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St. Vincent and the Grenadines

Vincentian children benefitting from home-based ECD programme

KINGSTOWN - On this particular morning 11-month-old Isanna is busy playing with home-made toys as her mother Isma Browne and community health aide Delana Campbell carefully watch and analyse her every move.

It is Isanna’s first home visit from the community health aide and she is quickly adapting to the new activities being introduced under the Early Childhood Health Outreach (ECHO) programme, which was designed to bring early stimulation, parenting education and health outreach directly to her living room.

Isanna is among scores of pre-schoolers across every parish in St Vincent the Grenadines who were previously denied access to formal Early Childhood Development (ECD) services which are critical to giving them the best possible start in life. ECHO has changed all that in a short three years.

ECHO uses methods of an informal home-visiting programme which support families in communities with limited access to ECD services by giving children access to early stimulation and parents the education and basic training to provide that stimulation on a continual basis.

The programme, which is being supported by UNICEF, addresses the development needs of the very young in disadvantaged conditions where children benefit from quality care, development of basic skills, better health and nutrition and at the next level, better performance in pre-school; and future education.

 ECHO reaching previously unreached 20%

The programme started three years ago as a two-year pilot in communities serviced by the Calliaqua health district. Calliaqua was identified due to the high level of poverty observed in the area, the unavailibity of day care centres and the high population of migrants.

“Before ECHO about 20 per cent of children were not exposed to formal early care or preschool settings. We are now in every community across the country and reaching the children who need the assistance,” says Sister Arlene James one of the co-ordinators of the project.

“Initially, which is normal, we were getting resistance from the parents because they did not want to accept the programme but as we progressed people became accustomed and accepted ECHO, especially parents who can’t afford to send their children to preschool; they welcome the programme,” she added.

“I know it works for a lot of them; some were doing the things but they did not understand what they were doing and the importance of it and they were a few who did not know of the need to stimulate their children. I would say now the parents have come to understand the importance of stimulation and what it means, for example to sing to children, talk to children and allow children to play … the importance of safe play,” the senior health worker adds.

James says one of the good features of ECHO is that parents are thought to recycle items they use in their homes to make safe toys for children and to make children’s rooms as stimulating as possible without incurring costs.

Benefits to health sector

She says there are also benefits to the health and education sectors because the aides are trained to pick up any growth and developmental or health challenges at an early age.

“They are trained to know what a child is expected to do or say at one month, two months, three months etc. – so when they go visiting they know what to look for, so if there is a deficit or an anomaly the aides are able to identify and report so that early remedial action could be taken” she adds.

Community Health Aide Annie Campbell, who was among the first aides to be trained in 2011, is full of praises for the programme.

“It is very good. Parents like it, the children love it and I like doing it. It’s a great opportunity to do the stimulation with the children, show the parents how to use everyday household things to make toys and also keep your eye on the infants’ health by checking that they are on track with their immunisation and so on,” the experienced health care worker said.

Delano, a 25 year-old parent is one of those who is happy with the progress his three-year-old son Andres has made since being exposed to ECHO.

“I never really thought of the importance of spending time to stimulate him and so but after they showed me how to do it I have been doing it on my own. He really showed a lot of improvement after I was able to do that with him,” the first-time father added.

Genesis in Roving Care Givers Programme

The ECHO programme had its genesis in the Roving Caregivers Programme (RCP) in St Vincent and the Grenadines under which infants in four rural communities were visited by professionals who went into the homes to show them how to support early learning in children, especially those not exposed to day care or pre-school.

“That programme was sponsored by donors and it was realised that those resources were about to dry up, but Ministry of Health officials and technocrats realised that it was a good programme and did not want it to die.

“The initial assessment was that the programme was sowing good seeds and so the planners thought about how best we could keep the Roving Care Givers Programme alive and they came up with ECHO,” James said.

Cost effective programme

In a time of constrained economic output one of the key considerations was that government would not have to face additional costs to get the programme running on the national scale. This has been achieved through training and using the existing structure of community health aides to take ECHO into homes.

As a way to ensure the sustainability of the programme government, through the Division of Nursing, has introduced an ECHO component in the training course which is mandatory for all persons in the island being trained as nurses.

“No one will therefore come into the system unaware or untrained in delivering ECHO to the communities across the island which need it. That way we will ensure that all infants in St Vincent and the Grenadines are exposed to that early stimulation which is of such critical importance to their development and future,” James concludes.



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