Working Together for Early Childhood

No. 5, 2011

Theme: Early Experiences Matter Ensuring Holistic Development for Very Young Children (0-3)

Write to us:

We look forward to your feedback. Kindly send in your comments and suggestions to: ARNEC Secretariat c/o SEED Institute 73 Bras Basah Rd. #07-01 NTUC Trade Union House Singapore 189556 E-mail: secretariat@arnec.net

Write for us:

ARNEC covers a large geographical area, totaling 47 countries in the Asia-Pacific region. This publication is one of the many ways that our Network has sought to share unique knowledge and learning. ARNEC Connections provide you with in-depth research summaries, field experiences and unique initiatives from the region that will benefit you as ECD professionals. As this is a publication for ECD professionals by ECD professionals. All articles are contributed by individuals who are ARNEC members and/or are working within the field of early childhood. ARNEC solicits articles once every year inviting you to send us your stories and experiences and share them in ways that are useful and meaningful to a wider audience. If you would like to have your article featured in ARNEC Connections, look out for the Call for Articles in 2012 with more details of the submission process.

DISCLAIMER
ARNEC Connections is published annually by the Asia-Pacific Regional Network for Early Childhood. The responsibility for all facts and opinions published in the various contributions are that of the authors and do not necessarily reflect the views of ARNEC.

UNICEF/China

PERMISSIONS
No written permission is necessary to reproduce an excerpt, or to make photocopies for academic or individual use. Copies must include a full acknowledgement and accurate bibliographical citation.

INTRODUCTION

Table of Contents
Introductions
Table of Contents ...................................................................... 1 Editorial Note ............................................................................. 3
CHEMBA RAGHAVAN

Coordination and Integration of Services

Support for Very Young Children in Remote Areas ................... 5 of Indonesia
SRI MARPINJUN & WAHDINI HAKIM

Holistic Approach for Child Development (0-3) in ...................... 9 the Estate Sector of Sri Lanka
MANEL WANIGARATNE, R.M.B ELLEGALA & R. NANAYAKKARA

Parwarish Markaz: Integrated Services for the Optimal ........... 12 Development of Children Ages 0-3
SHELINA BHAMANI & MAQBOOL RAHU

ECD in Emergencies
Researching Post-emergency Recovery for ........................... 15 Very Young Children
SITHU WAI

Promoting and Supporting Holistic Development: ................... 17 Baby Tents in Post-earthquake Haiti
LISA DETERS

Parenting Programmes
Ready, Set, Parent! ................................................................. 20
NICOLE TOMASELLO & MARY BETH DEBUS

GUANGHENG WANG & SHAOLI ZHANG

UNICEF/Lao PDR

The Experience of a 0-3 Programme Based on ...................... 21 MegaSkills in China

NO 5. 2011

INTRODUCTION
UNICEF/Mongolia

Service- and Community-based Parenting Support and .......... 23 Education Programme

MOHAMMAD IMAM NAHIL

The Best Start! Helping Parents for their Young Children ........ 26
MAR MAR THWIN

Community-based Playgroups for Early Learning and ............. 29 Development

ERLINOR UMALI

Campaigning for Integrated Early Childhood Development ..... 32 for Children Below Three
PRERANA MOHITE & RAFAT ALI

Assessment Measures & Professional Development Frameworks

Development of an Indigenous Scale in Pakistan: Care for ..... 34 Development Appraisal Tool
SANOBER NADEEM & GHAZALA RAFIQUE

Advancing the Cause for Quality ECCD Services through ....... 36 a Professional ECCD Development Framework
MAYA P. NAYO

Personal Voices and Reflections

Early Learning Opportunities for Children Under Three ............ 38 and their Mothers
SHAHIDA MOHIUDDIN

Assisting a Physical Challenged Mother in Creating a ............. 40 Learning Environment for her Child at Home
KARIM PANAH & RUBINA SHAHEEN

Featured Resources
Strengthening Parenting Practices: Recomendations and ............................ 42 Challenges in Asia and the Pacific by DEBBIE FANG Early Experiences Matter: Resource for Serving Children ............................ 42 Up to Age Three by ARNEC Disaster Risk Reduction and Young Children: Guidebook for the ................ 43 Asia-Pacific Region by JACQUELINE HAYDEN & KATHY COLOGON Advocacy Booklets: Working Together for Early Childhood by ARNEC ........ 43

ARNEC CONNECTIONS

INTRODUCTION

Editorial Note
By Chemba Raghavan, Editor, ARNEC

warm welcome to all our readers from the Editorial team of ARNEC! In this edition of our fifth annual, signature publication, ARNEC Connections, it gives us immense pleasure to compile and present initiatives on early childhood in the AsiaPacific region. This year, our focus is on the holistic development of the very young child, in the age range of 0-3. This years publication integrates articles on four broad topics in early childhood development (ECD) in the Asia-Pacific region. These include: (1) Coordination and integration of services, (2) ECD in emergencies, (3) Parenting programmes, and (4) Development of assessment measures and professional development frameworks. Additionally, we also present two sections featuring (5) Personal voices and reflections and (6) Featured resources. Coordination and Integration of Services It is widely recognised that ECD is about cognitive, social-emotional, physical and psychological care and development of young children. In the Asia-Pacific region, a frequently identified bottleneck in the provision of holistic ECD services is the lack of coordination among the relevant organisations. Responsibility for young children 0-8 rests with different agencies and ministries in countries in the region. In ARNEC Connections, we feature some noteworthy practices which address this issue of coordination and integration. The article from Plan Indonesia describes the process of leveraging the existing Posyandu service mechanism to provide low-cost, high impact ECD projects and how these are interwoven into the existing delivery structures through the integration of parenting education, nutrition and intersectoral coordination. Holistic early childhood development can occur only if there are coordinated and sustainable efforts towards ensuring maternal health and community empowerment. The article from Sri Lanka describes a Community Participatory Approach that empowers, advocates and raises awareness on the need for health and

welfare of mothers and young children in tea, rubber and coconut estate communities. Similarly, in Pakistan, a seamless continuum of integrated services for children aged 0-3 years is provided through the Parwarish Markaz programme in the underprivileged communities of rural Sindh province. The programme conducts parent seminars, trains female health workers for engaging in evidence-based practices, local health camps and home visits. The article underscores the importance of buy-in from stakeholders in the overall efficacy of holistic services. ECD in Emergencies In recent years, the Asia-Pacific region has witnessed multiple emergencies: earthquakes, tsunamis, floods and other natural disasters. Several communities in the region are battling the aftermath of natural as well as political conflicts. In these disaster-prone, conflict and post-conflict communities, providing safe environments and high quality ECD services can address not only the needs of young children, but can also serve as a healing context for the larger community. High quality ECD services in these contexts has been shown to empower community members, serve as an entry point for introducing child-friendly practices, and can help build resilience within communities as well. The case study from Myanmar illustrates the importance of assessment and developing appropriate tools for use in emergencies. Another article describing the use of baby tents in post-earthquake Haiti illustrates how the tents evolved into a context for the provision of holistic ECD services. Gradually, these tents came to be viewed as safe spaces, platforms for counselling, grounds for training caregivers, and for peer support, and even contexts for developing economic and wage-earning potential within the disaster struck communities. Parenting Programmes Care and development for very young children, particularly those under three, necessitate the active engagement of parents and primary caregivers who are

critical to the childs development in the early years of life. High quality ECD programmes have been shown to be particularly effective in communities where there is active parental involvement. The Ready Set Parent! programme, is one such. Developed and implemented in the State of New York, the programme can be implemented in many settings and provides training and materials for parents of young children. Another example is from Shanghai, China, where the programme focuses on encouraging parent involvement through regular parental feedback on the MegaSkillsbased curriculum. A pilot programme on holistic, coordinated parenting support and education for parents of 0-3 year old children comes from Meherpur in rural Bangladesh. The programme, led by Save the Children, provides two kinds of synergistic services: One is a service-based intervention with frontline government workers and the other is a community-based intervention focusing on effective coverage and participation. Save the Children has also spearheaded a programme in Myanmar called the Transitions Initiative, which includes baseline and change assessments of parenting programmes. These assessments indicate that there was a positive impact on childrens developmental outcomes in communities where parenting education programmes were implemented. Related efforts are also ongoing in ensuring parental involvement in childrens stimulation and play through the production of local, costeffective toys, in the context of communitybased playgroups for early learning and development, in two communities in Metro Manila in the Philippines. Many of these programmes attest to the value of parent involvement and empowerment and sometimes, also to the indirect effects on the larger community, notably the fathers. An illustration of empowering communities and ensuring government support in providing concrete, sustainable services for maternal and child health comes from Gujarat, India: The authors provide a detailed overview

NO 5. 2011

INTRODUCTION

of the Trials to Improve Practices (TIP) methodology which was an emic initiative, building from preliminary research in the community that led to the development of effective interventions with positive impact. The initiative also included an analysis of barriers in adopting new care practices, and has the potential for scale up to more communities. ARNEC has also produced a synopsis of the e-discussion held in 2011 on strengthening parenting practices in the Asia-Pacific region that linked together some of the challenges and recommendations from 13 countries in the region. Assessment Measures and Professional Development Frameworks An important step in advancing the cause of holistic early childhood is the development of assessment tools and resources. In Pakistan, the Care for Development Appraisal (CDA) tool for assessing and monitoring child development in the first three years of life, is a striking example of

on a report of an ECD worker, describes a programme for gradual empowerment and confidence-building for a differently-able, hearing-impaired mother. The initiative highlights the idea that the notion of inclusion should include not just children with disabilities or needs, but should encompass Another article from Save the Childrens community members and parents with such work in the Philippines focuses on needs as well. advancing the issue of quality in ECCD through the formulation and implementation In summary, it is heartening to see that there of a professional development framework is burgeoning interest and attention to the through a series of five phases, leading needs of the young child. However, it is clear towards capacity building and professional that increasing awareness of the importance development of caregivers and ECCD of the first three years of life in the Asia-Pacific region needs to be strengthened more. professionals. This issue hopes to do so by documenting noteworthy efforts in this direction, as we Personal Voices and Reflections move forward towards achieving our goal Describing the running of an Early Learning of building strong communities and in turn, Centre (ELC) for 0 to 3 year children and stronger nations, through holistic and hightheir mothers in Karachi, Pakistan, the quality ECD programmes. author reflects on the perceived advantages of the centre in becoming a source of information as well as support that cements parent involvement and empowerment in the community. Another reflective article, based one such initiative in the region. The CDA tool is a surveillance mechanism that can be easily administered by community workers to track childrens development and identify those at risk for delays, to ensure appropriate and timely interventions.

ARNEC CONNECTIONS

Plan International/Vietnam

COORDINATION AND INTEGRATION OF SERVICES

Support for Very Young Children in Remote Areas of Indonesia

By Sri Marpinjun & Wahdini Hakim, Plan Indonesia
Introduction National Education which is responsible for expanding early childhood education (ECE) services to the grassroots level also became interested in utilising Posyandu as the host of ECE programmes in the community. The Ministry established a special directorate for ECE, which supports ECE services through Posyandu (PAUD). In addition to the existing programme, the central government also introduced a national strategy and guidelines on holistic and integrated early childhood development in 2008. training modules and training of master trainers and cadres as ECCD Centre caregivers; and development of Information, Education and Communication (IEC) materials in collaboration with ECCD Directorate of Ministry of Education. The whole programme is referred to as the Taman Posyandu model developed by WHO Collaborating Centre (WHO-CC) of Padjajaran University, supported by UNICEF, Plan Indonesia and Frontiers for Health (F2H). After years of implementation, with support from AusAID through Plan International Australia, an evaluation of the ECCD programme and review of all of existing curricula for ECCD from different ministries (and several others conducted by nongovernment organisations including Plan Indonesia) were included in the curriculum review in 2010. The results highlighted the limitations of curricula and teaching methodologies that require high levels of human and physical resourcing inappropriate for very rural and remote sites such as those found in Nusa Tenggara Timur (NTT) Province (Aboud, 2010). The evaluation also made recommendations for curricula incorporating best practices from Indonesia and globally. To understand better the context of holistic and integrated early childhood services in rural and remote communities, an initial assessment was conducted in Sikka and Lembata Districts of NTT Province in 2010. The situational analysis explored parenting practices including traditional indigenous practices, child protection issues, health and nutrition situation as well as access, availability, and quality of ECCD services. The study revealed that in terms of parenting practices, many parents are more likely to fulfil and have concern around their young childrens physical needs, such as shelter, food and water, clean clothing and regular bathing. Meanwhile, parents and caregivers are less likely to be concerned

ndonesia is the biggest archipelago in the Southeast Asia region and is the fourth most populated country with more than 220 million people. The first country programme in early childhood providing services at grassroots level began in the 1980s through a community-based institution called Posyandu (literally means Integrated Service Post). Since then, the coverage of child survival and development related programmes in Indonesia has strengthened However, due to decentralisation since 2001, significantly. the understanding and implementation of By design, Posyandu is a community- programmes, standards and guidelines based health service belonging to the for early childhood development is still a community and is run by at least five challenge in many districts. Challenges volunteer Posyandu cadres. These cadres include poorly-trained community volunteers, are community members, mostly women, weak technical and management support usually having attained 6th grade level of from Posyandu working groups (Pokjanal), education. They are recruited through a insufficient capacity of local government community mechanism to work voluntarily institutions regarding technical aspects, and or for minimum incentives. On average, inadequate management and advocacy for there are 3-4 Posyandu in every village. increased resources. There is also a lack One Posyandu serves approximately 80- of coordination among different Ministries 100 children under five years old. Posyandu who has its own different curricula for use initially started with five priority programmes: in Posyandu and are trying to develop and maternal and child health, family planning, implement its own integrated curriculum. nutrition, immunisation and diarrhoea control. Posyandu is supported by a It is often in the poorest and most remote Posyandu working group (Pokja Posyandu) communities that children, parents and which exists from the village up to the caregivers have the greatest difficulty in national level. Pokja Posyandu functions accessing quality early childhood services. as a mentoring group for Posyandu. The Posyandu working groups usually Features of the Project consist of representatives of community or Posyandu beneficiaries, government, health Plan International in Indonesia (Plan workers and civil society organisations. In Indonesia), has been operating since 1969, reality, Posyandu works well in spreading mostly in remote areas in the country, and governments maternal and child health benefit more than 50,000 children and 400 communities nationwide. One of its core programme to the grassroots level. country programmes is Early Childhood Following this success, the government, Care and Development (ECCD). Over through the Ministry of Home Affairs has the past five years, Plan Indonesias Early expanded the role of Posyandu. The new Childhood Care and Development (ECCD) concept of Posyandu introduces additional programme has focused on expanding activities like parent education (BKB), the role of Posyandu for early childhood water, sanitation and hygiene promotion, education services (PAUD). This included and early childhood education (Pendidikan the development of local ECCD Resource Anak Usia Dini or PAUD). The Ministry of Centres at district level; development of

NO 5. 2011

COORDINATION AND INTEGRATION OF SERVICES

about non-physical needs such as early stimulation, and childrens social, emotional and cognitive development. Many parents lacked the understanding that fulfilment of childrens physical and non-physical needs can be done in parallel. Moreover, physical punishment is often used if children do not obey parents rules. However, some parents did show greater awareness to support child development, such as sending children to school or teaching them to read and write at home. Under-nutrition has also hampered growth and development of young children. The under-nutrition prevalence in Sikka and Lembata (37.3% and 33.8% Weight/Age Z-score respectively), is much higher than the national average of 18.4%. Although breast milk can protect children aged 0-6 months old from under-nutrition and common childhood illnesses, the breastfeeding rate was only 29.54% in Lembata (national average is 32.4%). The three main reasons for this were the existing myths/cultural beliefs around breastfeeding, lack of knowledge of how to prepare and store expressed milk (especially when mothers need to be away for some time during harvest and planting time), and lack of support for breastfeeding at home, in the community and in healthcare facilities (minimum number of breastfeeding counselling for instance). However the rate is much better in Sikka with 83.45%, probably due to current Breastfeeding Support Programme supported by UNICEF. There are also food taboos or pire that exists within particular An ECCD caregiver encouraging ethnic groups which prevent pregnant one child to lead an activity in women and young children from getting Sikka district. nutritious food. For example, pregnant women are not allowed to eat fish during pregnancy and post partum (Crisis Centre Managed ECCD was developed. The of University of Indonesia [PUSKRIS-UI], project is trying to demonstrate a sustainable system of community- managed ECCD 2010). supports centralised at the Posyandu level Past project experience and results from the that address barriers and strengthen early situational analysis contributed to deeper childhood outcomes, and which can be understanding of the situation for young adopted by more district governments. The children in rural and remote communities in focus is on high impact but low cost and Indonesia and have informed and shaped culturally appropriate community-managed project design and curriculum development. ECCD through Posyandu.

