Strong Families, Thriving Children "Sugira Muryango"_Activity C
Condition: Child Development, Social Protection
Study type: Interventional

Summary: 
      The proposed study will test the effectiveness of the Strong Families, Thriving Children
      "Sugira Muryango" program as delivered by community based workers and aligned with the
      Rwandan social protection system. Sugira Muryango is a preventive, family-based model that
      uses home visiting and coaching to encourage responsive parent-child interactions and
      discourage violence and harsh punishment targeting families living in extreme poverty.
      Integration of scalable, cost-effective interventions into poverty-reduction and other social
      welfare programs has great potential as an effective means to promote child development and
      reduce familial violence and in a range of culturally diverse, low-resource settings.
    

Detailed description: 
      Globally, more than 200 million children may not reach their full developmental potential due
      to poverty and adversity. This is most evident in World Bank-classified Low- and
      Middle-Income Countries (LMICs) struggling with the confluence of war, community violence,
      poverty and disease. Research across a range of cultures and settings finds that children
      living in compounded adversity face increased risks of poor child development outcomes and
      emotional and behavioral problems that can perpetuate a cycle of poverty and violence.
      Integrated programs and family-based interventions for promoting child development, healthy
      parent-child relationships and reducing household violence affecting children are
      insufficiently tested in culturally diverse and low-resource settings despite compelling data
      about such risks. The proposed study will investigate the effectiveness of the Sugira
      Muryango program as an innovative approach to early childhood development promotion. Sugira
      Muryango is a preventive, family-based model that uses home visiting and caregiver coaching;
      it encourages responsive caregiver-child interactions and discourages violence and harsh
      punishment among families living in extreme poverty. By providing home-based coaching that
      helps parents manage stress, reduce harsh punishment and engage in responsive parenting with
      early childhood stimulation, it is possible to effect improvements in parent-child
      relationships and child development outcomes. Sugira Muryango will be implemented alongside
      Rwanda's flagship poverty reduction initiative, Vision 2020 Umurenge Program (VUP). Classic
      VUP components mainly focus on cash-for-work on labor intensive public works projects. With
      government and development partner support, VUP is piloting a more enhanced public works
      model that has child and gender sensitive components, with flexible public works options that
      are closer to beneficiary households. Along such the expanded public works program currently
      under pilot by VUP, a minimum graduation package is also available, which is providing
      additional variables of financial literacy, asset transfers, skills training, and
      sensitizations surrounding a range of topics (e.g., education, health, nutrition).

      A four-arm cluster randomized trial (CRT) will enroll 1,040 VUP-eligible families with
      children aged 6-36 months to compare outcomes among children and parents in families
      receiving: (1) Control/Classic VUP, (2) Expanded VUP, (3) Combined Classic VUP plus Sugira
      Muryango and (4) Combined Expanded VUP plus Sugira Muryango. A cost analysis will provide
      practical information on the feasibility and cost of integrating Sugira Muryango into VUP
      programming and a process evaluation will produce useful implementation tools for
      dissemination and scale-up.

      Study Aims are to (1) assess effectiveness of Sugira Muryango in promoting responsive
      parenting, reducing violence and harsh punishment and promoting early child development in
      families living in poverty; (2) to assess the interaction between Sugira Muryano and
      classic/expanded VUP programming and (3) to assess costs, barriers and facilitators of
      integrating the Sugira Muryango package into VUP or other government programming, such as the
      Ministry of Gender and Family Promotion (MIGEPROF), which holds the early childhood
      development mandate. This initiative seeks to promote cross sectoral and ministerial
      collaboration, a key pillar of the Government of Rwanda.
    

Intervention name(s): Sugira Muryango
Intervention type(s): Other
Intervention description(s): Strong Families, Thriving Children "Sugira Muryango" is a home-visiting intervention that empowers low-income families enrolled in Rwanda's social protection system to support early childhood development and healthy family functioning.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The proposed study design consists of a four-arm cluster randomized control trial (CRT), which will span approximately 52 cells in 3 districts of Rwanda to compare outcomes among VUP eligible households with at least one child 6-36 months in the following study arms:
Classic VUP public works (control)
Expanded VUP public works (control)
Combined Classic VUP public works with Sugira Muryango (treatment)
Combined Expanded VUP public works with Sugira Muryango (treatment)
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention