The Assessment of the Effectiveness of Child Survival Interventions on Early Childhood Physical Growth and Developmental Milestones in Tanzania

Abstract

Early childhood interventions are recognized worldwide as key to optimal child physical growth and development hence the implementation of several packages worldwide aiming at achieving good physical development include weight, height, and developmental milestones. Nevertheless, previous assessments of the effectiveness of these interventions on the intended outcomes show mixed results and are compounded by the multiplicity of interventions which make it difficult to understand what works within the individual packages for better child growth and development. A retrospective analytical and mixed methods study was conducted in Arusha region to assess the effectiveness of child survival interventions on early childhood physical growth (weight and height for age) and developmental milestones using Compassion International Tanzania (CIT) interventions in Arusha region across 13 churches as a case study. Data of 780 randomly selected children who received the interventions for at least four years were extracted from the CIT database for analysis. 13 key informant interviews and six focus group discussions with mothers/guardians, program staff and church leaders were also conducted to obtain qualitative information to complement the quantitative data results using pretested and piloted open-ended interview/focus group discussion guides. Analysis of the quantitative data was done using STATA statistical Package version 16 and content analysis employed for qualitative data. The respective proportions of children who had appropriate height, weight and developmental milestones for age had improved from 87.3%, 96.1% and 94.0% at baseline to 96.1%, 98.8% and 98.1% at the time of assessment. Children who had completed all the required interventions were almost 10x, 9x and 16x more likely to be of appropriate height for age, weight for age and of normal developmental milestones than those who had not Odds ratio height for age 9.78 CI 4.48-21.25 p<0.001: weight for age 9.03 CI 2.35- 34.65 p<0.001 and appropriate developmental milestones 16.12 CI 2.64-98.35 p<0.001 indicating a strong effectiveness of the interventions. In fact, children who had inappropriate height for age meaning stunted declined from 12.7% at baseline to 3.9% at the time of assessment, those with inappropriate weight for age declined from 3.9% to 1.2% while those with inappropriate developmental milestones for age also declined from 3.0% to 1.9% during the same period. Key informant interviews and focus group discussions results showed that the interventions are well implemented, are of strong overall oversight and appreciated as beneficial by the beneficiaries.