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Nudging parents and teachers to improve learning and reduce child labor in Cote d'Ivoire.

ABSTRACT: Whether SMS-based nudge interventions can increase parent engagement and improve child learning outcomes across diverse contexts such as rural West Africa is unknown. We conducted a school-randomized trial to test the impacts of an audio or text-message intervention (two messages per week for one school year) to parents and teachers of second and fourth grade students (N = 100 schools, 2246 students) in Cote d'Ivoire. Schools were randomly assigned to have messages sent to (i) parents only, (ii) teachers only, (iii) parents and teachers together, or (iv) control. There were statistically non-significant impacts of the parents-only treatment on learning, although with typical effect sizes (d = 0.08, p = 0.158), and marginally statistically significant increases in child labor (d = 0.11, p < 0.10). We find no impacts of the other treatment conditions. Subgroup analyses based on pre-registered subgroups show significantly larger improvements in learning for children with below-median baseline learning levels for the parents-only arm and negative impacts on learning for girls for the teachers-only arm, suggesting different conclusions regarding impacts on equity for vulnerable children.

SUBMITTER: Wolf S

PROVIDER: S-EPMC10499780 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Nudging parents and teachers to improve learning and reduce child labor in Cote d'Ivoire.

Wolf Sharon S Lichand Guilherme G

NPJ science of learning 20230913 1

Whether SMS-based nudge interventions can increase parent engagement and improve child learning outcomes across diverse contexts such as rural West Africa is unknown. We conducted a school-randomized trial to test the impacts of an audio or text-message intervention (two messages per week for one school year) to parents and teachers of second and fourth grade students (N = 100 schools, 2246 students) in Cote d'Ivoire. Schools were randomly assigned to have messages sent to (i) parents only, (ii) ...[more]

PMID: 37704694

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Project description:BackgroundOne of the main objectives of health policy-makers is to promote children's growth, development, and survival. The current research evaluates the impact of breastfeeding on infant survival and highlights the major socio-economic determinants of child survival from 0 to 5 years old in Côte d'Ivoire.MethodsThis study uses Probit estimation to evaluate the impact of the type of breastfeeding on the survival of children aged from 0 to 5 years old. The main socio-economic determinants of child survival were identified and analyzed. The sample of the study covers 7776 children under 5 years old drawn from the Côte d'Ivoire Demographic Health Surveys and the Multiple Indicators cluster survey of 2012.ResultsA child is more likely to survive when immediate exclusive breastfeeding was practiced for up to 6 months. The probability of survival increases significantly when the mother lives in a healthy environment, when she has at least a primary school education, and when she plays a leading role in caring for the children. Likewise, when she better controls the market of some breast milk supplement and she chooses the best milk formula to complete feeding for her baby, the child's chances of survival increase significantly.ConclusionHealth policy-makers must strengthen programs to promote exclusive breastfeeding up to 6 months through social campaigns. It should also strengthen the capacity of health workers (midwives, nurses, doctors, etc.) to better guide and provide training to mothers and young women about childbearing age to allow them to practice exclusive breastfeeding for up to 6 months. It is only after 6 months that they have to complete infant feeding by providing some semi-solid food rich in vitamins, proteins, and minerals. Taking into account the time constraint when they are engaged in economic activity, they must choose the best formula milk to supplement breastfeeding. It is also important to educate women to improve hygiene in their housing, in their neighborhood and in their community in order to promote the welfare and health of their children.

Project description:Evidence suggests that bi-annual mass drug administration (MDA) of single-dose azithromycin to 1-11 month-old children reduces child mortality in high child-mortality settings. Several countries conduct annual MDAs to distribute azithromycin to individuals ages 6 months and older to prevent trachoma infection. This study examined the feasibility and acceptability of reaching 1-11 months-old children during a trachoma MDA in Côte d'Ivoire by extending azithromycin distribution to infants 1-5 months old during the campaign. In November 2020, the study piloted single-dose azithromycin for 1-5 month-olds during a trachoma MDA in one health district. Monitoring data included the number of children reached and occurrences of adverse drug reactions. Feasibility, the extent to which the target population received the intervention (coverage), was assessed through a population-based, household survey with parents/caregivers of eligible children conducted after the MDA. Acceptability was explored through in-depth interviews (IDIs) with parents/caregivers of eligible children, focus group discussions (FGDs) with community drug distributors (CDDs), and IDIs with their supervisors. CDD FGDs and supervisor IDIs also documented implementation challenges and recommendations for scale-up. 1,735 1-5 month-olds received azithromycin during the pilot activity (estimated population coverage of 90.2%). Adverse drug reactions were reported for 1% (n = 18) infants; all were mild and self-limited. The post-MDA coverage survey interviewed 267 parents/caregivers; survey-based intervention coverage was 95.4% of 1-5 month-olds. Qualitative data revealed high intervention acceptability among parents, CDDs, and supervisors. Implementation challenges included the need to weigh babies to calculate dosage for 1-5 month-olds and the need to obtain written informed consent from parents to provide the drug to 1-5 month-olds. CDDs also indicated the need for more information on azithromycin and possible side effects during training. Delivering azithromycin to younger infants appears acceptable to parents and implementers; >90% coverage indicates feasibility to integrate into a trachoma MDA. (Clinicaltrials.gov ID number: NCT04617626).