A community meeting as part of a situation analysis on caring practice.

years old, however, this project encourages community to also serve 5-6 years old for the following reasons. This age group of children needs more attention to handle the transition phase from preschool to primary school. In addition, with the expansion of Posyandu by the government, additional services of Posyandu such as the ECCD centre (PAUD) covers children up to six years old. This is also very much in line with the national legislation on early education The project targets children aged 0-6 years that ECE in Indonesia should cover children Project Description and Implementation old and parents/caregivers of children under up to six years. Based on the evaluation and situation six years old in Sikka and Lembata districts. analyses, a project called Community Normally, a Posyandu only serves 0-5 Following the curricula evaluation and

ARNEC CONNECTIONS

COORDINATION AND INTEGRATION OF SERVICES

confidence and commitment of parenting group members to work collectively to address community problems that affect all children. In this way, parenting education is viewed more as a force for change than a Plan Indonesia has recognised the course. importance of using Posyandu as an entry point to implement community managed Community-based ECCD centres: Quality ECCD. Firstly, Posyandu reaches every ECCD Centre complements and supports child aged 0-5 in the community and, when the family to prepare children 1-2 years they dont, the social infrastructure is there before enrolment to primary school (children to reach out to families. Secondly there aged 5-6 years old), thus promoting school is physical infrastructure already in place success, while also reinforcing social and in most communities that is appropriate, citizenship values that are important to community owned and safe although in the community. Quality programmes in some very remote locations, the structure ECCD Centres are designed to achieve may need improvement. Thirdly, there are measurable cognitive, social, emotional existing trained staff at the Posyandu, who and physical development indicators and can take leadership roles in promoting ECCD provide an enjoyable place for children to to the communities. Finally, the Pokjanal learn and grow. The project model try also to can serve as a vehicle where different local demonstrate that community parents can be institutions such as District Health Office, trained as highly effective ECCD caregivers District Education Office, Family Planning and that stimulating materials in ample Board and Family Welfare Movement (PKK)2 supply can be produced at low cost. can integrate programme and government response for early childhood through Transition to primary school activities: Transitions to Primary initiatives are the Posyandu. fourth essential component of ECCD As pilot areas, these two districts in eastern supports. There is increasing attention to Indonesia have limited resources compared the needs of children in the transition period to other areas, especially with regards to (children at grade 1-2 of Primary School). technical resources for improving the quality Plan supported parenting groups are the of ECCD. The project is implemented in pivotal point at which community dialogue every Posyandu of one or two villages in on transition issues develop. An empowered every sub-district, a total of 31 villages community is in a position to create demand across 13 sub-districts (8 in Sikka and 5 for more welcoming school environments, in Lembata). There are 99 Posyandu in all sincere outreach to disadvantaged families and support for school success. project areas support and government The new ECCD project consists of the Increasing commitment to ECCD: Community Managed following key components: ECCD is a preliminary model that will be Parenting education: This explores how tested in partnership with families, village parents with low levels of education can leaders, and government ministries at gain skills to effectively support their district and national levels. Early childhood childrens development. It aims to harness programmes should also be designed to best parenting practices in the community help change the systems. For this reason, and build new effective practices through advocacy is essential to make this happen. highly reflective and interactive skill- building sessions. It is also designed to build the Parenting Programme Supports the Early Years
1. The child development expert referred to here is Deborah Llewellyn, who has more than 30 years experience developing parenting and early childhood programmes in South Asia, South America, Africa and the US.

situation analysis, guidelines and materials for the project model were developed with technical assistance from an early childhood development specialist1.

children. The parenting component of the project began in March and aims to reach as many parents/caregivers as possible. It aims to harness best parenting practices in the community and build new effective practices through highly reflective and interactive skill building sessions. The parenting education programme is designed to build the confidence and commitment of parenting group members to work collectively to address community problems that affect all children. It also helps to develop parents understanding about the importance of the early years and practical skills to provide effective care and stimulation. In this way, parenting education is viewed more as a force for change than a course. This systematic approach to reaching parents is designed to build early childhood leadership in vulnerable communities and a sustainable skills base for supporting or managing child health, learning and protection activities in the community (Llewellyn, 2011). The initial target is to establish 99 parenting groups over three years in 31 communities. Each parenting group involves a maximum of 30 parents. Currently, 65 parenting groups are running, involving 1,950 parents/ caregivers. Community socialisation meetings have been held to identify core groups of 25 to 30 families with interest to strengthen child outcomes through parenting groups. These groups use an appreciative inquiry approach, building on strengths that already exist and promoting positive deviants (those with more successful parenting practices) as ECCD leaders. These groups will be empowered to take collective action for child development in their respective community. The collective action may include advocacy to the local government to be more responsive to child development issues in the area, such as supports for ECCD centres, transitions to primary supports/ activities, and child protection issues in the community. Parenting group discussions can also generate interest in other activities to improve child development, such as collecting and sorting local materials to support ECCD centres and household gardens (nutrition). addition, the consultation process

Parents are an important influence on their childrens early years. The implementation of the parenting curriculum in this project explores how parents with low levels of 2. PKK members are usually wives of political figures (past and present) whose social networks education can gain skills to effectively support the development of their young In and influence could be valuable

NO 5. 2011

COORDINATION AND INTEGRATION OF SERVICES

undertaken by Plan Indonesia identified the need to integrate more technical health topics for parents/caregivers in the parenting programme. The government, through the Ministry of Health, has developed the Maternal and Child Health (MCH) Handbook (Buku KIA), along with a manual for parenting class facilitators. Plan Indonesia will integrate existing village midwives into the project as facilitators for this technical parenting session that targets pregnant women. These parenting sessions will allow more in-depth discussion amongst health professionals and parents on the content of the MCH Handbook, which includes four main sessions: pregnancy care, delivery plan (including support for referral and preparing baby name in advance for birth certificate), newborn care (including facilitating provision of birth certificate), post partum care and family planning, therefore giving further support to the critical early years. Conclusion Young children living in poverty are the main target beneficiaries of this project. These vulnerable children are more exposed to risk due to health, family and community circumstances. They are likely to start school with limited language, skills, health, social and emotional problems that interfere with learning and thus imperil future development. Through this project, it is hoped that families with young children living in poverty will be supported, and the whole community will contribute to ensure that children gets the best possible start in life. In turn, communities with expanded capacity to promote effective health, development, learning and protection of their children are expected to positively impact community development outcomes, and support collective action for child development during the critical early years. Plan Indonesia recognises the importance of providing more evidence that young children living in difficult circumstances can achieve individual and social potential with effective early childhood supports. References
Aboud, F. (2010) Recommendation of ECCD curricula review in Indonesia. Unpublished report for Plan Indonesia Crisis Centre of University of Indonesia [PUSKRIS-UI]. (2010) The Situational Analysis of ECCD and Parenting Practices in Sikka and Lembata. Unpublished report for Plan Indonesia Llewellyn, D. (2011) Strengthening Families for Better Early Childhood Outcomes, A Parenting Education Curriculum Guide. Unpublished

A growth monitoring activity in a Posyandu.

Training for the caregivers at the ECCD centres.

Posyandu cadres recording and reporting on the children and mothers attending Posyandu.
Photo courtesy of Plan Indonesia

ARNEC CONNECTIONS

COORDINATION AND INTEGRATION OF SERVICES

Holistic Approach for Child Development (0-3) in the Estate Sector of Sri Lanka
By Manel Wanigaratne, R.M.B. Ellegala, & R. Nanayakkara, Plantation Human Development Trust
Introduction he estate sector in Sri Lanka consists of tea, rubber and coconut plantations, the three major crops that cover approximately 36% of all arable land in the country and has a resident population of nearly one million people. One third of this population is engaged in the production of the three major crops, with 70% of these workers (rubber tappers and tea pluckers) being women. The Early Childhood Care and Development programme (ECCD) was initiated in 2000 aiming at helping the workers to achieve enhanced productivity by providing them with basic welfare and thus creating a content workforce. It was also the first step in ensuring the survival, growth and development of the next generation of children. Empowering women on the value of being a healthy mother enabled them to take good care of the child before and after birth and to look after their own health as well. Lastly, the migration of mothers to live overseas and leaving their infants in the care of grandparents or relatives was another major concern in the estates. Methodology and Strategies A Community Participatory Approach is encouraged at all times in all project processes. Sustainability of any activity implemented in the estate sector depends largely on the consent and the commitment of the management towards workers well-being as well as the acceptance and ownership by the community. As such, the Plantation Human Development Trust ensures maximum participation of the management and the estate community in the planning and implementation of the project. PHDT Interventions Since its inception, PHDT has been promoting a holistic approach to meeting the needs of the formerly isolated estate populations by promoting cross-cultural partnerships and programme integration through advocacy and awareness building and also to ensure commitment and cooperation of the other four key players,

Until the mid-1970s, plantation workers have congested, unhygienic housing and living conditions, no sanitary facilities, high One of the challenges that we found for levels of illiteracy, and have little or no health estate mothers was breastfeeding. Once services and child care. the mother returns to the field, breastfeeding during work becomes irregular, even though With the privatisation of the plantations they are assigned to work in areas that are in 1992 by the Sri Lankan Government, in close proximity to the Child Development 26 Regional Plantation Company (RPC) Centre (CDC). Furthermore, poverty drives were assigned to manage the 448 estates. them to work and earn more resulting in The Plantation Human Development Trust irregular nursing of the baby. (PHDT) was also set up by a Cabinet decision to be the social development arm Complementary feeding was also of the estate sector in the newly privatised unsatisfactory for six months old babies environment. to two years old toddlers due to the lack of knowledge in complementary food PHDT set up its main office in Colombo and preparation. There were also lack of attention has seven regional offices. The 26 RPCs and growth stimulation opportunities for became members of the PHDT benefitting 0-3s at home due to ignorance. from the services and investments that flowed into the sector. At present, the PHDT has under its purview 448 estates covering 230,000 hectares of cultivated land and a resident population of 972,327 persons (244,137 families) in the plantations, covering the whole island. Issues in Estates (especially for children) The initial crches in the period from 1970 to 1990 were one room structures often with half walls around it or an ill ventilated room referred to as pullemadus situated near the muster sheds staffed by an untrained elderly female with 50 - 60 infants and children under her custodial care until the mothers return after work. Upgrading estate crches was the first form of welfare initiated by PHDT in 1997. This included providing proper custodial care to the children coupled with basic hygiene and nutrition care.

A child development centre in the estate sector of Sri Lanka.

NO 5. 2011

COORDINATION AND INTEGRATION OF SERVICES

namely estate management, health and welfare staff, child development officers, caregivers and the Child Development Committees. Some of the interventions are as follows: Capacity building among different stakeholders, including service providers, the families and the community is encouraged. Much of the initial investments through donor funding was expended on awareness programmes for the estate health staff (estate medical assistant and midwives), estate managers, plantation family welfare officers (PFWO), child development officers (CDO) and crche assistants, etc. Developing trainers on holistic ECCD Capacity building within the community was the next step, through the selection of community facilitators (CF), training of trainers, training of CFs and community assessments by the CFs. PHDT also transformed the existing pullemadus to crche status and there on to Child Development Centre (CDC) with every estate division having a CDC. Capacity building of families through Community Facilitators and developing Community Self Help Action Plans to provide loving and safe home environments for children and women through community group dialogue, creation of Child Development Committees, and CDOs. Presently PHDT is transforming the existing CDCs to Ideal Standard Centres by upgrading /renovating the existing centres, enhancing the training of CDOs, educating parents on child rights, together with strengthening of the Child Development Committees. Ongoing monitoring and evaluation continues at estate, regional and main office levels. Raising awareness among parents on the values of breastfeeding, complementary feeding, growth stimulation, parenting awareness through trained volunteers, immunisation, home management, nutrition and health care has improved the living standards of this sector. Eliminating gender bias in the community has increasingly become a focus. (Refuting the myth that the male child needs strength building and education while the female child is considered weak and only suitable to be tea pluckers, thus being given less nutrition, no education, etc.)

Implementation Experiences Mobilise pregnant mothers and their families for early registration with the midwife to enable follow-up on antenatal care. Antenatal care is provided to pregnant mothers by the estate midwife with the assistance of a health medical officer. Antenatal charts are used to monitor the progress and follow-ups by the midwife and the Estate Medical Assistant (EMA). Progression from line room (primitive home deliveries by untrained senior females in the community with unsterile rusty scissors/knives, etc. leading to infections, bleeding and deaths mainly due to tetanus to maternity ward deliveries, and presently to the nearest government hospital with health facilities. Emphasis on curative and preventive health care aspects has resulted in many benefits such as lesser incidences of low birth weight as well as reduction in infant mortality rates, maternal mortality rates and crude birth rates, etc. Improved nutritional status of pregnant and lactating mothers giving birth to healthy babies. Family planning and other related services have helped the estate community to have children by choice, and avoid/prevent teenage pregnancies too.

Work at a Child Development Centre (CDC) Worker mothers are entitled to maternity leave of three months, hence a child is enrolled at the CDC at four months and is in the care of the CDO from there on till age five, irrespective of the babys gender. At the CDCs, emphasis is placed on fostering the development of the whole child, including the social, emotional, physical, cognitive and language development. Play is valued as an important and essential vehicle through which children learn, grow and develop. Purposeful play activities are adhered to and lay the foundation for later formal education and successful adult functioning. Achievements of the ECCD programme PHDT has a monitoring and follow-up system at the regional and central level, which includes quarterly and bi-annual review meetings. Baseline assessments were done with the Community Facilitators before implementation and after completion of the programme. Information is collected annually through PHDTs Annual Health Return. ECCD initiatives 100% registration of the 16,000 (year 2010) pregnant mothers in all estates by the midwife 99% attendance at antenatal/postnatal clinics with 51% paternal participation 99% deliveries in government hospitals at present from 87% (2004) Reduction in the infant mortality rate from 29.2% (1994) to 8.8% (2009) Reduction in the maternal mortality rate from 10.2% (1994) to 0.72% (2009) Reduction in Crude Birth Rate from 17.4% (1994) to 14.3% (2009) due to family planning Reduced child malnutrition to 44% in the estate sector

Estate Level Implementation Structure

MANAGEMENT Estate Manager

Field

Factory

Office

Health

SERVICE PROVIDERS

EMA

Midwife

PFWO

CDO

Community Facilitators and Volunteers COMMUNITY Community Groups

FAMILY

Parents

Children

Pregnant and Lactating Mothers

Leaders and Youths

10

ARNEC CONNECTIONS

COORDINATION AND INTEGRATION OF SERVICES

PHDTs ECCD training has been recognised by the Ministry of Child Development and Women Empowerment as a Diploma Certification since year 2007 Improved community participation in child care activities, use of latrines, environment sanitation practices Improved male participation in child care activities, home based care, etc through awareness building for fathers The focus is to create a self-reliant estate community moving away from the old practice of total dependence on the management. Through education and awareness of the benefits that accrue through early childhood development, the community is encouraged to be responsible for the well-being of their children, whilst making a positive contribution to the plantation community and society as a whole.

CDC initiatives

Developed 619 CDCs up to ideal Photo courtesy of Vino Arumugam standards out of 1,544 CDCs Improved infrastructure facilities, equipment and furniture at CDCs Table 1 below gives the current child population from 0-5 years in the Estate Sector of Sri Improved quality custodial care, Lanka. complementary feeding programme and age-appropriate stimulation has Table 1: Present child population in estates increased CDC attendance from 35% Children Numbers Children registered Percent (2003) to 87% (2010) Mobilising parents and sustainability (0-5) at CDCs of the ideal standard of the CDC 0-1 15,905 13,900 87% has become the child development 1-3 29,655 23,868 80% committees responsibility 80% of CDCs are manned by qualified 4-5 33,992 26,411 78% CDOs Total 79,552 64,179 81% Reduction in malnutrition level from 67% (PHDT health bulletin, 1997) to Source: PHDT Annual Health Return, 2010 44% in 2010 The following chart gives an outline of the activities performed for each aspect of Conclusion development for all children enrolled at the CDCs from age four months to age five. PHDT has taken much effort and many approaches to arrive at the above achievements, and its next herculean task is to concentrate on the nutritional status of children as a priority, together with some other development initiatives. Activities at the Child Development Centre
nutrition intervention gross/fine motor skills health abits

Above: Outdoor play area for young children

growth and physical

drawing manipulative skills

A worker mother breastfeeding her child at a child development centre.

social
motivation to associate with others (adults/ children)

aesthetic total development

thinking power memory power decision making power creativity

emotional
love & affection protection appreciation freedom pleasant responding

intellectual speech and language

listening skills speech readiness for reading writing

Source: PHDT Managers Guide - Crche Focus (1997)

NO 5. 2011

11

COORDINATION AND INTEGRATION OF SERVICES

Parwarish Markaz: Integrated Services for the Optimal Development of Children Ages 0-3
By Shelina Bhamani, Aga Khan Foundation
and policy, so that they are supportive of young childrens overall development. The programme aims to ensure that children are ready for school and schools are ready for children. The RCCP do this through formal and informal programmes involving partnerships between families, communities, civil society and government. There is particular emphasis on ensuring programmes reach disadvantaged children whether disadvantaged through poverty, gender, remoteness, disability, etc. (AKF Hence, working with families of young Pakistan, 2006). children who are their primary caretakers is crucial. Development agencies around The HANDS-RCCP 0-3 pilot project aims to the world are emphasising that it is crucial provide a holistic approach to ECD in order to to initiate and expand community-based increase parents and caregivers knowledge, interventions for young children and their skills and confidence in their abilities to families. These interventions can help in support their childrens development in the meeting the needs of the communities and critical early years from preconception to developing quality programmes that not only three years. To cater to this need, HANDS attract the donor agencies to invest, but can established Parwarish Markaz, or 0-3 also provide sustainable alternatives for centres, in various communities in Sindh. the communities. ECD practitioners need to constantly update themselves with new Parwarish Markaz information about interventions around the world and develop their personal capacity The early intervention and development to develop strategies for low cost ECD centre, Parwarish Marzak, is being implemented in 29 marginalised initiatives for marginalised communities. communities in the Matyari and Hyderabad The Health and Nutrition Development districts of Sindh with approximately 800 Society (HANDS) for Community children, 30 trained ECD workers, 30 child Development is an example of such an care assistants and more than 15 support intervention. HANDS for Community staff including Lady Health Workers (LHWs). Development is a registered non-profit In Matyari, there are 26 Parwarish Markaz organisation working since 1979 towards focusing on areas in the Sayeeadabad, Hala human development and committed to and Matyari clusters. In Hyderabad, there serving the community in all aspects of are three Parwarish Markaz in the Latifabad cluster. The clusters are chosen with the improving life standards. rationale of serving the poor, neglected, and HANDS started the Releasing Confidence marginalised communities across the two and Creativity Programme (RCCP) for ECD districts. with the Aga Khan Foundation (Pakistan) to serve children 0-8 years old in the The core objectives of the Parwarish Markaz underprivileged communities of rural Sindh are: province of Pakistan. Training of key stakeholders in the community who are catering to the The RCCP works to ensure that young needs of children ages 0-3 years old childrens rights are honoured and met. Capacity development of the parents It works to influence the environments and community in regards to ECD affecting the child, family, community, school orldwide, there is support for ensuring Early Childhood Development (ECD) programmes for family and communities. The significance of family care is of vital importance in the development of very young children. Children learn who they are and what life is all about from the people they are with. For the vast majority of children it is the family, in its many and varied forms, which is the most important influence on the childs perception of self and others. (Arnold, 1998)

Growth monitoring of children ages 2-4 in Parwarish Markaz School readiness and preparation of young children ages 0-4 years old

Programmes at Parwarish Markaz All the programmes are conducted by trained ECD practitioners to ensure quality in the programmes and effective utilisation by the community. Furthermore, the pilot intervention of Parwarish Markaz is supported and integrated with HANDS other core organisational programmes health, poverty alleviation and education, and is provided technical assistance, human resource and thematic guidance as requested. For example, if they have to conduct a health seminar, then a health team from HANDS is consulted and extends their support. Some core programmes intervention are as follows: of the pilot

(a) Programmes for 0-2 years old: Parental Seminars

The programme starts by registering the parents of the intervention areas in HANDS health programmes. After registration, parental seminars are announced for the community in form of workshops, katcheris (local group discourse), and individual focus session during the home visits. It focuses on the capacity development of the parents on the topic of child development, child rearing practices, growth monitoring, breastfeeding and health and hygiene of young toddlers in the home setting. LHWs Training

Training of Lady Health Workers (LHWs) is an integral part of the programme. LHWs are trained to provide optimal health services to the mothers of young children in the intervention areas. These LHWs are wellequipped with the basic health care facility kit and are empowered to share what they

12

ARNEC CONNECTIONS

COORDINATION AND INTEGRATION OF SERVICES

learned and skills to the community in need. The need for LHWs emerged because local, untrained, and sometimes unequipped women (Dai, as called in the local language) used to deliver babies and provided advice on child rearing to mothers (the trend of Dai is still very much in practice). However, from past observations, there were many instances of mother mortality rate and unhealthy child rearing practices in the community. Local Health Camps child development, acquisition of skills for Accomplishments of Parwarish Markaz making learning environments conducive for the young children and enhancing their skills HANDS initiated the Parwarish Markaz on a small scale as its pilot intervention, for monitoring childrens holistic progress. which ended in September 2011. Hence, the success and impact of the programme Growth Monitoring is yet to be evaluated at a larger scale. At Parwarish Markaz, a monthly growth However, the intervention has touched monitoring of the enrolled children is the lives of many caretakers, parents and conducted. Moreover, children are also given the young children from the marginalised basic health awareness through interactive communities. It has given opportunities of activities. These efforts result in preparing employment to many trained mothers from the children not only psychosocially for the the community, catered to the basic health wider world but are also effective for raising needs of the young children and mothers awareness of basic health, hygiene and from the target population, advocated policy for 0-3 years old children rights, initiated nutrition facts. programmes and well-being practices at the local and government level, and had made School Readiness a significant impact on the communities to The scope of the RCCP is to expand access cater to the needs of young children. and improve the quality of teaching/learning in katchi (preschool) classes and classes Fatima (changed name), a lead teacher at 1 and 2 (with an emphasis on reaching Parwarish Markaz shared her experiences, girls and poor communities). The aim of I had never imagined that in our remote Parwarish Markaz is to provide learning village there could be a centre for children opportunities for children ages 2-4 years who are 2-4 years old. In the past, young old so that they are retained in the ECD children of these ages used to wander programme and continue their schooling in outside their house and their mothers used Grade 1 and onwards. Parwarish Markaz to neglect their basic learning and health provides opportunities to young learners to needs and they never used to send their kids adjust themselves in a social environment to school even when they turn 5-6 years old. away from their homes and learn some I am fascinated to now see children coming basic skills and content knowledge of the to the centres at the age of two and seeing world and enhance their body coordination that their families are now planning their future education as well. and fine and gross motor skills.

