BACKGROUND: Children with disabilities face many barriers to early childhood development services and to pre-primary education. Evidence on inclusive school readiness and community-based approaches in low- and middle-income countries (LMICs) still remains limited. OBJECTIVE: To explore the feasibility and acceptability of a co-designed training programme for caregivers to support school readiness among children aged 4-6 years in Bangladesh, Nepal, and Tanzania. METHODS: We conducted an evaluation using 16 focus group discussions with caregivers including those with children with disabilities and facilitators who participated in the programme. Analysis drew on Ecological Systems Theory to interpret influences at child, caregiver (microsystem/mesosystem), and facilitator (exosystem) levels. RESULTS: Participants reported gains in children's early learning and eagerness to attend school. Caregivers described increased confidence, more responsive and positive parenting, and greater advocacy for their child's needs. Facilitators reported improved capability to use inclusive techniques with caregivers. Three design features underpinned the perceived impact: explicit inclusive content on supporting children with additional support needs; participatory, play-based sessions co-facilitated by parent-teacher pairs; and low-cost, locally adapted materials. Reported challenges included variable attendance and punctuality, heterogeneity of children's needs within sessions, and transport and weather disruptions. CONCLUSIONS: A co-designed, school readiness training programme for caregivers was acceptable and engaging across three LMIC settings and was perceived to strengthen child learning, caregiver practices, and facilitator skills. Embedding such programmes within communities may accelerate equitable school readiness; however, ongoing training, supervision, and attention to contextual barriers are needed for sustained impact whilst scaling-up.
Chandna et al. (Thu,) studied this question.