Digital support systems to improve child development in Peru: A cluster-randomized controlled open-label trial

Digital technologies have the potential to transform early childhood development (ECD) interventions by delivering personalized support at scale. We conducted a cluster-randomized controlled trial in rural Peru to evaluate the effectiveness and cost-effectiveness of an artificial intelligence-supported digital parenting chatbot as well as traditional home visits as interventions to improve child development. Among 2461 caregiver-child dyads, both the digital and home-visiting interventions improved child development outcomes at 2.5 years of age, with standardized effect sizes of 0.11 and 0.17, respectively. At ¹/₁₅ of the cost of in-person support, the digital intervention yielded superior cost-effectiveness. These findings suggest that digital platforms can be a viable, scalable alternative to support children's development in resource-constrained settings.