Home visits supporting responsive caregiving and early child development. Multiple structured visits building caregiver knowledge, observable teaching behavior, and child autonomy.
Each visit is a structured caregiver coaching session. Frontline Workers guide parents through responsive interaction, model talk-and-play activities, discuss developmental milestones, and practice teaching behaviors with the caregiver. The intervention targets knowledge and observable behavior.
Structured guidance on noticing and responding warmly to a child’s cues. Workers use scenario-based coaching to build the habit of responsiveness across feeding, play, and daily routines, not just during the visit itself.
Language-rich interaction and age-appropriate play activities for cognitive and language development. Workers model activities with available household materials, no kit required, and coach caregivers to continue between visits.
Knowledge building on what children are developmentally capable of at each age, and what caregiver behavior supports progression. Caregiver knowledge of rapid development timing improved 33% in the Malawi pilot.
Observed teaching behavior improved 21% in the Malawi pilot. Workers do not just explain. They watch caregivers practice, give feedback, and code the quality of what they see using a structured visit checklist.
Supporting children’s exploration and independent problem-solving. This is the hardest sub-domain because it requires pattern-based behavior change across multiple interactions, not a single coaching session.
An in-app AI coach built on Dimagi’s Open Chat Studio platform reinforces learning between visits. The coach runs daily: presenting practice scenarios, identifying knowledge gaps, and drilling motivational interviewing techniques like open-ended questions and reflective listening. At the end of each day it asks about how visits went and provides tailored feedback grounded in real experiences.
ECD is the program that most challenged our assumptions about what intervention design needs to target. A few of the published findings:
A 50-caregiver baseline showed near-universal endorsement of responsive caregiving. Attitudes weren’t the gap. Knowledge and observed teaching practice were, and that’s where we saw movement. We doubled the visit cadence in the next round.
Workers who passed our digital test still struggled with nuanced in-home counseling. No single layer of training was sufficient. This improved with 78% of workers scoring above 80% during their first observed visits. Average performance increased from 85% to 91% in the second observed visit.
Autonomy encouragement requires consistent behavior change across many interactions, not a single coaching session. It’s the sub-domain least moved by the current visit structure. We aim to expand from 3 to 8-10 visits per child specifically to give this target more runway. We don’t know yet if it will be enough.
Let’s build a program together, starting with your target geography, age group, and budget. We’ll come back with a delivery plan, a cost-per-child estimate, and a partner list.
Let’s Design Your Program