Sub-Saharan Africa

The success of a child’s healthy development is largely dependent on their primary caregiver’s capacity. The 2016 Lancet Early Childhood Development Series1 highlights that efforts to support children are not likely to bear success unless they concurrently provide support for the caregivers upon whom children depend for care.

Many barriers exist to caregiving including that:

• Caregivers may lack the physical, psychological and social capacity to care for their child.
• Highly adverse conditions may introduce threats to caregiver’s well-being and their resources for caregiving.

In responding to these barriers, there is also recognition that frontline workers, who are often community volunteers and caregivers themselves, are not equipped with adequate skills to enable them to support caregiver needs.

Caring for the Caregiver (CFC) is a foundational training module that is designed to address these needs, and to complement existing maternal and child health programmes including the UNICEF/WHO Care for Child Development (CCD) Package and the UNICEF Infant and Young Child Feeding (IYCF) Package. CFC can also be utilised as a foundational course for other sector programs whose success is dependent on caregiver and family capacity (e.g. health promotion programmes such as WASH or child protection programmes).

CFC training translates well-established evidence on how to support emotional well-being and mental health, presenting these in practical activities which encourage self-care, family engagement and social support. The training package provides curriculum for training frontline workers to address barriers to responsive caregiving and it provides supporting implementation materials for counselling caregivers.

CFC was developed for the UNICEF West and Central Africa Regional Office (WCARO) by expert consultants, with a series of consultations and pilot training activities in two countries: Mali and Sierra Leone.

UNICEF

2019

This report which was issued by BRIDGE, Ilifa Labantwana, National ECD Alliance (NECDA), the Nelson Mandela Foundation, Smartstart and the South African Congress for Early Childhood Development (SACECD), is based on a survey of 3,952 ECD operators in South Africa conducted in mid-April 2020.

In line with government’s concern for lives and livelihoods, the organizations that issued the report believe that support needs to be offered to ECD operators owing to the circumstances they find themselves in due to COVID-19. The report constitues a proposal that requests government to appropriately assist ECD workforce during this precarious time of COVID-19.

After presenting the reasons why ECD operators should be accomondated in relief interventions and the impact on ECD operators' sustainability, caregivers and children, two possible interventions that the state can take to support the ECD sector during this time are presented: 1) Support to the ECD workforce to offset their loss in income and 2) Support to ECD operators due to loss of income from reduced fee payment.

BRIDGE, Ilifa Labantwana, National ECD Alliance (NECDA), Nelson Mandela Foundation, Smartstart, South African Congress for Early Childhood Development (SACECD)

2020

If there is one silver lining to the COVID-19 crisis, it’s probably the growing appreciation of childcare as an essential service and backbone to the growth and development of our economies. Maniza Ntekim, UNICEF’s Regional Advisor for East and Southern Africa, reminds us of the impor- tance of early childhood services, noting particularly that “If we leave early childhood education behind, we leave learning behind. If we are serious about tackling inequality, addressing the learning crisis, and making education systems work better, we have to scale up investment in early childhood education during and after this pandemic.” Early childhood services are even more important to parents now because to be productive and engaged in economic activities, they need safe, stimulating, and nurturing environments for their children. A focus on early childhood services is therefore critical in the broader plan to build back better.

Despite the well-established evidence that early childhood services are essential to human capital formation, socio-economic development, women’s employment, and increased equality, its workforce is one of the most undervalued in the world. This blog focuses on the early years’ workforce in Africa, calling for action to support them to keep services running.

AfECN

2020

There is mounting evidence on the positive link between high quality early childhood development (ECD) personnel and the physical, social, and cognitive development of young children.

To bring light to these challenges, and potential responses to them, the Early Childhood Workforce Initiative (ECWI) has developed 6 country briefs which highlight efforts to support the workforce across different geographies and services.

These country briefs were informed by desk reviews and information collected through key informant interviews (KII) with country experts from implementing NGOs, multilaterals, and research institutions, as well as program managers and government officials across 15 countries. After identifying six promising country approaches to highlight, we conducted further desk research and interviews to inform the country briefs. These interviews were particularly helpful for clarifying the key enablers and barriers to implementation in each country as well as the policy lessons for other countries.

The third of these briefs focuses on Kenya. Empowering Community Health Volunteers to Integrate Nurturing Care examines Siaya County’s approach to integrating nurturing care into the work of Community Health Volunteers by providing them with ongoing support and better recognition.

Vidya Putcha, Results for Development

2019

There is mounting evidence on the positive link between high quality early childhood development (ECD) personnel and the physical, social, and cognitive development of young children.

To bring light to these challenges, and potential responses to them, the Early Childhood Workforce Initiative (ECWI) has developed 6 country briefs which highlight efforts to support the workforce across different geographies and services.

These country briefs were informed by desk reviews and information collected through key informant interviews (KII) with country experts from implementing NGOs, multilaterals, and research institutions, as well as program managers and government officials across 15 countries. After identifying six promising country approaches to highlight, we conducted further desk research and interviews to inform the country briefs. These interviews were particularly helpful for clarifying the key enablers and barriers to implementation in each country as well as the policy lessons for other countries.

The third of these briefs focuses on Ghana. Bridging Access with Quality: Empowering Kindergarten Teachers with PracticalTraining to Support Child-Centered Learning explores the Fast Track Transformational Teaching (FTTT) Program’s approach to enhancing pre-and in-service training that improves kindergarten teachers’ practical skills and ability to implement the national play-based kindergarten curriculum.

