Responsive Caregiving Intervention in Tanzania

Policy Context

Early childhood development (ECD) is recognized as one of the most important foundations of future economic productivity. However, across  low- and middle-income countries  an estimated 250 million children under five are at risk of not reaching their developmental potential due to poverty, undernutrition, and limited stimulation environments. In Tanzania, fewer than half of children aged 24–59 months are developmentally on track across learning, psychosocial wellbeing, and health domains.

Parenting programs that teach caregivers how to play, talk, and respond to young children can improve these outcomes, but Tanzania has few structured ways to deliver such support at the community level. Moreover, evidence on how responsive caregiving interventions should be designed, adapted, and operationalized within existing community systems remains limited. 

This pilot seeks to understand whether Community Health Workers (CHWs), who already visit rural households, can deliver a proven caregiving program (adapted from UNICEF’s Care for Child Development) as part of their routine work.

Study Design

The pilot runs in Mvomero District, Morogoro Region, over 12 months. It brings together first-time mothers, fathers, CHWs, and district health officials to co-design how the caregiving program should be delivered, including CHW visit frequency, training design, session duration, and father involvement. Focus groups, interviews, and a co-design workshop will surface what caregivers want from the program and what CHWs can realistically deliver alongside their existing responsibilities.

The study will evaluate several implementation outcomes (e.g acceptability, feasibility, implementation cost, and sustainability). Special attention will be paid to maternal time poverty, livelihood activities, cultural norms, transportation constraints, low father involvement, and excessive CHW workloads. 

This pilot will produce a delivery plan to test a future randomized evaluation, along with the recruitment, retention, and cost estimates needed to design that trial.

Results and Policy Lessons

Results forthcoming.