Early Childhood Development Centres Research Articles

Early Childhood Development Programs in Nepal: Opportunities and Challenges

This article presents a comprehensive examination of the contemporary landscape of Early Childhood Development (ECD) initiatives in Nepal, focusing on both their quality and accessibility. Through a meticulous analysis of secondary data, this study scrutinizes the current state of Early Childhood Education and Development (ECED) centers, the pivotal roles of educators, and the efficacy and caliber of ECD programs, thereby elucidating the prevailing opportunities and obstacles. A high-quality ECD program is fundamental in extending developmental prospects to all children, including those facing adversities, by furnishing them with requisite care, support, and safeguarding. Realizing this necessitates concerted efforts from diverse stakeholders, entailing heightened investments in ECD and the advocacy of its developmental imperatives. Paramount among these stakeholders is the family, serving as the primary gateway to ECD interventions, underscoring the imperative for tailored interventions within familial contexts. Moreover, communities wield significant potential in augmenting ECD initiatives. Thus, a decentralized approach to ECD delivery across all strata of governance emerges as imperative. The realization of quality ECD hinges upon the convergence of multifaceted inputs, harmonized across various domains. By fostering synergy among these inputs, ECD programs can achieve their utmost efficacy and impact, thereby fostering holistic child development.

Guidelines for Organizing Bi-Multilingual Learning Experiences Using the Mother Tongue-Based in Early Childhood Development Centers within Diverse Social Contexts

Guidelines for Organizing Bi-Multilingual Learning Experiences Using the Mother Tongue-Based in Early Childhood Development Centers within Diverse Social Contexts

The Provisions of Learning Experiences in the Early Childhood Development Centers against the COVID-19 Pandemic

This study aimed to explore the provision of learning experiences for early childhood development at Childhood Development Centers (CDCs) during the Covid-19 pandemic, focusing on the "what" and "how" aspects. Data were collected from 57 participants through in-depth interviews and group interviews involving parents of young children, teachers/caregivers at CDCs, community leaders and committees, as well as relevant government agencies in two areas of Thailand. Content analysis was utilized to analyze the qualitative data gathered between July and November 2020. The findings revealed that CDCs employed various forms of capital, including: human, group and network, local wisdom, organizational, financial, and natural resources, to adhere to the National Childhood Development Center Standards. CDCs provided three distinct patterns of learning experiences for children: 1) Community participation within the local area, involving parents and networks associated with CDCs. 2) Enhancement of systems and mechanisms for collaboration with early childhood development among government, private sectors, and academic sectors at the district level. 3) Promotion of health and wellness among early childhood during the Covid-19 pandemic through encouraging child development, improving nutrition, and preventing the spread of Covid-19.

Unblocking the System to Strengthen Implementation of Early Childhood Development Policies and Practice in South Africa

Government sectors responsible for early childhood development (ECD) often have competing priorities and obligations which manifest through fragmentation, silo conflicts, and power dynamics, thus failing to implement ECD policies in South Africa effectively. This article aims to provide a framework for strengthening the implementation of ECD policies to enhance quality early childhood care and education (ECCE) in the Gauteng province of South Africa. Using a qualitative approach within an interpretive paradigm, data was obtained through open-ended semi-structured interviews, observations, and field notes. Key stakeholders, including ECD managers, practitioners, and education officials, were purposely sampled. The conceptual lens was used for exploring the current implementation of ECD policies at the systems level in the theoretical framework. The findings revealed communication and information blockages at the level of national, provincial, and district offices. As a result, ECD centers were left uninformed of the new policies and frameworks for implementation. A framework that stipulates standardized training for the Department of Education officials, support for ECD principals, managers, and practitioners, and open communication through bi-annual conferences and monthly community of practice (CoP) virtual meetings will ensure that policies are implemented and that quality ECD education is achievable in South Africa.

