PMID- 30885962 OWN - NLM STAT- MEDLINE DCOM- 20200408 LR - 20231012 IS - 1468-2044 (Electronic) IS - 0003-9888 (Print) IS - 0003-9888 (Linking) VI - 104 IP - Suppl 1 DP - 2019 Apr TI - Counting outcomes, coverage and quality for early child development programmes. PG - S13-S21 LID - 10.1136/archdischild-2018-315430 [doi] AB - Improved measurement in early child development (ECD) is a strategic focus of the WHO, UNICEF and World Bank Nurturing Care Framework. However, evidence-based approaches to monitoring and evaluation (M&E) of ECD projects in low-income and middle-income countries (LMIC) are lacking. The Grand Challenges Canada(R)-funded Saving Brains(R) ECD portfolio provides a unique opportunity to explore approaches to M&E of ECD programmes across diverse settings. Focused literature review and participatory mixed-method evaluation of the Saving Brains portfolio was undertaken using an adapted impact framework. Findings related to measurement of quality, coverage and outcomes for scaling ECD were considered. Thirty-nine ECD projects implemented in 23 LMIC were evaluated. Projects used a 'theory of change' based M&E approach to measure a range of inputs, outputs and outcomes. Over 29 projects measured cognitive, language, motor and socioemotional outcomes. 18 projects used developmental screening tools to measure outcomes, with a trade-off between feasibility and preferred practice. Environmental inputs such as the home environment were measured in 15 projects. Qualitative data reflected the importance of measurement of project quality and coverage, despite challenges measuring these constructs across contexts. Improved measurement of intervention quality and measurement of coverage, which requires definition of the numerator (ie, intervention) and denominator (ie, population in need/at risk), are needed for scaling ECD programmes. Innovation in outcome measurement, including intermediary outcome measures that are feasible and practical to measure in routine services, is also required, with disaggregation to better target interventions to those most in need and ensure that no child is left behind. CI - (c) Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. FAU - Milner, Kate M AU - Milner KM AD - Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK. AD - Murdoch Children's Research Institute, Melbourne, Australia. FAU - Bhopal, Sunil AU - Bhopal S AD - Maternal & Child Health Intervention Research Group, Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK. AD - Northern School of Paediatrics, Newcastle upon Tyne, UK. FAU - Black, Maureen AU - Black M AD - Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA. FAU - Dua, Tarun AU - Dua T AD - Department of Mental Health and Substance Abuse, World Health Organisation, Geneva, Switzerland. FAU - Gladstone, Melissa AU - Gladstone M AD - Institute of Translational Medicine, University of Liverpool, Liverpool, UK. FAU - Hamadani, Jena AU - Hamadani J AD - Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh. FAU - Hughes, Rob AU - Hughes R AD - Maternal & Child Health Intervention Research Group, Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK. AD - Children's Investment Fund Foundation, London, UK. FAU - Kohli-Lynch, Maya AU - Kohli-Lynch M AD - Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK. AD - University of Bristol, School of Social and Community Medicine, Bristol, UK. FAU - Manji, Karim AU - Manji K AD - Department of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. FAU - Ponce Hardy, Victoria AU - Ponce Hardy V AD - Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK. FAU - Radner, James AU - Radner J AD - Munk School of Global Affairs and Public Policy, University of Toronto, Toronto, Canada. AD - Center on the Developing Child, Harvard University, Cambridge, Massachusetts, USA. FAU - Sharma, Sonia AU - Sharma S AD - Mobile Creches, New Delhi, India. FAU - Tofail, Fahmida AU - Tofail F AD - Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh. FAU - Tann, Cally AU - Tann C AUID- ORCID: 0000-0003-0131-4952 AD - Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK. AD - Neonatal Medicine, University College London Hospitals NHS Foundation Trust, London, UK. FAU - Lawn, Joy E AU - Lawn JE AD - Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK. LA - eng GR - 001/WHO_/World Health Organization/International PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - England TA - Arch Dis Child JT - Archives of disease in childhood JID - 0372434 SB - IM MH - Adolescent MH - Canada MH - Child MH - *Child Development MH - Child Health Services/*organization & administration/standards MH - Child, Preschool MH - Developing Countries MH - Humans MH - Infant MH - Infant, Newborn MH - Models, Theoretical MH - Program Development MH - Program Evaluation MH - Quality Indicators, Health Care PMC - PMC6557221 OTO - NOTNLM OT - child development OT - coverage OT - disability OT - low- and middle-income countries OT - outcomes OT - quality COIS- Competing interests: None declared. EDAT- 2019/03/20 06:00 MHDA- 2020/04/09 06:00 PMCR- 2019/06/10 CRDT- 2019/03/20 06:00 PHST- 2018/09/19 00:00 [received] PHST- 2019/01/24 00:00 [revised] PHST- 2019/01/28 00:00 [accepted] PHST- 2019/03/20 06:00 [entrez] PHST- 2019/03/20 06:00 [pubmed] PHST- 2020/04/09 06:00 [medline] PHST- 2019/06/10 00:00 [pmc-release] AID - archdischild-2018-315430 [pii] AID - 10.1136/archdischild-2018-315430 [doi] PST - ppublish SO - Arch Dis Child. 2019 Apr;104(Suppl 1):S13-S21. doi: 10.1136/archdischild-2018-315430.