Early childhood

The Issue

UNICEF in Action

Resources on Early Childhood Development


A young child's right to comprehensive well-being

© UNICEF/CEECIS2013P-0375/Pirozzi

The arrival of a new baby is stressful, and all families need some support. Fortunately, the health sector in this region has frequent contact with women and young children: almost all women have access to prenatal care and deliver in hospitals. Most young children are vaccinated and receive basic well-child care and treatment for common illnesses. Furthermore, many countries have maintained programs where community or patronage nurses and other health providers visit families in their homes during pregnancy and the early childhood years.

However, while child health in this region has made significant progress, a number of challenges remain to establish the foundations for lifelong well-being during the early years.

The challenges

UNICEF is a strong advocate for quality home visiting services, which can contribute to parental well-being, positive and effective parenting skills, and positive outcomes for child health, nutrition, development and protection. However, the content of home visits currently provided in the countries of this region is often poor and primarily medical in nature. In addition, these services do not always reach the region’s most marginalized and vulnerable families.

Two decades of health reforms have furthermore greatly increased the variability of family outreach in the region. UNICEF assessments have found overall that community nurses tend to be poorly trained and do not have skills and tools to identify families that need more support. Their performance is often assessed by the number of visits, rather than family and child outcomes, and their approaches are not based on the wealth of scientific evidence of what young children need to thrive. In addition, community nurses lack clear referral pathways to coordinate with other services in the community, such as social services, social assistance and housing (for more information, click here). As a result, maternal depression, domestic violence, disabilities, harsh discipline, and lack of nurturing and stimulation with negative impact on the developing young child are not identified and addressed early on to prevent permanent delays in the young child’s development.

Children with developmental difficulties or disabilities constitute one of the most vulnerable and excluded group. Many disabling conditions can be prevented during gestation and the early years or ameliorated by early diagnosis and intervention. The social marginalization and “invisibility” of children with disabilities is compounded by poverty, the absence of an enabling policy environment, “medicalized” definitions of disability, poor data collection systems, lack of access to services, limited parent education and weak mechanisms to support families.

Children with disabilities are overrepresented in residential institutions. Institutional living can be permanently damaging to the development of these children because it does not meet their needs for responsive and nurturing care and a stimulating and safe environment.

The quality of services provided, equity gaps in reaching the most excluded, and supporting children with disabilities and developmental difficulties are the three foremost challenges that UNICEF will be addressing in the region in the coming years when pursuing its agenda for action on young child wellbeing.

Last updated November 2013



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