Reach Up in Guatemala

ChildFund had a long-standing experience on implementing parenting programs in Guatemala in a group modality. In 2014, the Japanese Strategic Development Fund, approved support, through the World Bank, for ChildFund to implement the “Pilot to improve the Development and Nutrition of Young Children in Poor Rural Areas in Guatemala” (Nuestros Niños Sanos y Listos Project) in indigenous communities in Guatemala. This initiative sought to enhance child development in the country through evidence-based interventions that could be efficiently scaled up through national programs.

The design of the intervention was set up to shed light on knowledge gaps identified in the literature regarding delivery modalities (groups modality vs home visits) while incorporating the elements of successful interventions in its design. ChildFund’s extensive experience in implementing parenting programs for child stimulation in Guatemala, particularly in group settings, laid a solid foundation for their engagement with the World Bank on the project.

At that time, Professor Lia Fernald, from the School of Public Health, University of California, Berkeley was working with the World Bank to prepare an ECD measurement kit. Being aware of the work of Professor Susan Walker and the Child Development Research Group at the Caribbean Institute for Health Research Unit, at the University of the West Indies, she introduced Reach Up to the Child Fund team. The Reach Up team was invited to present the intervention and given the extensive evidence of improving child development for vulnerable children in a home visit modality, this curriculum was selected for the home visit modality of Nuestros Ninos Sanos y Listos. This strategic decision not only capitalized on existing evidence but also ensured the development of a model that could be scaled up in the context of Guatemala. Nuestros Niños Sanos y Listos was implemented in partnership with two NGOs – Cooperation for Western Rural Development (CDRO) and The Association of Integral Development Cooperation of Huehuetenango (ACODIHUE).  It reached 5,500 registered children during the project lifetime and was implemented in local languages.

The program continues through the Juega Conmigo (Come Play with Me project), part of the Growing with You program. After a remote phase, that also included the Reach Up curricula and reached about 19,000 registered children, now Juega Conmigo project continue promoting playful parenting through group sessions and home visits working with local partners: CDRO, ACODHUE and Asociación Renacimiento.

Country team

Luis Miguel Gutierrez

Partnership Portfolio Manager, Child Fund

Sandra Sandoval

Early Childhood Development Senior Advisor, ChildFund

Linda García Arena

Chief of Party, Juega Conmigo team, ChildFund

Lucy Bassett

Professor of Practice at University of Virginia Frank Batten School of Leadership and Public Policy

Julieta Trias

Senior Economist at the World Bank

Hugo Brousset Chaman

Social Protection Specialist at the World Bank

Irma Arteaga

Associate Professor, University of Missouri

Implementation partners

ChildFund is a global community of people who care about children and take action to help them live at their fullest potential at every stage of their lives. The Reach Up curriculum was initially selected by ChildFund for the home visit modality of the pilot project "To improve the development and nutrition of young children in poor rural areas of Guatemala (Nuestros Ninos Sanos y Listos project)".

Find out more

The World Bank Group is one of the world’s largest sources of funding and knowledge for developing countries. Its five institutions share a commitment to reducing poverty, increasing shared prosperity, and promoting sustainable development. The World Bank provided funding for the pilot project "To improve the development and nutrition of young children in poor rural areas of Guatemala (Nuestros Ninos Sanos y Listos project)" which used the Reach Up curriculum for the home visiting modality.

Find out more

The Japan Social Development Fund (JSDF) is a Partnership between the Government of Japan (GoJ) and the World Bank which provide grants to vulnerable groups in low- and lower-middle-income countries around the world. The JSDF approved support, through the World Bank, for ChildFund to implement the “Pilot to improve the Development and Nutrition of Young Children in Poor Rural Areas in Guatemala” (Nuestros Niños Sanos y Listos Project)

Find out more

Working to make societies stronger, The LEGO Foundation provides opportunities for children to learn through play. In 2019, the Foundation provided a grant for adaptation of the intervention to be delivered through a combination of group meetings and home visits.

Find out more

Communities we serve

The pilot Nuestros Niños Sanos y Listos was implemented in 100 communities in the Departments of Huehuetenango, Quiché, San Marcos and Totonicapán between 2016 and 2019, reaching 5,500 children. In 2019, through a grant from the LEGO Foundation, the intervention was adapted to be delivered through a combination of group meeting and home visits, in line with the impacts obtained from Nuestros Niños Sanos y Listos.

The Nuestros Niños Sanos y Listos project continued through the Juega Conmigo (Come Play with Me project). However, in 2020, the Juega Conmigo project was suspended during COVID-19. A remote approach was established to continue the engagement through radio and digital means with funding from The LEGO Foundation. In addition, the World Bank, through the Strategic Impact Evaluation Fund, supported a pilot to assess the impact of delivering phone audio messages on child stimulation based on the Reach Up curricula.