Project description:BACKGROUND:In Côte d'Ivoire, induced abortion is legally restricted unless a pregnancy threatens a woman's life. Yet the limited available evidence suggests abortion is common and that unsafe abortion is contributing to the country's high maternal mortality. Our study aimed to estimate the one-year incidence of induced abortion in Côte d'Ivoire using both direct and indirect methodologies, determine the safety of reported abortions, and identify the women most likely to experience a recent induced abortion or an unsafe abortion. METHODS:In 2018, we conducted a nationally representative, population-based survey of women age 15 to 49 in Côte d'Ivoire. Women reported their own abortion experiences and those of their closest female confidante. We estimated the one-year incidence of induced abortion, and the safety of the abortions women experienced. Using bivariate and multivariate regression, we separately assessed sociodemographic characteristics associated with having had a recent abortion or an unsafe abortion. RESULTS:Overall, 2,738 women participated in the survey, approximately two-thirds of whom reported on the abortion experiences of their closest female friend. Based on respondent data, the one-year incidence of induced abortion was 27.9 (95% CI 18.6-37.1) per 1,000 women of reproductive age, while the confidante incidence was higher at 40.7 (95% CI 33.3-48.1) per 1,000. Among respondents, 62.4% of abortions were most unsafe, while 78.5% of confidante abortions were most unsafe. Adolescents, less educated women, and the poorest women had the most unsafe abortions. CONCLUSION:This study provides the first national estimates of induced abortion incidence and safety in Côte d'Ivoire, using a population-based approach to explore social determinants of abortion and unsafe abortion. Consistent with other research, our results suggest that legal restrictions on abortion in Côte d'Ivoire are not preventing women from having abortions, but rather pushing women to use unsafe, potentially dangerous abortion methods. Efforts to reduce the harms of unsafe abortion are urgently needed.

Project description:BackgroundKnowing the species composition and insecticide resistance status of the target vector population is important to guide malaria vector control. The aim of this study was to characterize the malaria vector population in terms of species composition, insecticide susceptibility status and potential underlying resistance mechanisms in Ellibou, southern Côte d'Ivoire.MethodsA 1-year longitudinal entomological survey was conducted using light traps and pyrethroid spray catches to sample adult mosquitoes in combination with larval sampling. The susceptibility status of Anopheles gambiae sensu lato (s.l.) to bendiocarb, deltamethrin, DDT and malathion was assessed using the World Health Organization insecticide susceptibility test. Additionally, An. gambiae specimens were screened for knockdown (kdr) and acetylcholineesterase (ace1) target site resistance alleles, and the expression levels of eight metabolic resistance genes, including seven cytochrome P450 monooxygenases (P450s) and one glutathione S-transferase (GST), measured with reverse transcription quantitative real-time polymerase chain reaction (qPCR).ResultsOverall, 2383 adult mosquitoes from 12 different taxa were collected with Culex quinquefasciatus and An. gambiae being the predominant taxa. Molecular identification of An. gambiae s.l. revealed the presence of Anopheles arabiensis, Anopheles coluzzii, An. gambiae sensu stricto (s.s.) and Anopheles coluzzii/An. gambiae s.s. hybrids. Anopheles gambiae mosquitoes were resistant to all insecticides except malathion. PCR diagnostics revealed the presence of ace1-G280S and the kdr L995F, L995S and N1570Y target-site mutations. Additionally, several genes were upregulated, including five P450s (i.e., CYP6P3, CYP6M2, CYP9K1, CYP6Z1, CYP6P1) and GSTE2.ConclusionThis is the first documented presence of An. arabiensis in Côte d'Ivoire. Its detection - together with a recent finding further north of the country - confirms its existence in the country, which is an early warning sign, as An. arabiensis shows a different biology than the currently documented malaria vectors. Because the local An. gambiae population was still susceptible to malathion, upregulation of P450s, conferring insecticide resistance to pyrethroids, together with the presence of ace1, suggest negative cross-resistance. Therefore, organophosphates could be an alternative insecticide class for indoor residual spraying in the Ellibou area, while additional tools against the outdoor biting An. arabiensis will have to be considered.

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Nudging parents and teachers to improve learning and reduce child labor in Cote d'Ivoire.

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Nudging parents and teachers to improve learning and reduce child labor in Cote d'Ivoire.

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