan Mahmud Sujon², Thach Tran³, Jane Fisher³, Fahmida Tofail², Shams El Arifeen², Jena Derakhshani Hamadani²

Affiliations

¹ International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Mohakhali, Dhaka, 1212, Bangladesh; Department of Women's and Children's Health, Uppsala University, Sweden. Electronic address: sheikh.jamal@icddrb.org.
² International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Mohakhali, Dhaka, 1212, Bangladesh.
³ Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.

PMID: 34942577
DOI: 10.1016/j.socscimed.2021.114657

Abstract

Background: There is evidence on benefits of psychosocial stimulation (PS) and cash transfer programmes in low- and middle-income countries on children's development. We integrated PS into an unconditional cash transfer (UCT) programme for poor Bangladeshi mothers to examine the effects on children's development.

Methods: This cluster randomized controlled trial was conducted in rural Bangladesh from July 2017 to December 2018 in 33 clusters, with 11 clusters randomly assigned to each of the three arms, namely i) PS + UCT ii) UCT-only and iii) Comparison. We enrolled poor mothers and child (6-16 months) dyads eligible to receive maternity allowance by the Government of Bangladesh. Trained local women imparted training to mothers to provide psychosocial stimulation to their children for one year. Children's cognitive, language and motor development were measured with Bayley-III, behaviour with Wolke's ratings and maternal self-esteem with Rosenberg self-esteem scale. The analysis was intention-to-treat.

Results: Of the 594 mother-child dyads, 40 (6·8%) were lost to follow-up. Compared to UCT-only, children in the PS + UCT had significant improvement in cognitive (B = 2.96, 95% CI: 0.46-5.47, Effect Size [ES] 0.24SD) and language (2.73, 0.39-5.00, ES 0.21SD) scores and were more responsive to examiner (0.30, 0.06-0.52, ES 0.27SD), while compared to comparison group, they had significantly higher cognitive (3.37, 1.27-6.19, ES 0.32SD), language (2.82, 0.53-5.10, ES 0.24SD) and motor (2.65, 0.24-5.06, ES 0.22SD) scores and were more responsive to examiner (0.30, 0.08-0.52, ES 0.26 SD). The mothers' self-esteem was significantly higher in PS + UCT (2.46, 0.94-3.98, ES 0.48 SD) and UCT-only (1.67, 0.02-3.20, ES 0.32 SD) compared to the comparison group.

Conclusion: PS integrated into an UCT programme benefited children's neurodevelopment and UCT improved mother's self-esteem. UCT programme may be an important platform for child stimulation programmes for rural poor populations.

Keywords: Bangladesh; Child development; Cognitive; Maternal self esteem; Psycho social stimulation; Unconditional cash.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Bangladesh
Child Development / physiology
Female
Financial Statements
Humans
Income
Mothers* / psychology
Pregnancy
Rural Population*