Early Childhood Comprehensive Care Strategy Political, Technical and Management Fundamentals

Home , Alejandro Gaviria Uribe, Juan Manuel Santos

EARLY CHILDHOOD COMPREHENSIVE CARE STRATEGY POLITICAL, TECHNICAL AND MANAGEMENT FUNDAMENTALS

Early Childhood Comprehensive Care Strategy POLITICAL, TECHNICAL AND MANAGEMENT FUNDAMENTALS

Coordination of the document Constanza Liliana Alarcón Párraga

Compil ation and production of the final te x t Marina Camargo Abello Adriana Lucía Castro Rojas

Editing Mariana Schmidt Quintero Carolina Turriago Borrero

Proof reading Lilia Carvajal Ahumada

Design and l ayout Misty Wells & Zea Asociados

Printer Panamericana Formas e Impresos S.A.

Bogotá D.C., Colombia 2013 ISBN 152152 Office of the President - R epublic of Colombia President Juan Manuel Santos Calderón

“De Cero a Siempre” Str ategy Spokeswoman María Clemencia Rodríguez de Santos

High Counseling for Special Progr ams. Office of the President High Presidential Advisor for Special Programs María Cristina Trujillo de Muñoz

National Pl anning Department General Director Tatiana Orozco Social Develoment Director Lina María Castaño Mesa

Ministry of Health and Social Protection Minister Alejandro Gaviria Uribe Deputy Minister for Public Health and Service Providers Fernando Ruiz Gómez

Ministry of National Education Minister María Fernanda Campo Saavedra Deputy Minister for Pre-school, Basic and Middle School Julio Salvador Alandete

Ministry of Culture Minister Mariana Garcés Córdoba Deputy Minister of Culture María Claudia López Sorzano

Department for Social Prosperit y Director Gabriel Vallejo López Deputy Director Mariana Escobar Arango

Colombian Family Welfare Institute General Director (Acting) Gabriel Vallejo López Early Childhood Director Natalia Velasco Castrillón

National Agency for Overcoming E x treme Povert y (ANSPE) General Director Beatriz Linares Senior Management Advisor Ingrid Rusinque Osorio

5 Early Childhood Comprehensive Care Strategy

Technical Team of the Intersectoral Commission for Early Childhood Comprehensive Care

High Counseling for Special Progr ams. Office of the President Intersectoral Commission Coordinator Constanza Liliana Alarcón Párraga

National Pl anning Department Health Deputy Director Anwar Rodríguez Chehade Advisor to the Social Development Director’s Office Juan Guillermo Alba Garzón

Ministry of Health and Social Protection Advisor to the Minister’s Office Ana María Peñuela Poveda Lifetime Group Coordinator Martha Imelda Linero

Ministry of National Education Early Childhood Director Ana Beatriz Cárdenas Restrepo Early Childhood Quality Deputy Director Claudia Milena Gómez Díaz

Ministry of Culture Arts Director Guiomar Acevedo Gómez Populations Director Moisés Medrano Bohórquez Early Childhood Advisor Sandra Argel

Social Prosperit y Department Advisor to the General Deputy Director Angélica María González Advisor Miguel Mauricio Ortega Colombian Family Welfare Institute Early Childhood Director Natalia Velsasco Castrillón Director of the National Family Welfare System Yebrail Haddad Technical Management Deputy Director for Early Childhood Care Carlos del Castillo Cabrales Operations Deputy Director for Early Childhood Care Javier Medina National Agency for Overcoming E x treme Povert y (ANSPE) Institutional and Territorial Supply Manager Juliana Sánchez Calderón Advisor to the Early Childhood Dimension of the Institutional Offer María Consuelo Castro

6 Early Childhood Comprehensive Care Strategy

Technical Team of the Entities Contributing to the Reference Studies

Ministry of National Education Ana Aideé Pachón Durán • Angélica María González Acevedo Carolina Pedroza Bernal • Doris Andrea Suárez Pérez Hellen Maldonado Pinzón • Luz Ángela Caro Yazo Nidia Esperanza Buitrago Rodríguez • Patricia Helena Torres Salazar Pedro Antonio Barbosa Caicedo • Sara Elena Mestre Gutiérrez

