Digital parenting support improves early childhood development in rural Peru

Globally, an estimated 250 million children under the age of five are at risk of not reaching their developmental potential due to poverty, limited stimulation and inadequate support for caregivers. Early childhood development shapes health, learning and economic participation throughout life. While evidence-based programmes such as home visits can be highly effective, they are resource-intensive and difficult to scale in many low- and middle-income countries.

In response, digital tools are being increasingly explored as a means of expanding current parental support interventions, complementing rather than replacing in-person care. As part of the project “Digital Support Systems to Improve Child Health and Development in Low-Income Settings”, funded by the Basel Research Centre for Child Health (BRCCH), the study examined whether a digital parenting intervention could reinforce nurturing caregiving practices in a rural, resource-constrained context. Findings were published yesterday in Science Advances.

Study design and intervention

The cluster-randomised controlled trial followed more than 2,400 caregiver–child pairs in the Cajamarca region of Andean Peru from infancy to early childhood. Communities were randomly assigned to one of three groups: an AI-supported digital parenting chatbot, an in-person home-visiting programme delivered by trained community workers, or a control group that received no additional support. Children were enrolled at a mean age of six months and followed until 2.5-3 years of age, when developmental outcomes were assessed.

Caregivers in the digital intervention group received age-appropriate guidance on play, communication, stimulation and caregiving via a chatbot accessible on mobile devices. The intervention was implemented using Afinidata, an AI-supported digital platform for parents that provides personalised, science-based activities and guidance. The chatbot operated through widely used messaging services, delivering weekly prompts and activity suggestions tailored to the child’s age and developmental stage, with recommendations adapted over time using caregiver feedback and engagement data. Caregivers could also ask questions, track developmental milestones and access short, evidence-based messages on early childhood development.

Findings and implications

Both the digital intervention and the home-visiting programme resulted in measurable improvements in children’s developmental outcomes at 2.5 years of age. While the home-visiting programme produced slightly larger gains, it required substantial human resources and ongoing operational investment. In contrast, the digital intervention delivered positive improvements in child development at roughly one-fifteenth of the costs of in-person support, reflecting its reliance on existing mobile infrastructure and limited additional staffing once established. This suggests that digital tools could help to improve early childhood development support in settings where workforce capacity and funding are constrained. 

“This study is not about replacing parents or professionals with technology,” says Günther Fink, first author and health economics expert at Swiss TPH. “The chatbot supports and encourages caregivers in what they already do every day – talking to, playing and engaging with their children – by providing timely, practical guidance that fits into their lives.”

Experience from the field also highlighted that digital tools are not equally accessible to all families and require careful adaptation to local realities. While mobile phone availability enabled broad access to the digital intervention, some of the most socioeconomically disadvantaged families faced barriers to enrolment, underlining the importance of embedding digital approaches within existing support structures.

“Some of the most vulnerable families still require direct, in-person support, and digital tools alone are not enough,” says Stella Hartinger, co-senior author and project lead in Peru. “From our experience in Peru, what made this intervention work was careful adaptation to local realities and close integration with existing early childhood services.”

These findings reinforce the need for a balanced mix of delivery models in early childhood development programmes, particularly in rural and resource-constrained settings.

“Home visits remain a highly effective approach, but they are difficult to scale in many settings,” says Daniel Mäusezahl, co-senior author and co-leader of the study. “Digital tools can complement existing services and help close gaps in early childhood support, especially in rural and resource-constrained areas.”

The study adds robust evidence to the growing field of digital support systems for early childhood development. It demonstrates that, when carefully designed and embedded in local contexts, AI-supported tools can strengthen parenting practices and contribute to improved child development outcomes without displacing human care. 

Why it matters

Supporting parents in resource-limited settings matters because early childhood development shapes health, learning, and life opportunities throughout children’s life and beyond. Yet many families receive little or no support during their children's early years. This study shows how digital tools can help fill the gap – extending evidence-based parenting advice to families who would otherwise go unreached, even in areas with limited resources.

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