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Early Childhood Development +Health/ Nutrition
Family
Birth
Home to
Early
Learning
Environment
Pre-
School
to
Primary
School
Child’s Development
Caregiver/Family
Child
Ages 3 -5Prenatal Birth - 3 Ages 5 - 8
1. Early Experiences Matter
2. Social Referencing
3. Nature versus Nurture
Approaches to
Learning
Milestones for early motor development
Promise of Preschool in Africa
Mozambique 2011
ECD ACCESSConventional Pre-Primary (GMR, 2012)
Country 1999 2010
Sub-Saharan Africa 10 17
Birundi 1 9
Comoros 2 22
Ethiopia 1 5
South Africa 21 65
Development risks at baseline
Risks Percentage
Stunting 42.3%
Risk of delays in fine motor skills (36-41 months)
70%
Risk of developmental delays(36-41 months)
65%
Orphaned 10.01%
Caregiver does not know how to read
42%
Caregiver does not speak Portuguese
51.35%
Source: Authors calculation from the baseline data for the impact evaluation (2008)
Peabody: Receptive Vocabulary (2008)
ECD/Preschool Conclusions
ECD/Preschool model effective at:
Target Children:
Increasing primary enrollment & attendance
Improve pro-social behaviors & decrease hyperactivity behavior
Improving hygiene practices and reduce diarrhea & skin infex
Reducing children’s time working on family farm
Older Siblings:
Increasing in school enrollment
Parents:
Changing parenting practices
Increasing labor market participation
NO IMPACT:
Improve child growth (stunting)**
Home-based (Essential Package)
Community Healthcare Workers (C4D)
Cascade ECD-Health Fairs
Parent-Child Community Gatherings
Mobile Program
Interactive Radio/ Phone Messages/ Email/ TV
What’s Trending: ECD ACCESSIntegrated, innovative, scalable
Interventions with stunted children highlight the
importance of stimulation
Integration of health, nutrition and education/cognitive stimulation (comprehensive programs) has larger and sustained impacts for children
85
90
95
100
105
110
Baseline 6 mo 12 mo 18 mo 24 mo
Grantham-McGregor et al, 1991
Control
Supplemented
Stimulated
Supplemented and stimulated
Non-stunted children DQ
4. Integrated Programming:
Nutrition/Stimulation
ECD Lifespan Approach
Adolescent
s
Pregnancy
Birth to
30 days
1 month to
3 years 5 to 6 years3 to 4 years 7 to 8
years
Child Protection, Global Warming, AIDS
Economic Strengthening / Health- Nutrition /
Women’s Development
Nutrition/Food Security Primary Education
School health and nutrition Maternal and Child Health
Adolescent
Development
Integration: Program + (ECD)
Maternal and Child Health
WASH
Maternal Education
Emergency Response
Youth
HIV/Protection
Resiliency and Peace Building
Basic Education (Emergent Literacy)
“Advantages and Disadvantages of Integration:
Opportunities for Integrating Early Childhood
Development (ECD) and Nutrition Programming”
Ann M. DiGirolamoa, Pablo Stansberyb, , Mary Lung’ahoa,c
a CARE International; b Save the Children; c Nutrition
Policy & Practice
Annals of the New York Academy of Sciences entitled
“Integrated Interventions in Child Development, and
Nutrition (forthcoming)
Dr Mandana Arabi, Dr Maureen Black, Dr Lia Fernald, Dr
Sally McGregor, Dr Ted Wachs, Dr Susan Walkers, Dr
Aisha Yusafzai
Health Nutrition ECD (HNECD)
Advantages
1. Cost effectiveness of HNECD programming
2. Co-location of services
3. Coordinated messaging
4. HNECD programs protect and promote children’s growth and development across multiple domains
Challenges
1. Staff workload
2. Supervisory Responsibilities
3. Common language activities
4.
5. Training/Orientation
ECD Menu of Services
USG Children in Adversity
1. Build Strong
Beginnings
2. Put Family care first
3. Protect children
from violence,
exploitation, abuse
and neglect
2 new ECD Resources
Essential Package Building Blocks
1. Positive caregiver-child
interaction
2. Developmentally-
appropriate approach
3. Link to broader systems
of integrated care
4. Eliminate barriers to care
and support
Activities parents can do with child…
0-2 months
1. Identify examples of promising practices of integrated programming.
2. Post- MDG agenda: Where sits early childhood? Should there be a separate ECD goal or embedded in current health/ nutrition goal. What might that look like?
Group Discussion
