Post jamaica

I am on my way back from Kingston, Jamaica, where the conference Early Childhood Development in the Caribbean took place on Thursday, November 14. The aim of the conference was to share recent findings of three studies by the IDB and distinguished researchers and stalwarts from the University of the West Indies (UWI).  The press and TV cover the event very widely as not only Jamaica but almost all Caribbean countries were represented in the event! We were also honored by the presence of Ingrid Bouterse-Waldring, the First Lady of Suriname, who is the Chairperson of the Suriname Early Childhood Development (ECD) Committee. The nice coincidence is that the day after, on November 15th, the Early childhood Commission (ECC) celebrated its 10 year anniversary  showing that Jamaica is a place for the rest of the world to look at to learn about long-lasting ECD policies and programs

The first study, presented by Prof. Susan Walker, showed some fascinating findings, there may be both intergenerational effects of stunting on development and also possible benefits from ECD interventions to parenting of the next generation.

Using as a basis the famous “Jamaica study”, a randomized controlled trial of nutritional supplementation and psychosocial stimulation given to stunted children for 2 years, researchers first compared children whose parents were stunted and non-stunted as children and, second, children whose parents received psychosocial stimulation in early childhood with those who did not. After adjusting for maternal characteristics and socioeconomic status, the children of the stunted no stimulation group had significantly lower overall development than children of non-stunted parents. Quality of the home environment in terms of responsive parenting and opportunities to learn was highest in children whose parents had received psychosocial stimulation in early childhood.

Prof. Maureen Samms Vaughan presented the second study, a UWI – Ministry of Health collaboration called the JAKIDS project. Its objective is to identify risk factors associated with poor maternal and perinatal outcomes. The new JAKIDS birth cohort started in 2011 contributes to our understanding of various factors (environmental, genetic, psychological and social) that may impact pregnancy outcomes, the quality of parenting, and the subsequent health, development and behavior of children. The two main findings of the study reveal that there are clear differences in development by gender (particularly in motor development) as well as how parents react to these differences in development; and that time parents spend with their children really matter for development.

These two studies had one common and intriguing finding that motivates the title of this post: boys are not being treated very nicely by their mothers and caregivers. The latter is a conclusion reached both in terms of absolute indicators (measured by the number of optimal positive/negative interactions) as well as in relation to girls.  In the first study, the HOME score (an index of good parenting practices) tended to be greater for girls than boys, even after adjusting for mothers vocabulary, occupation and SES score.

The second study showed a different measure of the quality of the home environment: boys had more negative interactions with parents (slapped and threatened more) than girls.  Given that boys are more vulnerable in early life than girls, particularly during the prenatal period, this finding is particularly worrisome. Caribbean boy’s large disadvantages in school achievement should not be a surprise given these findings. More importantly, interventions may have benefits for all children, but greatest benefits might be for those at most disadvantage, like boys in this case.

The last study, presented by Dr. Susan Chang-Lopez and Dr. Christine Powell showed a very hopeful finding.  A series of short videos were developed with different messages on playing and responsive interactions. They were shown in health clinic televisions while mothers and fathers waited for their appointments with the nurse. The results showed that it was possible to use health centers in Jamaica, Antigua and St. Lucia to significantly improve children’s cognition without increasing staff in the center or the time spent there. This could potentially be a very low cost yet effective solution. And indeed some Caribbean countries are seriously considering rolling out this model.

We closed the meeting with one common thought in the panel and the audience:  these studies will inform the agendas of reforms and the design of cost effective interventions not only in the Caribbean but elsewhere in Latin America.

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