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An estimated 249 million children under the age of five in low-and-middle-income countries (LMICs) are at risk of not reaching their developmental potential, with the majority of them living in South Asia. Despite this, there is limited evidence of early childhood development (ECD) programs focused on parenting for 0-3 years children in urban areas of LMICs. This study aimed to deliver a parenting programme in combination with a social safety-net (unconditional cash transfer-UCT) initiative to enhance child development and mother’s well-being.

A cluster randomized controlled trial (cRCT) was implemented with 599 mother-child dyads (children aged 6-16 months) in the deprived urban settings of Rangpur City Corporation, Bangladesh, from 2018 to 2020. The parenting intervention was integrated into the Bangladesh Government’s UCT programme for a period of one year. The cRCT consisted of two arms: i) Parenting and nutrition education combined with UCT (n=299, clusters=10) and ii) UCT only (n=300, clusters=10). Intention-to-treat analysis was performed to assess the effects and the cost effectiveness of the intervention in the trial.

Baseline information from the cRCT in children (n=599) indicated that factors such as age, sex, stunting, and quality of home stimulation environment were common determinants of child development. Attrition rate was only 6.2% (n=37) after one year of intervention. Adjusted multiple linear regression analysis (n=562) controlling for clusters showed that the intervention improved children’s cognitive, language and motor development. However, there was no improvement in physical growth. The intervention also improved fathers’ engagement in child development activities and reduced household violence against mothers. Mothers’ knowledge of childcare and home stimulation environment were the positive mediators for child development. The study also found that the intervention reduced maternal depressive symptoms and improved quality of life (n=547). The incremental cost effectiveness analysis within trial arms confirmed that the intervention was cost-effective for children’s development. An additional US$100 expenditure for parenting intervention was estimated to improve 0.42 SD in cognition, 0.38 SD in language and 0.17 SD in motor development.

Parenting intervention using UCT platform can improve child development outcomes for disadvantaged children and enhance mother’s well-being. These interventions have the potential to be scaled up in similar urban settings within LMICs.