The Sugira Muryango Longitudinal & Spillover Study

NCT05405400 | Completed

• 1 other identifier: 22.198.01
• Study Type: observational
• Target: 2,932
• Locations: 1 country
• Sites: 3

Brief Summary

The Early Childhood version of Sugira Muryango is a family-based, home-visiting intervention targeted at early childhood development and implemented with families living in extreme poverty in three districts of Rwanda. This version of Sugira Muryango was first tested in two small pilot studies and a large cluster randomized trial (CRT) was implemented between February 2018 and September 2019 . Pre- to post-intervention findings demonstrated that Sugira Muryango led to improvements in caregiver behaviors linked to child development and health as well as reductions in violence, which were sustained 12 months after the intervention, at which time improvements in child development were observed. The Research Program on Children and Adversity in the Boston College School of Social Work is led by Dr. Theresa S. Betancourt and will, in partnership with the University of Rwanda, FXB-Rwanda and Laterite, conduct a longitudinal follow-up study to investigate the longer-term outcomes of the Sugira Muryango intervention in families who participated in the CRT. The four-year follow-up will examine the long-term and sustained outcomes of the intervention. In particular, the investigators will look at key indicators of long-term positive outcomes for children such as school readiness and transition to formal schooling. Given the lack of longitudinal research on intervention programs supporting ECD in sub-Saharan Africa, this study will contribute greatly to the body of knowledge on the costs and benefits of investments in ECD and guide policy makers and government leaders on making impactful investments in children, leading to long-term benefits for the population at large. The follow-up study involves two activities: Activity A: Pilot to assess measures performance of newly added measures and field test study protocols. Activity B: Four-year follow-up of families who participated in the CRT of the Sugira Muryango intervention.

Conditions

Cognitive Change; Growth; Stunting, Nutritional; Language; Depression; Behavior; Violence; Parenting

Keywords

Early childhood development; Intimate partner violence; Rwanda; Intervention; Longitudinal

Outcome Measures

Primary Outcomes (10)

• "Home Observation Measurement of the Environment" infants/toddlers survey and early childhood survey

  Observation of caregiver engagement and stimulation of children (younger siblings and CRT children)

  Through study completion (4 years)

• "Ages & Stages Questionnaire - 3"

  Caregiver report on child's development (younger siblings)

  Through study completion (4 years)

• "Mullen Scale of Early Learning"

  Observation of child's cognitive, motor, and linguistic development (younger siblings)

  Through study completion (4 years)

• "Kaufman Assessment Battery for Children-2"

  Observation of child's cognitive and linguistic development (CRT children and older siblings)

  Through study completion (4 years)

• "Wechsler Preschool & Primary Scale of Intelligence"

  Observation of child's cognitive and linguistic development

  Through study completion (4 years)

• "International Development & Early Learning Assessment" stimulating care and play module

  Caregiver report on playful parenting activities and childcare arrangement (for all children)

  Through study completion (4 years)

• "Multiple Indicator Cluster Survey" child discipline module

  Caregiver self-report of child discipline practices and behaviors (for all children)

  Through study completion (4 years)

• Combined module based on "Multiple Indicator Cluster Survey" and "ISPCAN Child Abuse Screening Tool"

  Child self-report of experiences of discipline and violence (older siblings)

  Through study completion (4 years)

• DHS "Intimate Partner Violence" survey

  Caregiver self-report on victimization and perpetration of intimate partner violence

  Through study completion (4 years)

• "Child Behavior Checklist"

  Caregiver report on child's internalizing and/or externalizing (CRT children and older siblings)

  Through study completion (4 years)

Secondary Outcomes (22)

• "Observation of Mother-Child Interactions"

  Through study completion (4 years)

• "The Role of Play in Children's Learning"

  Through study completion (4 years)

• "Parental Acceptance-Rejection Questionnaire"

  Through study completion (4 years)

• DHS/Promundo "Father Engagement & Financial Decision-Making" survey

  Through study completion (4 years)

• "Gender Equitable Men" scale

  Through study completion (4 years)

Other Outcomes (7)

• "International Development & Early Learning Assessment" parent attitudes module

  Through study completion (4 years)

• "International Development & Early Learning Assessment" parent expectations module

  Through study completion (4 years)

• Epstein survey

  Through study completion (4 years)

Study Arms (2)

Treatment group

Families in the treatment group received one welcome visit, 12 visits from a community-based volunteer trained in the Sugira Muryango intervention over 3-4 months, as well as booster visits at 3 and 6 months. The primary caregiver, secondary caregiver if applicable, and any children ages 6-36 months participated in the sessions. Other family members were welcome to join as available.

Control group

Usual childcare (no intervention)

Eligibility Criteria

• Age: 3 Months+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

The population consists of families who participated in the earlier CRT. Families for the CRT were randomly selected from government-provided lists of families who were eligible for the Vision Umurenge Program (VUP). Families' participation in the VUP and selection into one of two versions of the VUP program, namely classic public works (cPW) or expanded public works (ePW), was determined by governmental policies and was not under the control of the research team. Eligibility for VUP indicates that the family was in the poorest category under Rwanda's poverty categorization system (Ubudehe 1). Families were living in Ngoma, Nyanza or Rubavu district of Rwanda and had at least one child between the ages of 6-36 months.

