title: The role of early childhood education programmes in the promotion of child and adolescent mental health in low- and middle-income countries.
abstract: BACKGROUND
  There is growing evidence that early childhood education (ECE) interventions can reduce the loss of developmental potential of disadvantaged children in low- and middle-income countries (LAMIC). Less attention has been paid to the potential of these programmes to prevent child mental health problems and promote child well-being.
  
  
  METHODS
  Peer-reviewed journal articles describing controlled evaluations of ECE interventions in LAMIC were reviewed to identify studies with child mental health outcomes. Studies with proximal outcomes for child mental health including caregiver practices and caregiver mental health were also reviewed.
  
  
  RESULTS
  Of 63 studies identified, 21 (33.33%) included child mental health outcomes; 12 of 16 studies with short-term measures showed benefits; 6 studies included a longer-term follow-up and all found benefits; 25 studies included caregiver outcomes: consistent benefits were found for caregiver practices (21 studies) and 6 of 9 studies that measured caregiver mental health reported benefits. Gains to child mental health may be most likely when ECE interventions include three main elements: (i) activities to increase child skills including cognition, language, self-regulation and social-emotional competence; (ii) training caregivers in the skills required to provide a cognitively stimulating and emotionally supportive environment; and (iii) attention to the caregivers' mental health, motivation and self-efficacy. Recommendations for the design and implementation of programmes are provided.
  
  
  CONCLUSIONS
  ECE interventions are an important component of mental health prevention and promotion in LAMIC, and promoting child and caregiver well-being is a fundamental aspect of interventions to improve child development.
authors.affiliation: School of Psychology, Bangor University, Bangor, UK; Tropical Medicine Research Institute, University of the West Indies, Kingston, Jamaica.
authors.forename: Helen
authors.initials: H
authors.lastname: Baker-Henningham
mesh_terms: D000293:Adolescent; D017028:Caregivers / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D018479:Early Intervention, Educational; D004505:Education, Nonprofessional / Q000706:statistics & numerical data; D005260:Female; D006293:Health Promotion / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000517:prevention & control*; D008603:Mental Health; D016487:Parenting; D010290:Parents / Q000193:education; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic
keywords: Early intervention (education); child day care centres; mental health; parenting education; preschool