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A groundbreaking study conducted by experts at the Department of Pediatrics at the University of Oxford has revealed that early interventions aimed at supporting the development of children living in marginalized communities can lead to significant improvements in their neurodevelopmental outcomes. Published in the European Journal of Pediatrics, the research focuses on Roma children in Eastern Slovakia, a group often facing the compounded challenges of poverty, stunting, and developmental delays.
The study, known as the Omama project, was led by Dr. Michelle Fernandes and the F1000 research group. It investigated the impact of community-based early child development (ECD) interventions on Roma children living in disadvantaged settings. These children, often deprived of the resources needed for optimal development, frequently face barriers to reaching their full developmental potential by the age of five.
The Omama study compared the neurodevelopmental outcomes of Roma children receiving ECD interventions at age two, with age- and sex-matched peers who did not receive similar support. Results demonstrated that the children who participated in the intervention showed significant improvements in cognitive, language, and motor skills, without direct interventions focused on poverty or nutrition.
The Roma community, Europe’s largest ethnic minority, experiences high rates of neurodisability, malnutrition, and poverty. The Omama program targeted children aged three weeks to 24 months, with interventions delivered by trained Roma women, affectionately called Omamas, which means “grandmothers” in Slovak. These women provided weekly, one-hour sessions in the child’s home, engaging both the child and the primary caregiver in activities designed to promote early development. Using the INTER-NDA mobile app, which provided a structured schedule of activities such as infant massage, play, reading, music, and responsive caregiving, the Omamas helped to stimulate the children’s neurodevelopment during a critical period in brain growth.
The results were remarkable. Children receiving the intervention were 88% less likely to experience delays in their neurodevelopment compared to their peers, showing significant improvements in all key areas of development.
Dr. Fernandes, Principal Investigator and MRC Clinical Research Training Fellow, highlighted the importance of early intervention, particularly during the first 1,000 days of life—the window from conception to age two when brain development is most rapid and highly sensitive to environmental influences.
“These findings confirm the potential of early interventions to significantly enhance the developmental prospects of children living in disadvantaged environments,” said Dr. Fernandes. “While the Omama project has made notable progress in reducing developmental delays, it also highlights the ongoing need for integrated strategies that address nutrition, health care, and education to achieve broader improvements in child health outcomes.”
The success of the Omama program has already led to its expansion in Eastern Slovakia, with plans to extend the initiative to Hungary, Northern Macedonia, and Greece. The program was implemented by the non-profit organization Cesta von [Way out], emphasizing the role of local community engagement for the program’s success. Olga Shaw, co-author of the study and representative from Cesta von, praised the Omamas as vital agents of change within their communities.
“Omamas are not only providers of care, but also key figures in promoting sustainable community development,” said Shaw. “Their involvement is central to the success and longevity of such projects.”
As the world continues to grapple with disparities in child development across disadvantaged communities, the findings of this study underscore the potential of early, localized interventions in improving the futures of children in vulnerable settings.
Disclaimer: The content of this article is based on the study “A community-based intervention (the Omama Project) improves neurodevelopment in impoverished 2-year-old Roma children” by M. Fernandes et al, published in the European Journal of Pediatrics (2025). The views expressed are those of the authors and do not necessarily reflect the views of any associated institutions.
