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

Pstansbery@unicef.org

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