Services for Children with Developmental Delays Must be Family-Oriented

New policy document provides vision for cross-sectoral support to families with children at risk of development delays

25 December 2023
UNICEF Representative and ministers verified the policy recommendations at a forum
UNICEF/North Macedonia/2023

Skopje, 21 December 2023 – Government and civil society partners together with UNICEF verified the policy recommendations defining strategic direction for development of an accessible and affordable early childhood intervention system in North Macedonia.

The mission of early childhood intervention is to assure that families with children aged 0-6 years at risk of developmental delays, receive resources and support that assist them in maximizing their child's physical, cognitive, social and emotional development.

“We are aware of the need to strengthen cross-sectoral communication with the Ministries of Health and Labor and Social Policy in the field of timely detection of developmental delays of children at an early age. And we are focused on that. Each institution has its own role in the process of identifying and providing support not only to children with developmental delays, but also to their families, as well as to educational institutions in the country,” said the Minister of Education and Science Jeton Shakiri.

” Children who receive quality care and development opportunities in the early years of life, are more likely to reach their full potential and enjoy productive lives. The earlier children at risk of developmental delays and children with disabilities receive assistance, the more likely is they will benefit from the interventions including increased learning and school performance, more supportive home environment and more chances to grow up in independent individuals,” said Patrizia DiGiovanni, UNICEF Representative.

Early detection and intervention of developmental delays are critical to ensure children receive timely support. However, current state-level early childhood development screenings and early childhood intervention services are either rare or do not exist at all, putting many children at risk and leaving them unregistered for services.

Only 44 per cent of children start receiving developmental screening before the age of three, and there are large inequalities in the provision of services, with families in rural areas, smaller ethnic communities as well as those with low-income remaining significantly underserved.

Based on the estimates, more than 17.000 children[1] from birth to six years old in the country may need early childhood intervention services.

The policy recommendations verified today at a forum gathering representatives from the Ministry of Health, Ministry of Education and Science, Ministry of Labour and Social Policy and members of civil society organizations, introduce and regulate at system level the design and delivery of Early Childhood Interventions services using a cross-sectoral approach.

The recommendations put an emphasis on the multidisciplinary nature of early identification and early childhood intervention services which require close coordination between the education, health, nutrition, and child protection sectors.

A key aspect of the new policy document is the introduction of family-oriented early intervention model, placing the family and the natural environments of the child at the center of interventions. To make this happen, services should be oriented towards providing support in the family or in the natural environments of the child, such as: kindergarten, playgrounds and other places where children spend time and perform daily routines. To place the family and the natural environments of the child at the center of interventions, parents also need to acquire knowledge on using daily routines to stimulate the development of functional skills in their child.

The Policy recommendations were developed through a participatory process based on the generated evidence from desk review of the legislative framework and the Situational Analysis on Early childhood development in North Macedonia.

They include structure for development of standards and procedures for Early Childhood Interventions services and define the roles, authorities, and tasks of each ministry within the system providing Early Childhood Interventions support to children and families.

This initiative is part of the framework of the joint UN project “From Knowledge and Engagement - to Empowerment and Participation (KEEP)” funded by the UNPRPD Fund. Working closely with the Ministry of Health, the Ministry of Labour and Social Policy and the Ministry of Education and Science, UNICEF supports introduction of a trans-disciplinary family-oriented model of early childhood interventions’ services in North Macedonia.

The verification workshop today was organized in partnership with the Association of Special Educators and Rehabilitators.



[1] According to the 2021 Census, there are 140.436 children under the age of six in North Macedonia. Using the probable rate of 12,5% (world statistics show that 10-15% of children from birth to six have developmental delays), as many as 17.554 children may need early childhood intervention services

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