An observational study in Cognitive Change, Growth; Stunting, Nutritional and Language, sponsored by Boston College. Completed at 3 sites in Rwanda. Open to participants aged 3 Months and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-08-06.
Sponsored by Boston College · Observational
The Early Childhood version of Sugira Muryango is a family-based, home-visiting intervention targeted at early childhood development and implemented with families living in extreme poverty in three districts of Rwanda. This version of Sugira Muryango was first tested in two small pilot studies and a large cluster randomized trial (CRT) was implemented between February 2018 and September 2019 . Pre- to post-intervention findings demonstrated that Sugira Muryango led to improvements in caregiver behaviors linked to child development and health as well as reductions in violence, which were sustained 12 months after the intervention, at which time improvements in child development were observed.
The Research Program on Children and Adversity in the Boston College School of Social Work is led by Dr. Theresa S. Betancourt and will, in partnership with the University of Rwanda, FXB-Rwanda and Laterite, conduct a longitudinal follow-up study to investigate the longer-term outcomes of the Sugira Muryango intervention in families who participated in the CRT. The four-year follow-up will examine the long-term and sustained outcomes of the intervention. In particular, the investigators will look at key indicators of long-term positive outcomes for children such as school readiness and transition to formal schooling. Given the lack of longitudinal research on intervention programs supporting ECD in sub-Saharan Africa, this study will contribute greatly to the body of knowledge on the costs and benefits of investments in ECD and guide policy makers and government leaders on making impactful investments in children, leading to long-term benefits for the population at large.
The follow-up study involves two activities:
Activity A: Pilot to assess measures performance of newly added measures and field test study protocols.
Activity B: Four-year follow-up of families who participated in the CRT of the Sugira Muryango intervention.
The aim of the study is to assess the impacts of Sugira Muryango on treated families compared to families receiving only usual care (controls) four years after the intervention. Moreover, at this visit, the investigators will also for the first time examine potential spillover effects of Sugira Muryango onto siblings of children enrolled in the original study. The longitudinal follow-up study will assess whether and to what extent Sugira Muryango has an impact on caregivers' awareness and utilization of available services; support for children's education and playful learning; home hygiene; parenting practices, including child feeding/nutrition, stimulation and sensitive care; experiences of intimate partner violence; use of harsh discipline; mental health, including depression and alcohol use; gender attitudes; and overall wellbeing. It will also assess whether and to what extent Sugira Muryango has an impact on children's physical development; cognitive and linguistic development; temperament; enrollment in early or formal education; school readiness, including self-regulation and early literacy and numeracy; mental health, including internalizing and externalizing and depression; behavior, including conduct problems; and gender attitudes. Finally, the study will assess potential covariates such as the impact of the COVID-19 pandemic and associated lockdowns, child disability, and household size and composition.
The specific objectives are:
To assess the long-term (4 years post-intervention) impact of Sugira Muryango on caregiver behaviors, attitudes, mental health and wellbeing, especially as related to parenting and intimate partner violence.
To assess the long-term (4 years post-intervention) impact of Sugira Muryango on previously enrolled children's physical and cognitive development and health.
To assess the long-term (4 years post-intervention) impact of Sugira Muryango on previously enrolled children's behavior, mental health, school readiness and gender attitudes.
To assess the long-term (4 years post-intervention) impact of Sugira Muryango on younger and older siblings of children enrolled in the intervention, including on their physical and cognitive development and health, and in the case of older siblings their school readiness, behavior and gender attitudes.
The following activities will be conducted during the proposed 4-year follow up study:
Activity A: Pilot to assess measures performance and field test study protocols.
Activity B: Four-year follow-up of families who participated in the Cluster Randomized Trial (CRT) of the Sugira Muryango intervention.
Our specific hypotheses are as follows:
Longitudinal Hypotheses
Sugira Muryango will have effects (superior when compared to usual care households) on a range of outcome domains, both new domains and those assessed in the prior CRT.
Spillover Hypothesis
Secondary exploratory analyses Analyses evaluating potential child and caregiver sex differences will be performed across all outcomes to examine differences in parenting behaviors and child outcomes as children get older and approach school age.
