This document discusses integrating early childhood development, health and nutrition programs in Uganda and Lebanon. It provides an overview of early childhood development and the importance of a holistic approach. It then details a project in Northern Uganda that trained health staff and peer educators to provide early childhood development messages to caregivers. Evaluation findings showed improvements in caregiver-child relationships, health behaviors, and decreased family violence. The document argues that early childhood development can help address protection issues by promoting nurturing relationships and protective factors against child abuse and neglect.
Child-health practitioners in Iowa must find better ways to address family, neighborhood and economic factors that shape children' health and well being, according to CFPC executive director Charles Bruner and Debra Waldron, director and chief medical officer of the Child Health Specialty Clinics at the University of Iowa. They presented at the Iowa Governor's Conference on Public Health in Ames on April 5.
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Child-health practitioners in Iowa must find better ways to address family, neighborhood and economic factors that shape children' health and well being, according to CFPC executive director Charles Bruner and Debra Waldron, director and chief medical officer of the Child Health Specialty Clinics at the University of Iowa. They presented at the Iowa Governor's Conference on Public Health in Ames on April 5.
Presentation slides from the Hunter Institute's recent Youth Mental Health: Engaging Schools and Families event with Professor Mark Weist. For more info visit www.himh.org.au
Pat Dolan, Professor and Carmel Devaney, Lecturer and Researcher UNESCO Child and Family Research Centre, School of Political Science and Sociology, Research and Innovation Centre, NUI Galway – Family support for families at risk, Expert Consultation on Family and Parenting Support, UNICEF Office of Research – Innocenti Florence 26-27 May 2014
Bernadette Madrid, University of the Philippines, Director of the Child Protection Unit, Philippines - Parenting support in the context of violence prevention, Expert Consultation on Family and Parenting Support, UNICEF Office of Research – Innocenti Florence 26-27 May 2014
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Davison is an Associate Professor of Nutrition at the Harvard School of Public Health. She completed her PhD at the Pennsylvania State University in Child and Family Development.
Panel 3 — Nutrition and Healthy Eating. As we understand more about what defines good nutrition for youth, we are also increasingly understanding the importance of instilling healthy eating habits for youth in the context of family, school, and sport. This varied panel covers major topics within this under-considered but important area of youth development.
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Bernadette Madrid, University of the Philippines, Director of the Child Protection Unit, Philippines - Parenting support in the context of violence prevention, Expert Consultation on Family and Parenting Support, UNICEF Office of Research – Innocenti Florence 26-27 May 2014
The Youth-Nex Conference on Physical Health and Well-Being for Youth, Oct 10 & 11, 2013, University of Virginia
"Developing Sustainable Family-Centered Obesity Interventions: What Can
We Learn from Developmental Psychology and Implementation Science?"
- Kirsten Davison, Ph.D.
Davison is an Associate Professor of Nutrition at the Harvard School of Public Health. She completed her PhD at the Pennsylvania State University in Child and Family Development.
Panel 3 — Nutrition and Healthy Eating. As we understand more about what defines good nutrition for youth, we are also increasingly understanding the importance of instilling healthy eating habits for youth in the context of family, school, and sport. This varied panel covers major topics within this under-considered but important area of youth development.
Lorraine Sherr, Professor, University College London– Parenting support in the context of HIV, Expert Consultation on Family and Parenting Support, UNICEF Office of Research – Innocenti Florence 26-27 May 2014
The information contained in these slides was shared during NAEYC's 2016 Institute for Professional Development conference held in Baltimore, Maryland June 5-8, 2016. These slides consolidate much of the early intervention information shared by SFL's Director of Early Childhood Education Initiatives, Kamna Seth, and Senior Manager, Gauri Shirali-Deo. The topic presented, Understanding Early Intervention: Reflecting on the Scope, Need for Early Diagnosis, and Implementation of Early Intervention, underscores the importance of identifying developmental delays and developing educational strategies to address the needs of diverse learners.
