Building capacity in health and education systems to deliver interventions that strengthen early child development

Abstract

Building capacity within health and education systems of low- and middle-income countries in order to deliver high-quality early childhood services requires coordinated efforts across sectors, effective governance, sufficient funding, an adequate workforce, reliable data systems, and continuous monitoring, evaluation, and improvement cycles; it also requires partnerships with the private sector, communities, and parents. In addition, building capacity requires leadership, innovation of strategies to fit into existing structures, evidence-based intervention models, and effective partnerships that help make interventions more culturally relevant, help finance them, and help create institutional long-term support and sustainability for them. In this article, we focus on identifying eight critical aspects of enabling systemic support for early childhood services. Every action that strengthens these critical aspects should be seen as necessary, but insufficient, steps toward a national strong governance structure for delivering a locally relevant and comprehensive early child development program that promotes children's developmental potentials.

What implementation evidence matters: scaling‐up nurturing interventions that promote early childhood development

“…The components of taking interventions to scale described under dimension 2 require not only evidence-based models, but also leadership, adequate workforces, effective partnerships with a range of implementation stakeholders, financing, and governance as shown in the framework reported by Nores and Fernandez drawing on lessons learned from scaling-up in the health and education sectors. 34 However, few studies have focused on these components. Cost data about nurturing interventions that might inform financial planning for programs at scale are limited, but employing standardized costing tools outlined by Gustafsson-Wright and Bogglid-Jones provides a way forward.…”

Diffusing and scaling evidence‐based interventions: eight lessons for early child development from the implementation of perinatal home visiting in South Africa

“…The majority of this science is concerned with the latter question, particularly fidelity to manualized interventions or questions of intervention duration (dosage), “implementation fidelity” being the degree to which interventions are implemented as dictated by the program manual/or as intended by the intervention's creators . The value of these evidence‐based features is clear (and elaborated by Nores and Fernandes). Yet, there is a need to conduct systematic replication work, with attention to context, when manualized interventions have shown efficacy.…”

Implementing aeioTU: quality improvement alongside an efficacy study—learning while growing

“…A set of 11 professional development workshops were developed on (1) positive discipline in the aeioTU experience and the importance of relationships and interactions; (2) play as a learning strategy in the aeioTU experience; (3) pedagogical tools and their use in classrooms, sensory areas, and common areas; (4) assessment of children's development and learning in the aeioTU experience; (5) sensory areas, their dynamics, intention, and contribution to the development and learning of children; (6) documentation as a learning tool in the aeioTU educational experience; (7) transition moments and their contributions to children's learning and development; (8) thought and language abilities through the learning strategies in the aeioTU educational experience; (9) r Internal pedagogical committees were established in all centers to assess the child monitoring and evaluation processes, as well as the implementation of learning strategies;…”

“…While quality may mean different things in different contexts, quality requires that attention is paid to the coherence of a program, its content, its participants, trainings, monitoring, and evaluation (see Ref. ), among other things. Understanding the quality of a program also requires understanding its implementation, e.g., any course corrections done early on, whether it was evaluated, how data were used, and what changes were made, for scalability and replication (see Ref.…”

“…Colombia advanced a comprehensive strategy on early childhood development (ECD) in 2011. 6,8,9 There is a national strategy known as De Cero a Siempre (DCAS) aimed at increasing access and improving the quality of early childhood services provided to poor children. Its objective is to deliver high-quality integrated early childhood services for 1.2 million in poverty under age 6.…”