Ministry of Culture Carolina Ospina • Claudia Mejía Fabio Alberto López • Graciela Prieto Juan Carlos Flechas • Juan Sebastián Suanca Margarita Ariza • María Teresa Jaime Pilar Bermúdez

Colombian Family Welfare Institute Early Childhood Director’s Office Ana María Ortíz Hoyos • Diana Marcela Rodríguez Ríos Gerson Orlando Bermont Galvis • Gladys Nubia Hernández Gloria Carvalho Vélez • Luz del Carmen Montoya Rodríguez Luz Marina Hoyos Vivas • Mary Luz Cárdenas Fonseca María del Carmen Bernal Latorre • Milbany Vega Salinas Yaneth Cecilia Romero Gamarra • Yohana Amaya Pinzón Nutrition Directorate Ana María Ángel Correa • Ángela Patricia Guarnizo Cárdenas Cenyde Leal Rodríguez Protection Directorate Alexandra Margarita Herrera Puente • José Antonio Romero Villarreal Family Directorate Blanca Leticia Arteaga Díaz • Claudia Marcela Rangel Esparza Martha Yaneth Giraldo Alfaro

Director of the National Family Welfare System Constanza Liliana Gómez Romero

Ministry of Health and Social Protection Adriana Estrada • Aldemar Parra Amanda Valdés • Ana María León Ana María Ortiz • Ana María Peñuela Poveda Ana María Rodríguez • Ana Margaret Raba Andrés Motta • Arturo Quintero Vergara Blanca Stella Patiño • Carolina Chica Zapata Carolina Delgado Torres • Catalina Borda Villegas Claudia Helena Prieto • Constanza Castilla Dayana Gómez • Diego Alejandro García Diva Jeaneth Moreno • Elsy del Pilar González Esperanza Lara • Fernando Ramírez Campos Gina Marcela Alba Díaz • Gloria Isabel Puerta Gloria Ochoa • Gonzalo Gutiérrez Isabel Cristina Idárraga V. • Javier Ricardo Bohórquez

7 Early Childhood Comprehensive Care Strategy

Jeannett Adriana Umaña • Jorge Eduardo Suárez José F. Valderrama • José Luis Ortiz Jovana Ocampo • Juan Carlos Correa Juan Manuel Rodríguez • Juan Pablo Corredor Lely Stella Guzmán • Leonardo Arregocés oenza Beatriz Ospino • Lía Marcela Guiza Luis Carlos Olarte • Luz Emilse Rincón Luz Stella Méndez • Marcela Calle Margarita García • María Elena González Martha Álvarez • Martha Patricia Ospino Martha Imelda Linero • Mery C. Bolívar Myriam Lucía Ramírez • Patricia Delgado Rodríguez Ruth Yelitza Rubio • Sandra Tovar Sara J. Torres M. • Yennifer Viviana Cano Yennifer Mariño

Administr ative Sports, R ecreation, Physical Activit y and Enjoying Free Time Department – Coldeportes – Diana Marleny Duque Giraldo

Special acknowledgments to Beatriz Londoño Soto Former Director of the ICBF, former Minister of Health and Social Protection, International expert on early childhood development. Colombia

Diego Andrés Molano Aponte Former Director of ICBF

Verónica Silva Villalobos Social Protection Consultant in Latin America and the Caribbean - World Bank

International entities providing feedback for the document World Bank Interamerican Development Bank Organization of Iberoamerican States for Education, Science and Culture Organization of American States (OAS) Panamerican Health Organization (PAHO)

8 Early Childhood Comprehensive Care Strategy

Specialists who wrote the reference studies that underpinning the present document