Dr. Roy Wade's Presentation from Childhood Adversity & Poverty: Creating a Co...SaintA
Dr. Roy Wade, a pediatrician from Children’s Hospital of Philadelphia, specializes in the connection between adverse childhood experiences and urban issues such as poverty, violence and health problems. This presentation was made during our community conversation on urban ACES and trauma informed care in Milwaukee.
Mental Health From A Public Health PerspectiveMHTP Webmastere
This presentation from the Washington State Department of Health to the TWG at their April 21, 2006 meeting, looks
at the relations and connections between public health and mental health.
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From Uganda to Lebanon: Experiences with Integrating Early Childhood Development, Health and Nutrition Programs_Laura Peterson_5.6.14
1. From Uganda to Lebanon:
Experiences with Integrating Early
Childhood Development, Health and
Nutrition Programs
Presenters:
Inka Weissbecker, International Medical Corps (IMC)
Jennifer Burns, International Medical Corps (IMC)
Mary Helen Carruth, Medical Teams International (MTI)
Laura Peterson, Hands to Hearts International (HHI)
2. Early Childhood Development
• Early years of childhood form the basis of intelligence,
personality, social behavior, and capacity to learn and
nurture oneself as an adult.
• Health services/workers and providers play an important
role in promoting development of young children.
• Focusing exclusively on targeted interventions such as
health and nutrition without considering the holistic nature
of ECD risks the hindrance of children’s complete growth
and development
3. Adverse Childhood Experiences (ACEs)
ACEs include:
•multiple types of abuse
•neglect
•violence between parents or caregivers
•other kinds of serious household dysfunction
•alcohol and substance abuse
•and peer, community and collective violence
4. Early Childhood – roots of health
Toxic stress (Adverse Childhood Experiences) in childhood
creates life-long consequences for a person's health and
well-being. It can disrupt early brain development and
compromise functioning of the nervous and immune
systems.
In addition because of the behaviors adopted by some
people who have faced ACEs, such stress can lead to
serious problems such as alcoholism, depression, eating
disorders, unsafe sex, violence, HIV/AIDS, heart disease,
cancer, and other chronic diseases.
5. Times of exceptional stress?
The settings we all work in –
•Emergency & post-emergency
•Conflict & post-conflict
•Developing communities/economies
These are all times of great risk for increased family stress,
abuse, violence, neglect, hunger, illness, mental health
issues, etc…
7. Post Conflict Environment
In the Northern Uganda, post-conflict context, service
provision is continually improving as the Ministry of
Health and NGOs re-construct health facilities and
provide health services at the community level.
Characterized by food insecurity, unreliable
infrastructure, and a fragile family unit.
It is an important time to rebuild community resilience
by strengthening the parent-child bond, developing and
reinforcing positive caregiving practices to improve long
term child health and well-being.
8. Early Childhood Development in Uganda
Early Childhood Development (ECD) policy was
established in 2007.
Investment in ECD is low.
ECD services are primarily sector based. Health,
education and social services are provided in different
settings.
The Early Childhood Learning Framework developed for
ages 3-6 years. As of yet, there is no framework for the
ages of 0-3 years.
10. Approaches to Promoting Positive ECD
Practices
1) Group sessions by health staff and Peer Educators for
patients waiting for services in health facilities and
during immunization outreach
2) Before midterm Peer Educators worked in female/male
pairs led group trainings in their communities to reach
both men and women caregivers (8 - 3 hour weekly
sessions)
3) After midterm Peer Educators delivered ECD lessons
directly to caregivers in their homes (8 visits to cover
each module)
11. Indicators to track ECD Impact
Linguistic Learning: % of mothers who told a story, sang or
named objects for their child at least 2 times per week
Responsive Feeding: % of mothers who report talking or
singing to their child while feeding them
Physical Development: % of mothers who report helping
their child walk, playing a lap game, massaging or rubbing
them gently, or by giving them objects with which to play
Cognitive Stimulation: % of mothers who provide cognitive
stimulation in the form of games such as “where are your
eyes”, etc.
