Many children in developing countries grow up in environments that lack stimulation, leading to deficiencies in early years of development. Several efficacy trials of early childhood care and education (ECCE) programmes have demonstrated potential to improve child development; evidence on whether these effects can be sustained once programmes are scaled is much more mixed. This study evaluates whether an ECCE programme shown to be effective in an efficacy trial maintains effectiveness when taken to scale by the Government of Ghana (GoG). The findings will provide critical evidence to the GoG on effectiveness of a programme it is investing in, as well as a blueprint for design and scale-up of ECCE programmes in other developing countries, which are expanding their investment in ECCE programmes.


Augsburg, Britta, Orazio Pedro Attanasio, Robert Dreibelbis, Edward Nketiah-Amponsah, Angus Phimister, Sharon Wolf, and Sonya Krutikova. 2022. "Lively Minds: improving health and development through play–a randomised controlled trial evaluation of a comprehensive ECCE programme at scale in Ghana." BMJ Journals 12 (10). http://dx.doi.org/10.1136/bmjopen-2022-061571.