Adriana Lucía Castro Rojas • Alberto Vélez Ángela Patricia Nocua Cubides • Blanca Luz Hoyos Henao Consuelo Angarita • Deidamia García Quintero Doris Andrea Suárez Pérez • Eliana Ramírez Elsa Castañeda Bernal • Ernesto Durán Strauch Esperanza Osorio Correa • Fadua Kattah Graciela María Fandiño Cubillos • Hellen Maldonado Pinzón Leonor Isaza Merchán • Luz María Babativa Javier Augusto Medina Parra • María Victoria Estrada María Consuelo Martín Cardinal • Marina Camargo Abello Marina Llanos • Martha Lorena Padrón Gómez Nora Corredor Martínez • Nisme Yurani Pineda Báez Paula Quintero • Sandra Marcela Durán Chiappe Yolanda Reyes Villamizar

With the support of: Camilo Ernesto Peña Porras • Jaime Rafael Vizcaíno Pulido

And recommendations by: Alejandro Acosta Ayerbe Ascofade Graciela María Fandiño Cubillos • Leonor Isaza Merchán María Cristina Torrado Pacheco • María Inés Cuadros Ferrer Marta Torrado Pacheco • Manuel Manrique Castro Olga Alicia Carbonell Blanco

International Development Experts Providing Feedback for the reference studies

Cassie Landers • Clyde Hertzman (R.I.P.) Jane Squires • Juan Narbona Helia Molina • Magdalena Janus Mary Young • Norma Reategui • Paula Bedregal • Sally Brinkman

9 Early Childhood Comprehensive Care Strategy

Photography Credits

Adriana Lucía Castro, pages 68 and 158 Adriana Gómez (Ministry of Culture), page 80 Candelaria Martínez (Agreement 442, 2012 for Early Childhood Comprehensive Care), pages 52, 102, 203d and 222

Carolina Turriago Borrero, pages 18, 39, 43, 47, 67, 93, 98, 109, 149, 189a and 197d César Carrión (Press Office, Office of the President), pages 40, 44, 56, 134, 138 and 141 Diego Díaz (High Counseling for Special Programs. Office of the President), page 173 Luis Eduardo Díaz, page 238 Elizabeth Sánchez (Sueños Alegres Kindergarden, San Andrés), pages 105 and 121 ICBF Team, page 234 Ventana de Infancia Team, United Nations, pages 213c and 230 Presidency Team, page 83, 86, 106, 133 and 242 Ministry of Culture Team, page 182 Ministry of Health Team, pages 114, 122, 137, 177, 189b and 189d Ingrid Marcela Moreno (Agreement 442, 2012 for Early Childhood Comprehensive Care), pages 126 and 213a

Juan Gabriel Muñoz (ICBF Press Office), pages 17, 21, 35, 51, 72, 75, 76, 84, 90, 113, 142, 145, 153, 161, 162, 178, 183 and 221

Laura Mercedes Hoyos (Agreement 442, 2012 for Early Childhood Comprehensive Care), pages 60, 110, 125, 164, 189c and 241

Liliana Ávila (Agreement 442, 2012 for Early Childhood Comprehensive Care), pages 36, 130 and 197c,

Linda Flor Salazar (Agreement 442, 2012 for Early Childhood Comprehensive Care), pages 63, 174, 203b, 213b and 229

Luisa Fernanda Juliá (High Counseling for Special Programs. Office of the President) front cover and pages 22, 30, 59, 64, 79, 94, 97, 117, 118, 129, 137, 146, 154, 157, 166, 170, 181, 187c, 187d, 197b, 225, 226, 233 and 237

Mariana Schmidt (Agreement 442, 2012 for Early Childhood Comprehensive Care), pages 55 and 213d

Paola Andrea Rueda (Agreement 442, 2012 for Early Childhood Comprehensive Care), page 187a

Resguardo Inga de Aponte (Agreement 442, 2012 for Early Childhood Comprehensive Care), page 187b

Sara Montoya (Reserva para la Infancia Foundation), page 101 Tatiana Ángel Muñoz (Reserva para la Infancia Foundation), pages 48, 71, 203a and 203c

10 Contents

Introduction ...... 15

Reference Studies Underpinning this Document ...... 25

First part Context for the Early Childhood Comprehensive Care Strategy in Colombia ...... 31

