1. Early Childhood Development +
Health/ Nutrition

2. Caregiver/Family
Child
Family
Home to
Early
Learning
Environment
Birth
PreSchool
to
Primary
School
Child’s Development
Prenatal
Birth - 3
Ages 3 5
Ages 5 - 8

4. 1. Early Experiences Matter

5. 2. Social Referencing

6. 3. Nature versus Nurture
Approaches to
Learning

7. Milestones for early motor development

8. Promise of Preschool in Africa
Mozambique 2011

9. ECD ACCESS
Conventional Pre-Primary (GMR, 2012)
Country
Sub-Saharan Africa
Birundi
1999
2010
10
1
17
9
Comoros
2
22
Ethiopia
1
5
21
65
South Africa

10. Development risks at baseline
Risks
Stunting
Percentage
42.3%
Risk of delays in fine motor skills
(36-41 months)
70%
Risk of developmental delays
(36-41 months)
65%
Orphaned
Caregiver does not know how to
read
10.01%
42%
51.35%
Caregiver does not speak
Portuguese
Source: Authors calculation from the baseline data for the impact evaluation (2008)

11. Peabody: Receptive Vocabulary (2008)

12. ECD/Preschool Conclusions
 ECD/Preschool model effective at:
 Target Children:
 Increasing primary enrollment & attendance
 Improve pro-social behaviors & decrease hyperactivity behavior
 Improving hygiene practices and reduce diarrhea & skin infex
 Reducing children’s time working on family farm
 Older Siblings:
 Increasing in school enrollment
 Parents:
 Changing parenting practices
 Increasing labor market participation
 NO IMPACT:
Improve child growth (stunting)**

13. What’s Trending: ECD ACCESS
Integrated, innovative, scalable
Home-based (Essential Package)
Community Healthcare Workers (C4D)
Cascade ECD-Health Fairs
Parent-Child Community Gatherings
Mobile Program
Interactive Radio/ Phone Messages/ Email/ TV

14. Interventions with stunted children highlight the
importance of stimulation
 Integration of health, nutrition and education/cognitive
stimulation (comprehensive programs) has larger and
sustained impacts for children
Non-stunted children
DQ 110
Supplemented and stimulated
105
Stimulated
100
Supplemented
95
Control
90
85
Baseline
6 mo
12 mo
Grantham-McGregor et al, 1991
18 mo
24 mo

15. 4. Integrated Programming:
Nutrition/Stimulation

16. ECD Lifespan Approach
Economic Strengthening / Health- Nutrition /
Women’s Development
Adolescent
s
Pregnancy
Birth to
30 days
1 month to
3 years
3 to 4 years
Nutrition/Food Security
Adolescent
Development
Maternal and Child Health
5 to 6 years
7 to 8
years
Primary Education
School health and nutrition
Child Protection, Global Warming, AIDS

17. Integration: Program + (ECD)
 Maternal and Child Health
 WASH
 Maternal Education
 Emergency Response
 Youth
 HIV/Protection
 Resiliency and Peace Building
 Basic Education (Emergent Literacy)

18. “Advantages and Disadvantages of Integration:
Opportunities for Integrating Early Childhood
Development (ECD) and Nutrition Programming”
Ann M. DiGirolamoa, Pablo Stansberyb, , Mary Lung’ahoa,c
a CARE International; b Save the Children; c Nutrition
Policy & Practice
Annals of the New York Academy of Sciences entitled
“Integrated Interventions in Child Development, and
Nutrition (forthcoming)
Dr Mandana Arabi, Dr Maureen Black, Dr Lia Fernald, Dr
Sally McGregor, Dr Ted Wachs, Dr Susan Walkers, Dr
Aisha Yusafzai

19. Health Nutrition ECD (HNECD)
Advantages
Staff workload
Supervisory Responsibilities
3.
2.
1.
2.
1.
Cost effectiveness of
HNECD programming
Challenges
Common language activities
Co-location of services
3.
Coordinated messaging
4.
HNECD programs
protect and promote
children’s growth and
development across
multiple domains
4.
5. Training/Orientation

20. ECD Menu of Services

22. USG Children in Adversity
1.
Build Strong
Beginnings
2.
Put Family care first
3.
Protect children
from violence,
exploitation, abuse
and neglect

23. 2 new ECD Resources

24. Essential Package Building Blocks
1. Positive caregiver-child
interaction
2. Developmentally-
appropriate approach
3. Link to broader systems
of integrated care
4. Eliminate barriers to care
and support

25. Activities parents can do with child…
0-2 months

27. Pstansbery@unicef.org

28. Group Discussion
1. Identify examples of promising
practices of integrated programming.
2. Post- MDG agenda: Where sits early
childhood? Should there be a separate
ECD goal or embedded in current
health/ nutrition goal. What might that
look like?