Early childhood development: Not projects, but a national programme and coordinated implementation needed

Photo: Collected

Proper nutrition and care are extremely important for a child’s development in the first eight years after birth. The first one thousand days after birth are called the ‘golden days’. During this time, the foundation of a child’s development is built through nutrition, education and protection. It is very important to advise mothers who come for antenatal care at this time about the necessary food, care and safe delivery.

The need for early childhood development must be presented with due importance to parents, families and society. Information on why early childhood development matters and which factors have a negative impact on children must also be disseminated widely.

In Bangladesh, rapid early brain development takes place in children between the ages of zero and eight. Investing during this period has a positive impact in every area in the future – education, health, mental well-being, productivity and higher income.

Children are the future of the nation. So, to build a sustainable society, the start must be made with children. Taking the necessary steps for their proper development is the responsibility not only of the family, but of everyone. The values of sharing, care and empathy must be instilled in children.

But we often create wrong food habits and introduce young children to unhealthy food. Families must be made aware of these matters. Early childhood development (ECD) must be viewed in an integrated manner. If we want a child to develop, the child must first be kept alive, and to keep the child well, the mother must also be kept well.

According to Bangladesh’s Comprehensive Early Childhood Care and Development (ECCD) Policy 2013, early childhood care and development means providing all the support needed to realise every child’s right to survival, protection, care, development and education, which will ensure the desired development from the child’s foetal stage.

The policy states that a total of 15 ministries will be involved in various ways in implementing these activities. Some progress has been made in implementing them by working together with the government and partners. But making the policies fully effective requires strong leadership and commitment, which must come from the Ministry of Women and Children Affairs.

The Bangladesh government has given importance to this sector. In this regard, the Comprehensive Early Childhood Care and Development Policy 2013 is an important milestone. Alongside it, there are various programmes in the maternal health, child health, nutrition, pre-primary education, parenting and social protection sectors.

Activities related to early childhood development are dependent on development projects or the development budget. If these services can gradually be taken up as regular government activities under the revenue budgets of the ministries and institutions concerned, the scope for their sustainable implementation will increase greatly.

Realistic thinking is also needed when adding something new. Early childhood development services can be incorporated within the existing responsibilities and service structures. For example, if parenting support, early stimulation or child development messages can be linked with existing health services, pre-primary education or community-level services, it may be possible to implement them far more effectively and on a wider scale without creating any separate new structure.

Combining these three perspectives – research, practical experience and policymaking – will help set realistic priorities to take early childhood development activities forward more effectively.

UNICEF Education Manager Md Iqbal Hossain said there is a need to move away from project-based work to a national programme. All children must be included step by step within a permanent budget. This is a multi-sectoral initiative, so coordinated implementation is essential. Local government must be involved in this.

He said there are many institutions in the country, and they have the goodwill and the capacity as well. But training is of no use if there are no activities. So there is no alternative to a clear programme, leadership and accountability. Formation of the necessary department for children, regular meetings of the national technical and coordination committees, and political commitment must be ensured.

He said, ‘I want to focus on one specific area – policy, its implementation and priorities. A comprehensive ECD policy was approved in the country in 2013. Today, even after 14 years, we do not see the desired progress. The roles of 15 ministries are defined in this policy. There is a coordination structure from the national to the local level, and even a system of accountability under the leadership of the prime minister was kept. Even so, implementation has not been possible.’

In his view, the big problem is that we see early childhood development as a programme, not as a policy. Just as the health ministry bears full responsibility for implementing the health policy, the same applies to the education policy. But in the case of early childhood development, the very understanding of who will lead and who will coordinate has remained weak so far.

He said, ‘Yet this is a multi-sectoral policy, where it is essential for the coordinating agency, the implementing agencies and the ministries concerned to have specific roles. Many gaps have been seen in this coordination over the past 13 years.’

Shyamal Kumar Roy, assistant director and head of department (lab) at the Institute of Public Health Nutrition, said, ‘We previously worked from maternal and child healthcare centres; now that has come under community clinics. These clinics are trying to deliver services to every six thousand people in rural areas. Although the activities were suspended in between, they have now resumed.’

He said, ‘In terms of policy we have a great deal, and the constitution also speaks of health and nutrition. But implementation is the biggest challenge. Rather than new policies, we should coordinate and put into effect the existing policies from now on.’

While working in the nutrition sector, he has seen that there is a lack of awareness among marginalised people. Many think this service is not for them. They must be told – this is their right.

He said, ‘Maternal care begins with the antenatal care (ANC) check-up. There, it is possible to provide counselling on everything – nutrition, food habits, vaccination, physical changes, child development. After that, safe delivery, postnatal check-ups and the child’s immunisation – all must be ensured in sequence.’

Fahmida Tofail, a scientist at the Maternal and Child Nutrition Division of icddr,b, said, ‘In my view, early childhood development is a multidimensional issue. It cannot be explained or solved with any single component. Early childhood care and development has tried to capture the issue through five components, but in reality many of our programmes cannot fulfil all these components. Funding and structural limitations are also at work here.’

She added, ‘We must put more emphasis on the period of pregnancy. Research has shown that the period of pregnancy is extremely important for a child’s development. Rapid brain development takes place from the very beginning of pregnancy, and a vast number of connections are formed every second until three years after birth. Here, along with the mother’s preparation, the preparation of the whole family is also essential.’

‘In particular, we have looked at the issue of maternal mental health with importance in our research. I think it is possible to link this with antenatal care, which can also be effective from an implementation point of view.’

Instead of taking up separate new programmes, it is more realistic to incorporate the issue through the existing infrastructure – such as community clinics, nutrition programmes or social protection programmes. However, for this the programmes must be simple, trainable and implementable. Ensuring coordination among the various sectors is also essential in this regard.