A community-based intervention (the Omama Project) improves neurodevelopment in impoverished 2-year-old Roma children: a quasi-experimental observational study

Journal article

High rates of childhood neurodisability are reported among the Roma, Europe’s largest ethnic minority community. Interventions targeting early child development (ECD) during the first 2 years of life can improve neurodevelopmental outcomes in vulnerable children; however, evidence from Roma preschoolers is scarce. In a quasi-experimental observational study, we compared neurodevelopmental outcomes at age 2 years, measured on the INTERGROWTH-21st Project Neurodevelopmental Assessment (INTER-NDA), between Roma children receiving a community-based ECD intervention (RI, n = 98), and age- and sex-matched Roma and non-Roma children (RC, n = 99 and NRC, n = 54, respectively) who did not receive the intervention in Eastern Slovakia. The intervention was delivered between 3 weeks and 20 months in weekly home-based sessions by trained Roma women from matched settlements to RIs. Compared with RC, RI had higher 2-year cognitive (B = 0.15; 95% CI, 0.04, 0.25), language (B = 0.25; 95% CI, 0.11, 0.38) and fine motor (B = 0.08; 95% CI, 0.01, 0.16) scores. After adjustment for covariates, cognitive delay decreased by 88% in RI compared with RC (aOR, 0.12; 95% CI, 0.03, 0.53). Linear growth at 24 months was a key predictor of developmental scores for both groups (range, B = 0.04–0.14; 95% CI, 0.01, 0.07 and 0.09, 0.20). Conclusions: Our results highlight that, without directly intervening on nutritional and poverty status, a community-based ECD intervention, delivered by trained Roma women to Roma children, can significantly improve neurodevelopmental outcomes at age 2 years. What is Known: • The Roma are Europe’s largest ethnic minority. High rates of neurodisability, malnutrition and poverty are reported in Roma preschoolers. • Optimal early child development (ECD) is foundational to lifecourse health and wellbeing. Early interventions improve ECD outcomes in vulnerable children; however, evidence from Roma communities is limited. What is New: • The Omama project is a community-based ECD intervention, delivered by trained Roma women to Roma children aged 3 weeks to 20 months living in impoverished settlements in Eastern Slovakia. • Roma children receiving the intervention had (i) higher cognitive, language and fine motor scores and (ii) lower rates of cognitive delay compared with controls.

Authors: Fernandes, M; Matuskova, O; Babelova, R; Santosa, WB; Shaw, O

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Springer
• Journal: European Journal of Pediatrics
• Volume: 184
• Issue: 2
• Article number: 133
• Publication date: 2025-01-14
• Acceptance date: 2024-12-31
• DOI: 10.1007/s00431-024-05967-9
• EISSN: 1432-1076
• ISSN: 0340-6199
• Language: English
• Keywords: Roma; INTER-NDA; Intervention; Neurodevelopmental delay; Early child development; Neurodevelopment