Assessment of growth monitoring among children younger than 5 years at early childhood development centres in Nelson Mandela Bay, South Africa

AbstractIntroductionEarly childhood development (ECD) centres are important community hubs in South Africa and act as sites for community detection of childhood nutrition problems. This study aimed to assess the ability of trained ECD practitioners with optimal support to correctly classify the nutritional status of infants and young children at ECD centres in the Nelson Mandela Bay.MethodsA descriptive, cross‐sectional study was used to collect data from 1645 infants and children at 88 ECD centres. Anthropometric measurements were taken by trained fieldworkers and growth monitoring and promotion infrastructure was audited at ECD centres.ResultsOf the sample, 4.4% (n = 72) were underweight by weight for age Z‐score (WAZ < −2) and 0.8% (n = 13) were severely underweight (WAZ < −3). Results showed that 13.1% (n = 214) were stunted by height for age Z‐score (HAZ < −2) and 4.5% (n = 74) were severely stunted (HAZ < −3). The prevalence of moderate acute malnutrition was 1.2% and severe acute malnutrition was 0.5%, while the prevalence of overweight was 9.2% and the prevalence of obesity was 4%. A significant level of agreement between the correct interpretation and the ECD practitioners' interpretation was observed across all the anthropometric indicators investigated. The true positive wasting cases had a mean mid‐upper arm circumference (MUAC) of 14.6 cm, which may explain the high false negative rate found in terms of children identified with wasting, where ECD practitioners fail to use the weight for height Z‐score (WHZ) interpretation for screening.ConclusionBy using ECD centres as hub to screen for malnutrition, it may contribute to the early identification of failure to thrive among young children. Although it was concerning that trained ECD practitioners are missing some children with an unacceptably high false negative rate, it may have been due to the fact that wasting in older children cannot be identified with MUAC alone and that accurate WFH plotting is needed. Onsite mentorship by governmental health workers may provide ECD practitioners with more confidence to screen children for growth failure based on regular WFH measurements. Moreover, ECD practitioners will be more confident to monitor the Road to Health booklets for missed vaccinations, vitamin A and deworming opportunities.

Early childhood practitioners’ awareness of gross motor milestone acquisition and movement guidelines

Background: Early childhood development (ECD) practitioners are essential in governing foundational aspects, such as gross motor development and participation in physical movement.Aim: This study aimed to determine ECD practitioners in Vanderbijlpark’s awareness of gross motor milestone acquisition and movement guidelines for children birth to 4 years. Associations between these ECD practitioners’ demographic aspects and their determined awareness were also explored.Setting: This study included 50 ECD practitioners (M = 36.9 years) from nine ECD Centres (ECDCs) in Vanderbijlpark, South Africa.Methods: A descriptive quantitative, cross-sectional design was followed. Data was collected using a self-administered questionnaire. Data analysis included descriptive statistics and associations between practitioners’ demographic aspects and their awareness of gross motor milestone acquisition and movement guidelines.Results: Correct awareness of gross motor milestone acquisition was mainly observed for milestones acquired during the first year of life. Participants’ awareness of screen time guidelines was relatively good, while their awareness of movement and sleep guidelines was poor. Having children, as well as the age of these children, respectively, correlated significantly with practitioners’ knowledge of standing alone (p = 0.007) and jumping 2 feet (p = 0.046). Participants’ work experience or training was not significantly associated with their determined awareness.Conclusion: The sample of ECD practitioners in Vanderbijlpark, South Africa, did not have adequate awareness of gross motor milestones and recommended movement guidelines for children birth to 4 years.Contribution: Limited awareness of gross motor milestone acquisition and movement guidelines amongst ECD practitioners’ warrants development of knowledge through ECD-related training, CPD opportunities, and short courses.