12. Findings from Focus Group Discussions
• Health Clinic staff reported giving ECD messages to 60-85% of
their patients
• baby massage, breastfeeding, nutrition, baby cues, language
and cognitive development and the importance of love and
affection.
• They credited the ECD trainings with improved relations
between staff and parents, increased use of HC services, and
a decrease in using traditional healers.
• They also attributed outcomes such as: improved child and
hygiene; greater affection between parent and child, with
parents being more communicative and gentle with their
child.
13. Findings from Focus Group Discussions
•Village Health Workers & Peer Educators reported giving
ECD lessons to an additional 88 people each (avg.) –
beyond their formal trainings that were documented
14. Findings from Focus Group Discussions
ECD trained parents:
•“because of the good relationship I
have established between me and
my child she now understands me
and listens to me and above all
loves me more than before”
•“children do not fear us anymore”
•“whenever my child hears the
sound of my bicycle while arriving
home, she runs out to greet me.”
15. Findings from Focus Group Discussio
•One father indicated that the ECD trainings showed him
that he had true value as a caregiver, something he had
not seen before. This realization led him to come home at
nights and not stay out drinking. At home he enjoyed the
affection his child had for him.
17. Findings from Final Evaluation
Arenas of Positive Change
1. Relationship with the child
2. Relationship between
parents
3. Health behaviors
18. Findings from Final Evaluation
•“Decreased family violence is an unexpected finding; attributed
it to the ECD interventions. ECD peer educators (PE) did teach
parents alternatives to violence when relating to their children
and parents found them effective.”
•“It is not possible to determine the causal factors for this
behavior change but we can say that in the non-ECD
intervention community, men did not talk about their wives
loving them more and they did talk about caning their
children.”
~ USAID Evaluator, Sue Leonard
19. How ECD is related to protection
Research has shown that six protective factors are linked
to a lower incidence of child abuse and neglect:
• Nurturing and attachment
• Knowledge of parenting and of child development
• Parental resilience
• Social connections
• Concrete supports for parents
• Social and emotional competence of children
20. WHO “Prevention Violence” report
Child maltreatment is in families that:
• Have difficulties developing stable, warm
and positive relationships
• Have a poor understanding of child
development, and therefore have unrealistic
expectations about the child’s behavior.
• Do not show the child much care or affection
• Have a harsh or inconsistent parenting style,
and believe that corporal punishment is an
acceptable form of discipline
21. WHO “Prevention Violence” report
1. Opportunities for parents to
practice new skills
2. Teaches parenting principles
rather than specific techniques
3. Teaches positive parenting
strategies, including age-
appropriate discipline
4. Considers difficulties in the
relationships between adults
in the family
22. Summary
ECD offers the perfect in-road to address a wide variety of issues,
and in particular, can promote safe, stable, and nurturing
relationships between children and caregivers which are protective
against neglect and abuse.
Benefits are lifelong foundation for > health, wellness and success.
Editor's Notes
ACEs - refer to some of the most intensive and frequently occurring sources of stress that children may suffer early in life.
There is significant evidence that links the circumstances of adversity and habits formed in early years to the non-communicable diseases of adulthood. – UNICEF
victims are more likely to become perpetrators and victims of other types of violence later in life
USA - lifetime cost per victim of non-fatal child maltreatment, was US$ 210,012 (est. 2010).
Emphasize:
reaching both mothers and fathers which seemed to be important to reducing family violence
Reinforcing ECD messages at different levels
By having male/female pairs as PE’s in each village, the men were very engaged and thereby improved overall outcomes
“Evidence suggests that parenting programs can be effective in preventing all forms of violence.”
Effective Parenting Programs included:
Solid program theory
Defined target population
Appropriated timed for receptivity
Acceptable to participants, relevant
Sufficient sessions
Measures and evaluations
What works? In terms of parenting education to reduce child maltreatment