The first 8 years of a child’s life are a critical period for cognitive, social, emotional, and physical development. These years present a unique opportunity to establish lifetime foundations for adequate development and growth. The best possible foundation in these early years can make a difference throughout adulthood.
Optimal early childhood development is ignited and shaped by the quality of the interactions between a child and their caregivers. Nurturing care proves to be a major pillar of child’s development, as clearly stated in the Nurturing Care Framework (WHO, UNICEF & World Bank Group, 2018).
It is estimated that 43% of children under five in low- and middle-income countries are at an elevated risk of poor development (Black et al., 2017). To help improve developmental outcomes, the implementation of low-cost interventions is recommended. These interventions should focus on health and nutrition, but also in other areas that are often neglected, such as social and emotional development, responsive parenting, and play and learning. In these communities, reaching more pregnant women, new mothers and fathers and their young children with preventative and promotive services has the potential to drastically improve developmental outcomes for these children.
A strong start for every child from birth to school-age
From birth to school age (0 – 8), children experience crucial stages of development that shape their future well-being. Early interventions during pregnancy and the first years of life are key to ensuring healthy cognitive, physical, and emotional development, especially in impoverished environments.
The Guideline on Improving Early Childhood Development (WHO, 2020) emphasizes four recommendations for enhancing ECD:
- Providing responsive care and early learning activities during the first 3 years of life.
- Promoting early learning and supporting caregivers in engaging infants and children.
- Integrating caregiving into interventions for optimal nutrition of infants and toddlers.
- Integrating psychosocial interventions to support maternal mental health into early childhood services.
It all started in Ethiopia
In 2018, ICDI, together with an Ethiopian partner organisation Education for Sustainable Development (ESD), started to implement the project ‘Making the first 1000 days count in Ethiopia’, piloting an approach that supports playful learning and responsive parenting activities for children under 4 and their caregivers in 7 communities in the Amhara region, combining home visiting and centre-based programmes.
In 2021, a new phase of the project started: scaling up the approach to 8 new communities, through the involvement of a new Ethiopian partner, Wabe Children’s Aid and Training (WCAT), and actively lobbying and advocating for promoting change in local and national policy. In these five years, we worked in 15 communities in the Amhara region.
From Ethiopia to Uganda
During the piloting and the scale-up phase in Ethiopia, we learned that the combination of modalities, encompassing home visiting, centre-based activities (Play Hubs), access to existing services, local ownership, financial support to vulnerable families, and holistic attention to all areas of child health and development, has proven effective. While we are still working on the sustainability of the model at regional and national level in Ethiopia, it is time to test the model in another African context. As such, we aim to transfer, implement, and adapt out model to Uganda, specifically the Busoga region.
We developed an innovative approach for community based ECD programmes for children 0-8. The main pillars of this model are:
- Enhancing a sense of ownership in the whole community with respect to the health and psychosocial wellbeing of children aged 0-8;
- Improving health and social integration of children aged 0-8 through the increased availability of and access to multi-sectoral services for parents and children (including prenatal care)
- Enhancing and improvement of early learning and parent-child interaction for children aged 0-8 through strategies that enrich parental skills and practices.
The goals, strategies and expected results of the project are summarised in the Theory of Change.
Transferring and adapting the approach
In this project, we will pay particular attention to:
- Expand the age group from 0 to 4 years to 0 to 8 years, to be able to support children in the transition from home to pre-school, from pre-school to primary school and, for those who do not attend pre-school, from home to primary school. The project will have specific interventions for each age group, their families (children up to 3 years old and children between 4 and 8 years old) and bridges between these.
- Engage teenagers who are at risk of dropping out of school and get pregnant early, to prevent school dropout and build their capacities in SRHR. In this category, we will also involve young mothers aged 10 – 24 years.
- Engage (young) parents in activities that can support their role as caregivers with a focus on social and emotional development, responsive parenting, and playful learning, paying particular attention to the role of fathers.
- Initiate intergenerational activities in which older members of the communities, including grandparents, can play an active role in promoting the well-being and education of young children and their parents.
- Increase and improve access to SRHR, pre-natal and post-natal services, and support mothers to prevent unwanted pregnancy through quality SRHR awareness activities.
- Promote high quality professional development for health workers, educators, social workers, and teachers, with respect to playful learning, inclusive education, and integration of services.
We will adopt a south-to-south learning approach, involving our Ethiopian partners as trainer and mentor of the Ugandan partner. In this way, we will ensure that partners will share their experience and knowledge and that the five years of piloting in Ethiopia and the lessons learned during this period will be the starting point of the implementation in Uganda.
The project at glance
The main components and activities are:
Component 1: Participatory community plans for children through the establishment of ‘ECD 0-8 Committees’:
1.1 Professional development and mentoring for Nascent staff on pillars of the project approach and strategies
1.2 Need assessment and mapping of services in target communities
1.3 Researching community’s norms, values and practices on maternal and infant health, the role of family members in child rearing and parents’ perception and satisfaction of services.
1.4 Creating local ‘ECD 0-8 Committees’ in 6 communities and train their members on playful learning, responsive parenting, and social and emotional development of children 0-8, and how to embed this in policy and practice.
1.5 The ECD O-8 Committees develop a ‘Community plan for children 0-8’. In addition, these committees set and monitor annual targets.
1.6 Community events to promote the creation of the local ‘ECD 0-8 Committee’ and ongoing awareness activities and information sessions for the communities.
Component 2: Facilitation of access to a multi-layered and integrated community health and social care support system.
2.1 Offer financial support to families for transportation and check-ups/services.
2.2 Support access to prenatal and postnatal care, including birth registration and vaccines.
2.3 Organise and facilitate home visits to improve pre- and post-natal health of mother and child, mother-child VIH transmission.
2.4 Facilitate enrolment of children aged 3 and more in ECEC services, preschools and primary schools, and non-formal initiatives.
2.5 Set-up a SRHR awareness group for (pre)teenage girls, that will organise prevention activities against early marriage and teenage pregnancy.
2.6 Lobby and advocacy activities: for services, favourable policies and influence programming for children through national learning and advocacy event
Component 3: Supporting parents to provide rich, safe, and nurturing environments for children aged 0-8.
3.1 Setting up of parents’ support groups for mothers, fathers and extended family (activities for parents and children in the Play Hub).
3.2 Identification of professionals to be invited to information sessions for parents’ support groups.
3.3 Setting up and opening of 2 Play Hubs.
3.4 Development and translation of information materials (information about childrearing, health, early learning and development).
3.5 Home visiting programme for vulnerable families with young children under 4 years of age to support parent-child interaction, playful parenting and early learning and attract them to participate in the centre-based activities offered in the Play Hubs.
3.6 Adaptation and translation of the Home Visiting Toolkit.
3.7. Technical support to Nascent to implement ECEC Play Hubs and Home Visiting Programme.
3.8 Study visit (to understand and transfer the approach)
- 600 children aged 0-8 (50% girls)
- 240 families
- 6 Communities/villages directly
- 800 families directly reached from Play Hubs and home visits.