Nurturing Care
For Early Child Development
Project Title
Nurturing Care for Early Child Development: Using the common elements approach to develop an integrated and scalable intervention for at risk mothers and children in Pakistan
Year
2019-2021
Collaborators
World Health Organization, Geneva, University of Liverpool, UK & Human Development Research Foundation (HDRF), Pakistan
Project Information
35-45% children are undernourished and over 40 million lags behind in their cognitive and socioemotional development in South Asia. Millions of children in low resource settings are at high risk of poor development due to factors such as undernutrition, inadequate stimulation and maternal depression. Evidence based interventions to address these risk factors exist, but often as a separate and overlapping packages delivered through disjointed systems, therefore posing problems in scale-up.
To address this, we proposed two innovations. First, we developed, using a common elements approach, a single integrated package that combines evidence-based elements from packages of care addressing early stimulation, responsive feeding and perinatal depression. Second, we developed an online training platform for non-specialists including community health workers and caregivers to be trained in the intervention.
The core components of common elements-based intervention are;
The core components of common elements-based intervention are;
- Maternal Psychological Well-being
- Family support during pregnancy, child birth and breast feeding
- Behavioral activation, problem solving, praise, positive reinforcement of desired behaviors, engagement of family and improving social support
- Child Development
- Improving maternal sensitivity and responsiveness towards infants by providing knowledge and resources to enable pleasurable and responsive play activity
- Nutrition
- Psychoeducation and behavior change about infant nutrition and feeding
- Responsive feeding
- Early initiation of breast feeding
- Exclusive breast feeding for six months
The ‘Nurturing Care Intervention’ is being implemented in a rural sub-district of Rawalpindi, in close collaboration with government programmes. It is being evaluated through an individual randomized controlled trial involving over 250 mother-infant dyads followed up over 12-months. The outcomes include assessment of caregiver-child interaction, infant’s development, quality of the home environment, maternal distress, social support and quality of life.
Early child development and infant nutrition are global priorities. Scalable interventions that integrate key theoretical constructs influencing ECD and employ effective measures to overcome implementation barriers are few and far between. The common elements approach can provide a new way of developing interventions that can improve the health, well-being and future potential of the population.