Early Childhood Human Capital Formation at-scale: Long-term Follow-up

We propose a 10-year follow-up of a large-scale cluster-randomized trial of a low- cost home-visiting intervention – providing materials and counseling – integrated into Bangladesh’s pre-existing nutrition program (JPubE 2024). Community health workers delivered the intervention to over 18,000 children aged 3–18 months in three of Bangladesh’s seven divisions. First follow-up surveys (then end-line) conducted 1–3 months after a 15- month intervention demonstrated significant improvements in cognitive skills (0.17 SD), language skills (0.23 SD; measured using Bayley-III), and socio-emotional development (0.12-0.14 SD; Wolke behavioral rating scales). The program reduced malnutrition rates and increased school attendance among older siblings. These impacts emerged through enhanced maternal agency, increased parental investments, and higher utilization of nutrition services. At costs of $6.84 per child, we estimated an internal rate of return of 18.9%, driven by integration efficiencies with existing infrastructure. Using the detailed location and contact information collected in the first follow-up, we propose to track the original participants (now aged 11-13), their older siblings who experienced positive spillovers, and younger siblings who may benefit from improved parenting practices. We also plan to sample non-targeted children from these communities to measure broader spillover effects. We aim to combine administrative data on national primary exam performance with direct assessments of cognitive and socio-emotional skills, anthropometric measurements, and self-reported aspirations and self-efficacy. Parent surveys will capture knowledge and beliefs about child development. Our proposed follow-up examines the long-term efficacy, equity, and cost- effectiveness of scalable early childhood interventions, providing policymakers with evidence on sustained impacts and parental investments in resource-constrained settings.