Quality and Inclusive Education in Zimbabwean Rural Early Childhood Development Centres

Globally, inclusive education lays a central role in improving and sustaining quality in Early Childhood Development (ECD) settings. Children with diverse needs and challenges are most vulnerable, marginalised and denied access to early education, especially in rural communities. This article explored the implementation of inclusive education towards achieving quality education in rural ECD settings of Mashonal and East schools of Zimbabwe. Grounded in the interpretivist philosophy, the study adopted a qualitative approach. Qualitative data from participants were gathered though semi-structured interviews and observations. The participants included three ECD teachers from three rural schools with ECD classes. The findings revealed that inclusive education is one of the measurement of quality in ECD centres. Despite being a crucial measure, data shows that rural ECD centres in Zimbabwe are not prepared for inclusive education. Although there are existing policies and acts on disability there was also a lack of support from the centres’ leadership and administration on the implementation. Our recommendations are that all stakeholders in ECD centres should support the implementation of inclusive education.

Effects of Cucurbita Moschata squash (Butternut) seed paste in improving zinc and iron status in children attending Early Childhood Development centres in Limpopo province, South Africa.

Cucurbita moschata (Butternut squash) seeds are a rich source of nutrition containing nutrients including iron, zinc, copper, calcium, potassium, and phosphorus. The aim of this study was to determine if Cucurbita Moschata squash seed paste improves zinc and iron status, anthropometric status, and dietary intake in preschool children. A pretest-posttest control group trial using cluster randomisation was conducted over 6 months. Four preschools were randomly assigned to receive 100 g of intervention or 100 g of a placebo as the control to enhance iron and zinc status. A total of 276 preschool children were recruited from eight government registered Early Childhood Development centres in Limpopo province, South Africa. The control group consumed Cucurbita moschata flesh twice-weekly, while the intervention group consumed Cucurbita moschata seed paste twice-weekly during a six-month period. Iron (serum iron, transferrin, transferrin saturation, ferritin) and zinc (serum zinc) status and anthropometric indices such as weight, height and mid upper arm circumference for children were evaluated at baseline and the endpoint. Iron and zinc-rich food consumption was measured using a 24-hour dietary recall and food record during the study, and dietary intake was estimated using a food frequency questionnaire which was conducted at the beginning and endpoint. The intervention group significantly improved in the mean serum iron 0.23 μg/dL (95% CI: 0.11;0.33); ferritin 0.21μg/dL (95% CI: 0.13;0.39), transferrin saturation 0.33% (0.23;0.74) and zinc 0.16 μmol/dl (95% CI: 0.13;0.25) at the end of the study. In addition, the intervention group exhibited greater mean weight for age of 0.13 z-score (95% CI: 0.28; 0.34) and weight for height of 0.04 z-score (95% CI: 0.12,0.05), as well as the consumption of iron (p < 0,001), zinc (p < 0,001), and vitamin C (p < 0.001). At the end of the trial, fiber (p < 0.001), riboflavin (p = 0.001), vitamin B6 (p < 0.001), and vitamin B12 (p < 0.001) were significantly higher in the control group. Thus, the inclusion of intervention in the diet of children in an impoverished area of South Africa improved the iron and zinc status of these children. This supplement could be a cost effective and sustainable approach to improve nutrient status in rural South Africa. Trial registration: Pan African Clinical Trial Registry (PACTR202308740458863).

Inclusion of young children with autism spectrum disorder during the COVID-19 lockdowns

Children with autism spectrum disorder face numerous challenges throughout their childhood and beyond. These challenges include demonstrating behavioural and emotional immaturity, and a lack of grasping intuitively unspoken rules and norms, to mention but a few. Deviating from the norm heightens these challenges. One of the sudden changes brought about by the national lockdown was the extended closure of early childhood development centres. There is a dearth of studies that explored the perceptions of early childhood care and education educators’ knowledge of the inclusion of children with autism spectrum disorder. As a result, I employed case study methodology to explore these educators’ perceptions of the inclusion of young children with autism spectrum disorder in regular education, as well as how these perceptions influenced the inclusion of these children in regular education during the lockdowns of the coronavirus disease (COVID-19) period. Three early childhood care and education educators from a semi-urban early childhood development centre were purposively sampled. Using the 4 key principles of special education needs and disabilities, I concluded that early childhood care and education educators lacked knowledge of teaching and accommodating young children with autism spectrum disorder in everyday education during the COVID-19 lockdowns. The study calls for a stern consideration of these educators’ knowledge development and reimagination of their understanding of children with autism spectrum disorder during trying times and beyond.