You may qualify if:

• living in the Rubavu, Ngoma or Nyanza District of Rwanda
• being VUP-eligible (according to the Rwandan government)
• having at least one child aged 6-36 months living in the home
• having at least one caregiver who was willing to discuss and enhance their caregiving practices by interacting with a home-visiting coach (a community-based volunteer or CBV).
• was aged 18 or older and cared for child(ren)
• having participated in the prior CRT
• living in Ngoma, Nyanza, or Rubavu districts
• having at least one child who participated in the CRT and who is currently living in the household.
• aged 3 months or older
• was not eligible to participate in the original CRT due to age (below 6 months or not yet born at the time of CRT).
• aged 12 years or younger
• lived in the household but was not eligible to participate in the original CRT due to age (above 36 months at the time of CRT)
• currently lives in the household that participated in the CRT.

You may not qualify if:

• caregiver(s) having severe cognitive impairments which precluded their ability to speak to the research questions under study
• families or caregivers being in the midst of crisis (e.g., a caregiver(s) with active suicidal attempts or psychosis). Families with ongoing crises or disabilities were excluded from the study and were referred to appropriate services.
• Siblings will be excluded from sampling for the spillover study if the primary caregiver has been away from the household for six months or more.

Sponsors & Collaborators

• Boston College: lead
• University of Rwanda: collaborator
• FXB-Rwanda: collaborator
• LEGO Foundation: collaborator
• The ELMA Foundation: collaborator
• Echidna Giving: collaborator
• Wellspring Philanthropic Fund: collaborator
• United States Agency for International Development (USAID): collaborator

Study Sites (3)

Homes and community buildings

Ngoma, Rwanda

Location

Homes and community buildings

Nyanza, Rwanda

Location

Homes and community buildings

Rubavu, Rwanda

Location

Related Publications (5)

• Barnhart, D. A., Farrar, J., Murray, S. M., Brennan, R. T., Antonaccio, C., Sezibera, V., Ingabire, C., Godfroid, K., Bazubagira, S., Uwimana, O., Kamurase, A., Yousafzai, A., Betancourt, T. (2020). Lay-worker delivered home promotes early childhood development and reduces violence in Rwanda; a randomized pilot. Journal of Child and Family Studies; 29, 1804-1817. https://doi.org/10.1007/s10826-020-01709-1

  BACKGROUND

• Betancourt, T. S., Franchett, E., Kirk, C. M., Brennan, R. T., Rawlings, L., Wilson, B., ... & Ukundineza, C. (2018). Integrating social protection and early childhood development: open trial of a family home-visiting intervention, Sugira Muryango. Early Child Development and Care; 190(2), 219-235.

  BACKGROUND

• Betancourt TS, Jensen SKG, Barnhart DA, Brennan RT, Murray SM, Yousafzai AK, Farrar J, Godfroid K, Bazubagira SM, Rawlings LB, Wilson B, Sezibera V, Kamurase A. Promoting parent-child relationships and preventing violence via home-visiting: a pre-post cluster randomised trial among Rwandan families linked to social protection programmes. BMC Public Health. 2020 May 6;20(1):621. doi: 10.1186/s12889-020-08693-7.

  PMID: 32375840 BACKGROUND

• Britto PR, Lye SJ, Proulx K, Yousafzai AK, Matthews SG, Vaivada T, Perez-Escamilla R, Rao N, Ip P, Fernald LCH, MacMillan H, Hanson M, Wachs TD, Yao H, Yoshikawa H, Cerezo A, Leckman JF, Bhutta ZA; Early Childhood Development Interventions Review Group, for the Lancet Early Childhood Development Series Steering Committee. Nurturing care: promoting early childhood development. Lancet. 2017 Jan 7;389(10064):91-102. doi: 10.1016/S0140-6736(16)31390-3. Epub 2016 Oct 4.

  PMID: 27717615 BACKGROUND

• Jensen SK, Placencio-Castro M, Murray SM, Brennan RT, Goshev S, Farrar J, Yousafzai A, Rawlings LB, Wilson B, Habyarimana E, Sezibera V, Betancourt TS. Effect of a home-visiting parenting program to promote early childhood development and prevent violence: a cluster-randomized trial in Rwanda. BMJ Glob Health. 2021 Jan;6(1):e003508. doi: 10.1136/bmjgh-2020-003508.

  PMID: 33514591 BACKGROUND

MeSH Terms

Conditions

Growth Disorders; Language; Depression; Behavior

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms; Communication; Behavioral Symptoms

Study Officials

• Theresa S Betancourt, ScD, MA

  Boston College

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Salem Professor in Global Practice

Study Record Dates

• First Submitted: May 27, 2022
• First Posted: June 6, 2022
• Study Start: April 20, 2022
• Primary Completion: June 30, 2022
• Study Completion: December 31, 2022
• Last Updated: August 6, 2025

Record last verified: 2025-08

Locations

RW (3)