The plan was to develop health care programs for OVC in those communities, initially as a pilot project to then be expanded more widely.
However, one of the realities was that the existing governmental health system was largely facility-based and with limited community access to needed services . So it is with much of the slums of Africa!
With our own broad experience in Primary Health Care, we were able to introduce them to aspects of PHC that they could pursue in their own households , while depending on back-up from the Government Health Centers and Hospitals.
An explosion of research in the neuro-biological, behavioral, and social sciences has led to major advances in understanding the conditions that influence whether children get off to a promising or worrisome start in life.
These scientific gains have generated a much deeper appreciation of:
(1) early life experiences, as well as the inseparable and highly interactive influences of genetics and environment, on the development of the brain and the unfolding of human behavior;
It is very important that the child has a relationship with the mother (or caregiver) that is nurturing, loving, protective, supportive, stimulating, encouraging – every day, week, month, for considerable time.
With that secure attachment , the child builds a foundation that includes a sense of self-worth, physical, social, cultural, cognitive development that prepares it to cope with this complex world into which it is born.
That can be beneficial for the child’s entire life.
We are, of course, concerned about the many children in the slums who would not have parents or caregivers.
Importantly, there would be limited under-standing that children who are simply neglected, even if not mistreated , could be harmed by the lack of a nurturing caregiver attachment. Indeed, harmed for life!
So, we shared these ideas and problems with our Health Committee and they were truly excited by the knowledge, and deeply interested in taking steps to protect the children in Mlolongo, Sophia, Bondeni and beyond.
So they began teaching the community about this, and gaining widespread support from them.
An important aspect of our Project has been the selection and training of CHWs.
These are women and men from the local communities who agree to visit every household on a regular basis, maintaining records on elements of PHC and caregiver-child interactions, and maintaining an information system that records and monitors the care of the children-under-5.
There are currently 2400 households with at least one child-under-5.
She has been invited to give lectures to the students, and they have welcomed Racheal’s inviting the masters level students to visit our community slums sites as field work, which has delighted all of them.
I have been invited as a visiting professor to provide support for presenting the science base of ECD.
The relationship between Daystar and our project has become very positive, and it pleases us that the university is revising the Department to become the Child Development Institute .
Racheal is now enrolled as a student in the Child Development degree program.
These disadvantaged children are likely to do poorly in school, and subsequently to have low incomes, high fertility, and provide poor care for their children, thus contributing to intergenerational transmission of poverty .
Four causes: malnutrition, iron and iodine deficiency, and inadequate stimulation.
Governments and civil societies need to consider expanding high quality, cost-effective, ECD programs .
And so our journey continues, as we are alert to further advances in the science of ECD, and sensitive to how such advances can enhance the strengths of our project and how these might benefit children in the larger Africa.