The Situation of Colombian Children under the Age of Six ...... 33

• Demographic Data ...... 34 • Caregiving and Upbringing ...... 35 • Health, Food and Nutrition ...... 38 • Initial Education ...... 43 • Recreation ...... 44 • Participating in and Exercising Citizenship ...... 45

Early childhood public policy in Colombia: a path to continue building ...... 47

• Early Childhood Care Before the Constitution of 1991 ...... 48 • Constitution of 1991 and Early Childhood . . . .61 • Generating Conditions to Draw Up an Early Childhood Public Policy ...... 62 Early Childhood Comprehensive Care Strategy “De Cero a Siempre” ...... 75

• Country Developments Compiled by the Strategy to Carry On ...... 76 • Challenges posed by the Strategy ...... 82

Second part Technical Grounds for Early Childhood Comprehensive Care Strategy ...... 87

Conceptual Grounds for the Early Childhood Strategy ...... 89

• Understanding Girls and Boys in Early Childhood from a Rights-Based Approach ...... 89 • Early Childhood Development ...... 94 • The Family’s Role ...... 103 • Environments where Children Develop . . . . .108

Comprehensive Care Fundamentals ...... 117

• Comprehensive Protection, an Action Framework for the Strategy ...... 117 • Children’s Rights and their Realizations: The Strategy’s Commitment ...... 121 • Early Childhood Comprehensive Care . . . . . 124 • Early Childhood Comprehensive Care Structuring Factors ...... 126 Third part Management of Comprehensive Care Strategy for Early Childhood: Institutions, Comprehensive Care Road-map, and Lines of Action ...... 167

Comprehensive Management Favoring Child Development ...... 169

The Strategy of Comprehensive Early Childhood Care: Relationship with Various State Agencies . . . 171

• The National Family Welfare System (SNBF) . . .171 • The Intersectoral Commission for Comprehensive Early Childhood Care . . . . 172 • National and regional bodies coordinated in favor of comprehensive early childhood development . .175

The Comprehensive Care Roadmap: Guidance for Management in Territories ...... 178

• RIA classifying criteria ...... 179 • The RIA, a Collective Production ...... 184 • A Roadmap Tailored to each Territory . . . . . 220 • Comprehensive Care Plan: Road to action . . . .223

Each girl and each boy in the Strategy ...... 225

• Adjusting modalities and services, and their transit into comprehensiveness . . . . 227 Lines of Action ...... 228

• Territorial management ...... 229 • Quality and coverage ...... 232 • Monitoring and evaluation of public policy . . . .239 • Social mobilization ...... 241 • Knowledge management ...... 242

Bibliography ...... 245 Introduction

The Early Childhood Comprehensive Care Strategy positions pregnant women, girls and boys from birth until the age of six in the center of action.1 Conceiving them as holders of rights, as unique and singular beings, active in their own development, valid and holistic interlocu- tors, and recognizing the State, the family and society as their duty bearers have set the pace of the Strategy.

The great challenge is being consistent with this posture from San Andrés y Providencia Islands to the Amazonas, in the central government and in the governments of the most remote regions, as well as in urban and rural areas. Colombia is committed to a long term ambitious project convening all the stakeholders involved in the development of children, throughout the whole country, in its full depth, diversity and complexity.

This is an ethical imperative, a vital intention of the nation recognizing the journey undertaken by the country towards an early childhood public policy, with different sectors of society collecting and discussing ideas, contrasting postures and experiences to reach agreements. It is strongly supported by scientific developments and conscientious studies of strategies carried out previously in Colombia, and also elsewhere, setting the basis for the country to act coherently towards the holistic development of early childhood, which is still under construction.

Looking at the historic transformations of this topic throughout the existence of mankind, clearly the concern for early childhood is very recent.

Quite possibly in some years we will not have to justify collective actions on this matter. Maybe society will soon consider it obvious that children must always be in first place and at the center of all comprehensive care.