English Literature in the Grade R Classroom: Exploring the Implementation of Children’s Literature Curricula in Selected Early Childhood Development Centres

The reading challenges children face in the lower grades of primary school in South Africa are well publicised. Children’s literature is critical in early childhood education, supporting growth in multiple domains. The study aimed to explore the implementation of Grade R children’s literature curricula at selected early childhood development (ECD) centres in Johannesburg. Four Grade R teachers teaching at different ECD centres were chosen as the study’s participants. The four ECD centres selected were in demographically disparate areas of Johannesburg. Two followed the Curriculum Assessment Policy Statements (CAPS) curriculum, one followed the Independent Schools Association of Southern Africa (ISASA) curriculum, and one followed the Reggio-Montessori curriculum. The study is a generic qualitative inquiry, and data were generated using semi-structured interviews with Grade R teachers at the ECD centres, observations of lessons, and document analysis. Three themes emerged from the data analysis. Firstly, the Grade R children’s literature curricula’s content, design, and implementation aim to develop children holistically. Secondly, Grade R teachers use different methods to teach children’s literature. Finally, Grade R teachers pay close attention to their classroom contexts when planning and executing children’s literature lessons. The authors conclude that the architecture of the children’s literature curriculum at the selected centres is a complex function of various factors. These include the content of the curriculum, the methods used by the teachers in delivering it, and the teacher’s responses to the contexts in which they teach.

Assessment of the Influence of Teaching Methods on Learners Preparedness for Primary Education in Kenya

The purpose of this research was to compare and contrast the efficacy of different teaching methods in preparing pre-primary school students for success in elementary school. Participants in the study included Curricula Support Officers (CSOs), Section Heads, Early Childhood Development and Education (ECDE) center administrators, and educators. The study took a descriptive survey approach. The sample size of 215 was determined by Yamane's (1967) formula and was reached by the use of a systematic sampling technique. Focus group discussions (FGD), questionnaires, and in-depth interviews were all used to compile the data. Quantitative data was analyzed using descriptive statistics, and the results were presented in tables, while qualitative data underwent content analysis and was presented narratively. Parametric and non-parametric tests were utilized in inferential statistics, and a 5% significance threshold was applied in a logistic regression analysis to assess the null hypothesis. The Shapiro-Wilk and Kolmogorov-Smirnov tests were used to check for normality. Since the calculated p-value of 0.042 was less than the required significance threshold of 0.05, the null hypothesis was rejected, suggesting that teaching practices had a sizeable impact on students' readiness for academic success. These results can be used by the County Government to provide better Early Childhood Development (ECD) programs. The National Government can use this information in policymaking and regulation to better track and control schools, which will improve students' readiness for the classroom. The results of this study may prove useful to teachers because they provide a variety of suggestions for improving the educational preparation of their students through ECDE programs.

Effects of Monitoring of Teaching and Learning on the Implementation of Competency-Based Curriculum (CBC) in Early Childhood Development (Ecd) Centres in Meru Central Sub-County

