Researchers in rural India tested a program called Stepping Stones that helps parents learn better ways to care for their young children. The program worked with local communities, using their own people as teachers and involving families in planning activities. When children were two years old, those who participated in the program showed better development in thinking, movement, and language skills compared to children who didn’t participate. The program was especially helpful for the poorest families. This shows that when programs are built with communities rather than just given to them, they work better and can help more children grow up healthy and smart.

The Quick Take

  • What they studied: Does a parenting and nutrition program that involves the whole community help young children develop better thinking, movement, and language skills?
  • Who participated: 656 pregnant women and their babies in 106 villages in rural India, followed from pregnancy until the child turned 2 years old. Some families got the new program, while others received regular government services.
  • Key finding: Children whose families participated in the community-based program showed significantly better development across all areas (thinking, movement, and language) by age 2. The poorest families saw the biggest improvements, with thinking skills improving by about 92% more than the control group.
  • What it means for you: Community-based programs that involve local people and respect local ways of doing things may be more effective at helping children develop. This approach could work in other poor communities, but results may vary based on local conditions and how well the program is run.

The Research Details

Researchers conducted a study in 106 villages across two rural areas in Maharashtra, India. They divided the villages into two groups: one group received the new Stepping Stones program, and the other group received only the standard government services. This is called a “cluster-randomized controlled trial,” which is one of the strongest ways to test if a program actually works. The study followed 656 pregnant women and their babies from pregnancy until the child turned 2 years old, measuring how well the children developed at that point.

The Stepping Stones program was different from typical top-down programs because it was built with the community, not just given to them. Local female volunteers called Balsakhis were trained to lead sessions. The program used creative methods like “Photostory” (using pictures to start conversations) to get families interested and involved. Communities helped plan what the program would teach, and a special Community Engagement Board made sure the program stayed connected to what families actually needed.

The researchers tracked how many people participated, how often they came, and how well the program worked. They also measured children’s development in three areas: cognitive skills (thinking and learning), motor skills (movement and coordination), and language skills (talking and understanding words).

This research approach is important because it shows what happens when you actually involve communities in designing and running health programs, rather than just telling them what to do. By using local volunteers and listening to what families needed, the program became something the community owned and believed in. This makes it more likely to work well and to keep working even after researchers leave. The study also looked at whether the program helped the poorest families most, which is important for making sure health improvements reach everyone, not just wealthy people.

This study is strong because it used a randomized controlled trial design, which is considered the gold standard for testing whether programs work. The researchers followed a large number of families (656) over two years, which gives reliable results. They measured actual child development using standardized tests, not just asking parents if they thought their children improved. The program achieved high participation rates (85% of households participated in at least one activity), which means the results reflect what actually happens when people use the program. The researchers also tracked how the program was actually delivered and made changes as needed, which is realistic and important. However, the study was done in one specific region of India, so results might be different in other places with different cultures and resources.

What the Results Show

Children in the intervention group (those whose families participated in Stepping Stones) showed significantly better development compared to children in the control group across all three areas measured: thinking skills, movement skills, and language skills. This means the program actually worked to help children develop better.

The most impressive results came from the poorest families. Children from families in the lowest wealth group showed the biggest improvements in thinking skills (92% better than control group), movement skills (72% better), and language skills (79% better). This is really important because it shows the program helped the families who needed help the most.

The program also changed how fathers were involved in childcare. At the start, only 4.3% of fathers participated in caregiving sessions. By the end, this jumped to 33.65%. This is significant because fathers’ involvement in early childhood is linked to better child development.

Local female volunteers called Balsakhis delivered over 80% of the program sessions on their own, showing that the program could be run by community members without constant outside help. This suggests the program could be sustainable and spread to other communities.

The program successfully integrated with existing government services (called Anganwadi services), meaning it worked alongside what was already in place rather than replacing it. This is important because it shows new programs can fit into existing systems. The Community Engagement Board and Curriculum Development Committees made sure the program stayed responsive to what families actually needed and could adapt when things weren’t working. The high participation rate (85% of households) and regular attendance (70% regularly attending sessions) shows that when communities are involved in planning, they’re more likely to actually participate.

This research builds on previous studies showing that involving communities in health programs makes them more effective. It adds new evidence that this approach works specifically for early childhood development in very poor, rural areas. The finding that the poorest families benefited most is important because many programs accidentally help wealthy families more. This study shows that community-based approaches can actually reduce this gap. The results support what other researchers have found: that programs designed with communities, not for them, tend to work better and last longer.

The study was conducted in one specific region of rural India, so the results might not be exactly the same in other countries or even other parts of India with different cultures and resources. The researchers didn’t compare this program to other parenting programs, so we don’t know if this approach is better than other methods. The study measured children at age 2, but we don’t know if the benefits continue as children get older. Some families may have dropped out of the study, which could affect the results. The study didn’t measure whether the program was cost-effective, so we don’t know if the benefits are worth the money spent. Finally, because this was a real-world program (not a laboratory study), many things could have affected the results besides the program itself.

The Bottom Line

If you’re working in a rural or low-resource community and want to help young children develop better, consider using a community-based approach where local people help plan and deliver the program. This approach appears to be more effective than just providing standard services. Make sure to involve fathers and other family members, not just mothers. Use local volunteers to deliver most of the program, with training and support. Try to work with existing government services rather than creating something completely new. Confidence level: Moderate to High for rural communities similar to where this study was done; Lower for very different settings.

This research is most relevant for: government health workers and NGOs working in rural areas; parents and families in low-resource communities wanting to help their children develop; policymakers deciding how to improve early childhood services; and communities that want to take ownership of health programs. This research is less directly applicable to wealthy urban areas with different resources and services, though some principles might still help. Healthcare providers in wealthy countries can learn from the community engagement approach even if the specific program doesn’t apply to their setting.

The study measured results at 24 months (2 years), so you would expect to see meaningful improvements in child development by age 2 if the program is well-implemented. However, some benefits might appear earlier (within 6-12 months), while other improvements might take the full 2 years. Changes in father involvement appeared to happen relatively quickly (within the program period). The program needs to be consistent and ongoing to maintain benefits; stopping the program might mean children lose some advantages over time.

Want to Apply This Research?

  • Track weekly attendance at parenting sessions and monthly assessments of child development milestones (first words, sitting up, grasping objects, etc.) using a simple checklist. Record which family members attended each session to monitor father and extended family involvement.
  • Users can set weekly reminders to attend community parenting sessions, log which activities they did with their child that week, and share photos or notes about their child’s new skills with the app community. The app could send tips for practicing skills at home between sessions.
  • Create a long-term tracking dashboard showing child development progress across thinking, movement, and language skills over months. Allow users to compare their child’s progress to typical development milestones. Send monthly summaries of attendance and participation to help families stay engaged and motivated.

This research describes a specific program tested in rural India and should not be considered medical advice. While the findings are promising, results may vary in different communities and settings. Parents should consult with their pediatrician or local health worker before making changes to their child’s care. This program was designed to work alongside standard government services, not replace medical care. If you have concerns about your child’s development, speak with a qualified healthcare provider. The study measured outcomes at 2 years old; long-term effects beyond this age are not known from this research.