Evidence for Better Lives Study (EBLS)

The Evidence for Better Lives Study (EBLS) is an innovative, global birth-cohort study. It is a collaboration of 13 universities and eight study sites in four different continents. In each city, the early childhood development of 150 children within their family and community contexts has been evaluated. The study has been accompanied by efforts to introduce and evaluate multi-sectoral prevention packages that can help young children to achieve their full potential. EBLS examines exposure to violence and other adverse experiences while also striving to illuminate how families in different cultures raise and support their children. It aims to contribute to global violence reduction as part of the United Nations' Sustainable Development Goals.

Milestones and achievements

The first ideas for EBLS began to take shape in September 2014 at the First Global Violence Reduction Conference in Cambridge (UK), jointly organised by the University of Cambridge and the World Health Organization (WHO). In December 2015, a group of researchers, philanthropists, and representatives from WHO, UNICEF Office of Research Innocenti, UNODC and the Global Partnership to End Violence against Children identified three priorities: to launch a pioneering multicentric birth cohort study in low- and middle-income countries; to focus on medium-sized cities and to collaborate with international, national and local stakeholders to support sustainable change; and to contribute to capacity-building by creating an interdisciplinary network of research teams that encourages mutual learning. In 2017 the Fondation Botnar agreed to fund an 18-month pilot study. An international research network, led by a Consortium, was set up to liaise with study partners. In 2018 and 2019, the Consortium implemented a pilot version of EBLS in eight low- and middle-income countries (LMICs): Ghana, Jamaica, Pakistan, the Philippines, Romania, South Africa, Sri Lanka and Vietnam. The pilot’s data included 1,208 pregnant women who were assessed during the third trimester of their pregnancy and when their child was around three months old. Measures obtained from mothers included mental and physical health, attitudes to corporal punishment, adverse childhood experiences, prenatal intimate partner violence (p-IPV), substance use and social/community support. Hair and dry blood spot (DBS) samples were collected from the pregnant women to measure stress markers. Additionally, to explore research participation among fathers, EBLS recruited 300 fathers in the Philippines and Sri Lanka. The research partners of each site liaised with local and national policy makers, NGOs and international organisations to diffuse knowledge and foster policy impact. Needs and resources in each site were assessed through interviews with experts, local government officials and practitioners, following WHO’s INSPIRE framework. The findings were documented in Addressing Violence Against Children: Mapping the Needs and Resources in Eight Cities Across the World, which was launched at the Second EBLS Symposium in November 2019 in Cambridge. Two films, produced thanks to an ESRC Impact Acceleration grant to introduce EBLS to policymakers and general audiences, were also premiered. The pilot study created a set of impact activities that have contributed knowledge towards the promotion of Valenzuela, one of the cities in EBLS, as a Pathfinder city in the prevention of violence. It also developed a rapid and low-cost qualitative method that can help countries around the world to reach a shared understanding of what is required to implement effective strategies to reduce violence. The pilot has generated several scientific publications, published in leading academic journals. Training sessions contributed to the professional development of a number of younger researchers, who have been involved in data collection, analysis and writing.

Third Wave of EBLS and future aims

Covid-19 and other local emergencies affected the running of the study. Early in February 2021, five sites began a third wave of data collection: Valenzuela (Philippines), Hue (Vietnam), Cluj-Napoca (Romania),
Koforidua (Ghana) and Kingston (Jamaica). This collaborative effort has been mostly conducted via telephone-based interviews, with children around the age of 18 months. This new wave aims to: 

  • Contribute to the better understanding of the link between the mothers’ exposure to adversity during childhood and pregnancy, and their children’s development in the second year of life. The comparative design of the study across five low- and middle-income countries (LMICs) will help to create the foundations of better prevention policy relating to mental health and early child development in LMICs.
  • Advance our understanding of the effects that COVID-related restriction measures had on mothers and their small children in low- and middle-income countries. These children will have spent most of their lives under exceptional conditions since the outbreak of the pandemic. Emerging evidence already suggests that the stress, fears and constraints linked to COVID-19 exacerbate health inequalities of families. Vulnerable families may experience more conflict and violence, and be less able to support their young children. These findings will be linked to relevant recommendations for prevention policy.

Going forward, the Foundational EBLS study could lead to a long-term birth cohort project on child and family well-being in eight LMICs. This long-term project has the potential to become a ground-breaking
contribution to human sciences and an enabler of child and family strengthening strategies. The latest findings already show how different manifestations of poor maternal well-being and psycho-social risk tend to be correlated.  Research on healthy child development needs to consider the variety of familial, neighbourhood and structural contexts that shape children’s lives globally. In particular, it is necessary to overcome the focus on WEIRD (Western, Educated, Industrialized, Rich and Democratic) societies and advance the understanding of mechanisms that vary across cultures.

Reports and other resources

We have held EBLS symposia and workshops at the University of Cambridge and presented the project to universities all over the world. Please visit the conference page and read the latest updates on our news page. On 25 November 2019 we launched two short films at the Second EBLS Symposium, held at Jesus College, Cambridge. The first video is for everyone to enjoy, the second is aimed at policy makers and institutional audiences. An article on the findings of the Study, published on the ISRA blog, can be found here. The key report was uploaded on the INSPIRE's website in 2021.