1 Early Childhood comprises the period between pregnancy and the age of five years, 11 months and 30 days. Therefore throughout this document this period is called “from zero to five” (understanding that it concludes at the end of the 5th year) or “From zero until the 6th birthday”.

15 Early Childhood Comprehensive Care Strategy

But those days have not arrived yet, and furthermore a large amount of research on human development2 has shown that most of the brain connections3 as basic language skills, motor skills and symbolic thinking and the basis for social interaction occur between pregnancy and the age of six. This means that although development occurs over life, the grounds are set during the first years increasing the complexity of the capabilities, skills and potentials of each person.

If this is the case, it is only natural to expect the State and society to make enormous efforts to ensure that these beings starting their lives have the necessary conditions for an optimum development and to fully live from the moment they are conceived. As stated in the very first lines, Colombia has committed to this, acknowledging the categorical imperative of early childhood rights.

Since the nineteen sixties the country has undergone important transformations on the conception of children and the care they should be provided, and consequently in 1990 Colombia formalized its adhe- sion to the International Convention on the Rights of the Child. The approval of the International Convention on the Rights of the Child by the Congress of the Republic of Colombia (Law 12, 1991), its inclusion in the Political Constitution of 1991 (Article 44) and passing of Law 1098, 2006 whereby the Childhood and Adolescence Code was enacted were other extremely important milestones. The challenge is that comprehensive care to early childhood is a permanent and sustainable responsibility of the State, essentially for ethical and political reasons.

In line with scientific and economic research4, the Colombian State embraces the evidences on human development stating that a

2 See for example Margaret Norrie McCain and J. Fraser Mustard (2002). The Early Years Study. Three Years Later and C. Nelson (2000) From Neurons to Neighborhoods.

3 Approximately 85%.

4 See for example J. Heckman and P. Carneiro (2003). Human Capital Policy. National Bureau of Economic Research – Working Paper 9495; L. Schweinhart (2004). The High/Scope Perry Preschool Study Through Age 40: Summary, Conclusions and Frequently Asked Questions. The High/Scope Educational Research Foundation; A. Rolnick & R. Grunewald (2003). Early Childhood Development: Economic Development with a High Public Return. The Region 17, 4, Supplement; A. Rolnick & R. Grunewald (2006). A proposal for achieving high returns on Early Childhood Development. Harvard Graduate School of Education, 10.

16 Introduction

good quality of life during childhood is reflected in adulthood and therefore the consequences of investment in health, education and social cohesion make it the most effective way of breaking the circle of poverty and considerably closing the gaps of inequality5. It is common knowledge that for Colombia it is still a challenge to make progress in inequality. Not just in ethical terms but also in strategic ones, the country is aligned with numerous studies evidencing that investing in early childhood is the most profitable investment society can make since it has the longest return period and it also results in less social investment in the long term.

5 Van der Gaag (2002). From Childhood Development to Human Development. In: M. Young (ed.), From Early Childhood Development to Human Development. Investing in our Children’s Future. Washington: World Bank.

17 Early Childhood Comprehensive Care Strategy

Seeking the Consolidation of a Public Policy

In 2010 the Ministries of Finance, Education and Social Protection and the Colombian Family Welfare Institute (ICBF acronym in Span- ish) hired a study and the outcome was a diagnosis of the situation on early childhood care in the country. It also examined international We turn like relevant experiences, it explored public-private partnerships that could the dolphins, be implemented to increase coverage and quality of early childhood we kick, we rest on the tips care, and it presented a set of proposals and recommendations to make of our toes at the institutions, regulations, standards and finances suitable to ensure the base of the universal care coverage for early childhood vulnerable populations. belly as if we were stretching Since one of the recommendations of the study was to create an upwards; we articulating and coordinating body for comprehensive care, a technical move our team was formed to agree on and consolidate a proposal and the action arms and our plan for the coming years. The results were reflected and included as a legs . We make priority in the “2010 – 2014 National Development Plan: Prosperity for these sudden All”6 wherein the government committed to design and implement a movements strategy involving decisive actions of the government sectors, planning, and startle our mothers . health, education, culture and wellbeing. Law 1450, 2011 enacting the Development Plan set out goals and specific investments for early childhood based on supplementary legal and technical developments, considering that early childhood comprehensive care will be a permanent and sustainable action of the State.

