Alam Simsim Outreach Program Impact Report

This 117-page study examines research that the Cairo, Egypt-based Social Planning Analysis and Administration Consultants (SPAAC) carried out for the Alam Simsim Outreach Program, which is a collaboration between Al Karma Productions (Cairo, Egypt) and Sesame Workshop (New York, USA). Alam Simsim is a multiple episode, half-hour television series developed by Egyptian educators, child development experts, scriptwriters, and film makers. Designed to provide children with an opportunity to learn a broad range of literacy, numeracy, cognitive, and social interaction skills, Alam Simsim uses humour, music, fantasy, and daily life situations to educate young children. It is the Egyptian adaptation of the educational television series Sesame Street.

To help extend the messages of the TV series, an outreach initiative was launched in December 2002 that sought to provide parents and caregivers with information and materials to improve their children's health, hygiene, and nutrition, as well as to promote the use of media as an educational tool in improving children's readiness for school. Working closely with local community development associations (CDAs), the outreach team developed a 2-month training component, as well as educational materials, for parents and children. These materials included story booklets ("Good Morning Khokha", "The Feast", and "A Very Important Day"), flash cards, and a healthy habits calendar. With the collaboration of 20 CDAs working in rural regions, nearly 11,000 parents, teachers, and other caregivers in Minya, Beni Suef and Cairo governorates were reached between April 2003 and January 2004.

Using an experimental design, researchers assessed changes in knowledge and behaviour before and after the outreach initiative among parents and children who received the intervention (the experimental group) and those who did not (the control group). Researchers interviewed 300 parents and 200 children ages 4 to 7. A cultural anthropologist also conducted in-depth observations of five households in the experimental community before and after exposure. This document shares the details of that research.

In brief, evaluators found that "both parents and children benefited" from the outreach programme, in that it "had a significant impact on health, hygiene and nutrition practices." While there was evidence of positive changes for many families, routines requiring commercial items such as toothbrushes were beyond the means of the poorest households. Notably, some families with limited economic means engaged in effective alternative practices such as brushing teeth with fingers. Financial circumstances confronting some families can be crucial considerations in the design of future training and outreach programmes. For example, researchers found that “not all parents could afford the additional expenses of separate towels, toothbrush and toothpaste, and having salad, fresh fruits and milk regularly." They recommended that the Alam Simsim outreach programme continue to model a variety of strategies, including ones that are most affordable and accessible.

Highlights from the Executive Summary follow:

The findings of the research indicate that the outreach program had a substantial impact on the health, hygiene and nutrition practices of parents and caregivers with respect to their children....The most notable changes occurred with respect to knowledge of hygiene practices such as the use of a personal towel (rather than a shared one) and knowledge of vaccinations. All of the parents who participated in the outreach activities greatly appreciated the program and felt that they benefited from it. Negative responses were minimal. They also greatly appreciated the outreach materials provided.

Based on reports from the parents in the experimental group, information on nutritional practices was the most appreciated and had the greatest impact on household practices. However, the impact of this component also proved the most difficult to directly measure. Nevertheless, there is substantial evidence that the households of the parents and children in the experimental group are now eating more fresh fruits and vegetables as a result of the outreach program. Evidence for increased milk consumption in these households is not as robust, but is still significant.

In addition to nutritional knowledge and behavior, the outreach program had an impact on hygiene behavior. Based on the reports of the parents who participated in the outreach program, there was a very clear, significant and measurable impact on the hygiene behavior related to the general cleanliness of the children in the households in the experimental group. In so far as generalizations are possible, the most dramatic improvements related to the use of separate towels for the children and to the children brushing their teeth. The general overall cleanliness of the children also improved, indicated by the increased proportion of children in the experimental group who reported that they washed their face before bed and in the morning, and that they washed their hands after playing. Health-related behavior was also impacted by the outreach program, but not as greatly as the nutrition and hygiene.

Data from pre- to post-exposure observations of households confirms the conclusion that participants gained knowledge from the program. Their abilities to put into practice their new understanding was related to their economic means. This is particularly the case in changes where there are costs involved such as buying toothbrushes and paste, separate towels, going to the doctor regularly and buying fresh fruits, vegetables and milk. Overall, however, the Alam Simsim educational outreach initiative had a measurable, positive impact on the health, hygiene, and nutrition habits of those who participated.