Local Health Camps are arranged quarterly where facilities of immunisation for women and children, oral re-hydration therapy and control of diarrheal diseases, nutrition counselling, growth monitoring, treatment of minor illness, ante-natal, post-natal, delivery services, treatment of acute respiratory infection and referral services to secondary care facility are given to the mothers of young children. House Visits

House visits are key component of this programme. Approximately 500 families are part of the programme where LHWs pay visits to support mothers. In many instances, children are gathered at a village camp (local place or park) where health check-ups are held for them. (b) Programmes for 2-4 years old: Sughar (Earning programmes mothers of the young children) for

A child painting with water colours.

This programme aims to empower mothers of young children who are below the poverty line. The overall aim of this intervention is to improve socio-economic condition of underprivileged communities especially mothers/caretakers with the provision of income generating opportunities through skill enhancement trainings and establishment of enterprises. Training of Teachers and Caregivers

A major focus of the programme is on the training of key stakeholders. Hence, the staff are sent to leading ECD training organisations to enable them to get equipped with the latest teaching and learning methodologies, awareness of recent trends in the field of

NO 5. 2011

13

COORDINATION AND INTEGRATION OF SERVICES

Saeeda, a mother enrolled in the Sughar programme, a farmers wife and mother of five children, shared that her monthly income was 2,500 Rupee and her three children were very young (ages 2-4) due to which she was unable to support her husband financially and had to focus on the needs of their children. Since she enrolled herself in Sughar programme, she now not only earns her living, but also sends her three young children to Parwarish Markaz where they are given opportunities for learning and play. Nathsha, mother of two children shared her experiences, My elder son used to be unwell for years. I had applied all those local methods but later they diagnosed him with polio disease. Since Lady Health Workers started visiting our homes in the village, now we are well aware that we need to give proper vaccination to our young ones. I now feel myself a good mother, as my younger daughter is very healthy and I have given her all the necessary vaccinations. There are many other numerous examples of experiences that clearly showed the impact of RCCP and Parwarish Markaz in the communities. Challenges and Steps Forward The programme has faced numerous challenges with regards to the lack of trained caregivers in the targeted areas, catering to cultural differences and trends in programme advocacy and execution, record keeping of the children and tracking their progress, lack of research studies focusing on programmes for 0-4 years old children, lack of skilled and well trained programme staff, convincing parents and community to participate in the interventions and programmes, sustainability of the programme on the community grounds, and striving to demand continuation of the programme after September 2011 from the Maqbool Rahu contributed to this article. government and internal agencies. References Regardless of all the challenges faced, HANDS aspires to work and advocate for AKF Pakistan. (2006) Releasing Confidence and Early Childhood Development with the Creativity Programme 2006-2011: Proposal same vision and believes that the change is a process and not an event, keeping in Arnold, C. (1998) Early childhood... Building our mind the inspiration from the quote of one Understanding and Moving Towards the Best of of HANDS program manager, The ECD Both Worlds. Paper presented at International Seminar, Ensuring a Strong Foundation: An journey has not ended but just begun.
Integrated Approach to ECCD, 23-27 March,

Above: Children at the Parwarish Markaz Photo courtesy of Health and Nutrition Development Society (HANDS) Institute for Educational Development, Aga Khan University, Karachi, Pakistan

14

ARNEC CONNECTIONS

ECD IN EMERGENCIES

Researching Post-emergency Recovery for Very Young Children

By Sithu Wai, Macquarie University
A Case Study from Myanmar incorporate holistic assessment including exploring needs, vulnerabilities, capacities and interactions among children and Why Focus on the Young? families affected by a disaster or crisis and Young children are undergoing profound humanitarian aid programmes. physical, mental, social and spiritual development during the early years of life. An Enhanced Framework - VACS Disruption during these years can have long term effects on every aspect of development: As part of the research project, Dr. Wai acute and chronic consequences are has developed a framework (VACS) which inevitable (Babugura, 2008). Acute covers assessment of short and longer term risks include mortality, malnutrition, needs of young children following a disaster diseases, stunting, impaired cognitive and or emergency. psychomotor development, behavioural problems, low educational attainment, The framework incorporates a holistic delayed academic progress and, in the long investigation of strengths, capacities, needs term, poor career achievement resulting in and vulnerabilities which are not included in loss of income potential and other aspects other assessment tools. Most importantly, the framework specifically targets young of quality life well into adulthood. children, who are often left out of other Essential life support measures such as assessment activities. water, sanitation, shelter and food are critical for survival of children but they are not The VACS framework consists of four enough to mitigate the impact of disasters components. These are: on the development of children (Aguilar & Vulnerability analysis (V) Retamal, 2009). AGIRI2 or stakeholder analysis (A) However, there is a profound gap in our Community analysis (C ) knowledge about effective aid programmes Strategy analysis (S) for very young children (Christoplos, 2006). These components are described below. Why the Need for a New Framework? Vulnerability analysis addresses seven Current guidelines and checklists for need components of human security (or safety). assessments being used by non-government These are: organisations are useful for short term relief but tend to lack focus on impact outcomes 1. Economic security of injury, death, livelihood disruption and 2. Food security difficulty in recovery (Blaikie, Cannon, Davis, 3. Health security & Wisner, 2003). Recent research suggests 4. Environmental security that disaster response should incorporate 5. Personal security not only rapid need assessments and 6. Community security damages but also assessment of existing 7. Political security social systems and local capacities for the purpose of rebuilding communities, which Each of these will be applied to conditions can in turn help prevent child morbidity, for young children and families. including long term psychosocial outcomes following disasters (Torjesen, 2007). of interviews and focus group discussions.

s part of a PhD research project1, Dr. Sithu Wai is researching ways to assess post emergency needs of young children affected by disasters and conflicts. The anticipated outcome is an enhanced assessment framework which takes into account holistic needs of young children and their families. The investigation includes an assessment of the humanitarian response to the needs of young children, including ways in which community capacity and community resilience impacts the recovery process for children and families. Where the Project is Conducted The project is conducted in the Irrawaddy Delta region of Myanmar, officially the Republic of the Union of Myanmar, which was devastated by a category IV cyclone (Nargis) Myanmar is the second largest country on the mainland Southeast Asia. Cyclone Nargis, the deadliest cyclone in the history of Myanmar, battered Irrawaddy Delta on 2-3 May 2008. With wind intensity of over 200 kilometres per hour, the cyclone claimed about 140,000 lives (TCG, 2010) and severely affected about 2.4 million out of the 7.35 million living in the affected township (Lateef, 2009). Target Respondents The research project was conducted in 2011, three years after the cyclone. The project targets children who were 2 4 years of age at the time of the disaster. With the focus on the affected children, now aged 5 7 years, the research involves gathering data from caregivers, community leaders and key service providers through the use

1. Sithu Wais PhD project is being supervised by Professor Jacqueline Hayden and Dr. Katey De This focus calls for new assessment tools Gioa from Macquarie University, Institute of Early and/or a different framework which can Childhood.

2. The name AGIRI analysis represent assessment and analysis of stakeholders in terms of Agents, Goals, Interactions, Resources, Institutions.

NO 5. 2011

15

ECD IN EMERGENCIES
AGIRI analysis (also known as stakeholder analysis) assesses external response capacity. Since coordination among various stakeholders is frequently identified as one of the most difficult barriers in delivering targeted, effective aid, this analysis incorporates coordination, resource mobilisation and strategic planning again, with a focus on the needs of young children. Community analysis incorporates participatory assessment tools to investigate community structures and capacities, coping mechanisms and response programmes. Community readiness assessments are also included under this category (Plested, Edwards, & Jumper-Thurman, 2005). Joint Assessment (PONJA)4, and others. The comparison will reveal the strengths and gaps in terms of generating information about young children and their families which can inform appropriate and effective post emergency responses. Findings from this study will be validated through a survey of global experts on ECD and emergencies. Expected Outcomes of the Project The enhanced framework will fulfil an identified need for ensuring that young children are included in emergency response assessments and program targets. References
Aguilar, P., & Retamal, G. (2009). Protective environments and quality education in humanitarian contexts. International Journal of Educational Development, 29(1), 3-16. Babugura, A. A. (2008). Vulnerability of Children and Youth in Drought Disasters: A Case Study of Botswana. Children, Youth and Environments, 18(1).

Strategy analysis collates acquired during vulnerability, stakeholder (AGIRI) and community analyses in order to identify holistic response programmes for reducing vulnerabilities of children and families. The focus of strategy analyses is on the activities and programmes of stakeholders and possible interactions of these activities with other human security components.

Blaikie, P., Cannon, T., Davis, I., & Wisner, B. (2003). At Risk: Natural Hazards, Peoples Vulnerability and Disasters: Routledge. Christoplos, I. (2006). Links between relief, rehabilitation and development in the tsunami The project will identify strengths and response. London: Tsunami Evaluation Coalition information weaknesses of current humanitarian (TEC).

programmes in conducting critical analyses. The information provided by this framework will be of use in humanitarian coordination and planning (for example, in cluster meetings), resource allocations (for example, by donors) and humanitarian evaluations in the future disasters or emergencies.

IASC. (2007). Initial Rapid Assessment (IRA): Guidance Notes. Geneva: Inter-Agency Standing Committee (IASC). Lateef, F. (2009). Cyclone Nargis and Myanmar: A wake up call. Journal of Emergencies, Trauma and Shock, 2(2), 106113.

Most importantly, the use of the framework will assist in improving conditions and Plested, B. A., Edwards, R. W., & JumperHow and Where the Framework is Being experiences of children and families affected Thurman, P. (2005). Community Readiness: A Tested? by disasters/emergencies. Handbook for Successful Change. Fort Collins,
CO: Tri-Ethnic Center for Prevention Research.

The research project is being conducted in five communities affected by the 2008 Cyclone Nargis in Myanmar. Through a variety of sources, and using the VACS framework as guide, information about the emergency response for young children will be gathered. The data will be compared with information which had been generated through conventional assessment tools such as the Initial Rapid Assessment by the InterAgency Standing Committee3, Post-Nargis

Additional Information At the time of submission of this article, the research project has developed the VACS framework and study tools for case study as guided by the framework. The case study, in five communities (villages) in Myanmar, is expected to be completed by the end of 2011. Initial findings are expected to be available by mid-2012.
TCG. (2008). Post-Nargis Joint Assessment: Tripartite Core Group (ASEAN the Government of Myanmar and the United Nations). TCG. (2010). Post-Nargis periodic Review IV: Tripartite Core Group (ASEAN the Government of Myanmar and the United Nations). Torjesen, K. (2007). The role of community in helping children in disaster. Ambulatory Child Health, 7(2), 105-108.

3. The Multi-sectoral Initial Rapid Assessment (IRA) Tool was the tool developed by the InterAgency Standing Committee (IASC) global Health, Nutrition and WASH Clusters in 20062009. The tool aims to provide faster and better multi-sector rapid assessment in the first few days of a sudden-onset crisis in order to guide the initial planning of urgent humanitarian interventions, identify needs for follow up assessments, and inform initial funding decisions (IASC, 2007).

4. Post Nargis Joint Assessment (PONJA) was an assessment conducted by the Tripartite Core Group (TCG), comprised of representatives of the Government of Myanmar (GoUM), the Association of Southeast Asian Nations (ASEAN) and the United Nations (UN) and ASEAN, in the Ayeyarwaddy and Yangon Divisions, Myanmar to determine the full scale of the impact of Cyclone Nargis and the requirements for both immediate humanitarian assistance needs and medium to longer term recovery (TCG, 2008).

16

ARNEC CONNECTIONS

ECD IN EMERGENCIES

Promoting and Supporting Holistic Development: Baby Tents in Post-earthquake Haiti

By Lisa Deters, Macquarie University
he devastating earthquake on 12 January 2010 in Haiti directly affected more than 750,000 children with an estimated 380,000 children displaced living in 1,200 displacement sites exacerbated by a cholera outbreak at the end of the year (UNICEF, 2011). In this fragile context, research was conducted to examine the myriad of responses supporting young children. Initial results highlight the benefits of providing baby tents in which various organisations incorporated the UNICEF Early Childhood Development (ECD) Kit to support their baby tent programming. These baby tents focused on the needs of the very young child, 0-3 years during the first phase response. ECD in Emergencies Extreme disasters are key platforms to expose the potential of ECD interventions, particularly as the youngest children aged 0-8 represent the highest percentage of affected populations in todays global emergencies. Recent research shows that over 200 million children under the age of five worldwide are not developing to their (full) potential due to poverty, poor health and nutrition and lack of stimulation, all compounded when an emergency strikes with prolonged disruptions to their developmental potential in both the immediate aftermath and in the longer term (Lancet, 2007). Young children are amongst the most vulnerable impacted from family disruption, loss of social fabric and destruction of support and protective systems yet can be neglected in terms of essential and adequate care and psychosocial needs impacting their early experiences and long term cognitive, psychosocial and neurological development (Grantham-McGregor et al., 2007). In these contexts, protective factors are frequently lacking making young children more vulnerable to a multitude of risks from injury, violence and sexual abuse. At the same time, children also possess inherent resilience which ECD programmes have been shown to encourage and facilitate healing, resourcefulness and collective support Concern Worldwide staff at their Baby Tent engage the mothers/ caregivers in singing and dancing, creating a special day at the tent. among the children, family and community (Connolly and Hayden, 2007), necessitating continued and greater advocacy for ECD in emergencies (ECDiE). ECDiE considers the impact of caretakers, families, safe and predictable environments critical for the overall well-being of young children, including interventions aimed to reduce the loss of human potential during childhood, particularly for the most disadvantaged children and their families in fragile contexts. It aims to provide holistic ECD to support childrens survival, growth, development and learning including health, nutrition and hygiene, and cognitive, social, physical and emotional development (GMR on EFA 2007, p.3) as child development is rapid, critical and highly dependent on adequate stimulation and effective care. From the research undertaken in Haiti, enabling ECDiE does not depend upon heavy financial investments, but rather requires imparting necessary skills, competencies and knowledge. Therefore integrated ECDiE interventions, amidst the disruption of normal safety nets, include family-centred and community-based activities that focus on holistic development of young children and their caregivers: targeting caregivers through information sharing, training and support services on prenatal care, holistic child development, home visits, health-related services and comprehensive programmes that combine early stimulation learning opportunities, nurturing environments, nutrition and health, child care and environmental improvements. The Baby Tent Baby tents were innovatively utilised in Haiti by an array of international non-governmental organisations, many supported by UNICEF and recipients of the UNICEF ECD Kit; however, for the purpose of this article, the focus will remain on the concerted efforts of two - Concern Worldwide and Accion Contra la Faim (ACF) or Action Against Hunger. Their baby tents provided young children 0-3 and their caregivers a safe place to access support, where mothers could breastfeed, caregivers could receive counselling, psychosocial support and information on child development, and expectant mothers