In response to the provisions of the Development Plan, the Early Childhood Comprehensive Care Intersectoral Commission was created (Decree 4875, 2011); and the Office of the President, the Ministries of Health and Social Protection, National Education, Culture and the Na- tional Planning Department, the National Department for Social Pros- perity and the Colombian Family Welfare Institute have a seat on this commission. Its role is to coordinate and harmonize policies, plans, programs and actions required to provide early childhood comprehen-

6 Colombia, Congress of Colombia (2011, June 16) Law 1450, 2011 whereby the 2010 – 2014 National Development Plan is enacted. Bogotá. Official Journal No. 48.102 Available at http:// www.secretariasenado.gov.co/senado/basedoc/ley/2011/ley_1450_2011.html

18 Introduction

sive care, being accountable for securing agreements between the different sectors involved.

The challenge of progressing towards an intersectoral goal needed the Government to define a mechanism to enhance convening and governance capabilities in the Intersectoral Commission, without weaken- ing the institutions but strengthening the competences of all the member sectors. Consequently the Decree provided that the Commission would be chaired by a senior government official directly appointed by the President of Colombia.

The efforts of the Commission are steered towards strengthening the institutions, ensuring leadership in each of the sectors involved, guaranteeing commitment of the directors and suitability of the technical team, and mobilizing resources and actions to ensure full development of the children through comprehensive care.

In connection with the objectives, the Commission’s actions are geared towards i) defining a long term, sustainable and universal early childhood comprehensive care policy with a population and territorial approach; ii) guaranteeing relevance, quality and articulation of the programmatic and social actions inherent to early childhood comprehensive care since before the conception and until the transition to formal education; and iii) developing a social mobilization process inspiring the understanding of early childhood and the interactions established with children in the different environments of life, with references embracing their integrality and human dignity.

The Commission has a technical committee comprising everybody responsible for directing early childhood programs and projects in each of the member entities. This committee is accountable for producing national and territorial programmatic elements and policies, and articulating and guiding the technical decisions taken in the Commission.

Also the Early Childhood Comprehensive Care Intersectoral Com- mission has a technical secretariat.

19 Early Childhood Comprehensive Care Strategy

Design of the Early Childhood Comprehensive Care Strategy

One of the first tasks undertaken by the Commission was to design the Early Childhood Comprehensive Care Strategy implemented as national and territorial planned actions, to promote and guarantee child development of girls and boys since pregnancy and until they turn six. Through unified and intersectoral work -from a rights-based approach and with a differential approach- it articulates and promotes the development of plans, programs, projects and actions for comprehensive care to be ensured for every child, according to their age, context and condition. Knowledge management promoted by the Commission, as well as the social mobilization inspired for debating and giving feedback on the different achievements accomplished are of extreme importance.

In order to design a public policy based on evidence, the Commis- sion hired studies on the implementation of the strategy, its financial sustainability, institutional capabilities, human talent supply and demand, child development, birth defects, among other matters. It also convened Colombian experts on early childhood to draw up technical guidelines in preparation for this document and it encouraged direct exploration with the community to identify early childhood differential features. The products delivered by these experts served as input for other materials to accompany the policy executors in their different fields of action.

Regarding mobilization, the Commission encouraged territorial dialogs and implemented face to face and virtual mechanisms for the citizen’s participation in providing feedback on the technical instruments and proposals developed to date. They have contributed to presenting a strategy to the country today with background, institutional framework, conceptual grounds, techniques and management based on the idea of building on the foundations, as regards to early childhood rights, under the State’s long term perspective and the potentials of articulated intersectoral actions.

