Early Human Development: An Interdisciplinary Approach

November, 2014

Pedro Maunde, Institute for Human Development Aga Khan University, Kenya

What children affected by HIV/AIDS need to thrive?

Abstract- This paper describes home based ECD approach at rural areas as the
most efficiency and efficacy intervention to responsively support caregivers and
young children affected by HIV/AIDS to thrive in positive way. The results of the
application demonstrate the models capability to provide a useful contribution to
the initiative planners and managers to develop sustainable interventions based on
the use of the Essential Package and care for child development tools aiming to
achieve development outcome of infants and young children affected by HIV/AIDS in
Mozambique.

Nutrition and environment & brain development

There are a lot of aspects depending to the child grow up and achieve their
potential development. Since before women turn pregnant its seems crucial to be
prepared in terms of the appropriate age and other determinant health conditions.
A child brain starts to develop just a few days after conception and before a mother
may even realize her state, reason why its so important into pregnancy to the
mothers diet contains enough folic acid to not restrict brain development and spina
bifida as well as to build the nervous system (Oates et al, 2012, pp. 21-22). The
mothers psychosocial well-being also affect brain development because when
stressed during pregnancy has effects on the fetus turning evident after birth and in
some cases maybe long lasting. In other hand, as was underlined by Bales et all
(2006), on their research on Early Exposure to Toxic Substances Damages Brain
Architecture, the environment of relationship where children develop is also
chemically composed by nutrients in a well-balanced diet essential for good health
and some chemicals that disrupt brain architecture are produced in our own bodies
as result of severe and prolonged stress. Taking into account position presented by
writers above, toxic stress in early childhood is associated with persistent effects
on the nervous system and stress hormone system responsible for causing damage
on brain architecture to lifelong problems in learning, behavior and physical and
mental health (Shonkoff et all, 2007). More than 40% of children aged 0 to 5 years
in Sub-Saharan Africa are sick and physical stunted at an early age due poor health
and malnourishment creating a lack of specific nutrients the reason why they
demonstrate later cognitive deficits, low school achievement and higher rates of
drop-out (Bartlett, 2010).

Early Human Development: An Interdisciplinary Approach

November, 2014
Attachment relationship
In families where there are two biologic parents caring for their children,
attachment relationships are usually formed with both parents and the quality of
relationship with each other affects their childrens attachments and subsequent
development (Oates et al., 2007, pp.6). In most of cases, children affected by
HIV/AIDS are growing without one or both biologic parents and its seems to be a
challenge to their emotional and social development.
According with Belsky (1999) referred by (Oates et al., 2007, pp.18), a sensitive
responsiveness is the most important factor in the quality of caregiving for the
promotion of healthy attachment so that rich communication between both
(caregiver and young children) will have positive impact to reach cognitive and
language development of young children. In other angle, due a lot of problems on
development trajectories of young children affected by HIV/AIDS and experiencing
different environment and challenge, their executive function and self-regulation
skills can be considered as broadly and strongly associated competence and
resilience in childhood over adolescence and adulthood (Masten & Wright, 2009).

Social interaction and learning process

Physical environment around children where they can safely play in order to provide
long term stability and social interaction encouraging their resilience and positive
development is perceived as crucial if these children affected by HIV/AIDS often are
assumed as living in an emergency environment (Bartlett, 2007). In context of
culture and learning, children who have access to family and community activities
that they are expected to take part in, first they monitoring adult and other children
activities to be well informed even when they are engaged in play. Furthermore, as
written by Brooker and Woodhead (2010,pp.20-36), the strong sense of identity
and belonging can be achieved when childrens learning trough participation in
daily families and peer groups activities and it enable children to develop a range of
knowledge and skills to progress in early childhood education and care.

Home based ECD as an efficient and efficacy to support infant and young
children affected by HIV/AIDS to thrive
In context of HIV/AIDs, nutrition and environment where the infant and young
children develop are considered as fundamental to ensure a child well-being and
also to form their brain architecture since early age. Healthy physical and social
environment offer to young children a valuable opportunity to enable them to build
the relationship they need to strengthen their brain architecture and consequently
to achieve cognitive, emotional, physical and language development.

