Dost’s Journey into the Heart of UP - 2021

We at Dost have always believed in one simple mission - to turn every home into a nurturing place for a child to learn, develop and thrive. Our program prides itself on reaching parents across the vast technological divide present in the country. We make responsive caregiving accessible to parents across broad socio-economic backgrounds. Since 2017, with our simple phone-cast products, we have reached these caregivers without accessibility barriers like the internet, smartphones, or even digital literacy.

It is known that the last couple of years have been years of unprecedented adversities. In India, too, the pandemic struck fatal blows to countless families- thousands of people lost their loved ones, unemployment skyrocketed, and the economy shattered. The year also saw multiple nationwide lockdowns where everyone was restricted within their homes and schools, and Anganwadi Centers across the country were shut down. As a result, there came a vast learning gap for most children, the worst affected being families from marginalized and vulnerable communities.

At this critical juncture, we partnered with UNICEF to expand our program under the title ‘Dular’ in the biggest state of India, Uttar Pradesh. The program went live in two districts of UP- Chitrakoot and Banda- enabling thousands of new caregivers across these two districts to hear our phone call-based ECD program.

Here, we expand on the monitoring and assessment studies we undertook to understand the users and our program outcomes.

A. What do we know about these caregivers? (Demography)

We conducted various studies to gather demographic information about our users.

We conducted an in-person demographic survey on 100 users to understand their occupations, educational levels, family structures, phone access, etc. Through the survey, we noticed that most of our target households rely on farming (60%) and manual labor (20%) to earn their livelihoods. And owing to poor infrastructure, 60% of the primary caregivers surveyed had not studied beyond Class X, and 12% were illiterate. To understand the family structure of our beneficiaries, we also collected data on no. of children below the ages of six - 50% of the respondents have two or more children (with an average of 2 children per household) below six years. Furthermore, 65% of primary caregivers reported using the internet on phones. However, our on-field observations suggest that they are not active internet users and do not consistently access the internet on their phones.

Dular’s predominant target caregivers have always been the primary caregivers - those primarily responsible for caring for the child. We noticed that 80% of our respondents were mothers, the child's primary caregivers. All of them were homemakers. We also found that around 20% of these mothers did not have access to personal phones. Phones are usually present with the fathers, who often go out to work. Thus, mothers keen on listening to our content do not get to listen to our calls.

B. Methods of intervention

Throughout the year, we implemented different methods of intervention. Starting with simple field visits where we talked to a few caregivers to design specific quantitative and qualitative surveys over time. These studies helped us to connect with the caregivers and understand their progress in knowledge, mindset and behavior level changes. The variety in our methods ensured that we gained a comprehensive understanding of user journeys and their everyday experiences.

• Touch Tone Response Survey (TTR survey): Short tools administered at different points in the caregiver’s journey into the program- baseline, midline and endline- over phone calls to measure attitude and behavior. The users received pre-recorded questions and had to choose appropriate responses from the options.
  
• Prompts: Single and straightforward questions (quiz-like) accompany the core content messages to measure caregivers' outcomes and feedback. 25,746 users have received one or more prompts, with an encouraging participation rate.
  
• Phone survey: A pre-post mixed-method study was conducted with caregivers who registered for the pilot launched in Feb 2021. This allowed us to map overtime changes in caregivers' awareness and adoption levels. The post-quant survey was administered with 36 caregivers, given a dropout rate of 60% since the pre-survey.
  
• In-person survey: This was a separate tool administered in person with a stratified random sample of 100 caregivers across the two districts of Banda and Chitrakoot in December 2021. The survey focused on understanding parental knowledge, attitude, and behavior.  
  
• Observational study: We collected 40 videos of the parent interacting with their child using a picture book. The Anganwadi workers facilitated this.

C. Initial Awareness Levels (Baseline)

We analyzed the caregivers’ initial awareness, mindsets, and behaviors through pre-post methods. The initial focus of the study was to collect product feedback, which was later expanded to collect caregiver knowledge, mindset and behavioral level information also.