Maggie Gratz and Vidya Putcha, Results for Development

2019

Interactive Audio Instruction (IAI) is a distance learning technology that can deliver low-cost, culturally appropriate education via radio or mobile audio technology. It is a highly effective tool to reach children who can be hard to reach through conventional programs, including the rural poor and children with disabilities. IAI can also be an effective form of service delivery in unstable and conflict-affected regions.

This document provides guidance for program designers and managers who may be interested in using IAI for early childhood development programming, it provides solid evidence for the viability of the IAI approach and outlines the process for designing and implementing an IAI program specifically for early childhood contexts – from initial start-up in a given community, to large scale expansion in a country. It highlights the main steps in the production cycle, the roles and responsibilities of government and communities, and provides useful tips for practitioners at each stage of the process.
The toolkit outlines the four phases in the IAI program cycle as they pertain to ECD programming in a facilitated group setting (early childhood classrooms, non-formal community learning centers, or other adult-led group childcare settings), with a particular focus on community-based early learning initiatives as a means of increasing access. Annexes provide more detail on processes, players and costs of an ECD IAI program, as well as a list of common pitfalls and means of avoiding them or minimizing their impact.

This case study is part of a larger effort to document and increase understanding of the various approaches for supporting children affected by HIV and AIDS in South Africa and around the world. The role of the child and youth care workers (CYCWs) who provide programs to those children and their families is of significant importance. Although they report high levels of job satisfaction they role is very demanding. Believing that offering enhanced psychosocial support to CYCWs would prove critical to the program’s success, in 2007 The National Association of Child Care Workers (NACCW) facilitated the development of an innovative model called Care for Caregivers (C4C). The model brings clinical psychologists directly to CYCWs for a six month program of professional psychosocial support through individual and group counseling.

This case study offers a detailed examination of the C4C model. The report provides an overview of the strengths of the C4C program, recommendations for the future implementation and extension of the program, as well as specific priorities.

Stunting and poor child development are major public health concerns in Malawi. Integrated nutrition and early child development (ECD) interventions have shown potential to reduce stunting, but it is not known how these integrated approaches can be implemented in Malawi. In this paper, the authors aimed to evaluate the current jobs status of community health workers and their potential to implement integrated approaches. This was accomplished by a desk review of nutrition and ECD policy documents, as well as interviews with key informants, community health workers, and community members. They found that Malawi has comprehensive policies and well-outlined coordination structures for nutrition and ECD that advocate for integrated approaches. Strong multidisciplinary interaction exists at central levels but not at the community level. Integration of community health workers from different sectors is limited by workload, logistics, and a lack of synchronized work schedules. Favorable, sound policies and well-outlined coordination structures alone are not enough for the establishment of integrated nutrition and ECD activities. Balanced bureaucratic structures, improved task allocation, and synchronization of work schedules across all relevant sectors are needed for integrated intervention in Malawi.

Today, there is a growing interest on the part of governments and other institutions to make large investments in the early years. However, many well-intentioned initiatives designed to support the health and development of young children struggle to move beyond the pilot or project stage. A critical factor in delivering quality services for young children is the quality of the workforce involved in delivering a service. In this Webinar, we will be discussing the challenges in scaling up the early childhood workforce by using two examples of programmes targeting children aged birth to three and their caregivers.These programs include the Cuna Mas Home Visiting programme in Peru, and a program supported by PATH in Mozambique to integrate early childhood development screening and counselling into the routine work of community health workers and clinical providers. Under the ECWI, R4D recently carried out (1) a country study on the workforce supporting Cuna Mas in Peru, and (2) a global landscape analysis of training and professional development for the broader early childhood workforce which includes a case study of PATH’s work in Mozambique.We are very fortunate to have as our Webinar panellists two of the researchers of the country study in Peru, Gabriela Guerrero (GRADE) and Kimberly Josephson (Results for Development), as well as Jordi Fernandez (PATH) and Nami Kawakyu (Kawayku Consulting) who are actively involved PATH’s maternal and child health work in Mozambique.To listen to the webinar recording, click the YouTube link below. Visit the webinar page to access all the webinar presentations.

The National Integrated Early Childhood Development Policy (NIECDP) (2015) is an important step in South Africa’s shift from a health system focused on curative, disease-based services to one based on prevention and health promotion. The NIECDP identifies a comprehensive vision of early childhood development (ECD) services to be delivered by 2030, seeking to strengthen and integrate these services across all government departments. While recognizing the Department of Health’s Community Health Workers (CHWs) present role in providing supportive health and nutrition services, the NIECDP envisages these CHWs playing a significant, and expanded, role in strengthening overall maternal and child developmental outcomes by providing parenting support and opportunities for early learning and stimulation through additional home visits and community-based activities for families and young children through the age of two, commonly defined as part of first 1000 days services. The evolving role of the CHW in ECD services is set against the backdrop of continued Primary Health Care Re-engineering efforts.

This study is intended to provide insight into how the Department of Health is endeavoring to implement the NIECDP, with particular focus on the role of CHW. It examines the experience of two provinces and aims to consider the implications for service delivery across the country, as well as provide recommendations to enable, prepare and support the CHW workforce to deliver on this expanded suite of early childhood services. Given that many countries are considering expanded roles of para-professionals such as CHWs, it is also hoped that this study will contribute further to the knowledge base around delivering integrated health and development services for young children across a range of contexts.

This study addresses the following primary research questions: 

• What is the status of implementation of the first 1000 days services in the NIECDP by the Department of Health? 
• What are the barriers and opportunities for the Community Health Worker to deliver the first 1000 days services outlined in the NIECDP? 
• What lessons can be drawn from their experience?