Final evaluation report : Lira District child survival project in Uganda

The project was implemented by Medical Teams International and the Lira District Health Office served a population of 124,379 and operated in Lira, Aromo and Ogur sub-counties of Lira District in Northern Uganda. The project used a two-pronged approach to improve the health and nutrition status of women and children under age five: (1) promoting behavior change and community mobilization to take appropriate responsibility for health; and (2)) building District Health Office (DHO) capacity to provide sustainable, quality service delivery at the facility and community levels. Educating health workers and caregivers about early childhood development (ECD) and simple actions they can take daily to support their infants was integrated as a key strategy. Quantitative data collected during the final survey showed a remarkable increase in key ECD indicators. After training in early childhood development, the percentage of mothers who played games which provided cognitive stimulation increased from 38% at baseline to 76% at final. The percentage of mothers who told a story, sang a song, or named objects for their child to encourage linguistic learning increased from 23% to 78% and the percentage of mothers who helped their child walk, massaged them, or played a game to challenge physical development increased from 63% to 84%. Also, integrating early childhood development with child survival interventions in Lira District led to improvements in parent-child relationships and has encouraged caregivers to spend greater and more meaningful time with children reading, singing, and playing games that encourage physical, cognitive and language development. Community members also report it has facilitated better relationships between spouses by helping parents better understand and interact with their children, which seems to be a contributing factor to reducing household violence. (Excerpts, modified)