Early Childhood Development (ECD)

National Social and Behaviour Change Communication Strategy for Integrated Early Childhood Development, Nutrition and WASH 2018 – 2024 (Government of Rwanda, 2018)

February 22, 2019

The National SBCC Strategy will build on the integration of Early Children Development, Nutrition and WASH sectors which provides opportunities of benefiting from integrated ECD, nutrition and WASH social behavior and communication services aiming at improving knowledge, attitude and practices at community and household levels.

This strategy seeks to address key determinants related to early children development, malnutrition and water, sanitation and hygiene (WASH) mostly related to knowledge, attitude and practices at community and individual levels. There are many impediments within the health systems that prevent people from having productive and healthy lives. Social and Behavior Change Communication (SBCC) addresses key barriers preventing people from adopting improved health practices. The Early Children Development, nutrition and WASH sectors within the health system can benefit positively from an SBCC strategy.

ECD, Nutrition and WASH have multi-sectoral dimensions that require contributions from different disciplines including but not limited to agriculture, economic strengthening, public health, gender, medicine, and social science. The theories and models fromthese different domains can be extracted to develop and deliver effective behavior change communications particularly in the context of promoting positive ECD, nutritional and WASH related practices at household and community level in Rwanda. By addressing key barriers related to ECD, Nutrition and WASH by promoting Community and Household integrated best practices, this will ensure optimum health status of the population of Rwanda.

Engaging Community Members to Adopt Effective WASH Practices for Nutrition (SPRING brief, 2017)

February 18, 2019

The first 1,000 days, the period from pregnancy to two years of age, are critical for early childhood development. During this time, children are especially vulnerable to stunting, an irreversible condition that can result in lifelong cognitive and physical deficits. In 2011, stunting, or low height-for-age, affected more than 165 million children worldwide (Black et al. 2013). Mounting evidence indicates that poor water, sanitation, and hygiene (WASH) practices contribute significantly to stunting. Improving WASH practices reduces diarrheal disease, environmental enteric
dysfunction, and soil-transmitted helminth (parasitic worm) infections. Combined, these reductions contribute to decreases in stunting.

In Ghana, stunting is a particularly serious challenge. According to the 2014 Ghana Demographic and Health Survey (GDHS), 19 percent of Ghanaian children under the age of 5 are stunted. Among the regions with the highest rates of stunting is the Northern Region, where the prevalence is 33 percent (GDHS 2014). WASH practices in many parts of the country contribute to this problem. The majority of households (93 percent) do not treat their drinking water by any method (GDHS 2014), while only 14 percent use an improved toilet facility that is not shared with other
households (GDHS 2014). In the two weeks preceding the 2014 GDHS survey, the overall rate of diarrhea reported among children under five was 12 percent, a figure which tends to vary seasonally.

The SPRING project is a seven-year USAID-funded cooperative agreement to strengthen global and country efforts to scale up high-impact nutrition practices and policies and improve maternal and child nutrition outcomes. SPRING has worked for three years in Ghana, where USAID has tasked it with helping to prevent stunting and reduce anemia in the Feed the Future Zone of Influence in 15 districts in the Upper East and Northern Regions.

SPRING’s “WASH 1,000” strategy promotes focused, evidence-based WASH behaviors to eliminate common fecal-oral contamination pathways in children during the first 1,000 days. The strategy takes an integrated, multi-sectoral approach, simultaneously delivering products, services, and information to households with pregnant and lactating women and those with children under two (i.e., 1,000-day households).

Click here for full brief.

Mobile phone-delivered reminders and incentives to improve childhood immunisation coverage and timeliness in Kenya (M-SIMU): a cluster randomised controlled trial (The Lancet, Volume 5:4, PE428-E438, 2017)

February 18, 2019

Background: As mobile phone access continues to expand globally, opportunities exist to leverage these technologies to support demand for immunisation services and improve vaccine coverage. The authors aimed to assess whether short message service (SMS) reminders and monetary incentives can improve immunisation uptake in Kenya.

Methods: In this cluster-randomised controlled trial, villages were randomly and evenly allocated to four groups: control, SMS only, SMS plus a 75 Kenya Shilling (KES) incentive, and SMS plus 200 KES (85 KES = USD$1). Caregivers were eligible if they had a child younger than 5 weeks who had not yet received a first dose of pentavalent vaccine. Participants in the intervention groups received SMS reminders before scheduled pentavalent and measles immunisation visits. Participants in incentive groups, additionally, received money if their child was timely immunised (immunisation within 2 weeks of the due date). Caregivers and interviewers were not masked. The proportion of fully immunised children (receiving BCG, three doses of polio vaccine, three doses of pentavalent vaccine, and measles vaccine) by 12 months of age constituted the primary outcome and was analysed with log-binomial regression and General Estimating Equations to account for correlation within clusters.

Click here for full study.

Adding a Nutrition Behavior Change Communication Component to an Early Childhood Development Intervention in Malawi (IFPRI Discussion Paper 01804, 2019)

February 18, 2019

In Africa south of the Sahara, including Malawi, an estimated 61 percent of children below the age of five are developmentally challenged as a result of poverty, malnutrition, and lack of early stimulation and learning opportunities. Early-childhood development (ECD) programmes, which aim to improve young children’s survival, health and development are considered one of the most cost-effective human capital investments that can be provided by governments particularly when compared to subsequent schooling interventions. Community-based Childcare Centres (CBCCs) are a key element of ECD programs in Malawi. CBCCs serve 3–5-year-olds by promoting holistic child development through provision of safe and stimulating environments, access to health and nutrition services, and capacity building for parents and caregivers. In Malawi, there are an estimated 11,000 CBCCs across the country, but many are not functional. Lack of food provision at the CBCC leads to high rates of absenteeism and is considered one of the main reasons for the closing of CBCCs. To address this, Save the Children in partnership with Chancellor College-University of Malawi developed an integrated agriculture-nutrition package that was implemented alongside the standard ECD component. This included activities to promote nutritious food production and consumption, promotion of optimal feeding and caring practices, and engagement with parents in pre-school meal planning and preparation.

The Nutrition Embedded Evaluation Program Impact Evaluation (NEEP-IE) cluster randomized control trial aimed to assess the effectiveness of implementing an agriculture and nutritional intervention through CBCCs in Malawi. This newly published paper presents the impact results of this control trial, focusing on child development outcomes of pre-school children during a 12 months intervention period.

Click here for full paper.

Adding a Nutrition Behavior Change Communication Component to an Early Childhood Development Intervention in Malawi (IFPRI Discussion Paper 01804, 2019)

Site Navigation

Social Networks