The document discusses early childhood development programs in various countries, highlighting strategies for implementation and evaluation of such programs. It also reviews evidence from The Lancet series on the importance of early childhood development and the impact of adverse and positive experiences on brain development. Examples are provided of early childhood development best practices and gaps within the KIDSS project in addressing health, nutrition, and educational needs of young children.

1. Early Childhood Development:
From science to practice including
research
MaureenKapiyo-THRIVE ProjectCoordinatorKenya,TanzaniaandMalawi,CRS
LeslieChingang-DeputyChiefofPartyKIDSSProject,CRSCameroon
AlfonsoRosales-MaternalandChildHealthSeniorTechnicalAdvisor,WorldVisionUS
JohnHembling-SeniorTechnicalAdvisorforHealthEvaluationandResearch,CRS
JoyNoelBaumgartner-AssistantProfessor;Director,EvidenceLab,DukeUniversity
ElenaMcEwan-MaternalandChildHealthSeniorTechnicalAdvisor, CRS
1

2. Session Objectives
• Describe different ECD program
implementation strategies and lessons
learned in various countries
• Discuss the evaluation design issues for
ECD programs
• Demonstrate communication strategies for
engaging stakeholders on integrating ECD
programming across sectors
2

3. Figure 1
The Lancet 2017 389, 77-90DOI: (10.1016/S0140-6736(16)31389-7)
Copyright © 2017 Elsevier Ltd Terms and Conditions
Theeffectsof contexts,environments,andnurturingcare

4. Relations among key processes in early
childhood development policies
The Lancet 2017 389, 77-90DOI: (10.1016/S0140-6736(16)31389-7)
Copyright © 2017 Elsevier Ltd Terms and Conditions

5. Action at global, national, and local levels
is needed to increase political commitment
to and investment in early childhood
development

6. The Lancet series reviewed:
– evidence linking early childhood development with
adult health and wellbeing
– evidence related to key biological and psychosocial
risks
– Summarized neuroscientific evidence on both adverse
and positive experiences affecting early brain
development
– Concluded that inequities in development begin prior
before conception, and that timely interventions
reduce inequities and increase productivity
6

7. 7
Country programs examples

8. Figure 1
OVC Social Services-Community
-ECD-OVC Host Ministries/program &
policy
-Civil Society Organizations (CSO) ECD-
OVC services & ECDC Network
-Church/Dioceses ECD-OVC Programs
-ECD-OVC TWG SOP -
linkages/advocacy/OGD
-Child Protection policy (GRC)
-CRS-KIDSS PEPFAR (5 years)
-INGO (CRS; UNICEF; Plan
International)
OVC Programs/Institutions
PMTCT & Well-baby Clinic
-Maternal & child health (responsive
IYC feeding, immunization etc)
-ECD messages (e.g. PP; child dev’t;
fathers’ role; nutrition; hygiene;
protection)
-Growth & Dev’t monitoring
-Dev’tal screening & follow up
-ECD Referrals/Counter referral
Early Childhood Education/Inclusive
- Child Friendly/Play
spaces/neighborhood
School for ages 0-5
PTAs
Community Workers & OVC Care
Groups
- Coordinated
messages/counseling/demonstration
on ECD, hygiene, nutrition, health,
father’s role in ECD,
-OVC; HES support, supervision,
referral etc.
OVC Group Homes
-orphanages
-handicap centers (e.g. pro-handicap;
National Handicap Center -
OVC House Hold
(parents/caregivers/child/members of
families/grandparents)
-HIV+ Pregnant women
Stable, sensitive & responsive relationship; child
rights & protection
-Early stimulation & positive parenting/child
rearing practices
-proper health & nutrition-appropriate feeding
practices; breast feeding; supplementation (HES)
-Safe & stimulating indoor/outdoor early
childhood environment (e.g. ECD local materials-
toys, books, shapes blocks, shakers)
-Peer-group-social integration (neighborhood)
-Referral/Counter referral/linkages
-SILC focused on ECD HH
Child
Effective linkages between Social Systems for Continuum of Comprehensive
Support & Care for OVC 0-5 (KIDSS MODEL)