Early Human Development: An Interdisciplinary Approach

November, 2014
Within healthy environment mentioned above and where the young children
affected by HIV/AIDS are living with secondary caregivers we need to create and
promote a sensitive responsiveness through healthy attachment, factor depending
to reach better communication between caregivers and young children and crucial
to ensure their cognitive and language development. These young children need
also to experience challenge environment in order to develop their executive
function and self-regulation skills extremely crucial to enable them to copy in
positive way with a lot of problems on their development trajectories.
Playground1 and other types of plays are fundamental to build young children long
term stability and social interaction, especially for those who affected by HIV/AIDS.
Through participation in daily plays will develop positively their knowledge and skills
into a learning process.
All social determinant of health highlighted above which has impact on child
development, particularly for those who are affected by HIV/AIDS when well
observed at poor and vulnerable community. Home based ECD approach its an
efficient and efficacy model to meet responsively infant and young children needs
to thrive in positive way.

The practical way to disseminate information on child care and

development to caregivers and young children affected by HIV/AIDS
A home visit is a common and suitable activity used by field work 2 when we are
implementing home based ECD3 approach. Community volunteers and other staff
members based at the community we are serving normally are using different tools
such as the Visual Reference Guide of the Essential Package, Care for Child
Development and others to meet caregivers and young children needs when they
visiting at weekly or be-weekly base. During this types of visits the local community
volunteers build a trustfully relationships with ECD household and at the end with
caregivers and young children. The environment created enable the community
volunteers to share useful information using positive communication skills.
Parental group meetings is another activity to use when we need to share
information on how to responsively take care to infant and young children,
particularly those affected by HIV/AIDS in order to thrive as desired. The mentioned
tools above can be shared at these meetings so that the parents can use.
1

Physical environment around children where they can safely play in order to provide long
term stability and social interaction encouraging their resilience and positive development
(Bartlett, 2007).
2
Community volunteers, Community Facilitators and others who are working at community
level, in most of case directly with our target groups.
3
Home visits to Early Childhood Development target households conducted by field workers
include community volunteers.

Early Human Development: An Interdisciplinary Approach

November, 2014
In other hand, radio and television campaign is another means to be considered to
disseminate information on child care and development although exist considerable
differences between both. If compared with radio, using television its possible to
talk and illustrate the way which we responsively have to take care the young
children to thrive positively. The disadvantage on using television is the lake of
availability of this equipment at community level, referring particularly to the
vulnerable families.

Conclusion
Child development involve a lot of knowledge and skills we need to support
vulnerable families to take care their infant and young children, special for those are
affected by HIV/AIDS so that they can thrive in positive way. Its important to know
that we have to ensure healthy brain development through well balanced nutritional
diet and healthy environment before and after the birth. Healthy environment
includes physical and psychosocially in order to avoid a stressful daily life at
caregivers, infant and young children environment.
The promotion of healthy attachment is also crucial to build a qualitative and
trustful relationship between the caregivers and infant and young children,
particularly those affected by HIV. It is enabling them to establish a positive
communication and learning environment at the end. It is also important to ensure
that young children experiment challenge environment to enable them to develop
their executive function and self-regulation skills considered as crucial.
Home based ECD approach at community level can be seen as a practicable model
to support infant and young children to thrive. Through the use this approach, the
caregivers has a useful environment and opportunity to share and learn on how
ensure a secure and positive child development since early age.

References
Oates et al. Early Childhood in Focus 7: Developing Brains. The Open University,
2012;
Bartlett, S. (2010). Childrens health and well-being. Improving learning
achievement in early primary in low-income countries: A review of the research.
(pp. 7 8). Geneva: Aga Khan Foundation. Retrieved from
http://www.akdn.org/publications/2010akf_learning_achievement.pdf

Early Human Development: An Interdisciplinary Approach

November, 2014
Bales et all. Early Exposure to Toxic Substances Damages Brain Archicheture.
National Scientific Council on the Developing Children Spring, 2006;
Shonkoff et all. The Science of Early Childhood Development: Closing the gap
between what we know and what we do. National Scientific Council on the
Developing Child Harvard University, 2007;
Oates et al. Early Childhood in Focus 1: Attachment Relationships, quality of care in
young children. The Open University, 2007
Masten, A. & Wright, M. (2009) Resilience over the lifespan: Developmental
perspectives on resistance, recovery and transformation. In J. Reich, ED. Handbook
of Adult Resistence New York: Guilford Publications. P. 226.
Bartlett, S. (2007). Bridging the gap: Save the Children's transitional housing project
after the tsunami in Ampara District, Sri Lanka. Save The Children.
Brooker, L & Woodhead, M. Early Childhood in Focus 6: Culture and Learning. The
Open University: Milton Keynes, 2010