NO 5. 2011

17

ECD IN EMERGENCIES
could receive neo-natal information and advice. Such a tent was the appropriate place for specific attention and support for a baby without a mother, for the newly single father and advice for mothers and parents HIV-positive. Both women and men who had lost their partners and other family members and were left with small children to survive without family support, a home, job, and income were welcomed. An Integrated Response For both organisations, the baby tents were viewed as an entry-point for a multi-sector response, providing children and caregivers access to health, nutrition and sanitation services aside from opportunities to play, interact and stimulate the young children through the use of the play and manipulative items in the UNICEF ECD Kits. The tents were outfitted with play mats and mattresses and for simple health and nutrition screenings, some offered the services and expertise of nurses, nutritionists and child psychologists, included hand washing stations and were located near toilet facilities where feasible. realised that for most mothers it was not very easy for them to take care of the baby, to stimulate the baby. They were coming to the baby tent, but they would put the baby on the mattress and they were just waiting and they did nothing with the baby. So we started to organise group discussions to explain why it is important to play with the baby, how to stimulate the baby, what to do when the baby is crying, many very basic things, but just to support the mothers. Both Concern Worldwide and ACF provided training for their baby tent staff on the UNICEF ECD Kits ensuring that the items were used effectively with the children and caregivers while encouraging their staff to use them in a creative and culturally appropriate manner. The two organisations also collaborated in the sharing and exchanging of best practices with the use of the ECD kits. Holistic Development Founded upon principles of holistic ECD, the baby tents upheld and encouraged family and community-based care recognising how best to support the young child. Upon entering the baby tents, it was evident that they were strategically constructed as safe spaces and decorated as cheery spaces. The spaces provided critical connections to varied supports from the emotional to the physical for both the caregivers and their child, and extremely valuable, connected the caregivers to each other. Fostering Community Although the habit of the baby tents for both organisations was not to routinely supply gifts of food or non-food items, aside from the provision and access to a wealth of information, psychological support, counselling, friendship, and most importantly from the interviewed caregivers comments, the aspect of community, motivated continued participation. Frequently, the tents had a social function or party and offered a nutritious snack such as fruit. These simple functions served to boost morale and distract from the day-to-day difficulties and realities. The value of the tent was best described by a young mother as providing a sense of escapism if only for a few hours to enjoy some companionship, have a fun moment and a laugh in the safety of the tent. The caregivers coming together to talk and share was psychosocial support in practice. Further, bonding or a fostering of familial bonds was evident in the way that the adults were attentive and cared for each other and all of the children present. This sense of community fostered by the baby tents was remarked upon during interviews with both Concern Worldwide and ACF staff. Emerging Benefits Numerous unintended and exemplary beneficial activities also emerged from the baby tents. Some tents have seen the development of work-for-cash programmes; for example, in one tent a Haitian artist taught the women how to make bags and hats out of candy wrappers to sell. Other tents have supported economic initiatives amongst the caregivers such as crocheting or knitting items to also sell. At one such tent it included the knitting of baby hats with the names of the babies of the expectant mothers in the baby tent. The baby hats were then hung up in the tent so when the mothers delivered their child the tent celebrated the birth and symbolically took down the hat to be placed on the newborn. Another baby tent put on a concert as the caregivers enjoyed singing, so the baby tent staff rented choir robes and organised a performance. Still another tent encouraged the talent of a good artist that resulted in multiple paintings of the baby tent and some works for sale. To be underscored is the fact that the baby tents are building on the caregivers talents and interests and in so inherently supporting their psychosocial

In an interview with Concern Worldwide, the staff member stressed the idea that the baby tent was developed to support multisectoral work as an integrated programme. ACFs baby tents functioned similarly with an integrated programme, specifically with nutrition support aiming at not only preventing but curing the treatment of severe malnutrition for children under five, thus involving screenings in the tents alongside The baby tent put forth great efforts to psychosocial and play activities organised fully support the caregiver, recognising that children have ongoing needs that with the use of the UNICEF ECD Kits. must be addressed by their caregivers In an interview, an ACF staff shared the whether they require direct supervision, benefits of integrated programming in the breastfeeding, assistance with feeding baby tents, Here is where both mental and protection from hazards and that health and care practices are really linked their well-being is highly influenced by the to ECD because our main objective is to emotional and psychological state of their reduce malnutrition, but because we know caregivers. It initiated with simply providing that one of the first causes of malnutrition is daily encouragement and active listening inappropriate or lack of care practices and by trained staff attempting to maintain the it includes how you play with the child, how emotional health of caregivers, with the you care for the child, how you stimulate desired result being that the caregivers him, the attention you give him, etc. And would be in the right disposition to have this necessarily involves for us to do some the motivation and desire to stimulate their activities, like playing activities and to show babies. The Concern Worldwide and ACF baby tents recognised the importance of the mother the means of stimulating. healthy and happy caregivers, with an ACF A Concern Worldwide staff responsible staff member succinctly stating, Everything for managing the baby tents added, We depends on the state of the mothers.

18

ARNEC CONNECTIONS

ECD IN EMERGENCIES
health, providing them with enjoyable and meaningful activities. Further Research Holistic ECD responses in situations of emergency provide a window of opportunity to build back better1 with a focus on the well-being of the young child and caregiver. The baby tents in Haiti provide one positive example supporting the young children and their caregivers emotionally, physically and for some economically while positioning ECD in the form of the baby tent as a valuable commodity within the community. However, there remains a call for continued research on supporting the very young child in emergency contexts and for more research, baby tents and beyond, to ensure that both holistic ECDiE is included in the immediate emergency response and that well intentioned interventions are empirically based and do not exacerbate negative outcomes for young children and their families in fragile contexts (Sims, Hayden, Palmer, & Huchins, 2002). Authors note Thank you to the support from UNICEF Haiti Country Office, Concern Worldwide Haiti Country Office for the support and ACF Country Office in the provision of interviews and site visits. References
Grantham-McGregor, S., Cheung, Y.B., Cueto, S., Glewwe, P., Richter, L. & Strupp, B. (2007). Developmental potential in the first 5 years for children in developing countries. Lancet, 369 (9555), 60-70. Lancet. (2007). Vol 369. www.thelancet.com. Sims, M., Hayden, J., Palmer, G. and Huchins, T., (2002) Young Children Who Have Experienced Refugee or War-related Trauma, European Early Childhood Education Research Journal, vol.10, no.1, pp 99-110. UNICEF. (2011). Children in Haiti: One year after the long road from relief to recovery. United Nations Childrens Fund Haiti Country Office. 1 UNICEF uses the terminology build back better in reference to the need to restore quality education in fragile contexts such as post-earthquake Haiti (http://www.educationandtransition.org/resources/unique-programme-improves-the-qualityof-education-in-haiti-after-the-quake/ UNESCO. (2007). Strong foundations: Early childhood care and education. Education for All Global Monitoring Report. Paris, France: UNESCO.

Above: Mothers and caregivers bring their babies to Concern Worldwides baby tent knowing that the little ones will be provided a safe and shaded space to rest under the caring eyes of staff.

Above: The baby tent provides a safe and clean atmosphere for the babies to play with toys, crawl and explore the tent under the watchful and caring eyes of the staff.

Below: The artistic decorations hanging from the roof of the baby tent provide stimulation for the babies as a staff from Concern Worldwide hold them. Photo courtesy of Lisa Deters

NO 5. 2011

19

PARENTING PROGRAMMES

Ready, Set, Parent!

By Nicole Tomasello & Mary Beth Debus, EPIC (Every Person Influences Children)
he continuum from infancy to childhood is well documented as a critical period of rapid cognitive, emotional and physical development (Shonkoff & Phillips, 2000). The reality is that many parents are not cognizant of the degree to which, or mechanisms by which, their behaviours and interactions with their infants and toddlers shape the future successes of children as they enter school and move toward independence.

focus on specific individual and family issues. Group settings offer a unique strength. When facilitated using an active learning approach, group workshops offer parents a strengthbased, supportive and educational setting in which they can discuss similar issues, and solutions to these issues, with other parents. The Ready Set Parent! (RSP) programme, developed and implemented by EPIC Every Person Influences Children and Baker Victory Services, provides one-onone visits and group workshops to help parents raise their children using healthy and developmentally appropriate parenting practices. The programme is typically implemented in New York State but is suitable for any location. It is a programme for all parents of newborns, but it is especially focused on high risk families. The parents of these families are likely to have low incomes, be single parents, earn less than a high school education and be diagnosed with a mental illness. The programme has three key learning areas including Parenting, Literacy, and Health & Wellness, and it includes the following three components: Hospital Coordinators visit parents and caregivers of newborns in the hospitals within 48 hours of child birth. More than 7,000 caregivers are visited annually. They are informed about community resources; provided information on parenting, literacy, nutrition, safety, health and wellness; and introduced to the Infants & Toddlers workshops described below. While in the hospitals, parents are invited to a one-hour newborn class to learn more about newborn care and development. During this time, parents develop important parenting skills that will benefit their baby well into the future. Childrens books are given to newborn class participants and parents are strongly encouraged to read to their babies. Finally, parents are invited to participate in the eight-week Parenting Infants & Toddlers workshop series designed to increase parental knowledge, attitude, and confidence. The aim is to increase

Parents are not always aware of the parenting behaviours associated with under-stimulation and the consequent poor development of childrens cognitive, language, social and motor development (Conrad, Gross, Fogg & Ruchala, 1992). Furthermore, harried parents may be passively inattentive or provide so little stimulation to their infants and toddlers that it can border on neglect. Parents with a variety of risk factors can engage in more aggressive child discipline or provide such inadequate caring environments as to create the dynamics associated with increased vulnerability for disrupted physical and cognitive maturation and associated developmental disabilities (Olds, Sadler & Kitzman, 2007). The risk factors that 1. can negatively impact parenting and child development include poverty, isolation from effective support systems, unstable housing, neighbourhood drug and alcohol problems as well as challenging neighbourhoods with high rates of violence and crime. Many of these factors are compounded by parental substance misuse, potential consequent childhood malnutrition, and founded events of abuse and neglect (Child Welfare 2. Information Gateway, 2003).

the frequency of high quality interactions with infants and toddlers and facilitate the development of the infants or toddlers cognitive, language, personal/ social, gross motor and fine motor skills. Demographic data are collected and participants receive regular updates on workshops scheduled in their communities. Workshop topics include Tuning in to Your Baby, Coping, Establishing Routines, Learning through Play, Setting Limits, and Promoting Literacy. Each workshop series includes two 2-hour Dr. Talks on Infant Sleep/Nutrition and Safety/Childhood Illnesses. Parents receive toys for their children through regular attendance at workshops. This research-based programme has been evaluated in collaboration with the University at Buffalo, USA, since 2007, using a realtime methodology and a pre-test and posttest design with natural comparison groups. The programme has consistently yielded positive results including a statistically significant increase in parental self efficacy, positive parenting behaviours and family relationships. The Ready Set Parent! Parenting Infants and Toddlers workshops can be implemented in a variety of settings. They have been provided to mothers living in a substance abuse treatment facility with their children. Even in this setting, participants have demonstrated positive results in the areas of parental knowledge and confidence. The programme is appropriate for at-risk populations and parents and children with a variety of cultural backgrounds. In the fall of 2010, EPIC brought the Parenting Infants and Toddlers workshops to Singapore by providing a three-day Facilitator Training to staff, board members, and partners of the Association for Early Childhood Educators, Singapore (AECES). The first day of training was primarily focused on the development of effective facilitation skills and working with groups. The second day oriented participants to EPICs Parenting Workshop Series, with a heavy emphasis on Parenting Infants and Toddlers, a component of

Programmes developed to increase positive parenting and promote healthy childhood development include a variety of implementation techniques including home visiting, individual counselling, and group workshops. These programmes have strengths and limitations based on targeted outcomes and delivery methods. Home 3. visiting uses the familys environment to assist the parents in their disciplining and teaching tasks. One-on-one counselling offers personalised discussions and a direct

20

ARNEC CONNECTIONS

PARENTING PROGRAMMES
Ready Set Parent! The third day focused on EPICs family literacy programme, Ready, Set, Read which is often the programme that parents attend after participating in Ready Set Parent! The training included the facilitation of both a parenting workshop, and a Ready, Set, Read workshop, with specific feedback on each participants strengths and development opportunities. In addition to the core curriculum, the participants and trainers discussed the difference between the EPIC facilitation model and the more traditional training model most often used in Singapore. All agreed that the facilitation model would require extra effort on the part of the facilitators to engage parents, but that the benefits would be well worth it. Parents often share with EPIC staff that the Ready Set Parent! and Ready Set Read programmes were not only helpful in educating them about various parenting and child development topics, but that they were also helpful in connecting them with other parents and finding them resources and supports needed to raise healthy children. More extensive research outcomes on Ready Set Parent! and Ready Set Read, and their impact on various groups, will be released in the near future. References

The Experience of a 0-3 Programme based on MegaSkills in China

By Guangheng Wang, Shanghai Changning District Institute of Education & Shaoli Zhang, Shanghai Elite Baby Early Learning Centre
Background MegaSkills1 are the attitudes, behaviours and habits that determine achievement in schools and beyond. We find that young parents, born in the 1970s and 1980s, think of education much differently than that of their grandparents. They pay more attention to their childrens attitudes, behaviours and habits than just only trying to improve their childrens intelligence quotient. We find that these aims could be achieved through the activities based on MegaSkills. Most of the MegaSkills training programmes used now are for children aged four and over, but we have revised these learning activities creatively for very young children aged 0-3, which we named the Baby Star Programme at the Shanghai EliteBaby Early Learning Centre. It is a programme designed by professional staff for curriculum development and a professor from East China Normal University, and has been implemented since October 2009. a subsidiary programme, or an extension of the Baby Star Programme, which has expanded from the centre to the home. It focuses on the continuing benefits of the activities that children can take part in, which began in February 2011. Aims and Objectives The sub-programme is both centre-based and home-based. It is provided for very young children and their parents who take part in the Baby Star Programme. One of the aims and objectives is to promote young children to acquire habits, skills and behaviours conducive to their success in the kindergarten and their future life. One more important aim and objective is to help parents become empowered. Parents obtain information about parenting, learn about parenting skills, and master parentchild games applied at home, which can improve the quality of the parent-child interaction.

Child Welfare Information Gateway (2003). Substance abuse and child maltreatment: The biggest difficulty we have faced during Bulletin for professionals. Washington, DC: US the modification and the localisation of the Another aim and objective is for the teachers Department of Health and Human Services. activities was not only adapting it to the in the Baby Star Programme. The teachers

Chinese cultural context but maintaining its essential learning purpose. We have selected a number of Chinese fairy tales, Shanghai folk plays and other things that have local, cultural features to be used as materials for the activities in the Baby Star Programme under the premises that Olds, D. L., Sadler, L., & Kitzman, H. (2007). these revised activities are consistent to the Programs for parents of infants and toddlers: original ones in nature.
Conrad, B., Gross, D., Fogg, L., & Ruchala, P. (1992). Maternal confidence, knowledge, and quality of mother-toddler interactions: A preliminary study. Infant Mental Health Journal, 3(4), 353-362.

learn about the parents needs and can also get their suggestions to make the parentchild activities implemented in the centre more appropriate for very young children and their parents. Approaches, Methods and Materials The activities of the sub-programme are

recent evidence from randomized trials. Journal carried out once a week after the parent-child of Child Psychology and Psychiatry, 48(3-4), 355- The programme introduced in this article is curriculum of the Baby Star Programme. 391. The content and instruction of the activities Shonkoff, J. P. & Phillips, D. A. (Eds.). (2000). From neurons to neighborhoods: The science of early childhood development. Institute of Medicine. Washington, DC: National Academy Press. 1. MegaSkills was created by Dr. Dorothy Rich, author, lecturer and pioneering leader, in the field of parent involvement in education. It develops childrens inner engines for learning. There are 11 skills that they focus on: Caring, Common Sense, Confidence, Effort, Focus, Initiative, Motivation, Perseverance, Problem Solving, Responsibility, and Teamwork. The MegaSkills training programmes are used by over 4,000 schools across the United States and abroad.

are sent to the parents by e-mail to support them to learn and practice at home. The instruction consists of three aspects, including parenting knowledge (e.g. the introduction of MegaSkills), parenting skills (e.g. parenting tips to cultivate childrens responsibility), and parent-child games suitable for home.

NO 5. 2011

21

PARENTING PROGRAMMES
Parents give their feedback after they practice the activities at home every week. The contents of the feedback contribute to understanding the effects of the implementation of the sub-programme. Main Outcomes, Results and Lessons Learned According to the parents feedback and the teachers teaching reflections, the main outcomes and results of the sub-programme appear to support two aspects: parenting capacity and curriculum construction. Parenting Capacity: The sub-programme is warmly welcomed by parents. The parents feel that they have learned a lot about MegaSkills and feel that the activities based on MegaSkills for very young children are feasible and effective. The perception is that this sub-programme is suitable for parents to practice at home, and that it is Above: A parent-child game focusing on caring especially good for parent-child interactions Photo courtesy of Yinqi Tan and his parents and their relationships. On the other hand, parents want to learn more about parenting skills through the sub-programme and have expressed the desire to take part in a more systematic parent education programme. Curriculum Construction: The parents feedback has been utilised to enhance the centre-based and home-based programme content. Their feedback also contributes to the ongoing construction of the parent-child curriculum of the Baby Star Programme. The parents have thus become competent, active agents in the early learning centre. Current and Follow-up Plans A longitudinal study to research the effect of the Baby Star Programme on childrens attitudes, behaviours, and their habits is being done. It is our ultimate aim to Above: One of the activities at the Baby Star Programme which focuses on teamwork perfect the Baby Star Programme based on MegaSkills in parallel with the sub- Photo courtesy of Shanghai EliteBaby Early Learning Centre programme. References
Rich, D. (1998). MegaSkills: Building Childrens Achievement for the Information Age. Boston: Houghton Mifflin.

22

ARNEC CONNECTIONS

PARENTING PROGRAMMES

Service- and Community-based Parenting Support and Education Programme

By Mohammad Imam Nahil, Save the Children

their services. Simultaneously, caregivers (both primary and secondary) also share and support each other at an interpersonal level in utilising recommendations and overcoming various challenges. Communitybased interventions are being implemented In the community-based intervention model, by 48 CWs in 24 communities in 13 villages. two Community Workers (CWs) selected by the caregivers in each community are Job Aid and Materials: Both interventions practicing specific key trained by Save the Children. The trained emphasise CWs organise group sessions in the recommendations. However, remembering community and train some (usually 12-15) and following all the key recommendations caregivers (primary service recipients), who are a big challenge for the caregivers in a have children between 0-3 years. These rural community. Thus, some innovative primary service recipients work as materials were introduced to improve the p e e r educators in the community. service delivery mechanisms and strengthen They counsel and support other caregivers household level child rearing practices. (secondary service recipients), who could These include: not attend the session and resides in close proximity to the primary caregivers, on a. Child development card: This card responsive care and positive parenting contains age specific, (i.e. Birth-6 months, practices. In the group sessions, the primary 712 months, 12 years and 2-3 years) recipients report to the CWs on the number positive childrearing recommendations of secondary service recipients counselled towards holistic childhood development and supported by them. CWs will randomly under three basic areas - Food-Health visit caregivers (both primary and secondary) & Nutrition, Communication, and Play & to offer support and recommendations Games. Frontline workers use this card with whilst observing them to help improve caregivers to convey key recommendations at satellite clinics, community clinics and family welfare centres. Frontline workers also conduct routine household visits. This model is being implemented by ten frontline workers in 26 communities in 12 villages.

n some rural areas of Meherpur district in Bangladesh, Save the Children has been implementing two parenting support and education programmes 1) service-based and 2) community-based intervention for children 0-3 years old. This endeavour is part of a comparative study in which the objective was to determine and/or develop an effective programme ensuring childrens holistic development, which is perceived as childrens physical, cognitive, language and psychosocial development at a very early age. Another objective was also the improvement of caregivers knowledge and community awareness. This article aims at sharing strategies and experiences learned from these two parenting education programmes. Programme Strategies and Tools Training and Capacity Building: A new training curriculum was developed by integrating age-specific health and nutrition recommendations along with responsive care and other positive childrearing practices. Initially, frontline workers of the selected intervention areas were trained using this curriculum. The curriculum is largely practice-oriented instead of merely transferring knowledge and each module has one or two specific key recommendations for caregivers to practice at their household level. For example: Hug your child often and show your love; Wash your hands; Offer a wide variety of food; Start the child on selffeeding at eight months and so on. Intervention Models: The service-based intervention model is implemented by government frontline workers, i.e. Family Welfare Assistants (FWA), Family Welfare Visitors (FWV), Family Planning Inspectors (FPI) and others at the Directorate General of Family Planning (DG-FP), Ministry of Health. Along with undertaking other responsibilities, frontline workers counsel and support the caregivers of 0-3 year old children who are visiting the service centres by providing parenting education on ECCD in addition to the required health services

Parenting support in the satellite clinics (service-based).

