Childhood development is a maturational process resulting in an ordered progression of perceptual, motor, cognitive, language, socio-emotional, and self-regulation skills. Thus, the acquisition of skills through the life-cycle builds on the foundational capacities established in early childhood.
Multiple factors influence the acquisition of competencies and skills, including health, nutrition, security and safety, responsive caregiving, and early learning. Each are necessary for nurturing care. Nurturing care reduces the detrimental effects of disadvantage on brain structure and function which, in turn, improves children’s health, growth, and development
The Science of Nurturing Care
Over the last three decades, scientific findings from a range of disciplines have confirmed that the most critical elements of child, adolescent and adult health, wellbeing and productivity take shape during the early years and in particular the first 1000 days. By the time a baby is born, their brain has almost all the neurons it will ever have, and by the age of two years massive numbers of neuronal connections are made which are later trimmed based on which are most frequently used.An optimal environment supports brain development, while an adverse environment harms development both in the short term but importantly also over the longer term. For example, under nutrition during pregnancy, leading to low birth weight, raises the risk of chronic diseases in adulthood. Adversity associated with extreme poverty may lead to diminished care by overworked, stressed and demoralized caregivers. Relentless adversity, without opportunities for compensation or recovery affects the psychological and neurological development of young children.
Children who do not experience the nurturing care necessary to enable their capacities to flourish, are less healthy, grow poorly, learn less and complete fewer grades at school, are more likely to have difficulties relating confidently to others, and earn less as adults. Without intervention, as adults they are estimated to earn close to a third less than the average annual income of their peers. This makes it harder for them and their families to better their lives, leading to debilitating, inter-generational cycles of poverty. These individual costs aggregate across society, constraining wealth creation and eroding national earnings. It is estimated that some countries spend less on health than they are predicted to lose in the future as a result of the high burden of poor early childhood growth and development. Early competencies make it easier to learn new skills, and build confidence and the motivation to learn more across the life-course. Early intervention is not only cost effective but makes later essential interventions across the life-course more likely to succeed.
It is estimated that 250 million children (43%) less than 5 years of age in low and middle-income countries are at risk of suboptimal development due to the risk factors of poverty and stunting alone. Risks to early child development are biologically and contextually determined. Thus, exposure to one risk commonly means exposure to multiple risks. Risk factors include extreme poverty, poor maternal nutrition, sub-optimally breastfeeding, HIV infection, stunting and all other forms of malnutrition, limited cognitive stimulation, caregiver mental health problems, child maltreatment such as physical, sexual and emotional abuse, and neglect; disabilities, home and community violence and exposure to environmental toxins. Nurturing care is therefore a multi-sectoral issue and requires co-ordinated action across various sectors (Health, Education, Agriculture, Child protection unit, Civil Society, Private sector, Non Governmental Organizations amongst others).
What is nurturing care?
Nurturing care is what the infant’s brain expects and depends upon for healthy development.
The brain becomes increasingly complex as we grow older and while new connections continue to be made, the brain is built only once and it is built under very special conditions. Nurturing care is the set of conditions that provide for the optimum care of young children. It refers to a stable environment created by parents and caregivers with support from policies, services and communities that ensures children’s good health and nutrition, protects them from threats, gives them opportunities for early learning, through interactions that are emotionally supportive and responsive. Nurturing care is essential for child development and lays the foundation for life-long health and well-being and builds human capital in the child today, the adolescent and adult tomorrow, and in the next generation in the future.
In the first years of life, parents and intimate family members are the best providers of nurturing care, which is why family-centered care is important. Engagement between parents and their young child, expressed before speech, develops through cuddling, eye contact, smiles, vocalizations and gestures; it is the engine that propels brain development. Through these mutually enjoyable interactions, parent and child create a communication channel through which the young child learns language, forms cognitions, and comes to know the world around them. By observing their young child and discerning their child’s needs and intentions, parents help their young child learn about the world by describing and explaining their own and their child’s behaviour. While nurturing care for infants is natural to our human survival, it can be undermined by stressors and challenges. Extreme poverty and a struggle for survival under conditions of war and conflict make it very difficult for families to provide care for their young children, as does young parenthood, disability, family violence, substance abuse and maternal depression, amongst others.
Nurturing care envelops early child development and comprises all essential elements for a Child to grow physically, mentally and socially: Nutrition, Health care, Love and security, Protection from danger, Opportunities to learn and discover the world.
Domains of Nurturing Care
Young children’s healthy development depends on nurturing care—care which ensures health, nutrition, responsive care giving, safety and security, and early learning.
Scale of Early Childhood Development in Siaya County
The Journey started in 2013 through support from PATH. The department of Health was supported to initiate ECD- Nurturing care services in 23 health facilities out of the 213 health facilities in Siaya County.
In 2017, a team from Siaya County met with Hilton Foundation representatives and requested for further support to scale ECD in the whole of Siaya County. Later the County received communication from Hilton Representative that they had accepted to support the noble initiative of scaling ECD in Siaya.
At the beginning of the year 2018, through support from Hilton Foundation, the Governor of Siaya together with the ECD focal officer were invited to attend a course on Scaling Early Childhood Initiatives at the John F. Kennedy School of Government at Harvard University (HKS) in the United States of America.
After the training, the team developed a work plan for scaling ECD in Siaya County. The proposed model adopted for scaling ECD was government led multi-sectoral approach with the first lady being the patron. The focus in Siaya County is an integrated approach which addresses ECD from age o to 5 years with the Key players being Health, Education, Agriculture, Social services and Children’s department, Office of First Lady and Governors office. The process of developing a road map for scale is on course with all stakeholders being consulted and engaged at appropriate times.