Study benefits and justification Potential societal benefits of the study include increased knowledge about evaluating ECD and parenting in Rwanda, increased knowledge of ECD in Rwanda, and increased knowledge regarding family-based ECD interventions to improve child development outcomes in low-resource settings. Intervening in early childhood has been demonstrated to be highly cost-effective for improving child development and life outcomes, yet interventions in low-resource settings-particularly in sub-Saharan Africa-are limited and not always well-evaluated or systematically implemented. At the individual level, families who participate in the study will receive free disability and behavioral screening for eligible children and will be connected with support services should a disability or other risk of harm be identified.
The key research question is whether Sugira Muryango provides lasting benefits to children in households that received the intervention. Little longitudinal research into home-visiting ECD interventions in this region exists; findings from the proposed research will add critical evidence to inform Rwanda's expansion of ECD support to families as well as learnings for other countries.
The study has been reviewed and approved by the Rwanda National Ethics Committee, the National Institute of Statistics of Rwanda, and the National Council for Science and Technology in Rwanda.
227 studies on the registry are indexed under Growth Disorders; 25 are open to participants now.
This study's enrollment of 2,932 is above the median of 231 across 78 observational studies indexed under Growth Disorders.
Browse Growth Disorders studies →Boston College is the lead sponsor of 38 studies on the registry; 7 are open to participants now.
Counted across the registry records on this site, refreshed daily.
The population consists of families who participated in the earlier CRT. Families for the CRT were randomly selected from government-provided lists of families who were eligible for the Vision Umurenge Program (VUP). Families' participation in the VUP and selection into one of two versions of the VUP program, namely classic public works (cPW) or expanded public works (ePW), was determined by governmental policies and was not under the control of the research team. Eligibility for VUP indicates that the family was in the poorest category under Rwanda's poverty categorization system (Ubudehe 1). Families were living in Ngoma, Nyanza or Rubavu district of Rwanda and had at least one child between the ages of 6-36 months.
Participated in the Sugira Muryango CRT in 2018-19 (Trial Registration Number NCT02510313).
Family inclusion criteria for the CRT were:
Further caregiver inclusion criteria were:
Inclusion criteria for younger siblings are:
Inclusion criteria for older siblings are:
Exclusion Criteria:
Other than not meeting inclusion criteria, specific family exclusion criteria for the CRT were:
Families in the treatment group received one welcome visit, 12 visits from a community-based volunteer trained in the Sugira Muryango intervention over 3-4 months, as well as booster visits at 3 and 6 months. The primary caregiver, secondary caregiver if applicable, and any children ages 6-36 months participated in the sessions. Other family members were welcome to join as available.
Usual childcare (no intervention)
"Home Observation Measurement of the Environment" infants/toddlers survey and early childhood survey
Observation of caregiver engagement and stimulation of children (younger siblings and CRT children)
Time frame: Through study completion (4 years)
"Ages & Stages Questionnaire - 3"
Caregiver report on child's development (younger siblings)
Time frame: Through study completion (4 years)
"Mullen Scale of Early Learning"
Observation of child's cognitive, motor, and linguistic development (younger siblings)
Time frame: Through study completion (4 years)
"Kaufman Assessment Battery for Children-2"
Observation of child's cognitive and linguistic development (CRT children and older siblings)
Time frame: Through study completion (4 years)
"Wechsler Preschool & Primary Scale of Intelligence"
Observation of child's cognitive and linguistic development
Time frame: Through study completion (4 years)
"International Development & Early Learning Assessment" stimulating care and play module
Caregiver report on playful parenting activities and childcare arrangement (for all children)
Time frame: Through study completion (4 years)
"Multiple Indicator Cluster Survey" child discipline module
Caregiver self-report of child discipline practices and behaviors (for all children)
Time frame: Through study completion (4 years)
Combined module based on "Multiple Indicator Cluster Survey" and "ISPCAN Child Abuse Screening Tool"
Child self-report of experiences of discipline and violence (older siblings)
Time frame: Through study completion (4 years)
DHS "Intimate Partner Violence" survey
Caregiver self-report on victimization and perpetration of intimate partner violence
Time frame: Through study completion (4 years)
"Child Behavior Checklist"
Caregiver report on child's internalizing and/or externalizing (CRT children and older siblings)
Time frame: Through study completion (4 years)
"Observation of Mother-Child Interactions"
