{
  "abstract": "Objectives To evaluate the implementation and contextual drivers of the EN-REACH parent group intervention—a school readiness program for children aged 4–6, including children with disabilities—across Bangladesh, Nepal, and Tanzania, using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework.Methods This mixed-methods process evaluation was embedded within a cluster-randomized trial of 1,550 parent-child pairs in 160 clusters. The eight-session intervention promoted early learning and inclusion. Quantitative data on participation and outcomes were integrated with qualitative insights from caregivers, facilitators, and stakeholders, analysed thematically and mapped to RE-AIM domains.Results Reach: The intervention reached 93.7% of the target population, with strong enrolment across diverse settings. Participation was supported by school sensitization and stakeholder endorsement. Effectiveness: Positive trends were observed in caregiver-child interaction, inclusive practices, and school readiness, particularly among children not attending pre-primary education. Adoption: Ministries of Education in all three countries supported implementation, and local facilitators endorsed embedding the model into government and NGO schools. Implementation: High fidelity was achieved (>90% session attendance). Culturally adapted, play-based sessions and flexible delivery supported engagement. Barriers included community stigma and limited disability-friendly infrastructure. Maintenance: Caregivers and facilitators expressed strong support for institutionalising the intervention in school curricula. Longer term follow up and implementation is needed to understand maintenance.Conclusions Parent-focused interventions are feasible and inclusive in LMICs. Targeted support for vulnerable families and integration with primary school systems can bridge service gaps for children aged 4–6, especially those with disabilities.",
  "authors": [
    {
      "affiliations": [
        "Lshtm, London, United Kingdom"
      ],
      "name": "Jaya Chandna"
    },
    {
      "affiliations": [
        "University of Gothenburg, Gothenburg, Sweden"
      ],
      "name": "Rejina Gurung"
    },
    {
      "affiliations": [
        "Lshtm, London, United Kingdom"
      ],
      "name": "Proma Paul"
    },
    {
      "affiliations": [
        "Ihi, Dar Es Salaam, Tanzania, United Republic of"
      ],
      "name": "Jitihada Baraka"
    },
    {
      "affiliations": [
        "Golden Community, Pohkara, Nepal"
      ],
      "name": "Honey Malla"
    },
    {
      "affiliations": [
        "Iccdrb, Dhaka, Bangladesh"
      ],
      "name": "Mohammad Abdul Awal Miah"
    },
    {
      "affiliations": [
        "Golden Community, Pohkara, Nepal"
      ],
      "name": "Omkar Basnet"
    },
    {
      "affiliations": [
        "Ihi, Dar Es Salaam, Tanzania, United Republic of"
      ],
      "name": "Mustafa Miraji"
    },
    {
      "affiliations": [
        "Ihi, Dar Es Salaam, Tanzania, United Republic of"
      ],
      "name": "Nahya Salim Masoud"
    },
    {
      "affiliations": [
        "Lshtm, London, United Kingdom"
      ],
      "name": "Cally Tann"
    },
    {
      "affiliations": [
        "Iccdrb, Dhaka, Bangladesh"
      ],
      "name": "Ismat Ara Mili"
    },
    {
      "affiliations": [
        "Iccdrb, Dhaka, Bangladesh"
      ],
      "name": "Mohamed Bakari"
    },
    {
      "affiliations": [
        "University of Gothenburg, Gothenburg, Sweden"
      ],
      "name": "Ashish Kc"
    },
    {
      "affiliations": [
        "Ihi, Dar Es Salaam, Tanzania, United Republic of"
      ],
      "name": "Karim Manji"
    },
    {
      "affiliations": [
        "University of Glasgow, Glasgow, United Kingdom"
      ],
      "name": "Paul Lynch"
    },
    {
      "affiliations": [
        "Iccdrb, Dhaka, Bangladesh"
      ],
      "name": "Jena Hamadani"
    },
    {
      "affiliations": [
        "Lshtm, London, United Kingdom"
      ],
      "name": "Joy Lawn"
    }
  ],
  "title": "89 Process evaluation of multi-country school readiness intervention using the RE-AIM framework",
  "uid": "d9687a51-f78b-58f9-a8fd-5645744de705"
}