Europe

Health mediators – you are not alone!

By: Ivana Miljković

This blog post is a repost courtesy of UNICEF Serbia. Read the blog in Serbian here.

 

 

Serbia, Bor, Valjevo, 17 September 2020 – Marina Sinanovic, the only health mediator in Bor, is in an abandoned school, visiting the Demiri family. The mom, Elida, explains to her that she has been taking care of the five children on her own during the past month, because their father, Nesat, finally found a job.

Nadjija and Ibarim, already teenagers, help with caring for their younger sisters Elena, 6, and Leonora, 3, and their brother Nebojsa, who is 10.


© UNICEF Srbija/2020/Pančić

“Marina always tells us what to eat, to wash our hands, to study,” says Nadjija. Meanwhile, Elena brings her bag and shows us her toys. “I got building blocks and dolls. It’s for me and my sisters,” she says proudly.

 


Two and a half years ago, Marina decided to become a health mediator because she herself experienced discrimination and rejection as a child. She wanted to help her community, but also to help Roma children grow up to be more self-confident. Today, she cares for 400 Roma families.


 

© UNICEF Srbija/2020/Pančić

 

“There are a lot of Roma people who are uneducated and illiterate and are afraid to go to the doctor. Mothers take their children to get vaccinated, but they don’t go to the gynaecologist. I'm here to convince them, schedule an appointment, take them there. When the coronavirus pandemic started, the parents were afraid for their children, so I kept calling the doctors at the Primary Health Care Centre to ask what to do if the child coughs or has an allergy, which syrup to take, what to eat,” she describes how she spent days during lockdown.

 


During the state of emergency, she would answer more than 100 calls, messages and questions on social media daily. She was especially concerned about pregnant women and young mothers.
“I gave them advice on what to do with their babies, how to breastfeed them. I have excellent cooperation with the visiting nurses as well,” says Marina.


 

The fact that health mediators had many years of training about the importance of early childhood care and development, nutrition and learning through play, and were also empowered to help the Roma population in exercising their rights to health and social protection and education, proved to be especially useful during the COVID-19 pandemic.

 


© UNICEF Srbija/2020/Pančić


Marina and her colleagues were ready to devote themselves to children and help the most vulnerable families in difficult and unpredictable circumstances.


 

 

Marina says she can't tell just how many online meetings and workshops she organized with parents and children. The children learned new words, numbers, learned to calculate, to draw. Whenever there was distribution of humanitarian aid, including family boxes for learning and play, she would use the opportunity to explain to them how some resources, toys and board games can be used both for learning and bringing together family members, particularly siblings.

“I advised parents on how to play with their children, what stories to read to them. They had to fill that time, to forget that they were in lockdown. The children were thrilled, because in this difficult situation, when the family redirected all its money to buying food, the children received toys, to help them connect with their parents,” says Marina.

 


And 180 kilometres west of Bor, in the city of Valjevo, Gordana (Goca) Petrovic takes care of 600 Roma families.

 

“Whatever we needed, from paperwork to food and hygiene packages, we called our Goca. We have four children, and our eldest son Nemanja (16) has cerebral palsy, and she provided us with diapers for him. Can you imagine how much Goca means to us?”  This is how Darko Omerovic, who together with his family, receives welfare and lives in a Roma settlement on the outskirts of the city, talks about a family friend, a mother of three children, and a health mediator.

When Gordana started working 11 years ago, they were the first family she visited.

“That was when I first saw Nemanja, he was 5 at the time. I immediately took him to the dentist and to get vaccinated. I became so attached to this child, but he also became attached to me,” says Gordana.


She has helped them move to a better house, helped Nemanja get help from a neurologist, urologist, and physical therapist, and made sure that Ilija, 15, Aleksandra, 13, and Sara, 3, are vaccinated and that they receive everything they are entitled to through the social, health care and the education systems.

© UNICEF Srbija/2020/Pančić

 

The Omerovic family is just one of 600 Roma families Gordana is helping gain access to health care services. The lockdown due to the coronavirus pandemic was a challenge for everyone, and Gordana had to switch from fieldwork to phone and online counseling.

“We communicated by phone, via Messenger, Viber, and social networks. I connect with the family and teach them how to wash their hands properly and wear masks, I remind them to keep their distance and eat healthy food. I’m proud of all of them because they were disciplined. Until June, we didn’t have a single Roma person who was infected with the coronavirus, and to date, only four have been registered as positive to COVID-19,” says Gordana.

 


© UNICEF Srbija/2020/Pančić


She provided drinking water cisterns to the settlements without sewerage, and together with the Red Cross, she managed to visit each family at least once and bring them hygiene packages, food and toys. She didn't forget the Omerovic family. Sara, the youngest, was the happiest she received some toys and she proudly keeps telling us all the time, “I am three and a half years old.”
 

 

She always has her favourite doll with her. The thing she likes doing the most with Gordana is colouring. They also learned to count to 5, they boast. When her older sister is studying or is at school, what she likes the most is playing with building blocks with her dad.

“I don’t know a better father than Darko. He takes them to school, to the doctor, he plays with them. He gives all of himself to his children,” says Gordana and adds, “I also played dominoes with the children online for an hour and a half. It was a nice and new experience for them.”

However, what many needed the most during the lockdown was psychological support and a kind word.

“They were afraid. It was hard for them not being able to work. You know, many families are financially dependent on just one family member. I kept repeating to everyone – this, too, shall pass, the most important thing for you is to stay healthy,” says Gordana and recalls how she was afraid herself.

 


Gordana and Marina are just two out of 85 health mediators working with 60 Primary Health Care Centres across Serbia. They enjoy the trust of the community because of their dedicated work, but also because they are Roma women who come from Roma settlements and speak the Roma language.