Departments of Huehuetenango, Quiché, San Marcos and Totonicapán

Departments of Quiché, Sololá, San Marcos, Totonicapán, Alta Verapaz and Chiquimula

Our Approach

The home delivery modality of the Nuestros Niños Sanos y Listos (NNSL) program, based on the Reach Up program, was implemented in 2017 and 2018. Local women from the communities – Madres Guías (mother guides) – were trained to deliver the intervention in the beneficiaries households.

The remote modality, was piloted in response to the COVID-19 pandemic, while the in-person program was suspended. Using technology (voice messages) parents were trained in early stimulation (based on Reach Up curricula adapted to Guatemala under the NNSL program). Beneficiaries were participating in Juega Conmigo project before the COVID-19 pandemic started. Due the success of the pilot, Juega Conmigo continued implementing a remote modality until 2023, through radio programs delivered by mobile speakers, local and community radio stations; also through short videos and key messages sent by SMS or WhatsApp. The contents, in Spanish, K’iche’, Mam, Kaqchikel and Q’eqchi’, were based on Reach Up curricula adapted to Guatemala, Accompany Me to Grow (Ministry of Education modality) and group sessions of ChildFund. During this remote phase, Juega Conmigo project reached around 19,000 children and their families. In July 2023, Juega Conmigo project resume the face to face activities, proposing group sessions and home visits (Reach Up curricula), this last ones targeting children with disabilities, malnutrition and/or adolescent mother. Through the whole modality, it aims to reach around 12,000 children and their families.

Key Stats

The home visits between August 2017 and December 2018 reached approximately 1,356 children, aged 0 – 36 months. Visits were conducted fortnightly and lasted one hour.

The pilot remote delivery lasted 3 months (September to November 2020) and reached 5,500 children (aged 6 – 36 months). Two messages (1-2 minutes in duration) were sent weekly (up to a total of 20 messages) to caregivers.

The continued remote delivery using radio spots, radio programs and short videos was delivered fortnightly, over a 24-month period (July to December 2020 and January 2020 to June 2023). This intervention reached approximately 19,000 children, aged 0 – 48 months.

Group sessions and home visits targeting children living in vulnerable situations began in July 2023 and will run up to December 2024. The program aims to reached 12,000 children aged 0 – 48 months.

Organisational Structure

Community managers and community volunteers (Madres Guías ) were trained to deliver the Nuestros Niños Sanos y Listos project. Community managers supervised the community volunteers.  Currently, it is the same structure of the Juega Conmio project. Coordinators, from local partners (NGOs), supervised the community managers and community volunteers.

Cultural Adaptations

The Reach Up methodology was adapted to the Guatemalan rural indigenous setting. The curricula were edited to incorporate illustrations depicting Mayan people, local songs and native animals. Toys were also recreated to emulate familiar objects made of local recycled materials. The guidelines were simplified and included more illustrations, rather than text so they could be more easily understood by Madres Guías with low education levels. The intervention was implemented in local indigenous languages and Spanish. All the survey instruments used for the impact evaluation were adapted and translated to two indigenous languages (K’iche and Mam) and Spanish. Adapting Reach Up to the Guatemala context introduce several innovations, first, it was the first time that Reach Up was adapted to indigenous populations, and, second, it was one of the few interventions that compared two delivery modalities within an experimental setting. The World Bank designed a rigorous impact evaluation to measure the impact of each delivery modality. The translation and cultural adaptations for the messages used in the remote modality in 2020 were done by Erika Dunkelberg, Consultant for IADB, World Bank, CAF, GRADE, UNICEF, OAS, Ministry of Education and the Ministry of Social Inclusion in Peru.

Outcomes

Impact on children:
• For the home visits we had impact on fine motor and language skills (MDAt Instrument).
• For the remote modality, we had impact only on language skills as measured by the McArthur.
Expressive and receptive language
Outcomes - Fine and gross motor skills
Impact on caregivers:
• In terms of parental practices, we had impact on HOME Cognitive Stimulation Scale and FCI overall Scale.
• In terms for parental practices, we had impact on the FCI - play activities.

Research & Publications

Arteaga, Irma and Julieta Trias (2023). Can technology narrow the early childhood stimulation gap in rural Guatemala? Results from an experimental approach. AEA RCT Registry. July 13. https://doi.org/10.1257/rct.5980-1.2.

García, Linda (2021). The radio is still alive! And it has helped foster children´s development during the pandemic. Primeros Pasos Child Development. https://blogs.iadb.org/desarrollo-infantil/en/radio-helped-foster-childrens-development-pandemic/

Sierra, Alejandro (2023). Summary of the results from the Knowledges, Attitudes and Practices (KAP) in radio programs. https://juega-conmigo.org/posts/summary-of-the-results-from-the-knowledges-attitudes-and-practices-kap-survey-cycle-4.

Trias, Julieta and Irma Arteaga (2024) “Home visitation or group intervention? Training parents on early stimulation in rural Guatemala” World Bank mimeo.