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

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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

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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

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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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