Participation rates in a group-based early childhood development program: Evidence from rural China

Developmental delays during early childhood are common in low- and middle-income countries (LMICs). Parenting training programs can effectively support early childhood development, but caregivers' participation rate in these programs has been relatively low. Conditional cash transfers (CCTs) have been shown to increase participation in many LMICs, but they have not been used in previous programs in rural China. This study investigates the factors associated with participation in a parenting training program in rural Zhejiang, China and evaluates the effect of a CCT intervention on participation. Quantitative data from a baseline survey and participation records were used to examine the associations between household characteristics and participation and estimate the effect of CCTs. Child gender, the level of child development, family economic status, and the home environment were associated with participation. The participation rate among recipients of CCTs was 59% while the CCTs were implemented, and it remained at 53% after they ended. Qualitative data from interviews with caregivers were used to identify barriers to participation. Limited awareness of early development, time constraints, and limited familial support hindered participation. Although the CCTs increased participation, only a minority of the frequent participants reported that the cash incentives motivated their participation. To increase engagement with parenting training in rural China, practitioners should combine financial incentives with efforts to build awareness for early development and to improve familial and social support for participation.