20 Introduction

As a result of the two year’s work framed by the agreement of various entities and sectors of the population, the Commission presents a strategy based on understanding and empirical evidence, offering very specific guidelines to organize the actions in the territories favoring early childhood and with the characteristics pertaining to all the places where there are children. One of the tools resulting from this study is the Early Childhood Comprehensive Care Roadmap (RIA, acronym in Spanish), which undoubtedly will tune all the country to ensure that every child develops integrally.

What has been Implemented

Since the Strategy is committed to the present, efforts have also been conducted towards its implementation. This has entailed a large mobilization of public and private resources, as well as international cooperation, all joining efforts in successfully supporting comprehensive care tasks like infrastructure, access to cultural goods and services and qualification processes of education, health and culture agents throughout the country.

21 Early Childhood Comprehensive Care Strategy

At the territorial level, through the National Family Welfare System and with the decisive support of international cooperation, the Strat- egy has deployed its technical cooperation for the territorial governments to become acquainted with, take ownership of and implement the instruments built to drive the execution of the early childhood policy. In the framework of the territorial dialogs, it has opened settings for national and local intersectoral meetings to jointly analyze technical support requirements and to establish working agreements. Based on specific requests and undergoing processes in the territories, the Commission has provided direct technical accompaniment, has sought the support of experts on very specific matters and has revised and presented recommendations to proposals and documents developed by the territorial entities.

Additionally it has favored exchanges and internships between of- ficials of the territories and meetings of working experience promoters with early childhood in different contexts and with different populations to enrich the technical perspective provided by having contact with previously tested knowledge and experiences.

From a monitoring perspective, the Strategy has taken important steps in three different fields. Under the Unique Children’s Informa- tion System (SUIN, acronym in Spanish) providing information on the holding of children’s rights, it has introduced early childhood indicators; also progress has been made in harmonizing systems and procedures to record and track the care that the National Family Wel- fare System offers to children; and a tracking system for every single child is being structured as one of the fundamental axis for the Strat- egy’s implementation.

The Strategy has put important efforts into the qualification of the human talent offering care to the children during their early childhood,

22 Introduction

driving training processes in the territories under the comprehensive care model, emphasizing on children’s rights, children’s development and the differential approach, among other topics.

This Document

The fundamentals of the Strategy are set out below for them to be revealed, understood, shared and put into practice by all the stakeholders sharing the responsibility of providing fulfilling, decent and happy lives to Colombian children.

The document is structured in three parts: the first one: “Context for the Early Childhood Comprehensive Care Strategy in Colombia” stages a quick overview of early childhood, its progress and challenges, and a summary of the main events marking the transformations in the country on how to understand children, until reaching the postures currently showing the way. This first part points out the main components that the Strategy reassesses to continue making progress, as well as the challenges undertaken to effectively guarantee the rights of the people whose lives are just beginning.

The second part of the document presents the “Technical Grounds for the Early Childhood Comprehensive Care Strategy” organized in two fields: conceptual foundations as regards to early childhood and those of comprehensive care.

The third part presents the core components of management towards a comprehensive development of children under the age of six, the relationship of the Strategy and the different State bodies, the lines of action, and maybe one of the most promising developments of the Strategy –The Early Childhood Comprehensive Care Roadmap- a use- ful tool to organize actions in the territories.

23 Early Childhood Comprehensive Care Strategy

The Strategy, Commitment to Early Childhood

The Early Childhood Comprehensive Care Intersectoral Commis- sion invites all the country to seal a commitment with early childhood, towards ensuring that children can develop and lead their lives just as they wish, to advocate for their environments, to contribute to the development of their communities from the moment they are born and to continue doing so throughout their lives.

This means that knowledge, experience and background, as well as technical, administrative and financial resources need to be available for the process. The Commission fully understands that this will only be possible if all the country participates based on trust relationships between the parties, on collective and transparent cooperation attain- ing important results on innovation, quality, integrality and social inclusion.

The invitation is to generate mutual listening situations between the different stakeholders in order to define and prioritize actions related to early childhood comprehensive care, based on the requirements of the territory and to establish a joint working agenda.

Only then can we say that the commitment for the full development of early childhood has been sealed by the State, the family and society, in each of the territories in the country.