NO 5. 2011

23

PARENTING PROGRAMMES
areas for improvement, limitations or other socio-economic and cultural issues affecting programme outcomes. Further, the card promotes self-monitoring; it saves more time and labour for both the service provider and the recipients. Relevant and culturally appropriate pictures have been used with each recommendation in the promise card and child development card. These help the less educated or even illiterate caregivers to perceive and remember the recommendations. and caregivers use this card as a reference as well. (see above for the front page of a child development card) b. Promise card: The promise card (example of the card is shown on the right) has been developed for each age category (i.e. Birth-6 months, 7-12 months, 1-2 years and 2-3 years). Each promise card contains 12 specific, age appropriate recommendations that a caregiver has to promise to practice each month. In every subsequent month, they bring the promise card to service providers for follow-up and support. This card encourages a caregiver practicing the recommendations largely as she makes a commitment. In each card, there is also a place where the service provider writes down the reasons if the caregiver did not make a commitment or could not practice any item, thus, enabling identification of Lessons Learned: Success and Challenges Coverage: So far, about 22% of the children have been covered by the service-based intervention. Uneven workload and lack of workforce are significant challenges that make it difficult to reach the maximum number of children with this model. For example, on average, one Family Welfare Assistant may be asked to reach 600 households in five working days for family planning counselling. The community-based intervention has faired better with about 65% of the children in the community receiving services during the defined period so far and has reached about 72% children shortly after their birth. Service Quality: The service-based intervention has high social acceptance and credibility among the community because of the frontline workers (particularly the FWAs) strong community connection in the birth control and education programmes, and their relevant expertise. One mother said, We trust them. Whereas, community workers had to struggle a lot to receive a positive response and faith from the communities because they came from different socio-economic backgrounds with less or no relevant experiences 35% are adolescent girls and 45% are homemakers despite that the services provided by CWs are of good quality. However, it was noted that the number of contacts in a month between caregivers with service providers is an important factor. In community-based intervention, the average number of contacts is about twice a month and in service-based intervention once every two months. In the service-based intervention,

Parenting support provided in the community (community-based).

24

ARNEC CONNECTIONS

PARENTING PROGRAMMES
A mother (peer educator) says, What I learnt from our elders had been practicing with my child. We used to think that childrens brain and other skills were mostly god-gifted and could slightly be developed through education only the more a child read, the more his/her brain develops. Now I have come to know the fact. Ill practice all those possible recommendations and provide early stimulate to develop my childs brain and other skills and must teach others (relatives and neighbors) about this.

During a satellite clinic session: A service recipient (service-based) the location and distance of households were determining factors affecting the frequency of contacts and caregivers knowledge. In a survey, it was found that among the recipients who took the survey, about 36% in the service-based and 68% in the community-based interventions were able to implement the key recommendations and understand child development, especially their social and cognitive milestones, as well as the importance of early stimulation and responsive care. the community, particularly among fathers/ husbands, was a big challenge. Fathers remained disengaged in the interventions largely because of their responsibility as the wage-earner and the cultural construction of fatherhood (child rearing is considered to be solely the mothers responsibility), In community interventions, Community Support Groups (CSGs), comprised of different professionals and community leaders were formed in the community. The CSG members supported the interventions and advocated in the community to create an enabling environment. They played an important role in motivating the fathers, thereby ensuring mothers involvement in the programme.

Sustainability: Ensuring sustainability is a challenge in the community-based intervention unlike the other intervention. Community workers are volunteers and there was a considerable turnover rate (8.5%) of CWs in past seven months in spite of providing some regular refresher training Prospects and motivations. We need to think about allocating some incentives that would be The government (Directorate General of Family Planning) is also working with valued in the local communities. Save the Children in this endeavour to Community participation and awareness: improve existing ECD service delivery In rural communities, men/husbands head mechanisms and quality. Nevertheless, it most of the families and women/wives have is obvious that each intervention model has a serious lack of decision-making power its strengths and limitations. For example, regarding various child rearing practices the community-based model is effective (Baseline survey, 2010). Even womens at achieving maximum coverage and participation in the programme is largely community participation; on the other hand, decided by their husbands. Therefore, it is the service-based intervention has excellent important to involve men/husbands (fathers credibility, skilled workforce and resources. of the children) with the intervention as well. Therefore, we need to think about necessary However, ensuring participation among collaborations and synchronisation of these

Above: Parenting education session (community-based)

two models to ensure an optimum outcome and maximum long-term benefits for holistic childhood development of children between the ages of 0-3.

Photo courtesy of Save the Children

NO 5. 2011

25

PARENTING PROGRAMMES

The Best Start: Helping Parents for their Young Children

By Mar Mar Thwin, Save the Children
his article discusses Save the Childrens work in parenting education and how it brings about positive changes in childrens lives and parental behaviour. Helping young children develop to their fullest potential cannot be done alone at home or it cannot be successful without the full participation of the wider community. Save the Children in Myanmar has many years of experience in implementing Early Childhood Care and Development (ECCD) programmes. This has enabled significant lessons to be drawn on how to ensure that ECCD in communities is developed in such a way that it is sustainable and an asset to the community. Since 2006, Save the Children has been implementing the Transitions Initiative programme that aims to support communities for quality ECCD services through centre activities and parenting education sessions, and to support children for their smooth transition from home or ECCD centre to primary school. This article highlights the parenting education programme part only. Getting Communities Involved In its community-based approach, there are several key steps that facilitate full community participation. The outline of the

process is as follows. Community awareness raising on the importance of early years of a childs life is undertaken through advocacy sessions, meeting with local authorities, focus group discussions with community leaders and family members, video shows and Information, Education and Communication (IEC) materials. This is followed by initial dialogue with the community that leads to a shared understanding of the activities and also explores the commitment required from the community. A Participatory Learning and Action (PLA) exercise is carried out together with the people to obtain a profile of each community. A geographic and demographic picture is compiled and incorporates information on the communitys economic situation, cultural beliefs and current child care and development practices, attitudes in care of disabled children, community involvement, parents attitude to education, health of the children under five, nutrition practices for the children under five and reproductive health and its challenges. Once the PLA has been completed, the overall analysis is shared in a public meeting with the whole community. At this meeting, the community members select the people they consider representative, to serve on the Management Committee. Women

are mobilised to be members as well. Management Committee members receive a number of training sessions over a period of time on a variety of topics: the concept of ECCD, Team Building, Management and Leadership skills, Community Development, Social Mobilisation and Community Participation, Toy Making, Book Keeping and Community Action Planning. Once the ECCD centre is established, and 3-5 years old children have gone through programmes at the centre, Parenting Education (PE) sessions (focusing on 0-3) take place about nine months later. By that time, the community members have seen some noticeable changes in the ECCD centre children. Establishing Parenting Education Sessions To introduce the PE programme in the community where the ECCD centre is already established, a public meeting for the whole community is held and the importance of the role of family members is highlighted for the development of their young children (0-5) at home (Save the Children, 2009). The process for the PE programme is also explained. The community and the ECCD Management Committee have to identify

Above: Facilitating a parenting education session in Myanmar. Photo courtesy of Save the Children

Above: A mother and baby during a parenting education session.

26

ARNEC CONNECTIONS

PARENTING PROGRAMMES
work, plenary, games, story-telling, role play, singing and dancing, reading out the story booklets, and use of audio cassette player. It focuses on the interactive communication between PEFs and the participants, who do not need to be shy about being illiterate because they are not asked to write down anything. A Training of Trainers (ToT) for the PEFs who are from ethnic minority groups is carried out separately and Save the Save the Children has undergone the Childrens local staff are present to translate process of piloting, reviewing and modifying and interpret throughout the training. a set of PE modules (refer to the next page for module example) over a decade The ECCD Management Committee, ECCD based on the field experiences and lessons caregivers and PEFs work together to run a PE session once a week for of parents with learned. Current PE topics are: Building self-confidence of parents and 0-5 aged children. ECCD centre serves as a venue and sometimes these sessions take caregivers place in a house or monastery compound. Supporting childrens development Interactive relationship and Learning The number of participants is limited to ten. In some communities they run two emotional skills Childrens participation in daily routines sessions a week and can therefore work with 20 parents. Regular PE sessions come Positive discipline to an end after eight weeks. The PEFs are Learning through play Keeping children healthy and Safe unpaid volunteers but they enjoy the role of being the Facilitator among their peers. This environment Resiliency and Overcoming childrens motivates them to complete their task. After one cycle of eight modules is completed, the common fear Managing Committee together with PEFs The PEFs are trained in a participatory organise another cycle of PE sessions for learning approach and they have to apply it new participants. These sessions take into in their practical work. The duration for each account local seasonal commitments, for module is around one hour. The methodology example, they do not normally function includes brain-storming, pair work, group during the harvest time. the right people who can be Parenting Education Facilitators (PEFs), usually mothers and more mature women fit into these roles. This is because they have the interest, experience, credibility and respect within a community to have this education and facilitating role. They also need to have good interpersonal skills as well as an interest in early childhood care. Facilitating Parenting Education Sessions According to a Save the Children study of the impact of ECCD on household economy undertaken in the same context of this PE programme, found that the primary care takers of young children (0-3 years old) are mothers (83%), relatives (13%), elder siblings (3%) and neighbours (1%) (Save the Children, 2010). In the project data on PE sessions, mothers represent 96 % and fathers 4% of 15,551 PE participants so far. In the Mid-term Evaluation (2010) of the Transitions Initiative programme that started its implementation since 2006, the impact of the Parenting Education programme was also explored. With regard to the process of the sessions, the perspectives of the parents are largely backed up by those of PE facilitators. They felt that the sessions were effective, using appropriately straightforward language and effective methods such as role-play. However, some pointed out that the PE sessions were more difficult to conduct in ethnic language speaking areas and that they would welcome more materials in ethnic languages as well as self-study materials. Save the Children field staff perceived PE facilitators to be generally effective, good communicators, patient and having basic knowledge, but could benefit from further

Module 2: Supporting Childrens Development

General Objective Required Materials Recap of Previous Topic To gain the knowledge of required supports for successful child development UNICEF PE booklets, Illustrations of child development in different stages Participants stand in a circle and the facilitator throws a ball to one of them. The person who receives the ball has to talk about one point she remembered from the previous topic or one particular activity she had exercised with her child at home. Then she throws the ball to other participants. Discussion with illustrations about child development stages To know the different stages of child development 35 minutes Plenary discussion with participants on: How do children grow and change by stages? What do the parents think of it by looking at the illustrations? Break into four small groups and discuss about the developments in each age group: 0-1 group, 1-3 group, 3-5 group, 5-8 group PE Facilitator adds in where necessary based on their discussion points (PEFs can check the reference in the annex) ... ...

Activity 1 Objective Duration Tasks

Activity 2 Activity 3

NO 5. 2011

27

PARENTING PROGRAMMES
development of their confidence and skills. The comments above suggest some definite changes in practice in at least some communities, probably linked to the quality of training as well as other factors. Through a project monitoring data, it was interesting to learn that although only mothers attended, in some cases the learning spread to fathers and the wider community, as the women supported each other, or discussed what they had learned with their partners. Assessment of the Parenting Education Sessions Save the Children has been assessing developmental gains of ECCD children of two different cohorts: 3 years and 6-8 months old and 4 years and 6-8 months old. The first cohort was assessed by a receptive vocabulary test1 and the latter in a draw-afigure test. The first assessment was taken as a baseline, in which children of that group had parents who did not attend the parenting education sessions (were not available yet). Another assessment was undertaken six months after on the children who had enrolled in the centres in their first two weeks and where parenting education sessions have started. So far, seven assessments have been carried out and a significant change can be noticed between the first and the second assessments, which was done after the parenting education programme was implemented. It was also interesting to see the differences of scoring in the baseline assessment between the seven states (99% of population are from ethnic groups) and the seven divisions (where there is a high density of Myanma population) of Myanmar. This reflects the different child rearing practices
1. Vocabulary has been demonstrated as the single most important factor in predicting future success at the point of school entry and correlates highly with verbal intellectual ability. Children with high scores on receptive and expressive vocabulary are more likely to complete school and go on to further education. This is the factor that gives middle-class children in the West such an advantage over less fortunate social groups. Receptive vocabulary is a more fundamental building block of language than expressive vocabulary because listening comes before speaking. Vocabulary has been shown to correlate highly with general verbal ability. Demonstrable developmental gains by Graham Cameron, Education Advisor, Save the Children Myanmar (2006-2009)

What parents learned from parenting education sessions It is not appropriate for children at nursery age to learn to read and write. I learned not to beat the children but fulfil their needs. I like PE sessions a lot. I also understand the topics. What I appreciate most was the Role Play. The sessions are very useful and applicable. I learned many things from PE - that a childs brain can be damaged when they are hit or scolded, child can hear voices from the time since they are inside the mothers womb, children should be allowed to participate in activities, explaining to children with patience and ways to console the children when they are afraid. We also learned to teach children by letting them participate in households activities, to explain reasonably when they are doing wrong, to let them speak with guests, to fulfil their needs and let them play. We learned that parents should listen to children and give more time for conversation with children. Improvements in Home Environments as a Result of Parenting Education Parents said: We explain what is right and wrong to our children instead of hitting. We allow children to participate in the household activities. There are so many differences in methods learned in PE discussion with conventional child care practices. For example, before I used to hit and yell at the children and did not take time to care for them. Now I refrain from beating and care more. I used not to care much about the kids hygiene. Now, I have better hygiene practice. After the PE discussion, fathers give more time to children, listening and caring the children. PE Facilitators said: There is better relationship among children and parents. Parents avoid scolding and quarrelling in front the children. Parents give more time to speak with their children.
and customs between Myanma and ethnolinguistic groups. It can be assumed that Myanma children have been motivated and/ or stimulated as early as possible. With the low score for the receptive vocabulary test in the baseline assessment, the developmental gains of children in the states are highly noticeable rather than those in the divisions. The difference between the baseline and the second assessment is the only spot where we can trace the impact of parenting education programme. The later assessments were undertaken in the context of parenting education activities already being in place. The findings of these assessments confirm that early childhood development can be achieved through early interventions with and by parents at home and by the wider community. Conclusion With an attempt to overcome language difficulties, Save the Children is now in the process of utilising more visual aids in parenting education sessions for ethnic language speaking people so that they can understand the topics better. References
Save the Children (2009). A Strategic Approach to ECCD in Myanmar Save the Children (2010. A Study of the Impact of ECCD on Household Income and Livelihood Opportunities in Myanmar Seel, A. & Tin U.A. (2010) Mid-Term Evaluation Report, Save the Children

28

ARNEC CONNECTIONS

PARENTING PROGRAMMES

Community-based Playgroup for Early Learning and Development

By Erlinor Umali, Save the Children

Children works, families from disadvantaged communities usually do not give priorities in providing stimulating activities for children. Most of the childrens toys are commercially made and only families with means are able to access these toys. children. The 13 workshop topics were lifted from the Early Steps to School Success Parent-Child Groups manual developed by Zero to Three, National Centre for Infants, Toddlers and Families: Soft Toys Production Language Development: Talking the Talk Literacy Development: Sharing Books Early Writing Skills Singing and Storytelling Promoting Thinking Skills through Exploration Building Problem-Solving Skills Through Play Promoting Thinking Skills Through Pretend Play Learning Through Active Play Making Active Play Part of Your Day Promoting Self-Confidence and SelfEsteem Promoting Cooperation and SelfControl Promoting Relationship: Building Skills Through Play The Playgroup Session After completing the workshop on ParentChild Playgroup Curriculum, volunteers went back to their communities to recruit three to five parents with children below three years of age. They conducted playgroup session

n 2007, Save the Children introduced Early Steps to School Success (ESSS) as a global initiative to be piloted in the United States, El Salvador and the Philippines through the support of Mattel Foundation. ESSS is a continuum of services from birth through the early primary years which is cost effective and a replicable model of action for children. It also recognises that there is no magic year that will guarantee success. Thus, children need support throughout early childhood to develop the health, behaviour, and learning skills they need to be successful in school.

