The Progress of Nations

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 The time to sow
 Commentary: Early childhood care

Simple transforming steps

Copyright© UNICEF/98-1117/Pirozzi
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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