The competency-based curriculum (CBC) is a set of courses or syllabi, which promote learning areas in which the learner is gifted and skilled. The curriculum was adopted in Kenya in January 2017, when such a change occurs in education various stakeholders and resources are needed to be considered for smooth implementation. However, in Kenya, various stakeholders have expressed concerns regarding implementation of CBC. The purpose of this study was to find out the effects of monitoring of teaching and learning on the implementation of competency- based curriculum (CBC) in early childhood development (ECD) centres In Meru Central Sub-County. Lewin’s Theory of Planned Change guided the research. With adoption of descriptive research design, the study targeted 84 head teachers, 256 ECDE teachers and one Sub-County Curriculum support officers (CSO) in Meru Central Sub County. The study used a sample size of 14 head teachers, 51 ECDE teachers and the CSO in charge of education in the sub county. A simple random sampling was adopted to select participating schools and stratified sampling to select the head teachers, purposive sampling was used to consider ECDE teachers as the respondents for the study and the CSO. The main data collection tools to be used in this study included; questionnaire for head teachers and the ECDE teachers, interview schedule for the CSO and the observation guide that also guided the researcher on the availability of the instructional resources. The study quantitative data was analyzed using descriptive statistics modeled in percentages, mean and standard deviation while inferential statistics was correlated using Pearson product moment correlation. Qualitative data was analyzed using themes and prose. Discussion of the data was made, conclusion drawn from the findings and the study made conclusions recommendations and suggestions based on the research findings. The study found that that head teacher frequently monitors lesson attendance for effective implementation of CBC and invites quality assurance officers in school. The study concluded that Teachers held positive perceptions towards implementation of CBC as the head teachers were constantly following the curriculum implementation process right from classroom activities. The study recommended that the government should purchase more computers in schools for successful integration of technology in CBC program due to increasing population in schools. The purchasing of teaching and learning resources should also be prioritized especially for practical work and preparation of teaching aids for teachers.

The COVID-19 pandemic’s effect on family leisure activities of working parents with pre-school aged children

ABSTRACT The COVID-19 pandemic and its associated lockdown in South Africa led to the closure of leisure spaces, and Early Childhood Development (ECD) centres, forcing parents who were non-essential employees to work from home. This created a crisis for families, with significant consequences for family leisure time and activities. This paper explored the impact of the pandemic for parents with pre-school aged children (PSAC) and aimed to identify changes to family leisure during this period. Data was collected through self-administered questionnaires (n = 140) among parents at three selected ECD centres in Cape Town. The findings indicated that participants experienced higher emotional and tiredness levels because of the pandemic-induced changes, often neglecting themselves in their attempt to balance work, life and care for their PSAC, without their traditional support structures. The findings confirm a significant impact on family leisure, with leisure activities decreasing, and switching from outdoor, relational to home and family-based activities. The study identifies the type of leisure activities and changes caused by the pandemic and the effect it had on parents’ work-life balance and overall wellbeing.

Linking Care and Support Systems to Improve Childhood Malnutrition: Early Childhood Development Practitioners’ Perceptions of Integrating Multisectoral Systems in South Africa

Introduction: Child malnutrition is a persistent global challenge. It is the cause of nearly 45% of global child mortalities. To ensure positive child health outcomes, integrated multisectoral approaches among families, communities, and government systems to ensure positive child health outcomes are neccesary. Objectives: This study identifies how different care support systems can be linked to ensure optimal childhood nutrition outcomes in South Africa. This is through multisectoral approaches from the early childhood development (ECD) practitioners' perspective. Materials and Methods: We integrated the components of the different support systems and multisectoral approaches. The conceptional framework of the causes of malnutrition by The United Nations Children's Fund (UNICEF) recognizes that malnutrition is due to inadequate care services, diet, and care practices influenced by individual, household, community, and structural determinants. While the Nurturing Care Framework, which looks at how policies and services can support families, parents, and other communities in providing nurturing care. Design: A sequential mixed methods approach was used. For the quantitative method, we did a cross-sectional descriptive analysis of 2 966 children who were under-five years' old in the 2017 South African National Income Dynamics Study (NIDS) between July and August 2022, we conducted five in-depth interviews with ECD practitioners using this qualitative method, and the data was analyzed using thematic analysis. Data was triangulated to understand the factors influencing children’s nutritional outcomes and to provide the narratives of ECD practitioners. This enabled us to highlight challenges and opportunities in linking children to services they need. Results: This study showed that 22.16% of children were stunted, 16.40% were overweight, and 5.04% were underweight. ECD practitioners reported a lack of support received at health facilities and other social services when making referrals, a lack of parental support in nutrition programmes, systemic challenges experienced in getting ECD centers registered, and the ECD's inability to qualify for subsidized nutrition grants. Conclusion: It is critical for us to understand the challenges and opportunities for multisector collaboration. This understanding will enable strategies and policies aimed at providing efficient and effective service referral and service delivery to improve childhood malnutrition in South Africa.