In response, Save the Children has put a special focus in developing a portfolio on early stimulation and has implemented the Parent and Child Playgroup Session. The Playgroup aims to enhance the capacity of parents to support their childrens learning abilities in the areas of language and literacy, thinking skills, socio-emotional and physical ESSS goals are that children will enter skills. The Playgroup Session started in school with the psychosocial, cognitive, 2008 in selected communities of Pateros physical and nutritional well-being needed and Taguig in Metro Manila. to succeed; parents having the skills and knowledge to support their childrens proper Playgroups Volunteer Training development and learning; community norms and services are supportive to the Volunteers were recruited among community needs of families and young children; members who showed interest in working with that schools will welcome young children parents of very young children. They must with developmentally appropriate learning be willing to undergo training and workshops environments; and finally that there is a and conduct sessions with parents without strong connection between home and any remuneration. Volunteers also attended school. ESSS has four stages of programme toy making workshops and the 13 workshop on parent-child playgroup implementation: Strong Beginnings which sessions cover pregnancy through 12 months, First curriculum. Objectives of the training are to Steps to School Success from 12 months to enhance capacity of volunteers to facilitate 36 months; Stepping Up to School Success parenting education sessions and have basic from 36 through 60 months; and, Stepping knowledge in developing soft toys for young Forward in School for school age children. Experts have stressed that learning in children starts in the mothers womb. Good nutrition, health, and early stimulation then become the key contributing factors to reduce the risk of poor development among very young children. Parents as the primary caregivers play a very important role in providing these needs for children to develop to their full potential. In communities which are fortunate to have functional support groups like local health workers, parents can have access to some health and nutrition interventions for their young children. However, education on early stimulation is usually lacking, or worse, is not even mentioned. In urban areas where Save the

Sample session guide of the playgroup session

Duration 5-10 minutes 10 minutes 20 minutes Activity Presentation of the topic, objectives and key messages for parents Warm-up Activities (Can be a song, rhymes or simple games for children) Activity 1: It depends on the topic of the day (i.e. shared reading with parent and the child). Actual demonstration of how to do it. Activity 2: Allowing parents to do it with their child. Allowing parents and children to choose the book and read the book together. Recap Developing a book for their child

20 minutes

5 minutes 30 minutes - 1 hour

NO 5. 2011

29

PARENTING PROGRAMMES
of about one to two hours on weekends with these parents and their children. The meeting place was either the volunteers house or the house of one of the parents where there is available space. The strategy used is mostly around allowing parents to interact with their very young children through play and the use of manipulative materials, which the volunteers have learned to make during the training. Part of the playgroup sessions is teaching the parents how to make soft toys themselves that they can use at home. At times when parents are busy sewing the toys for their kids, volunteers are conducting storytelling, songs and games for young children. conduct of the session, all enrolled parents were interviewed by the playgroup volunteer using a questionnaire. Then, there is an on-the-spot visit to the enrolled mothers home to observe her child care and rearing practices. Results of the interview and the observations served as the pre-test of the parents. After two to three months of completing the session, volunteers conduct an observation and interview the parents again to check whether there are changes in their rearing and caring practices for children. Support from the Community This intervention became a showcase of an effective model of providing support for young children. The programme was able to gain support from the local government units (LGU) and the parents associations. While conducting the sessions, local community officials provided support in the form of snacks and transportation for volunteers during the training. In some cases where there is no support from the LGU, parents themselves brought food for their snacks during the session. Opportunities The component on soft toys production opened an opportunity for community livelihood. The playgroup volunteers were able to market their products to other interested individuals and groups. The income from sales was then put up as a sustainability fund to support their activities for young children. Some parents also expressed their interest to join in this small enterprise. One of the playgroup volunteers, who had a talent in designing, was in charge of continuously improving and seeking new designs for their soft toys. She was also looking after quality control for the groups outputs. However, the volunteers still kept in mind their main responsibility as volunteers,

Parents who attended the session expressed their appreciation of the programme because they were able to produce toys that they can play with their children. They learned songs, Support for Continuing Stimulation at rhymes and games that their children really Home enjoyed playing. It also gave them a better To ensure continuity of the stimulating perspective of the relationship of positive activities at home, each volunteer was interaction to their childrens proper growth provided with a kit containing more than and development. 40 pieces of storybooks suitable for young children and some manipulative toys. Other significant changes were pointed out Parents were allowed to borrow books and by the post-test conducted among parents. toys, bring it to their homes and read and When previously the parents would simply play using those materials with their kids. let their child play with their toys alone, They have to return those materials at an after the sessions they have become more agreed time, for the use of other parents/ conscious in playing with their child or caregivers. With this strategy, 23 playgroup children. Furthermore, parents before do not volunteers were able to reach 129 parents/ want to have anything to do with books, but after they have attended the sessions, they caregivers of 130 children. read or browse books together with the child. Integration with Other Programmes Some playgroup volunteers are also village health workers and they were able to integrate the key health messages for mothers during their sessions. Some of the soft toys they have developed were donated to the health centre where a kiddie corner was set up. The kiddie corner is accessible for all children to use and play while they are at the health centre for their immunisation and/or consultation. Change in Parental Behaviour Parents with children below three years of age were selected to undergo orientation sessions on the programme. After the orientation, they decide whether to attend the training sessions. This is done to know how many parents were interested and how many groups or sessions needed to be conducted to reach all of the interested parents and caregivers. Before the actual

Playgroup volunteers developing childrens books made of cloths.

30

ARNEC CONNECTIONS

PARENTING PROGRAMMES
that is, to increase awareness of parents on References the importance of early stimulation in the development of their children. Early Steps to School Success Parent-Child Based on the results, Save the Children demonstrated that intervention with the parents is important and critical to ensure that the child develops fully. This parenting education programme was established and also integrated in other Save the Children interventions for children. This is so that parents will become more aware of their roles in the development of their child, and therefore be more conscious to apply positive parenting practices.
Groups, Save the Children and Zero to Three Institute

Right: Mothers reading their self-made books to their children. Below: A child happily playing with toys her mother made for her. Photo courtesy of Save the Children

NO 5. 2011

31

PARENTING PROGRAMMES

Campaigning for Integrated ECD for Children Below Three

By Prerana Mohite & Rafat Ali, The Maharaja Sayajirao University of Baroda, India

ations have strong biological, socioeconomic and political reasons for investing in ECCD. Changed demographic, socio-economic and political circumstances have amplified the need and demand for integrated programmes catering to care and development of the young. Programmes for child care and early education have grown dramatically in recent years. However, despite the impressive growth overall, coverage remains low, distribution skewed, quality poor, attention to the learning and development of children under three weak, and many more programmatic challenges to be met (Arnold, 2004). Over the past two decades significant progress has been made to improve health and nutritional status of children and women. The status has improved, still, millions of children die in developing countries before their fifth birthday. International organisations and governments continue to emphasise on further reducing mortality, with much less attention to the development and welfare of the survivors. The vital question is: What happens to children who survive? These children may have escaped death, but fall victim to impaired development. According to Myers (1992), the need is to move beyond programmes aimed primarily at survival and invest much more in programmes devoted to growth, development and care in early childhood to help children realise their individual and social potential. Over the last five years, India has seen impressive economic growth as well as progress in terms of human development. The economy has experienced a growth rate of 9% in 2006-07. Nevertheless, poverty and malnutrition remain harsh realities for millions of women and children. Infant mortality remains as high as 63 deaths per 1,000 live births. Most infant deaths occur in the first month of life, with up to 47% in the first week (UNICEF, 2011). The centre-based approach of providing micronutrient supplements, immunisation and supplementary nutrition to pregnant women and children has been a major

booster in fighting preventable diseases and malnutrition. In fact, these are among the major developments in the past two decades towards attainment of universal access to basic health care. The approach has promoted community participation and inter-sectoral collaboration as key strategies towards attaining health for all. But, the centre-based approach falls short of meeting the developmental and psychosocial needs of children under three. The children under threes typically stay at home. Providing optimal development opportunities ensures success in their later development. Hence, there is need to pursue a home-based approach to cater to children under three.

programme) ensures greater sustainability

A strategy called Trials to Improve Practices (TIP) methodology was put into application to comprehend prevalent prenatal and early child care practices, and design interventions for behaviour change. TIP is a formative research technique used in BehaviourCentred Programming. TIP allows programme planners to pre-test actual practices which the programme promotes. Mothers (or family members) try proposed practices and their experiences and opinions are used to design the programme. Flexibility is the key to successful TIP. The research plan should be flexible and based on participants needs and Background researchers should fine-tune the contextual, motivational, and action components of a Research on the relationship between recommendation. health, nutrition and stimulation indicates that adequate food supply, micronutrient TIP gives programme planners an in-depth supplements, education and absence of understanding of families preferences, disease, independently are not enough to capabilities, and the obstacles they face in assure childs survival (Engle, 1999). Childrens improving their health and their motivations growth and development is fostered when all in trying new behaviours and practices. TIP these variables are present within a caring focuses on behaviours, what people do, rather environment. than on knowledge, or what people know or believe. Trials are the best way to gauge the In 2001, Early Childhood Development acceptability of a practice and the best ways of Learning Resource Centre (ECD-LRC), the M.S. promoting it. University of Baroda with UNICEF, undertook a research study covering Vadodara, Valsad and Action Dang districts of the State of Gujarat in India. ECD-LRC is a state level resource centre In the first phase was a baseline survey, where focusing particularly on research, capacity 400 mothers were surveyed about child rearing building and advocacy towards strengthening practices and beliefs in rural, urban and tribal ECCD. The three-phase project aimed to blocks of Vadodara district, Gujarat. The survey promote integrated development of children yielded rich data on practices for prenatal care of below three in Gujarat. The key assumptions pregnant women, immunisation, breastfeeding, were: complementary feeding and psychosocial care Early years are critical for optimal of children under three. These practices were development categorised as optimal, neutral and detrimental Intervention for children under three for integrated early childhood development. should be home-based Major practices highlighted as detrimental Family and community involvement links were for prenatal care, neonatal care and home and early childhood interventions, breastfeeding. Reduced food intake and no iron and ensures change at family and supplementation during pregnancy, discarding community level colostrum after child birth, are examples of Routing the intervention through the detrimental practices. Integrated Child Development Services (ICDS) (the worlds largest outreach The second phase involved home-based

32

ARNEC CONNECTIONS

PARENTING PROGRAMMES
interventions for behaviour change, using the TIP methodology. TIP was implemented in three steps; pre-trial, trial period and posttrial. During pre-trial, existing practices of the family was analysed using a questionnaire. Feedback was given to the mother on her practices and improved practices/behaviours were recommended for trials. The mother and the field worker negotiated the practices for trials. For a three-week period i.e. trial period, the mother practiced the recommended behaviours. During post-trial, the mother gave feedback about the trials; how she felt about the experience; what was easy and difficult; if she discussed the new behaviours with anyone and what they said; how she would recommend the same practice to a friend, etc. Analysis of results revealed the effectiveness of TIP in bringing behaviour change for integrated early childhood development. Almost 80% of mothers practiced the recommended behaviours during trial period. Some reasons for not practicing the recommended behaviours were lack of time, cultural beliefs and lack of inclination due to pre-existing habits. Changing Behaviour: A Tall Task Behaviours are easy to change when benefits are observable. Nutrition-related behaviours such as feeding hind milk (i.e. feeding from one breast till it becomes empty), feeding small quantity of food at short intervals while initiating complementary feeding, etc. are easily practiced by mothers as their benefits are easily observable. For instance, the child sleeps well and longer when hind milk is given. The child cries less and remains in a good mood when food is given at short intervals. Superstitions related to food and eating habits are difficult to change because of their culturally-embedded nature. Contextuallyrooted explanations are effective in bringing change. For example, in rural Vadodara, mothers discard colostrum since it is considered as stale milk. In these rural areas, first milk of the cow after her delivery is consumed as it is considered highly nutritious. The same example is used with the mother cows first milk is consumed since it is highly nutritious; similarly the first milk of the mother is also very nutritious and must be fed to the newborn for increased immunity and nutrition. Steps Towards Capacity Building Systematic home visits using effective communication prove very useful for bringing behavioural change. A simple, systematic, handy guideline for home visits was prepared, mass-produced and distributed among frontline functionaries in Vadodara, Valsad and Dang districts. Moreover, based on the analysis of reasons for deferring practice of recommended behaviours, a handbook was prepared stating recommended practices and context-based explanations for queries related to the recommended behaviours. Other Information, Education and Communication (IEC) materials like posters, calendars and flash cards were also prepared and mass produced for distribution. The idea was to build capacities of ICDS and health functionaries of Vadodara, Valsad and Dang districts in communication strategies for behaviour change. By now ECD-LRC has trained approximately 2,000 frontline functionaries in communication strategies for behaviour change to optimise integrated early childhood development. Pocket Guide for Fieldworkers To summarise, the following points can be drawn as lessons learnt from the project: Involvement of government agency right from the start of the project ensures ownership and even after you withdraw sustained inputs can be seen. Involvement of the community ensures greater sustainability of the change. An empowered community will empower its families. Rather than having dos and donts, select the middle path; negotiate. Mothers feel obliged to practice recommended behaviours if they have negotiated. Time is a constraint for frontline functionaries; hence focus on helping functionaries organise home visits to make them systematic, effective and regular. Always begin with concrete behaviours where immediate results can be seen. Mothers and family members are concerned about the well-being of the child. Hence, if the intervention benefits the child, the credibility and trust in the fieldworker increases. Habits are difficult to break, hence begin with behaviours which are easily doable such as psychosocial care behaviours.

Psychosocial care-related behaviours are easy to perform, require no expenditure and no additional time invested. The mother can talk to the child while doing her daily chores; can hold the child in her lap while cooking meals. Hence, mothers reported psychosocial care behaviours as doable and felt pleasure in being Building Capacities for Sustained Input involved with the infant without worrying about finishing pending tasks. The third phase was essentially for capacity building of front line functionaries at the Hygiene-related behaviours such as washing state level (including ICDS and Health hands with soap after urination and defecation, Department) to upscale the intervention and cleaning the breast before feeding the child, ensure sustainability. Based on the insights washing utensils before feeding, etc are and learning from the first two phases, difficult to change, since they are governed IEC materials and a training module were more by habit. prepared, field-tested and finalised. Frontline functionaries were trained using the module.

The TIP results showed 79% of behaviour change after the trial period, suggesting the role of effective communication in behaviour change. Hence, a module in communication strategy for behavior was prepared. The communication module was also field-tested and made available to trainers for use. References Cultural beliefs are hard to break and sustainable change will not happen until Arnold, C. (2004). Positioning ECCD in 21st century. intervention at family level is accompanied by Coordinators Notebook, no. 28. Consultative Group on Early Childhood Care and Development. community intervention.
Engle, P. (1999). The role of caring practices and resources for care. Asian Development Review 17(1,2), 132-167. Myers, R. (1992). The twelve of who survive: childhood

Strengthening

programmes

early

development in the third world. London: Routledge UNICEF (2011). India statistics (retrieved on June 28, 2011). http://www.unicef.org/infobycountry/india_ background.html

NO 5. 2011

33

ASSESSMENT MEASURES/PROFESSIONAL DEVELOPMENT

Development of an Indigenous Scale: Care for Development Appraisal Tool in Pakistan

By Sanober Nadeem & Ghazala Rafique, Aga Khan University
Introduction

arly child development (ECD) could be viewed as a continuum, starting from pre-conception, when the state of nutrition, health, social environment and education of mother affects the growing baby, to eight years of age when most of the developmental trajectories are set for life. The first three years of life are critically important for developing neuronal connections within the brain, which are rapidly moulded and conditioned by stimuli from all modalities of sensation. The brain is particularly responsive to experiences and environments during this period and the importance of providing supportive and nurturing experiences for young children in the earliest years, when brain development is most rapid cannot be overemphasised. This critical and formative period is characterised by rapid cognitive and social development that links with lifelong trajectories of health, learning and behaviour.

learning deficits that further limit learning ability, health, responsible social behaviour, and later earning opportunities. Information regarding childrens developmental status is necessary for understanding where our children are today, what factors positively or adversely affect them, and what we as a community, society, and country can do to provide quality care for our children. Rationale for Developing the CDA A large-scale community-based study was conducted by the Aga Khan University, Human Development Programme (HDP), in rural and urban Sindh of Pakistan, to understand the social and contextual environment of children. The study identified two major gaps that contributed to the growth and developmental delays in children. First, parents lack the knowledge and skills to assess the growth and development of their child, and are therefore unable to provide the age-appropriate stimulation as well as resources during early childhood. Second, community-based workers (CBW), though very eager to help, lack basic relevant skills and resource materials to assess delays or educate parents/caregivers.

the development of young children at the household level are available, HDP strived to develop a simple, easily comprehensible and culturally appropriate tool that equips community-based workers in developing countries with essential skills to adequately assess children and to give comprehensive and timely advice about growth and development to their parents/caregivers. The Care for Development Appraisal (CDA) tool has been developed as a step toward monitoring and positively influencing the early developmental status of children in rural and urban communities in Pakistan. CDA is successfully being implemented in community-based ECD programmes of two communities - Tando Jam, District Hyderabad, Sindh, and in Pringabad, District Mastung, Balochistan, from 2005 onwards by locally trained women called Early Childhood Development workers (ECDWs). The purpose of the Care for Development, Appraisal Tool for Assessing and Monitoring Child Development: First Three years development is to: Help in early identification of growth faltering and developmental delays Educate caregivers on health, nutrition and promote greater attention towards social environments, child care, and nurturing practices Serve as liaison between the caregiver

Furthermore, the first three years of life are notable for the acquisition and application of basic functional abilities, the more stimulating the early environment, the more positive connections are formed in the brain and the better the child thrives in Given that assessing child development in all aspects of his or her life (Irwin, 2007; community settings is difficult as no universal Hertzman, 2004; Balbernie, 2001). Early child development indicators for assessing childhood assessment and screening of these basic functional abilities is the integral part of any ECD programme that helps in early identification of developmental delays, disabilities, and behavioural socialemotional and learning problems in young children (Durkin 1998; Thorburn 1995; Zaman 1990). Early effective intervention not only has long-term beneficial effects on health, mental and physical performance, and productivity but also helps to avoid future costs of remedial education and programmes that deal with social problems like violence and crime (Shonkoff & Phillips, 2003; Young, 2002). It is estimated that at least 200 million children, mostly from developing countries, suffer from developmental delays (Grantham-McGregor, 2007). Pakistan accounts for 8 million of these children. Many Pakistani children do not survive infancy, and more than 30% are physically stunted before their second birthday, with associated

34

ARNEC CONNECTIONS

ASSESSMENT MEASURES/PROFESSIONAL DEVELOPMENT

and the community-based worker. Address and encourage better integration of existing child-related services at individual and community levels were identified on the basis of scientific underpinnings as well as cultural relevance. To identify age-appropriate assessment items for the respective domains an items pool was generated using majority of international instruments and standards like the Bayley Scale of Infant Development, the Denver Screen, the Ages and Stages Questionnaire, the Vineland Adaptive Behaviour scale, etc A norm development study on 1,002 children was conducted in a peri-urban settlement in Karachi to assess the feasibility of all the selected functional abilities and physical structure of the CDA tool and to identify the norms of physical growth and mental development in a developing country. The study population was heterogeneous in its ethnic distribution. Distribution of boys and girls was almost equal. For the child assessment component, distribution of each item of the psychometric assessment was considered in terms of normal, delayed and accelerated development. If the item had at least 50% of distribution in its normal category then that item was retained in that specific age group. The 50% cut-off was kept because it was the minimum possible number which could have clearly distinguished the three categories. After pre-testing, the CDA tool was evaluated by a panel of independent multidisciplinary external reviewers including national and international experts from the field of child psychiatry, child psychology, paediatrics, community health nursing and family practice. The current CDA tool has a hundred items in five developmental domains. Components of the CDA tool The CDA tool has four components: 1) Manual that has 2 main sections: a) Child Assessment Section: to assess child development including gross motor, fine motor, language, cognitive and social emotional development and physical growth, and b) Caregiver Education Section: for educating caregivers on appropriate nutrition, hygiene, vaccination, safety, early childhood stimulation and creation of conducive environment to improve developmental outcomes in children under the age of three (Avan, 2011). 2) Appraisal Tool, 3) Picture Booklet and 4) CDA Toolkit which are used at the household level for assessments Use of the CDA Who are the users? The CDA tool can be administered by community-based workers who might be functionaries of a health, education or an ECD service and have been trained for ECD support during regular household visits with parents, or primary caregivers. During each visit, the community worker will observe and record the childs growth and development, discuss progress or delays with parents, emphasise suggestions to improve their childs developmental status or, if necessary, refer the child to an appropriate care provider. The ECD workers find it to be a practical and easy to use tool that provides them with necessary skills to not only assess the childs growth and development but also to support and enhance the caregivers understanding of best practices and enabling environment for promoting the childs growth and development. How will it be used: Administration Time: The average assessment time for a one year old child is 15 to 20 minutes and for an older child is 20 to 30 minutes. Standardised Kit: The objective assessment of the developmental status requires certain standardised material for stimulation and manipulation. As the assessment would be primarily performed in the home setting, we aimed for limited, basic and easy-toadminister testing material. The material for CDA tools has been standardised, packaged in the form of a kit and available from AKUHDP. It is recommended that only items from the standardised kit should be used for child assessment otherwise the assessment might not be valid and reliable.

