 | | A
child is weighed on a sling scale in a rural health post in Kenya. Low birthweight is a
major factor in the deaths each year of 4 million infants worldwide in their first
month of life. |
We no longer have the excuse of ignorance. We know of good working examples of the integrated approach that ensures
children’s survival and brings out their potential. Programmes in India, Jamaica, Kenya,
Peru and Turkey, for example, offer important lessons and hold out promise for similar
gains elsewhere.
So too does an evolving integrated early childhood care and development approach in
the Philippines, which demonstrates the success communities have had in weaving
together health, nutrition, psychosocial care and early education services for young
children.
This programme aims to cut infant and child mortality, malnutrition and
elementary school drop-out rates by half. These are crucial objectives in a country where
nearly one third of children are underweight or stunted, and the under-five mortality rate
is 44 deaths per 1,000 live births.
Around the country children in child-care centres, like the ones in the Philippine
village of Capagao, play with well-worn toys and with musical instruments improvised from
discarded bottles and bamboo slats, leaf through books and learn from brightly coloured
posters about animals, the alphabet and hygienic hand-washing practices. Health and
nutrition workers in the village are trained to counsel parents on better early childhood
care, including exclusive breastfeeding and oral rehydration therapy (ORT). Children
receive their routine immunizations at the health station. Health workers maintain a map
of all houses in the community in which is recorded every child’s growth, access to
iodized salt and other micronutrients and the availability of clean water and sanitation.
These are simple steps; they are also life-saving and life-transforming ones. More
importantly, the services are accessible within communities and are locally run. They include health care, day care, primary education and parent-effectiveness
training. In typical villages, day-care workers, midwives, health workers and child
development workers focus on multiple areas, so that health and nutrition workers now
understand how children best begin to learn, and day-care workers are now aware of health
issues.
UNICEF is supporting these efforts with local governments in 20 provinces and five
cities by bolstering basic social services in rural communities through the establishment
of community health and nutrition posts. In Capiz Province alone, 200 such posts are to be
in place by the end of 2000. These health and nutrition posts provide mothers with a venue
to meet, discuss health, nutrition and psychosocial needs of their babies, to be
counselled by the village health worker and to have access to basic services such as
vitamin A and iron supplements.
In the tiny island province of Guimaras, where child
poverty rates exceed 70 per cent, a child-minding centre exists for poor families,
allowing both parents to work. Day-care centres are being built village by village. Nationwide,
the number of accredited new centres increased by 11 per cent in 1998, to more than
20,000.
UNICEF is helping improve the health of mothers and the capacity of parents and
other caregivers to provide a loving and stimulating home environment for young children.
Through a community-based parent-effectiveness service programme, organized parent groups
learn about child health, psychosocial care, nutrition protection and even gender
relations. UNICEF also supports training of day-care and local health workers and
distributes parent-counselling cards and other information materials to grass-roots service
providers.
In three regions in the Philippines, an integrated early childhood care and development
project is being funded by the World Bank and the Asian Development Bank, with support
from UNICEF and in partnership with local and national governments.
Efforts such as these are vitally needed all over the world, and
a broad and vocal alliance – a truly global movement –
is needed to support them, to help give voice and visibility to
what is being done. The efforts of governments, all sectors of civil
society, religious and grass-roots organizations, the media and
international organizations are crucial in helping make children’s
rights the priority.
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