Healthy eating perceptions of mothers and caregivers of children in South Africa.

The perceptions of mothers and caregivers of children attending early childhood development (ECD) centres play a very critical role in promoting healthy eating habits in children and impact long-term health consequences. Food preferences that are developed during childhood continue into adolescence and adulthood and are difficult to change. The aim of the study was to assess the perception of mothers and caregivers of children attending ECD centres regarding healthy eating practices. The study was conducted in ECD centres in Gauteng, North West and Limpopo. A quantitative descriptive design was used to collect data among 290 respondents using a structured, researcher-administered questionnaire. The findings indicated that the majority (77%) of respondents did not believe that choosing a healthy diet is a matter of knowing foods that are good and bad for health. The majority (59%) of respondents believed that the food they eat and drinks are healthy and see no need to make changes. The study findings showed that the majority of respondents lack awareness about choosing healthy diets. Furthermore, the current dietary patterns of respondents and their children will remain the same as long as the mothers and caregivers feel that the food they eat is healthy. The findings of the study contribute to the appropriate measures of educating mothers and caregivers in offering healthy diets to children at home and in early childhood centres.

Effectiveness and Preferences on Mainstreaming Early Childhood Stimulation Services in Tanzania: A Case Study of Community-based Early Childhood Development Initiative

Early childhood stimulation (ECS) services are globally championed due to their proven ability to help children at risk of developmental delay attain their developmental potential. This study explored the effect of different ways of mainstreaming ECS services on child development. A mixed research approach was employed, involving quantitative and qualitative collection methods. Quantitative data was collected using the adopted ZamCAT tool administered to 334 children sampled from the benefited households. Qualitative data was collected through focus group discussions with the parents (n=4) and in-depth interviews with the key informants (n=14), respectively. The collected quantitative data were coded and analysed using Statistical Package for Social Sciences (25), and the collected qualitative data were analysed through content analysis. The binary logistic regression model was employed where the results showed a significant effect on child development from home visiting (p = 0.01) and Early childhood development centres (p = 0.016) compared to clinic outreaches. Children's nutritional status was also an influencing factor for a child to attain optimal developmental status. Furthermore, both community members and ECS services providers highly preferred ECD centres and home visiting services as opposed to a preference for clinic outreaches. The study concludes that when children are subjected to ECS services, attaining optimal development potential regardless of the household background characteristics is the forecasted result. Therefore, the study underscores the capacitation of communities on ECS practices utilising the available enabling environment and increased budget allocation for developing specific ECD policies and deploying experts.

Enabling educator oral health literacy: An impetus for oral health promotion in early childhood development.

This study reports on the process evaluation of an oral health promotion intervention for educators (principals and teachers) at early childhood development (ECD) centres within a low-socioeconomic community in South Africa. This approach was based on the premise that oral health literacy plays a significant role in shaping personal health and serves as an impetus to influence change in others. Using a cross-sectional, descriptive study design, 91 educators participated in the oral health intervention as part of their 1-year ECD training programme. The pre-test questionnaire measured perceived dental status, oral health-related knowledge, attitudes and practices and impact of oral health problems on oral health-related quality of life (OHRQoL). The post-test questionnaire evaluated the usefulness of the oral health workshop to participants, intentions for personal change as well as for the inclusion of oral health in their ECD centre programme. Participants reported: having their natural teeth (80%), being happy with their mouth (56.2%), having oral problems (34%), inadequate oral hygiene practices (43%), dental visits when symptomatic (74%), a compromised OHRQoL and inadequate knowledge of oral problems experienced. Oral health promotion activities at ECD centres were limited, with only 34% reporting on toothbrushing programmes. Following the intervention, participants reported positively on aspects such as, the value of the workshop for themselves and their ECD centres, intentions for personal change to hygiene practices (56%), dietary practices (76%) and dental visits (63%). The incorporation of oral health education in their ECD centres was mentioned by most educators. Daily toothbrushing was noted by up to 40% while some highlighted their engagement with parents. Building oral health literacy among educators has the potential for personal change and serves as an impetus to introduce oral health promotion programmes at ECD centres. The findings may be used to advocate for oral health partnerships with established community-based structures to increase access to oral care in ECD centres in underserved communities.