This CDA tool is a surveillance tool and not intended for identifying specific deficiencies / disabilities of growth, development or health. The basic purpose is to be able to identify children at risk and create early awareness of delays so that appropriate measures can be implemented. It is guided by illustrations that assist in educating caregivers, who have a limited literacy level, and who work in developing countries, on topics such as child nurturing and stimulation of the childs functional abilities. Development of the CDA The development of this invaluable CDA tool, from its conceptualisation to testing and publishing, has taken five years of intense hard work and commitment by the multidisciplinary team. The psychometric ability of the tool proved quite reasonable in terms of its content validity as well as concurrent validity. The tool has the capacity to identify and track vulnerable children or those at high risk in community setting. The CDA tool was developed in a step by step process. An extensive literature review was carried out comprising contemporary scientific literature from relevant disciplines as well as prevalent instruments of child development in early 2004. Succinct features and suggestions were noted and domains for child growth and development

A child attempting to walk during a child assessment in a home setting.

NO 5. 2011

35

ASSESSMENT MEASURES/PROFESSIONAL DEVELOPMENT

What is the Frequency of Assessment? During the first year of life, assessment is to be done on a monthly basis at home, since this period of life is characterised by rapid growth and development and also by definitive developmental milestones that children achieve on a monthly basis. As children move into the second and third years of life, they develop more complex abilities over longer intervals. Hence, during this time, children may be observed every three months. Conclusion The CDA tool is a reliable instrument that can be used in the community setting by trained community-based workers to track normal development of children and identify those at risk of delay so that appropriate action can be taken. The CDA tool also serves as a useful source of information and education on early childhood development for caregivers in Pakistan who have a limited literacy level. This tool was recently introduced to the ECD workers of Aga Khan Health Service, Pakistan and Aga Khan Education Service, Pakistan. These workers support families and communities to play an active role in achieving optimal developmental outcomes for the children in Gilgit-Baltistan and Chitral (Northern mountainous regions of Pakistan) under the Releasing Confidence and Creativity (RCC) 0 3 pilot programme. Further dissemination of the tool is planned and the HDP team would be delighted to provide technical assistance to those interested in implementing CDA tool within their own setting. References
of Epidemiology, 147(3). Grantham-McGregor S., Cheung, Y.B., Cueto, S., Glewwe, P., Richter, L. & Strupp, B. (2007). Developmental potential in the first five years for children in developing countries. The Lancet, 369: 6070. Hertzman, C. & Power, C. (2004). Child development as a determinant of health across the life course. Current Pediatrics, 14: 438-443. Irwin, L.G., Siddiqi, A., Hertzman, C. (2007). Early Child Development: A Powerful Equaliser. Report prepared for the World Health Organisation Commission on Social Determinants of Health.

Avan, B.I., Nadeem, S. & Rafique, G. (Ed.). (2011). Care for Development Appraisal Tool for Assessing Shonkoff, J.P., & Phillips, D.A. (2003). From neurons and Monitoring Child Development First Three Years: to neighbourhoods: The science of early child Reference Manual. Aga Khan University. development. Washington, DC: National Academy Press, pp. 338-346. Avan, B. I. (2007). Early Childhood Development in Pakistan: The relative contribution of neighbourhood, Thorburn, M., Desai, P., Paul, T.J, Malcolm, L., Durkin, socioeconomic inequalities and home environment to M. & Davidson, L. (1995). Identification of childhood growth and psychomotor development, PhD thesis, disability in Jamaica: The ten questions screen. London School of Hygiene & Tropical Medicine, International Journal of Rehabilitation Research, 15: University of London, United Kingdom. 115127. Balbernie, R. (2001). Circuits and circumstances: The Young, M.E. (2002). From early child development to neurobiological consequences of early relationship human development: Investing in our childrens future. experiences and how they shape later behaviour. Washington, DC: World Bank Publications. Journal of Child Psychotherapy, 27(3), 237-255. Zaman, S.S., Khan, N.Z., Islam, S., et al. (1990) Durkin, M.S., Hasan, Z.M. and Hasan, K.Z. (1998). Validity of the Ten Questions for screening serious Prevalence and correlates of mental retardation childhood disability: Results from urban Bangladesh. among children in Karachi, Pakistan. American Journal International Journal of Epidemiology. 19: 613620.

Advancing the Cause for Quality ECCD Services Through a Professional ECCD Development Framework
By Maya P. Nayo, Save the Children
Research indicates that the period from conception until up to the childs first three years of life is critical for his/her development, hence, training and education of parents, families and caregivers including Early Childhood Care and Development (ECCD) workers on how to best handle this period is crucial. At present, knowledge and skills of ECCD workers in the Philippines are at different capacity levels, thus the quality of ECCD services varies largely depending on the worker. In some instances, the ECCD workers depend solely on instinct or personal experience of bringing up a child and use that experience as a basis for dealing with and educating mothers and young children. Furthermore, their interventions are largely primarily remedial in nature. In an environment where young children are exposed to multiple risk factors like poor health and low levels of stimulation at home (as is the case in many poor families in the Philippines), childrens brain development is likely to be negatively affected. the Republic Act 8980 institutionalising a national system for ECCD, which includes among others the expansion of service delivery for children six years old and below, and the education of their parents and caregivers. In May 2011, an amendment to this law (Early Years Act) was approved by the Senate (awaiting approval by Congress) that recognises the first six years of a childs life as the first cycle of educational development, further emphasising the need to improve ECCD curriculum, parental education and involvement, ECCD management and human resource development. In addition to improving access to quality ECCD services for Filipino children, Save the Children also works towards improving the competency of day care workers and/ or ECCD professionals as they have a very crucial role to play in the development of children under their care. development of ECCD workers, for example, we start with the local government units which has jurisdiction over delivery of day care services at the community. For Taguig City, a professional development framework was developed in partnership with its city government. This aimed to equip ECCD workers of Taguig with the right skills and attitude in dealing with young children, starting from birth to six, at the same time strategically upgrade their level of education and/or professionalisation. Currently, the benefits and remuneration for ECCD workers are tied to qualifications and other standards set by concerned government agencies. The Professional Development Framework

The local government unit of Taguig, through its then City Mayor Sigfriedo Tinga, has identified ECCD as a priority programme of the administration in terms of increasing One of the strategies employed by Save access and improving the quality of day care the Children in its ECCD programming is service. At that time, there were 118 day In 2010, the Philippine government passed partnership building. For the professional care centres serving 8,273 children.

36

ARNEC CONNECTIONS

ASSESSMENT MEASURES/PROFESSIONAL DEVELOPMENT

A formative inquiry among the 114 day care workers. workers of Taguig City was done in 2007 that led to the formulation of the Professional Phase 4: Designing the Professional Development Framework for ECCD workers. Development Programme The framework basically outlines a fivephase process leading towards the implementation of a Capacity Building Programme or Professional Development Plan for all ECCD professionals such as day care workers. Phase 1: Defining and developing competency levels The simple definition of competency is the expected knowledge and skills required of an ECCD professional to effectively practice his/her profession especially with very young children or those that are three years old and below. Defining their competency levels would therefore entail looking at their current skills set vis--vis their actual experience in the field. Results of the Taguig research generated five competency levels in terms of the following: Personal qualifications educational attainment, trainings attended, years of service, awards and recognition Community service parental education, membership and participation in community affairs The Professional Development Programme will be designed in such a way that it is childspecific. Specific programs will be developed according to the age and developmental needs of children being served by certain groups of ECCD personnel. identified for the training, which started in October 2011. An orientation session will be held prior to the actual training to level off with the day care workers regarding Save the Childrens and their expectations upon completion of the training. Initially, Save the Children, in consultation with the local government units responsible for each day care worker, plans to come up with an arrangement for the day care workers to make a commitment to serve for at least two years after their training.

Phase 2: Assessment Given the definition of each level of competencies, the day care worker is assessed to determine at what level they are classified. To further obtain an accurate assessment, a field observation tool is used to check on the teachers relevant capacity (knowledge and skills), practices and attitude inside the centre and while interacting with children.

Furthermore, a peer review and selfassessment was also administered, and then a final interview was conducted in Conclusion and Next Steps the end. All of these became the basis for determining the final competency level of It is planned that Save the Children will go back to the Taguig again to get updates on each teacher. the status of the day care workers. They will also revisit the professional development Phase 3: Certification Process framework together with the Taguig City After results have been validated and the Government. At the moment, Save the final assessment is completed, the City Children has initiated a partnership with Social Welfare office overseeing the day a local university for the professional care workers issues a certification to the development training of ECCD facilitators, day care worker. The final assessment government day care workers and preschool then becomes the input for professional teachers from their impact areas in Metro development counselling of the day care Manila. Initially, there are 46 day care workers

There are various pathways that have been identified to obtain professional upgrading: Upon completion, the training will lead to a certificate course in Early Childhood First Track: Support Group ECCD Care and Development for the non-college workers meet in teams regularly to graduates or masters credits for college discuss solutions they have tried, graduates. The course will run for 52 relevant readings, inputs and new Saturdays (or an estimated 2 years) or 52 learning acquired from training whole day classes (if taken straight). At sessions. the end of the training, the participants are Second Track: Mentoring A more expected to have undergone a curriculum experienced ECCD professional focused on child development principles works with one or more ECCD worker. and best ECCD practices especially around Another example is a private preschool Pregnancy up to three years old. This adopting a public preschool or day training will build on evidence culled from care. Mentoring may be in the form of research around the world on topics such exposure and classroom observation as proper nutrition and early stimulation. in the private preschool to learn about It also develops community partnerships classroom strategies and techniques, as it will explore coordination and support sharing and passing on of still useful among community members to sustain such materials, and an open consultation and programmes and make more lasting impact dialogue between the ECCD workers to the children. from both learning centres. Third Track: Formal Courses in Early References Childhood Development (Universities/ Colleges) This will entail development Baker-Henningham, H. & Boo, F. (2010). Early Childhood Stimulation Interventions in Developing Countries: A of flexible courses like distance Comprehensive Literature Review (www.iadb.org) education, staggered courses or Borisova, I. (2011). Strengthening Parenting Practices ladderised training. Fourth Track: Informal courses provided in Early Childhood - Rationale, Challenges and Recommendations for Parenting Programmes. ARNEC/ by various organisations other Save the Children Presentation: ECCD Webinar, 13 April institutions or organisations are also 2011. offering non-credit courses or trainings ECCD Council. (2010). The State-of-the-Art Review of but would surely be beneficial to the Day Care Service in the Philippines: A Survey Research ECCD workers. Volume 1: A National Report on the Implementation Fifth Track: Self-study - continuing of Day Care Service in the Philippines. Makati City, learning and research through available Philippines: Author resources. Republic Act 8980: Early Childhood Care and
Development Act. Section 2. Declaration of Policy. (2007). Senate Bill 2802: Early Years Act. Section 5. System Framework and Components. (2011). Umali, E. (2007). Professionalising ECD Service Providers Metro Manila Programme. Presentation: Stakeholders Meeting in Taguig City. Manila, Philippines: Author Bonga, M., & Umali, E. (2007). Global Leader Report Budapest. Presentation: Global Leader Gathering in Budapest, Hungary. Budapest, Hungary: Author NAEYC. (2003). NAEYC standards for early childhood preparation: Advanced programmes. In Preparing early childhood professionals: NAEYCs standards for programmes, ed. M. Hyson. Washington, DC: Author

NO 5. 2011

37

REFLECTIONS

Early Learning Opportunities for Children Under Three and Their Mothers
By Shahida Mohiuddin, Bahria University
he first three years of a childrens life are a period of incredible growth in all areas of their development. Quite often, when passing through my vicinity i.e. Garden West Karachi, I have noticed isolated mothers with their children crying in their laps. This observation enabled me to interact with such mothers through an Early Learning Centre that I started in 2010. The centre caters to children from zero to three years and sessions are divided into two groups. Fortnightly, children from 0-1.5 years of age accompanied by their mothers meet and discuss related issues of child development with an expert. The children get an opportunity to interact with their own age group while the mothers are involved in their discussion. Likewise, children from 1-3 are also invited for a fortnight. The children are able to develop new skills while they attend the reading and storytelling sessions. They get an opportunity to make new friends and to develop a sense of joy and belonging within their own age group as teachers encourage them to express themselves through artwork, singing and storytelling. Mothers of the children also attend sessions where they learn about holistic development of their children. The mothers share their own life stories which give an insight to the group of mothers. Individual counselling and e-mail services are also available for them. We notice that these mothers and children enjoy the programme and are happy that the Early Learning Centre is closer to their homes. Background Having done my Masters in Psychology and a PhD in Education specialising in Childhood Development, I developed a keen interest in working towards this key area in the society I live in. Moreover, since I have been visiting the USA quite frequently over the past 23 years, I have observed various platforms being set up for children to exhibit their talents and skills. For example, the childrens library programmes are amazing as librarians read a book with music and puppets and children are deeply involved in the scenes before them.

Therefore, based on my observations abroad and the demands of most young It is a series of programmes focused on parenting competencies mothers, I initiated the Early learning Centre strengthening

to facilitate these mothers in understanding (monitoring, positive discipline, confidence) and nurturing their young ones to best of and fostering parents involvement in childrens development in order to promote their capabilities (Mohiuddin, 2000). childrens academic, social and emotional competencies and reduce behavioural Programme Description problems. The parenting programmes The major objectives of the Early Learning are grouped according to the age of their children, i.e. babies (0-18 months) and Centre are: toddlers (18 months to 3 years). Descriptions To facilitate mothers to understand their of these programmes are: own needs and share their learning with other mothers. Parents: Babies Programme (Ages 0-18 To help mothers play an active role with months) their spouses and other family members in the developmental processes of their This programme consists of a six part young children. programme focused on helping parents To provide educational play way learn to observe and read their babies cues activities to the young children at the and learning ways to provide nurturing and Early Learning Centre to facilitate their responsive care including physical, tactile, holistic development. and visual stimulation as well as verbal communication. The Early Learning Centre conducts a two-way process programme where both Part 1 - Getting to Know Your Baby mothers and their children, 0-3 years old, (0-3 months) are addressed. For mothers, educational Part 2 - Babies as Intelligent Learners sessions are organised according to their (3-6 months) needs. They are given opportunities to learn Part 3 - Providing Physical, Tactile and with new fun skills and knowledge. This is a Visual Stimulation fairly new concept in this community. Part 4 - Language Development Part 5 - Gaining support from Learning in early childhood is not just surrounding about pre-set curricula outcomes; it is Part 6 - Babies Sense of Self (6-12 about child initiated discovery, children months) exploring and learning through play and successfully engaging and communicating Parents: Toddlers Programme (onwards 18 with a range of people. The classrooms in months-3 years) the Early Learning Centre for 1 to 3 yearsold are divided into various sections such This programme supports parents and as Computers, Dramatic Play, Toys and builds their optimal parenting skills. It Games, Sand and Water, Library, Outdoors, consists of a seven part programme focused Music and Movement, Cooking, Discovery on strengthening positive and nurturing parenting skills. Each programme builds on Science, and Art and Construction. the previous. Parenting Programme Part 1 Childs Play Part 2 - Toddlers Language An expert volunteer team was involved in Part 3 - Social Development preparing the curriculum of the parenting Part 4 - The Art of Praise and programme. We got inspiration from Encouragement Incredible Years Parenting Programme Part 5 - Positive Parenting Skills Series and the National Association for Part 6 - Handling separations anxiety the Education of Young Children (NAEYC) Part 7 - Positive Discipline-Effective: guidelines for curriculum for 0 to 3 years Limit Setting and Handling Disruptive old children. At each step, we adapted the Behaviour programme to our context.