As most of the users were from remote and rural settings, we found out that there was already some evidence of free play - 70% agreed that children learned through play and reported that their children play with household items. However, when asked about ‘structured play’, around 40% of the caregivers (45% in Birth-3 yrs & 34% in 3-6 yrs) reported not playing with children regularly; 56% reported having no specific playtime or no playtime at all. One possible inference can be that these caregivers engage their children through household chores but no other recreations.

We also found evidence of caregivers in the Birth-3 yrs program who practiced but did not understand the importance of talk-touch-play - 20% reported not talking to their infant at all. Similarly, 33% were unsure if singing or talking to a very young child helps their development.

Additionally, we observed weak KAB (knowledge, attitude, and behavioral) evidence of caregivers in using Art for the child's learning and social-emotional development. 61% of caregivers (3-6 yrs) agreed that ‘creative activities are only good as a hobby’, and 46% of users agreed that ‘too much time spent on activities like drawing, singing, and dancing makes the child develop slowly.’

This conventional mentality was also seen around the socio-emotional aspects- 77% of caregivers agreed that children do not understand or get affected by parents fighting or using abuse. However, many caregivers (70% ) reported knowing of ‘such stress, which can affect the child's whole life’. While measuring Parental Impact, we realized that it is crucial to address parental stress. We saw an alarming 67% of caregivers reporting that most of their stress comes from being parents.

D. Our Findings across Methods

We employed subsequent phases of assessment once the caregivers had listened to most of our content to investigate if there were any significant and sustainable improvements in their knowledge, awareness, and adoption levels.

Through our methods, we found out that after listening to the calls, parents recognized the importance of the home environment in a child’s life - 65% of caregivers (vs. 14% in pre-study) agreed that the home environment is not just limited to caregiving, but is also conducive to learning. Furthermore, around 86% of caregivers reported that home environment could help the child to learn something new (see chart below for program-wise responses).

          Birth to Three Years                                                                Three to Six Years

% Caregivers who report that the household is adequate for the child to learn something new

*based on responses to in-built product quizzes - endline prompts

81% of the caregivers in the post-study (vs. 40% in pre) agreed that young children (birth-3 yrs) need parents to actively engage them through ‘talk, touch, and play’. In the qualitative survey, most caregivers reported becoming aware of the ‘home environment as the first place of learning’ and the ‘primary caregiver as their first teacher’.

We also observed positive behavioral shifts in parental management of tantrums post-intervention. Only 6% of caregivers by midline (vs. 47% in the baseline) reported to ‘always scolding/threatening the child when child gets stubborn.’

Further, we noticed a shift in perspective for art as a learning medium. In Qual Post-study, most caregivers reported that they saw value in their child practicing non-academic activities such as drawing, singing, and playing. Caregivers also linked art-based activities with brain development- one caregiver reported, “Trying out new things leads to mental development."

Overall, around 70% of caregivers, through multiple surveys, reported that they learned something new and helpful from the program. Parents (75%) also reported adopting these new learnings. A breakdown of themes mentioned by parents can be found in the chart below:

67% Caregivers reported knowledge that 0-6 yrs is when most of the development happens*

*Open-ended question asked in Endline via Phone interviews - 36 (as part of pre-post)

F. Parent Testimonials

1. A father of a 5 yr old from Chitrakoot UP says:

“I used to be busy with my work and hardly used to spend time with my child, but after listening to the ‘Dulaar Program’ I got to know the importance of spending time with my child. Now I ensure that I take some time out from my schedule daily to talk and play with my child. It has become a routine now”

2. A mother of a 2.5 years old child from Chitrakoot UP says:

“Parents can teach whatever they want to the child with the help of Dulaar activities like teaching through play, identifying relations, how to speak to people, and color identification. Additionally, how parents behave with their child is how the child turns out as an adult”.

The Way Forward

This year, we at Dost have started moving ahead of the parent-reported data. Through a well-established research method, we collected videos that are now going through observational analysis. We are also developing child-level indicators to understand the program’s impact on the caregiver’s children. After creating a special place in the hearts of Banda and Chitrakoot’s parents, Dulaar is all set to launch in 9 aspirational districts, enabling us to reach thousands of new caregivers. As you can see, while we have come a long way, we have only just begun.

‍