Research Description
Globally, approximately 250 million children under 5 years of age are at risk of not reaching their full developmental potential. Children living in low- and middle-income countries (LMICs) are at increased risk of not reaching their developmental potential, due to poverty and its manifestations such as undernutrition, infectious diseases, exposure to heavy metals and toxins, exposure to psychosocial issues including maternal depression, domestic and societal violence and lack of access to quality healthcare. Besides the direct and immediate impact on children and their families, this has significant long-term implications for LMIC societies, in terms of lost human capital and increased costs to the health and education sectors. Our work in early childhood development spans multiple topic areas: nutrition, developmental delay, and retention in care as well as multiple countries including Lesotho, Rwanda, Guatemala, and Peru.
The Global Health Partnership’s Early Child Development Working Group, housed within the Department of Global Health and Social Medicine at Harvard Medical School and chaired by Ann Miller of the Research Core is an interdisciplinary initiative that seeks to understand, analyze, innovate on, and help solve some of the most pressing developmental challenges facing children in resource poor settings. The Working Group brings together physicians, researchers, educators, and public health professionals to bring maximum impact to child development research, policy and programming.
Research Projects
An individualized approach to promote nurturing care in low and middle income countries: a hybrid effectiveness/implementation trial of the international Guide for Monitoring Child Development
Description: To assess in 2 LMICs (Guatemala and India) the real world effectiveness, cost-effectiveness, and scalability of the Guide for Monitoring Child Development; an early child development intervention package that can be used to screen children’s development and provide individualized interventions with children on different developmental trajectories in multiple LMIC settings.
Core Member(s): Ann Miller (PI: P. Rohloff)
Funder: NIH/NICHD
Funding Number: R01 HD100984
Global health delivery partnership’s early child development working group
Description: This project brings together early child development researchers and implementer sites (health care and ECD NGOs) to increase awareness of the needs and opportunities in global child development, to develop research and interventions to understand risks and protective factors,and to promote healthy development for children in the world’s least resourced settings.
Core Member(s): Ann Miller (Co-Chair)
Funder: N/A
Funding Number: N/A
Universal baby: video innovation for infant neurodevelopment in Peru
Description: Main Objective: to demonstrate feasibility and efficacy of the addition of culturally appropriate and locally developed video to a community-based intervention to reduce neurodevelopmental delay among children in the context of poverty and limited health infrastructure.
Core Member(s): Ann Miller (PI: Lecca, L.)
Funder: Grand Challenges Canada: Stars in Global Health
Funding Number: N/A
Do population-level cross-national surveys promote language-based inequities?
Description: Systematic review of the effect of linguistic minority on child development as measured in DHS and MICS when controlling for wealth.
Core Member(s): Ann Miller
Funder: N/A
Funding Number: N/A
CASITA (Peru)
Description: A community-based early childhood intervention using evidence-based strategies deployed by well-trained, well-supervised community health agents (CHAs) in the community, developed and implemented by Socios En Salud. CASITA targets the central sphere of the child’s environment—the family—and to ultimately support the healthy neurodevelopment of children at risk for delay through an intervention designed to increase caregiver knowledge, capacity, and self-efficacy at providing developmentally stimulating interactions with their young child. Additionally, CASITA focuses on providing caregiver socio-emotional support.
Core Member(s): Ann Miller
Funder: Grand Challenges Canada, Abbvie Foundation
Funding Number: N/A
Pediatric development clinic (Rwanda)
Description: In 2014, Inshuti Mu Buzima, in collaboration with the Rwanda Ministry of Health with support from UNICEF and specialists from Boston Children’s Hospital implemented a novel Pediatric Development Clinic (PDC) to provide comprehensive follow-up with early intervention to at-risk under-five children, led by nurses and social workers in a district hospital and surrounding health centers in rural Rwanda. We assist IMB to design and implement their program evaluations, including assessments of malnutrition and recovery from malnutrition, retention in care and reasons for attrition from the program.
Core Member(s): Ann Miller
Funder: N/A
Funding Number: N/A