LEAPS-NCHD Program Evaluation
Condition: Child Development
Study type: Interventional

Summary: 
      An estimated 88 million children drop out of primary school each year worldwide, and the
      highest number of dropouts are in the first and second grade. A proven strategy to reduce
      dropout from primary school is participation in early childhood care and education (ECCE)
      services that bolster young children's health, development and readiness for school. Access
      to quality ECCE services remains highly limited in Pakistan: less than 50% of four-year-olds
      are estimated to attend ECCE services, and skilled ECCE workers remain scarce.

      To address these challenges, LEAPS (Youth Leaders for Early Childhood Assuring Children are
      Prepared for School) was developed as a cross-generational strategy to support the learning
      and development of young children (3.5- to 5.5-year-olds) and female youth (18- to
      24-year-olds). The program provides vocational training to female youth, referred to as
      Community Youth Leaders (CYLs), to deliver a community-based preschool program in rural
      Sindh, Pakistan. The LEAPS program was previously developed in partnership with Pakistan's
      National Commission for Human Development (NCHD), a government entity charged with supporting
      community health, education, and vocational training programs. Efficacy and feasibility of
      the LEAPS strategy were demonstrated through a prior pilot evaluated in a cluster-randomized
      controlled trial in 2015 (NCT02645162).

      The NCHD is now seeking to integrate the LEAPS program within their full suite of services
      and to scale the program across 99 villages in rural Sindh under the technical guidance and
      support of a local implementation support team led by the Aga Khan University. This
      intervention utilizes two strategies: i) the first is the implementation of the LEAPS
      program, led by NCHD; and ii) the second is the technical support of the NCHD, to ensure the
      system is able to support program expansion and sustainability.

      This study uses a cluster-randomized stepped-wedge design with three steps to assess program
      impact on school readiness and child and youth development outcomes across the 99 villages
      ("clusters"). All clusters will begin in the control state (i.e. access to standard community
      services). Prior to the start of the trial, clusters will be randomized to 'cross-over' to
      the intervention state (i.e. introduction of the LEAPS-NCHD program) during one of three
      sequential steps. Each step will be approximately 9-11 months. By the end of the trial, all
      clusters will have been exposed to the intervention. Measurement is assessed across all
      clusters at each step. The total duration of the trial will be 31 months. A process
      evaluation will also be conducted to examine the large-scale implementation of the LEAPS-NCHD
      Program.
    


Intervention name(s): LEAPS-NCHD Program
Intervention type(s): Behavioral
Intervention description(s): The LEAPS-NCHD program trains young women aged 18 - 24 years with a minimum of 10 years of basic education to be preschool teachers, or Community Youth Leaders (CYLs) in community-based preschools in rural Sindh. CYLs will receive two weeks of classroom-based basic-training and 6 months of on-the-job coaching and support. A maximum of 20 children aged 3.5 -5 years old will be enrolled in each preschool. One preschool will be opened per cluster (village). Children will receive a minimum of 6 months of program exposure between assessment rounds.
Allocation: Randomized
Intervention model: Crossover Assignment
Intervention model description: This study uses a cluster-randomized stepped-wedge design with three steps to evaluate the impact of LEAPS-NCHD program. Ninety-nine clusters (villages) are enrolled. Thirty-three clusters per step are randomly selected to cross-over from receipt of standard services (comparison) to receipt of the LEAPS-NCHD program (intervention). Unit of randomization is at the village (cluster) level. A process evaluation will assess program rollout for fidelity, adherence, quality, and cost.
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: Early Child Development; School Readiness; Early Childhood Education; Youth Development