crs’ guiding framework to integrate child health
Post on 05-Oct-2021
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Elena McEwan, MDSenior Maternal and Child Health Adviser
Integrated Nutrition ConferenceNairobi, Kenya 14 -15 September, 2015
CRS’ Guiding Framework to Integrate Child Health, Nutrition and Early Childhood
Development
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Why integrate ECD with other sectors?• Early Childhood Development- period
of life that begins prenatally and
extends to eight years of age
• Is the most rapid and crucial
developmental processes in cognition,
language, social-emotional
development, and physical health
occur during this period
• Protective factors : healthy food, clean
water, health care, and educational
opportunities are crucial elements for
brain development
• Combining ECD interventions with
health, nutrition, and across other
sectors is efficient.
Fetus Late Infancy/Toddler Pubertal
Developmental Perspective
Thompson & Nelson, 2000
1000 days
Current ECD activities and levels and the Guide
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• Key assumption: Disease reduction supports healthy child growth & development
• Child gains in physical & brain development
• Improved nutrient absorption leading to improved nutritional status
• Reduce water & excretion related disease (diarrhea, helminthes etc.)
• Improve WASH practices in households, health & feeding centers, ECD Centers & preschools (7 Pt Plan)
• Key Assumption: Families seek out & receive needed services
• Quality social services contribute to a nurturing, supportive environment which meet basic & developmental needs
• Quality social & protective services are available & accessible
• Strong social services & child protection systems are in place
• Capacity building of gov’t & civil society for a strong social service & child protection system
• Key Assumption: Developmental outcomes improve when IYCF behaviors are taken up
• Community experiences lower child mortality & healthier children
• Stunting & morbidity in young children reduced
• Healthy feeding practices from birth to 2 promote growth, development & health across domains
• Infant has the best possible nutritional start
• Pre- & Post-natal Maternal nutrition protects mother's & infant's health
WA
SH
SOC
IAL
SER
VIC
ES
NU
TRIT
ION
CRS’ GOAL: All young girls & boys are protected & valued by family & community in an enabling environment to
thrive & grow towards integral human development
• Key Assumption: Communities & HHs will see benefits & embrace ECD supportive practices & services
• Child development across domains is supported & monitored at family & community level
• Increase self-efficacy in parents
• Increased awareness among pregnant women, fathers, CHWs, lay religious leaders & health workers’ skills
• Communities with skills to deliver ECD messages & assess developmental milestones at growth monitoring, hh & health facilities with competency to counsel parents at ANC & assess developmental milestones at each point of care
• Key Assumption: Improved early grade instruction builds cognitive, social-emotional & language skills
• Children's needs are met & their education supported
• Children transition well to primary school
• Children have improved skills across the developmental spectrum, cognitive, social-emotional & language
• More infants & young children benefit from early education services
• Promote early stimulation & education by working with parents, caregivers & center staff
• Key Assumption: ECD resources are optimally used when parents have equity in decision making, literacy & stronger parenting skills
• With nurturing caregivers & families, child has access to developmental resources
• Children are cared for by ECD competent parents or family members, working collaboratively
• Teach parents to identify developmental needs, & identify & train couples in family strengthening skills. Increase adult literacy.
• Early ID of parents who would benefit from parent education & couples strengthening
HEA
LTH
EDU
CA
TIO
N
FAM
ILY
STR
ENG
THEN
ING
CRS’ GOAL: All young girls & boys are protected & valued by family & community in an enabling environment to
thrive & grow towards integral human development
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Health facilities staff with competencies to provide early
stimulation & positive parenting counseling to pregnant women &
husbands during ANC
CRS’ Theory of Change integrating Child Health/ Nutrition & ECD…
Community Health Volunteers with competencies to provide follow up to referred pregnant women, & deliver
early stimulation & positive parenting messages at IYCF activities during group sessions & home visits
Pregnant & lactating women & husbands improve their knowledge, skills and self efficacy in early
stimulation & positive parenting
Pregnant /lactating women & husbands practice early stimulation/positive parenting behaviors from 0-2
Child development across domains is supported & monitored at family, community and facility levels
Children 0-23 months grow and thriveSo
th
at
Core elements of positive parenting / caregiver support
• Reassurance and support to caregivers—building their confidence
• Reinforcing their role—emphasizing/providing evidence on the
importance of parenting
• Information about childhood ages and stages, gender issues, etc.
• Transactional exchanges; i.e., advice for parents about how
children respond to adults’ words or authority
• Practice on specific skills and feedback to build competence
• Meeting others (to break social isolation of caregivers)
• Strengthening couples/partners
• Practical material support
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Opportunities to integrate positive parenting messages
• Mothers (pregnant women) support groups: Prevents toxic
stress/Low Birth Weight/Prematurity
• Breastfeeding support groups
• Child health days
• Growth monitoring sessions
• Integrated Community Case Management
• Care Groups
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Opportunities to integrate positive parenting messages
• Antenatal Care
• Well baby program
• Vaccination visits
• Sick child Care (limited)
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THANK YOU!!
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