Abstract
The latest evidence demonstrates the importance of nurturing care from conception to lay a strong foundation for children's cognitive, socio-emotional and physical well-being. The interventions enhancing parental practices in children's health and growth, protection from neglect, abuse, and injury have lifelong impact on health, learning, economic productiveness outcomes. Existing maternal and child health delivery platforms might potentially be utilized to integrate Early Childhood Development interventions. However, there is a dearth of studies demonstrating the feasibility and effectiveness of an integrated MCH and ECD model. ECD component was integrated into MCH program activities, implemented and tested in Armenia. For 14 months, all mothers of children aged 0 to 23 months (1300) living in 43 communities in Gegharkunik province (Armenia) participated in the study. Twenty-three intervention communities (680 children) received added ECD package to MCH intervention, and 20 control communities (630 children) received only MCH intervention. We used a quasi-experimental intervention-control design, with pre-and post-data collected. Variables measured and compared were related to child development, nutrition status, parental child care (stimulation, discipline) and nutrition practices.Intervention sites showed 83% higher odd of total ECD composite score (cognitive, language, motor) compared to children in the control sites. Child caregivers had better child care, nutrition practices and early learning support than controls. No change was found in discipline practices and stunting rates. MCH-ECD integrated model is an effective delivery platform for improving parenting behavior, child growth, and development.
Highlights
More than 200 million children under five in the developing world do not fulfill their potential for development (Grantham-McGregor et al, 2007), resulting in a total loss of $196 billion in annual productivity (Engle et al, 2011)
This research began with the assumption that by merging an Early Childhood Development (ECD) intervention focused on parental education to promote nurturing care into an established, community-based MCH delivery platform, child development outcomes would improve
The expansion of early childhood development programs is a fundamental step to meeting the sustainable development goals that aspire to reach the > 200 million children under 5 in the developing world who currently do not fulfill their potential for development
Summary
More than 200 million children under five in the developing world do not fulfill their potential for development (Grantham-McGregor et al, 2007), resulting in a total loss of $196 billion in annual productivity (Engle et al, 2011). Malnutrition, and learning environments that do not provide enough responsive stimulation, children develop poorly or fail to develop critical thinking and learning skills. The absence of these skills adversely affects their learning, school performance outcomes, and their success in life (UNICEF, 2006). The early age groups (0–5 years) are predominantly covered by the health sector, mainly for survival and growth, but health care providers often fail to detect problems with cognitive, language, and socioemotional development. If child development is closely monitored in the early years, children perform well in school and contribute, when adults, to their nation's economic productivity (Campbell et al, 2014).
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