9. Entry Points for a ECD intervention
Programmatic entry points
 Health programming targeting children, e.g. PMTCT/ANC, Growth and
developmental screening, OVC, Immunization,
 Nutrition programming, e.g. Food diversity, IYCF, nutritional screening,
measurement of MUAC
 Education programming, e.g. pre-school preparedness, early
stimulation
Service Delivery platform
 Household; e.g. home-based care
 Health facilities
 Institutions like ECD safe spaces, schools,
9

10. Evidence based Strategies
Health & Nutrition
 Rapid development of the brain occurs first 2 years
 Feeding in the first 1000 days is essential for optimal growth &
Development
 Immunization EPI, combine with Vit. A
Community-based
 Home visit
10

11. ECD best practices in KIDSS
- An ECD baseline survey describing gaps in development and ECD health,
nutritional and educational services
- ECD framework for KIDSS (delivery platform, delivery agents, number of
messages, message materials, Dosage, Delivery strategy, Supervision and
Training/Refresher)
- Develop flipchart for home-based care to facilitate key messages, and
demonstration
- Pretest-learn-adjust-implementation-monitor/supervision
- KIDSS strengthen family wellbeing through positive parenting during
home visit (0-5years)
- Government buy-in (adopting KIDSS tool, KIDSS supporting to develop
national ECD policy.
- Families positive feedback on positive parenting and early stimulation
demonstrations.
11

12. Gaps in KIDSS ECD programming
- Donor restriction (is a core, near core or non-core activity?)
- Agents profile not clear, lack of trained personnel in ECD, Child
protection, nutrition, development milestone monitoring
- Non-systematic ECD referral system and formal linkages
- Nurses and doctors lack the knowledge in ECD, and not
motivated to practice new things.
- Lack of standard for budgeting.
12

13. Factors important for scale up of ECD program
(case KIDSS)
13
• National ECD policy document,
strategic plan or implantation plan
• Sufficient human resources
(trained agents, full time as
against volunteers.
• Integrated ECD program which
include MCH, Growth monitoring,
Breastfeeding, nutrition, WASH,
Immunization,
• Establishing play areas in health
facilities, day-care centers,
community-based safe spaces

14. The Lancet series reviewed:
– evidence linking early childhood development with
adult health and wellbeing
– evidence related to key biological and psychosocial
risks
– Summarized neuroscientific evidence on both adverse
and positive experiences affecting early brain
development
– Concluded that inequities in development begin prior
before conception, and that timely interventions
reduce inequities and increase productivity
14
The Lancet 2017 389, 77-90DOI: (10.1016/S0140-6736(16)31389-7)

15. Hypothesis tested
StuntedCognitive, language
and motor
development
Early learning
support Child feeding
practice
Population in GBG vs. control will have …
Agu!
Violating
disciplining

16. Delivery Platform Design
Time 1
Nov 2014
Time 2
Apr 2015

17. Measurements
1. Caregiver’s survey (adapted MICS tool)
2. Weight and height assessment
3. Ireton scale
4. Bayley III
5. Focus group discussions

18. Outcome indicators
1. % of children scoring above 85 in all 3(cognitive,
language, and motor composited sub-scales per BSID III)
2. % children stunted
1. % children whose household members in the past 3 days
were engaged at least in 4 early leaning support
activities (UNICEF MICS)
2. % of children receiving minimum diversity in last day.
3. % of parents with violating disciplining practice (MICS)

19. Overall effect of intervention
Stunted
Cognitive, language
and motor
development
Early learning support
Minimum diversity
Agu!
OR 1.83
P=0.025
OR 1.55
p=0.013
OR 2.22
p=0.012
OR 0.96
p=0.013
OR 1.11
P=0.501

20. 59%
75%
83%
75%
71%
82%
87%
81%
Total score Cognitive Language Motor
Contol Intervention
% of children that achieved at least 85 scores
on BSID III
OR=1.5
p=0.175
OR=1.68c
0.151
OR 1.82
p=0.025
OR=1.36
P=0.291

21. % of children that achieved at least 85 in total
composite in Vardenis region only
46%
64%
84%
62%
73%
78%
94%
81%
Total scores Cognitive Language Motor
Contol Intervention
OR 3.41
p=0.003
OR 2.03
p=0.073
OR 1.68
p=0.151
OR 1.36
p=0.291

22. Conclusions
• GBG is effective for all who participate
• Even more effective economically
disadvantaged areas
• Longer duration studies are needed to view
the long-term effects of GBG