Predicting child outcomes in Bhutan: Contributions of parenting support and early childhood education programmes

The Royal Government of Bhutan has increasingly emphasised Early Childhood Care and Development (ECCD). The Ministries of Education and Health provide services to support child development, including health care, Care for Child Development (C4CD) and centre-based ECCD programmes. C4CD is an evidence-based parenting programme for children younger than 36 months, while centre-based programmes are provided for children aged 3-5 years. This study examined the association of participation in C4CD and ECCD programmes with child development. A list of 54 randomly selected ECCD centres from nine districts in Bhutan was generated. We surveyed 232 parents of 3-5-year-olds from the 54 centres and another 245 parents from nearby areas whose 3-5-year-old children were not attending ECCD programmes. Parents reported on home-based activities and early childhood development. Controlling for sociodemographic variables, we found that both ECCD attendance and C4CD participation were positively associated with child developmental outcomes, particularly in the Learning and Psychosocial Well-being domains. Children who were attending ECCD programmes had higher developmental outcomes than non-attenders, and the gap between the two groups was greatest among older children. Parents who participated in C4CD provided more stimulating home learning environments than other parents, with most variability within home learning environments observed within subsample of parents whose children did not attend ECCD programmes. In addition, the frequency of home-based activities fully mediated the relationship between C4CD participation and child developmental outcomes. The findings support the scaling up of both ECCD and C4CD programmes.