 

In 2008, the Ministry of Health of the Republic of Serbia launched a project within which a network of health mediators was established and through which they were educated and empowered to support Roma communities in the health care system, and above all, to support families with young children. The process of institutionalization (integration) of their occupation and profession into the system is still ongoing. The pandemic has shown very clearly how important their role is, and their impact on families, thanks to the trust they have built.

UNICEF, as the Ministry of Health’s long standing partner, is supporting the continuity and quality of services provided by health mediators during the COVID-19 pandemic thanks to the financial support of GlaxoSmithKline (GSK). GSK is committed to improving the health of Roma children in the Republic of Serbia and the region through the “Together for Better Health” initiative.

 

Quality preschool starts with supporting teachers


 

World Teachers’ Day poses the opportunity to celebrate teachers and their important role in the lives of young children. Early years educators are a part of children’s lives at a critical time in their development. These professionals — through their day-to-day interactions — have the opportunity to transform a child’s developmental trajectory. Today we revisit a blog post by Vidya Putcha of Results for Development, which shares key insights for decision makers to strengthen the roles of early years teachers.


Preschool — often the first time that children interact with the education system — can be a powerful opportunity to support children’s growth and development at a critical stage in life. In Ukraine, the government has acted on a strong commitment to preschool education by providing families with affordable opportunities through its public system of education. However, like many other countries, the system struggles to keep pace with demand. In 2014, for example, 90,000 children were waiting for places in public preschools, with 15,000 in Kyiv alone. Additionally, more attention is needed to improve the quality of preschool programs.

Finding ways to better position and support preschool teachers, who are at the core of the system, is crucial to addressing these challenges. In an effort to learn more about their role and provide recommendations for how to strengthen this workforce, Results for Development (R4D), the Ukrainian Step by Step Foundation and the Institute for Education Development recently carried out a study on preschool teachers in Ukraine. This research was published in a new report, Supporting the Early Childhood Workforce at Scale: Preschool Education in Ukraine, and surfaced critical insights which may be illuminating for policymakers in other countries looking to strengthen the roles of personnel working with young children and families:

1. Provide ample opportunities for hands-on learning early on in preschool teachers’ training.

While nearly all preschool teachers in Ukraine have completed some higher education in teaching, a number of preschool teachers we spoke with described having limited practical opportunities during their higher education. Higher education programs were described as being heavily lecture-based and focused on outdated approaches, with opportunities for student teaching often coming too late in the program and facilitated by teacher educators with very little teaching experience themselves. We also learned that it is difficult to sustain a healthy pipeline of preschool teacher candidates, as many graduates of teacher training colleges and universities do not go on to work in preschools. This may be a product of higher education institutions not effectively fostering a professional interest in preschool teaching among its students.

Hands-on learning can help prospective teachers understand how to apply new knowledge to their work in preschools. At the same time, these opportunities may allow teachers to reflect on their future careers and help to sustain their interest in the field.

2. Offer a range of in-service trainings and ensure that teachers have opportunities to connect and learn from one another.

Encouragingly, preschool teachers are able to receive in-service training every five years with funding from local budgets. We heard that teachers appreciate these opportunities and particularly enjoy being able to connect with and learn from peers. Teachers we spoke with advocated for more of these opportunities, which suggested to us that practical knowledge from peers may better address their professional needs than training courses. However, while these in-service training courses seem to be beneficial to teachers, there are concerns about the quality and variability of the trainings, in particular, that teachers have limited choice in offerings which often do not reflect varying needs and interests.

Many teachers are already poorly compensated so it is important that they have access to training and professional development opportunities that do not require their own personal financial investment. Since teachers may have varying experience and backgrounds, designing different types of training courses, giving teachers the freedom to choose those that best meet their needs, and facilitating peer learning opportunities, can help in ensuring the relevance of offerings.

3. Provide more targeted support on engaging with parents and identify ways in which feedback from parents can be incorporated in programs. 

Teachers and other school personnel frequently noted that communication with parents was their biggest challenge. Teachers felt that parents were not involved enough in their child’s development and ignored recommendations on how to support children at home through activities such as reading. At the same time, although many parents we spoke with lauded preschool teachers in public institutions for the work that they do despite low pay and heavy workloads, we learned that a growing number of families are enrolling their children in private preschools as they are drawn to the modern approaches that teachers in these school employ as well as the flexibility offered by these schools.

Efforts to better understand these dynamics could help in strengthening relationships and ensuring that families’ needs are being met in public institutions. Teachers also need support from senior teachers and leaders to help them better communicate with parents in order to ensure complementary home and school environments.

4. Hire and train auxiliary staff to offset challenging workloads and allow for more targeted support to children with special educational needs.

While teachers were strongly motivated by a desire to work with children, they described heavy workloads often resulting from large class sizes and paperwork. This was often further compounded by insufficient time and experience to provide individualized support to children, particularly those with special educational needs who were more frequently part of classrooms after the recent shift to inclusive education in the country. A new initiative to introduce the role of teacher assistants to support inclusive classrooms has been met with great enthusiasm and has potential to alleviate some of these challenges.

Efforts to deploy and mainstream auxiliary staff roles can help to unburden teachers and improve their ability to provide individualized support to children.

Empowering preschool teachers to thrive in their day-to-day interactions with young children can be challenging, given limited resources and the complexity of working with this population. While the insights above are only a small sample of how we can course correct, they offer ideas for how the early childhood workforce can be supported to make a lasting change in the lives of young children. The Early Childhood Workforce Initiative looks forward to supporting countries with knowledge and evidence as they embark on efforts to support these critical individuals. 


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