The development of digital tools to assess and enhance the ethic children development in early childhood development centers

The research aimed to study the effects of digital tools on ethnic children in child development centers from four districts of Lamphun Province, Thailand. The samples were teachers, parents and health promoting hospital staff from the early childhood development centers 57 people in total from cluster sampling and randomized pretest-post-test control group design. The research instruments were interviewing form, focus group discussion recording form, questionnaire, and child development evaluation form. All digital tool assessment items were qualified with higher accuracy than the specified criterion of 0.50. Its correlation coefficient was higher than 0.85 at 0.05 significantly level. Conditions and needs for context analysis of digital tools had been conducted to develop and use it for evaluating the development of ethnic children in the centers. The data were analyzed using descriptive statistics and T-test. The results revealed that the digital tools compared with documents was different in use between the experimental and the control group of the study with statistically significant at 0.05 and teachers’ satisfactions of using the digital tools were also in high level. The study outcomes demonstrated that the development of digital tools in early childhood could enhance the ethical development of young children and provide educators and parents with valuable insights into a child's progress.

Enabling environment and support as determinant of quality in ECCD centres in Bhutan: An analysis of the findings of quality monitoring of ECCD centres in Bhutan

Quality in Early Childhood Care and Development (ECCD) centres is central to the effectiveness of programmes they provide but it is not limited to what early educators do with children on a daily basis emphasize that quality in early childhood education encompasses such facets as how engaging and safe the centre is, if there is a range of strategies and activities employed to make learning experiences meaningful, whether families and communities engage in the educational process, and if there is a systemic support from the larger community for the effective functioning of the centre. Recognizing the centrality of a holistic definition of early childhood education, the design of centres in Bhutan is founded on internationally accepted concepts and approaches that integrate critical aspects of quality learning environment. The Bhutan Quality Framework, with four specific domains and 29 indicators, define quality in terms of not just focusing on learning activities and strategies, but also encompassing child safety and well-being, quality of interaction and communication, and family and community involvement.This paper is essentially a report on the state of ECCD centres across the country, generated on the basis of assessment carried out using the quality monitoring tool for ECCD centres. The paper highlights the status of ECCD centres in terms of quality of learning in general and analyzes the levels of attainment in each of the four domains of quality. The paper further specifies the state of quality in ECCD centres by districts and types of centres to illustrate their strengths and weaknesses in varying situations and environments. The paper analyses the key findings of the survey and provides a number of recommendations that could contribute to heightening quality of ECCD programmes by addressing shortfalls in the different aspects of quality in ECCD centres

Combined screening of early childhood development, hearing and vision by community health workers using mHealth tools in a low-income community

ABSTRACT Children in low-income communities are at risk for developmental delays and sensory losses. mHealth screening tools enable community health workers to detect developmental delays and sensory losses. This study aims to describe a combined (developmental and sensory – hearing and vision) mHealth-supported screening programme conducted by community healthcare workers with children aged four-six years (n = 63) at early childhood development centres in a low-income community. Early childhood development practitioners (n = 5) assisted with developmental screening. Referral rates were 30% (n = 19) for development, 6% (n = 4) for hearing and 5% (n = 3) for vision. The average screening time for combined screenings was 11.72 min (SD 3.45 min). Post screening questionnaires probing participants' perspectives and experiences of the combined screening were positive. A combined mHealth-supported screening programme conducted by community health workers and early childhood development practitioners appears viable, supporting early detection of developmental delays and sensory losses in children from low-income communities.