Observation of caregiver's sensitive care (younger siblings)
Time frame: Through study completion (4 years)
"The Role of Play in Children's Learning"
Caregiver self-report on play for children's learning and development
Time frame: Through study completion (4 years)
"Parental Acceptance-Rejection Questionnaire"
Caregiver self-report of stimulating care and play
Time frame: Through study completion (4 years)
DHS/Promundo "Father Engagement & Financial Decision-Making" survey
Caregiver self-report of financial decision making and father engagement in the family
Time frame: Through study completion (4 years)
"Gender Equitable Men" scale
Caregiver self-report of views of gender and masculinity
Time frame: Through study completion (4 years)
"Multiple Indicator Cluster Survey (5)" WASH module
Caregiver self-report of home sanitation \& hygiene
Time frame: Through study completion (4 years)
World Health Organization "Infant and Young Child Feeding Practices" survey
Caregiver self-report of feeding practices
Time frame: Through study completion (4 years)
"Hopkins Symptom Checklist (25)"
Diagnostic tool for depression and anxiety in caregivers
Time frame: Through study completion (4 years)
"Enrollment in early education" survey
Caregiver report of child's enrollment in early education
Time frame: Through study completion (4 years)
"Child Enrollment in Formal Education" survey
Caregiver report of child's enrollment in formal education
Time frame: Through study completion (4 years)
"Service utilization" survey
Caregiver self-report on services utilized, e.g. government and non-governmental inputs and services
Time frame: Through study completion (4 years)
Anthropometric measures: height in centimeters
Measure of child height in centimeters (younger siblings and CRT children)
Time frame: Through study completion (4 years)
"Preschool Self-Regulation Assessment"
Caregiver report of child's self-regulation (CRT children)
Time frame: Through study completion (4 years)
"Infant Behavior Questionnaire"
Caregiver report of child's temperament (younger siblings)
Time frame: Through study completion (4 years)
"Early Childhood Behavior Questionnaire"
Caregiver report of child's temperament (younger siblings)
Time frame: Through study completion (4 years)
"Early Grade Reading Assessment"
Assessment of early literacy skills in children (older siblings)
Time frame: Through study completion (4 years)
"Center for Epidemiological Studies Depression Scale"
Diagnostic tool for depression in children (older siblings)
Time frame: Through study completion (4 years)
"Gender Equitable Men" scale
Child self-report of views of gender and masculinity (older siblings)
Time frame: Through study completion (4 years)
Anthropometric measures: weight in kilograms
Measure of child weight in kilograms (younger siblings and CRT children)
Time frame: Through study completion (4 years)
Anthropometric measures: standardized height-for-weight
Height and weight will be combined and the resulting scores standardized and reported as z-scores (younger siblings and CRT children)
Time frame: Through study completion (4 years)
Anthropometric measures: standardized height-for-age
Height and age will be combined and the resulting scores standardized and reported as z-scores (younger siblings and CRT children)
Time frame: Through study completion (4 years)
Anthropometric measures: middle upper arm circumference in centimeters
Measure of child circumference of middle upper arm in centimeters (younger siblings and CRT children)
Time frame: Through study completion (4 years)
"International Development & Early Learning Assessment" parent attitudes module
Caregiver self-report of attitudes towards children's education
Time frame: Through study completion (4 years)
"International Development & Early Learning Assessment" parent expectations module
Caregiver self-report of expectations towards children's education
Time frame: Through study completion (4 years)
Epstein survey
Caregiver self-report of support for children's education
Time frame: Through study completion (4 years)
World Health Organization "Alcohol Use Disorders Identification Test (AUDIT)"
Caregiver self-report of alcohol use and/or abuse
Time frame: Through study completion (4 years)
"Flourishing Scale"
Caregiver self-report on quality of life
Time frame: Through study completion (4 years)
"Gender Equitable Men" norms scale
Caregiver self-report of perceived norms related to gender and masculinity
Time frame: Through study completion (4 years)
"Youth Conduct Problems Scale - Rwanda"
Child self-report of conduct problems (older siblings)
Time frame: Through study completion (4 years)
PDFs hosted by the registry, ClinicalTrials.gov.
Plan to share: Undecided
Ran from Apr 2022 to primary completion in Jun 2022, 2 months.
Of 42 observational studies under Growth Disorders, half reached primary completion within 43 months of starting (the median), counting those still running; a quarter within 21 and three quarters within 55. This study's 2 months is below that.
How these figures are worked out, and which studies are left out of them.
This study is completed, as verified in Aug 2025. You cannot join it, but the record below documents what was studied.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
Boston College