38

ARNEC CONNECTIONS

REFLECTIONS
Essential Features of the Programme Play The essential feature of the Early Learning Centre is the play activities for children .Nowadays in Pakistan, especially in Karachi, there is no peace and in these very uncertain situations, parents cannot take their children to parks and amusement places, therefore children are confined to their homes. The Early Learning Centre provides opportunities for children to play and socialise with other children. Children love to come to play and meet their friends. Books for Children and Mothers One of the facilities available at the centre is a library for mothers and their children. In my country, the literacy rate is not satisfactory and one of the reasons is the lack of reading habit among children and adults (Pariakian, R. & Lerner, C., 2010) Therefore, one of the goals of the centre is to develop a reading culture among both mothers and children. Storytelling and book reading are essential features of the ELC programme. After the session, mothers and children can borrow books from the library which they can enjoy the whole week. The concept of library for mothers is new in my area. Counselling Services Often mothers faced challenges while dealing with their young children or developing a positive relationship with their in-laws and their husbands. These mothers are looking for a trusted friend with whom they can discuss and develop wisdom for problem solving. In ELC, counselling services are provided to the mothers. It is emphasised to these mothers to take a few minutes out for themselves and to spend time in solitude as a means of relaxation. We also encourage them to practice yoga and meditation. Often the mothers problems are not solved but they are happy that they have friends around them and their children are enjoying playing with other children. Through the ELC programme, mothers and volunteers spend their time doing their best to provide opportunities for holistic development of their children. The focus of the programme is mainly on child and his holistic development. Bahria University Certificate Programme Recently, during the summer from 5-8 July 2011, I arranged a short certificate programme for mothers at the Bahria University. After conducting a needs

Reading books serves as a foundation for literacy. At the centre. mothers and children are reading books together. analysis with mothers, I developed the curriculum. As a visiting faculty I arranged this programme under the Educational Psychology programme, covering four major topics spread over four days (16 hours total). The topics of the programme included: Shaping youngest minds Disruptive behaviour of children: Diagnosis and treatment Multiple intelligences and role of parents Managing young children effectively Each session of the programme opens a new window of understanding and attending the programme was a very pleasant experience for mothers. During the programme, parents got ample opportunities to think creatively and express their thoughts. They discussed their issues regarding parenting. This programme transformed them and they reported that they learned skills to deal with their children positively. Conclusion I believe that the Early Learning Centre programme is creating a positive difference in the lives of young children and their mothers in Pakistan. They are able to enjoy learning through play and make friends with children of their age. At the same time, the centre also provides a platform for mothers of very young children to come together, otherwise they are at home and isolated from society. Above: Children playing together using recycled materials and learning to live peacefully Now, they can discuss about their common issues and socialise with each other, and Photo courtesy of Abdul Aziz Muhammad importantly, they can also learn how to look after their well-being and how they can play an effective role in the developmental process of their young children. References
Mohiuddin, S. (2000). An Evaluation Study of Early Childhood Education in Pakistan (PhD Thesis) Karachi: Hamdard University. The Incredible Years: Parents, Teachers and Children Training Series. http://www. incredibleyears.com/program/parent.asp Pariakian, R. & Lerner, C. (2010). Beyond Twinkle, Twinkle: Using Music with Infants and Toddlers. NAEYC. www.naeyc.org/yc/pastissues Fayyazuddin, S. et al. (2010) The State of Pakistans Children Report. Society for the Protection of the Rights of the Child (SPARC). Islamabad

NO 2. 2009

39

REFLECTIONS

Assisting a Physically Challenged Mother in Creating a Learning Environment for her Child at Home
By Karim Panah & Rubina Shaheed, Aga Khan Education Services
Introduction ood child care has become one of the most important and well debated topics of contemporary research focusing on the crucial role parents are expected to play in the rearing of their children leading to their holistic development. A World Health Organisation (WHO) report asserts that childrens physical needs must be met but at the same time their emotional and psychosocial needs also have to be fulfilled to develop as stable, well-adjusted and sociable human being (1997, p. 5). They also cited different studies stating that infants who are abandoned and separated from their mothers become unhappy and depressed, sometimes to the point of panic (1997, p. 5). WHO also said that child rearing is simple and natural that seems to be part of our biological and cultural heritage and can therefore be easily facilitated or reactivated in sensitive human caregivers (1997, p. 6). Similarly, Peisner-Feinberg et al. (1997), reported the positive relation between child care quality and childrens cognitive and socio-emotional outcomes. Furthermore, when examining the level of post-training sensitivity and sense security among child caregivers, Howes, Galinsky and Kontos (1998), reported that six months following intervention, security scores increased and caregivers of children who became secure or remained secure were more sensitive towards well care practices. Therefore, it appears that mother and other caregivers appear to benefit from additional training and technical support in improving child rearing practices at home and school. This becomes even more crucial if the mother or caregiver is differently-able or less confident in rearing their own children. Background The Aga Khan Education Services, Pakistan (AKESP) in collaboration with other agencies of the Aga Khan Development Network (AKDN) and the local communities in Gilgit-Baltistan and Chitral regions has been implementing a multi-dimensional Early Child Development (ECD) initiative titled Releasing Confidence and Creativity (RCC) programme.

maternal grandmothers home. His mother suffers from hearing impairment by birth and The model has two components: 0-3 and 3-8 therefore, had developed the feeling that that focus on holistic development of children she cannot rear her child the way others do. to ensure improvement in their mental and physical growth as well as enhancement of On my first visit to their home, I saw Ali social skills. The 0-3 component particularly playing alone with mud in front of the house. works with parents/caregivers to increase He was too shy to talk to me or react to their knowledge, skills and abilities in order to my gestures. His mother was cooking food support their childrens holistic development inside the house. An animal shelter was from birth to age three. One of the prominent near the place where Ali was playing and features of this component is the regular and conditions of hygiene appeared inadequate. frequent visits of ECD workers to mothers The mother went up to Ali, washed his hands at their homes to observe child rearing and took him inside the house for lunch. practices, patterns in social interaction The child wanted to play with water and and learning environment provided to the mud but the mother was quite reluctant as children. They focus on four main domains she thought it was unhygienic for him. After of child development in addition to health eating his food, Ali insisted on going outside and hygiene (Tufeyl and Altaf, 2009). and to resume playing but the mother did not want him to do so, so he just ran away from Rubina, one of the ECD workers associated her. with the RCC programme, decided to record her reflections while working with a Alis mother has been attending the ECD differently-able mother (38 years old) of a centre-based activity sessions where school going child named Ali (pseudonym, participants developed learning material for two and half years old). Employing a children. However, I noticed that there were qualitative mode of data collection the ECD no learning materials available in Alis house. worker developed records of her reflection On my inquest, the mother angrily (in sign during several sessions with mother and language) informed me that the material was child and detailed home visits. Rubina used kept under the bed because other children in to visit families in the selected village to raise the house used it, depriving her son from it. mothers awareness regarding their role in the upbringing and holistic development of I observed that Ali lacked confidence as their children. he was dominated by other children in that house. Since his mother cannot speak and This paper presents the analysis of her hear, other family members ignored her and reflections in the form of a case narrative the son. During my first and second visits, I highlighting the strategies employed to talked to the family members and stressed support the mother, and the subsequent, that they should pay attention to Ali and his gradual shift and improvement observed in mother. I also developed a learning corner the interaction between the mother and the in the house by involving both Ali and his boy. Findings of the study broadened our mother and made her realise that the child understanding of how a mother who cannot would participate if she involves herself speak and hear as the more physically able actively. mothers, can also positively impact her child rearing and caregiving practices to enable Next, Ali and his mother attended the centreher child to develop holistically. based session under my observation. Alis mother and I talked (in sign language) about Case Narration by the ECD Worker her health and other topics of mutual interest. Ali also asked his mother (in sign language) As an ECD worker of the 0-3 pilot project, if he could go to the resource room. At that when I started interacting with Alis mother time in the centre, children were threading who is a differently-able person, I became beads as part of a physical activity. Ali got curious to explore how she is different from a excited and started threading the beads so-called normal mother in terms of rearing the way other children did. His mother also her child. Ali is the only child of his separated helped him but she was restricting him to use parents and lives with his mother in his only red colour beads constraining him from

40

ARNEC CONNECTIONS

REFLECTIONS
playing freely with others. Nevertheless, Ali became quite social and observant as he went on to play with the slides where other children were also present. Towards the end of the session, I gave a demonstration to the mother on how to work with the child and why to let him feel free to do things on his own. The mother observed me, when I was working with Ali. Ali played with different objects freely with excitement and his mother observed him with enthusiasm. had increased. I discussed with the mother the importance of having learning materials at home and she assured me that she would visit the centre frequently and improve the quality of the learning corner at home for her child. Conclusion and Lessons Learnt Research indicates that the increasing cases of childrens developmental problems especially in the cognitive, emotional, and social domains may be because families in general ignore the developmental needs of their children (Shore, 2011). Ali and his mother in this case present a unique example of how differently-able mothers deal with child rearing challenges when there is no provision of external support. Analysis of the reflections recorded by Rubina indicates that a differently-able mother can be motivated and supported to take charge of her childs holistic development when awareness and training opportunities are offered. that they can support their child to grow as cognitively, emotionally, and socially developed individual. References
Howes, C., Galinsky, E., & Kontos, S. (1998). Child Caregiver Sensitivity and Attachment. Social Development, (7)1, 2-26 Peisner-Feinberg, Ellen, Burchinal, and Margaret (1997). Relations between preschool childrens child-care experiences and concurrent development: The Cost, Quality, and Outcomes Study, Merrill-Palmer Quarterly: Journal of Developmental Psychology, 43(3), 451-477 Shore, E, L. (2011). Rethinking Well-Child Care. Retrieved on June 10, 2011 from http:// pediatrict>aappublications.org/content/114/1/210. full Created on 6/3/2011 Tufyeyl, M., & Altaf, A. (2009). Releasing confidence and creativity programme: midterm evaluation report, submitted to the Aga Khan Education Service, Pakistan (AKESP) World Health Organisation (WHO). (1997). Improving Mother/child Interaction, To Promote Better, Psychosocial Development in Children. Retrieved on April 12, 2011 from http://www.who. int/mental_health/media/en/29.pdf

On our second visit to the centre, Ali and his mother looked much happier and confidently interacted with the other children present there. Ali used sign language to communicate with his mother and showed her the objects around him. He asked questions without any hesitation. He went on to play with the slides, but the mother wanted him to read more books. He sat down and read a book for a while and then went to play again. Soon he got tired and went home. I suggested to his mother that she makes frequent visits with Ali to the centre so that he gets the opportunity to interact with other children of Although this study does not employ a his age and play with the learning materials. comparative analysis of differences or similarities between learning ability of On my second home visit, I found that Ali a differently-able mother and that of a was in the corridor with his cousins. The physically normal mother, it is evident house was clean and so were Ali and his from our practical experience of working mother. When Ali saw me, he ran to his with mixed-ability group of mothers that all mother and told her excitedly that his teacher mothers can learn and exercise appropriate was here. Alis mother took me to her room child rearing and caring practices if equal where she had created a learning corner. opportunity is provided. The case indicates Colourful displays were pasted on the wall; that a differently-able mother can develop a chart showing parts of the body, shapes, learning materials and create learning fruits, alphabets, numbers and others. I corners for her child at home the way worked with Ali in the learning corner as he a physically normal mother can do. To showed great interest in it and the mother enable such mothers to adopt good child was happy too. It was noted that she had care practices, it is important that the ECD started behaving like a normal mother and workers work closely with them at their own interaction between the child and her mother places and help them build the confidence

Photo courtesy of Aga Khan Education Services, Pakistan (Releasing Confidence and Creativity Programme) Below: Ali and his mother visits an ECD centre in their village.

NO 2. 2009

41

FEATURED RESOURCES

Strengthening Parenting Practices: Recommendations and Challenges in the Asia-Pacific

By Debbie Fang, ARNEC
The e-Discussion on the topic of Strengthening Parenting Practices: Challenges and Recommendations for Parenting Programmes in Asia and the Pacific took place from 25 May to 8 June 2011, and generated a total of 113 posts from 13 countries in the Asia-Pacific region and beyond. The purpose was to help document existing best practices in the region pertaining to parenting in the early childhood period and to identify the gaps and challenges that needed to be addressed in this area; thereby raising awareness about the importance of engaging with families and caregivers in early childhood practice. 2. 3. programme? reached fathers in addition to mothers What do we hope to change/strengthen/ and other female caregivers? improve in parenting or care giving practices? Download the synopsis of this e-discussion How does your community or your on the ARNEC website: www.arnec.net. programme currently engage and support parents (or caregivers more broadly) in caring for very young children? What experiences about parenting programmes (not necessarily successful) can be shared from the different places you work? What are some of the key programmatic challenges and obstacles you have faced in implementing your parenting programmes? Were you able to find solutions to overcome these challenges? What are some of the key success factors you have identified in your practice? What are some examples of programmes that have effectively

4.

5.

Seven questions were posed to participants prior to and during the course of the e-Discussion. They were also reemphasised at relevant intervals throughout 6. the discussion. The questions are as follows: 7. 1. What is the goal of a (your) parenting

Resource Package for Serving Children Up to Age Three

By ARNEC
The Resource Package for 0-3 was developed by ARNEC to include a range of information on ECD about very young children in the region, with specific attention to children under three years old. It aims to serve as an advocacy and information tool for ECD professionals to use when advocating on the issue with/for various stakeholders. at the Asia-Pacific Regional Conference on Early Childhood Development, 8-10 November 2011 in Singapore. It is hoped that with this Resource Package initiative, ARNEC can work towards developing a knowledge and sharing culture of noteworthy practices and programmes that can help not only improve the services provided for young children and families but also inform policy development and share what works, how it works, how it can be implemented and how it can be monitored. This effort will work towards helping our youngest children and families in the most disadvantaged situations.

The package contains several items in different formats, including policy briefs, a compilation of existing programme/services and a video, which can be used for advocacy with different target audiences. For example, the policy brief on a specific topic around ECD for children under threes could be used in dialogues with policy makers. The video highlighting positive interactions between Download the resource package along with the very young and their caregivers can the policy briefs and video on the ARNEC be used by practitioners and parenting website: www.arnec.net. education trainers to facilitate a session with parents. The resource package was disseminated

42

ARNEC CONNECTIONS

FEATURED RESOURCES

Disaster Risk Reduction and Young Children: A Guidebook for the Asia-Pacific Region
By Jacqueline Hayden & Kathy Cologon, Macquarie University
This guidebook was designed to fill some gaps in the current approach to Disaster Risk Reduction (DRR) and young children. The focus is on the social variables and community level activities associated with DRR for young children. (Mitchell, Haynes, Hall, Choong, & Oven, Download the guidebook on the ARNEC 2008; Morris, van Ommeren, Belfer, Saxena, website: www.arnec.net & Saraceno, 2007). The guidebook was designed to be used by agents and organisations that have an interest in the well-being of young children and families. The guidebook can be used to assist communities in identifying the strengths and gaps in their DRR and support for young children.

DRR refers to the concept of reducing risks and strengthening supports in order to mitigate the impact of disasters. Beyond policy and political issues (at national and international levels), DRR takes place at the community level and the programme level. The processes and recommended tools need to be adapted for each situation and Young children have specific needs which context. In many cases the very act of can be addressed in DRR processes and reviewing these items will raise awareness activities. Research suggests that resilience of issues which need to be considered in within the early childhood development terms of support for young children at the (ECD) sector could be an important DRR community level. factor for young children (Shores, Grace, Barbaro, Flenner & Barbaro, 2009). The data gathered through the use of the Furthermore, it is suggested that children tools provided in this guidebook constitute in emergency situations benefit from being evidence which can inform advocacy activities for enhanced support. informed and involved in their community

Advocacy Booklets: Working Together for Early Childhood

By ARNEC
This series of six booklets have been prepared by ARNEC, with the objective of highlighting regional trends and issues specific and unique to the Asia-Pacific region for promoting and strengthening ECCD policies and practices. Additionally, the booklets highlights a need for particular advocacy within the Asia-Pacific region by introducing five key advocacy messages that are evidence-based, regionally contextualised and prioritised based on diverse sources of information. The messages have been adapted and made culturally relevant, yet confirms, reflects and emphasises global messages about how the young child needs an enabling environment at home, community and centre, supported by proactive child-friendly policies at national and international levels. In addition, the messages are supported by examples and noteworthy practices from the Asia and Pacific region, representing the collective voice of several ECCD professionals in the region. ARNEC wishes for the booklets to be Download the booklets on the ARNEC used by ECCD professionals to add to website: www.arnec.net their knowledge and generate a common understanding of what is meant by ECCD in the region in order to inform policy makers better. The six booklets consist of one overview booklet and five booklets each booklet representing one advocacy message. The booklets do not have to be read in order to understand the next. The Early Years: Ensuring a Childs Right from the Start ECCD Begins at Home: Caring for Children in a Nurturing and Stimulating Environment Quality Early Childhood Matters: Making a Critical Investment for a Countrys Future Inclusive ECCD for All: Valuing and Respecting the Unique Needs of Every Child Integrated ECCD: Working Towards a Seamless Early Childhood System

NO 5. 2011

43

NOTES

ARNEC Connections No. 5, 2011 ISSN 2010-1252

UNDERSTANDING OUR NETWORK

ARNEC works towards a vision in Theme: Early Experiences Matter: which the developmental potential of Ensuring Holistic Development for Very the young child is realised with support Young Children (0-3) from families, communities and states in all member countries in the Asia-Pacific region. For more information, contact: The Asia-Pacific Regional Network ARNEC Secretariat for Early Childhood (ARNEC) was c/o SEED Institute established to build strong partnerships 73 Bras Basah Rd. #07-01 across sectors and different disciplines, NTUC Trade Union House organisations, agencies and institutions Singapore 189556 in the Asia-Pacific region to advance Website: www.arnec.net the priority on and investment in early E-mail: secretariat@arnec.net childhood. Editor Chemba Raghavan Consultant, UNICEF East Asia and Pacific Regional Office and Research Advisor, ARNEC Editorial Board: Maki Hayashikawa Education Specialist, UNICEF East Asia and Pacific Regional Office Mami Umayahara Programme Cycle Management Specialist, UNESCO Bangkok Kishor Shrestha Professor, Research Center for Education Innovation and Development, Tribhuvan University Coordination, Final Editing, Design and Layout: Kanitha Kongrukgreatiyos Communications Officer, ARNEC Cover Photo: UNICEF/Samoa MISSION AND ACTION PILLARS ARNEC works to ensure the rights of every child to optimal holistic development. To achieve this aim, ARNEC implements programmes in the following activity areas (Action Pillars): Advocacy for Policy Change: Support national partners and members in their assessment and review of national early childhood policies, frameworks and implementation, and facilitate the exchange of models and tools from other contexts. Knowledge Generation: Facilitate the continuous analysis and synthesis of regional ECD evidence and research, identify priority areas for further learning, and support strategic research activities. Information Management and Dissemination: Provide a platform for ECD professionals to share information and resources, ensuring these are easily accessible to all. Capacity Building: Provide opportunities for professional development and learning related to ECD through strategic ARNEC events, external outlets, and strengthen national networks through targeted technical support. Partnership Building: Build external

partnerships and coalitions to create a supportive environment to leverage resources for ECD and ARNECs capacity to fulfil its mission In February 2010, the ARNEC Secretariat moved from the UNICEF East Asia and Pacific Regional Office in Bangkok to SEED Institute in Singapore. ARNEC is guided by 15 Steering Committee members made up of ECD experts from the Asia-Pacific region who provide direction for the planning and development of the Network and its activities. Six core team members have agreed to support ARNEC. They are UNESCO Asia and Pacific Regional Office for Education, UNICEF East Asia and the Pacific Regional Office, Plan International, Open Society Foundation, Save the Children and SEED Institute. WHO ARE OUR MEMBERS? Our members are individuals in the field of early childhood who is concerned with young children and families of Asia and the Pacific. The Networks strengths draws upon the support of our members who are experts in health, education, nutrition, social welfare, human development, social research or policy, sociology, or anthropology. Becoming an active ARNEC member means you are able to contribute your knowledge and share with others your experiences. Friends of ARNEC, or institutional memberships, are also available and receive additional benefits such as the eligibility to enter into joint activities with ARNEC and be featured on our website. Interested individuals or organisations may find out more information about the ARNEC membership categories on www.arnec.net.

ARNEC Advocacy Messages

Message 1: The Early Years: Ensuring a Childs Right from the Start Message 2: ECCD Begins at Home: Caring for Children in a Nurturing and Stimulating Environment Message 3: Quality Early Childhood Matters: Making a Critical Investment for a Countrys Future Message 4: Inclusive ECCD for All: Valuing and Respecting the Unique Needs of Every Child Message 5: Integrated ECCD: Working Towards a Seamless Early Childhood System