In remote settings characterized by extreme poverty, poor access to health services, and high rates of HIV/AIDS, caregivers often struggle to provide adequate care, potentially hindering children's development. To address this issue, a study was conducted to test the effectiveness of a community-based child health and parenting intervention aimed at improving child HIV testing, health, and development in rural Lesotho. This matched cluster-randomised, controlled trial took place in the Mokhotlong district and involved 34 community clusters. These clusters were randomly assigned to either an intervention or wait-list control group. Participants included caregiver-child dyads, with children aged 12-60 months at baseline. The intervention comprised eight group sessions delivered at informal preschools, along with mobile health events offering HIV testing and other services. Primary outcomes measured were caregiver-reported child HIV testing, language development, and attention, with assessments conducted at baseline, immediately post-intervention, and 12 months post-intervention.
The study enrolled 1040 children (531 in the intervention group and 509 in the control group) and their caregivers. Results indicated that, compared to the control group, the intervention group had significantly higher rates of child HIV testing at the 12-month follow-up. Additionally, the intervention group showed significant improvement in child receptive language according to caregiver reports immediately post-intervention, although this effect was not sustained at the 12-month follow-up. No significant differences were found between groups for direct assessments of receptive language, expressive language, or attention. These findings suggest that integrated child health and parenting interventions, delivered by trained lay health workers, can effectively enhance child HIV testing and development in such challenging environments.
