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Epidemiological study of a developmentally and culturally sensitive preschool intervention to improve school readiness of children in Addis Ababa, Ethiopia
  1. Negussie Deyessa1,
  2. Simon Webb2,
  3. Eric Duku2,
  4. Ann Garland3,
  5. Irving Fish4,
  6. Magdalena Janus2,
  7. Menelik Desta5
  1. 1School of Public Health, Addis Ababa University, Addis Ababa, Oromia, Ethiopia
  2. 2Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
  3. 3School of Leadership and Education Sciences, University of San Diego, San Diego, California, USA
  4. 4Department of Neurology, New York University School of Medicine, New York, New York, USA
  5. 5School Readiness Initiative, Addis Ababa, Ethiopia
  1. Correspondence to Professor Magdalena Janus, Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada; janusm{at}


Background Early childhood is a dynamic period of physical, psychosocial and cognitive development, where age appropriate intervention during the preschool years influences psychosocial, behavioural and academic achievement of children. This study evaluated the impact of a comprehensive preschool intervention on psychosocial, cognitive and behavioural school preparedness among children in Addis Ababa, Ethiopia.

Methods Employing a cluster-sampling design, 150 preschool children who received the basic preschool curriculum (non-intervention) were compared with 100 randomly selected children who received a comprehensive preschool curriculum (intervention) using the Early Development Instrument (EDI) in five domains. Sample t-tests compared means of domain scores. Binary logistic regression analysed proportions of vulnerability in domains and overall.

Result There were no group differences in gender, age, special need status or child’s first language. Intervention children had higher domain scores on social competence (mean difference 0.67 (SE=0.26)), emotional maturity (mean difference 0.77 (SE=0.29)), language and cognitive development (mean difference 0.67 (SE=0.40)), communication and general knowledge (mean difference 0.82 (SE=0.34)). Accounting for confounding variables, intervention children had a lower chance of overall vulnerability to domain problems (adjusted OR (AOR)=0.38; 95% CI 0.13 to 1.15), language and cognitive development (AOR=0.21; 95% CI 0.03 to 1.64), and social competence (AOR=0.20; 95% CI 0.08 to 0.45).

Conclusion The comprehensive intervention was associated with better outcomes on early childhood development across four domains. It is recommended to extend this programme to other areas of Ethiopia, where children do not have appropriate school preparation, to reduce risk of school dropout, negative personal and societal outcomes.

  • child health
  • health inequalities
  • developing country

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  • Contributors ND, MD, AG and IF contributed to the study conception. ND, SW, ED and MJ and MD contributed to conceptualisation and design of the study and interpretation of the analyses. ND, SW and ED carried out the analyses. ND, SW and MJ drafted the manuscript. ED and MD contributed to critical revisions of the manuscript. All authors contributed to revisions of the final manuscript.

  • Funding The intervention was funded by the Ethiopian School Readiness Initiative, a registered non-profit organization functioning under the premises of New York University, and the ELMA Foundation, USA.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study received approval from the Research Ethics Review Board of the Medical Faculty at the Addis Ababa University and conformed to the principles embodied in the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. The terms of data availability will be negotiated with the funders.