24 Reference Studies Underpinning this Document

In order to design the Early Childhood Comprehensive Care Strategy fundamentals and the technical guidelines, the Early Childhood Comprehensive Care Intersectoral Commission hired studies and their outcome served as the reference for the preparation of this Document and other material used for its implementation. The Commission thanks the authors for their contributions, as well as the agencies who participated either through cooperation agreements or with direct funding.

• Situation of Children During Early Childhood Ángela Patricia Nocua Cubides Cooperation Agreement 442, July 26, 20127, Early Childhood Com- prehensive Care. 2013

• “Cero a Siempre” Tells You: The Current Situation of the Children from Pregnancy up until their First Two Years of Life in Colombia Jaime Vizcaíno Cooperation Agreement 442, July 26, 2012, Early Childhood Compre- hensive Care. 2013

• Technical Fundamentals of the Comprehensive Care Strategy Marina Camargo Abello and Adriana Lucía Castro Rojas With the support of the Inter- American Development Bank 2012

7 This Agreement was executed between the Ministry of National Education, the Ministry of Health and Social Protection, the Ministry of Culture, the Colombian Family Welfare Institute, the Saldarriaga Concha Foundation, the Éxito Foundation, the United Nations Children’s Fund (Unicef), the Bancolombia Foundation and the Génesis Foundation.

25 Early Childhood Comprehensive Care Strategy

• Technical Guidelines for Promoters of Development Environments Ernesto Durán Strauch Coordinated by the Ministry of Health and Social Protection and supported by the Inter- American Development Bank 2012

• Technical Guidelines for the Comprehensive Protection in the Exercise of Children´s Rights since Early Childhood Martha Lorena Padrón Gómez Coordinated by Colombian Family Welfare Institute 2012

• Analysis of the Most Significant Experiences Developed and Guided Towards Strengthening the Family for Full Development of Children and Adolescents Leonor Isaza Merchán, with the collaboration of Carmen Midaglia and Héctor Rodríguez Coordinated by the Colombian Family Welfare Institute. Supported by the Inter-American Children’s Institute (OAS). 2011

• Technical Guidelines on Education and Accompaniment for Families with Children in Early Childhood Angela Patricia Nocua Cubides Coordinated by the Colombian Family Welfare Institute. Supported by the Inter-American Children’s Institute (OAS). 2012

• Technical Health Guidelines in Early Childhood Blanca Luz Hoyos Henao Coordinated by the Ministry of Health and Social Protection. Support- ed by the Inter- American Development Bank 2012

• Technical Food and Nutrition Guidelines for Early Childhood Nora Corredor Martínez Coordinated by the Ministry of Health and Social Protection. Support- ed by the Inter- American Development Bank 2012

26 Reference Studies

• Pedagogic Guidelines on National Initial Education Graciela María Fandiño Cubillos, Yolanda Reyes, Sandra Marcela Durán Chiappe and María Consuelo Martín Cardinal Coordinated by the Ministry of Health and Social Protection. Support- ed by the Inter- American Development Bank

• Recreation Guidelines Esperanza Osorio Correa Coordinated by the Administrative Sports, Recreation, Physical Activ- ity and Enjoying Free Time Department –Coldeportes-. 2013

• Feeling and Doing, Growing and Creating: Guidelines for the Participation in and Exercise of Citizen Rights in Early Childhood Elsa Castañeda Bernal and María Victoria Estrada Coordinated by the Ministry of Culture and the Rafael Pombo Foun- dation 2012

• Manual on the Territorial Implementation of the Early Childhood Comprehensive Care Strategy Deidamia García Quintero and Javier Medina Parra Supported by the World Bank 2012

• Recommendations for Incorporating the Differential Approach in the “Cero a Siempre” Strategy Carolina Turriago B., Clemencia Ángel :, Liliana Ávila G., Marina Bernal G., Laura Victoria Gómez C., Laura Mercedes Hoyos G., Candelaria Martínez M., Ingrid Marcela Moreno P., Paola Andrea Rueda C., Linda Flor Salazar A., Mariana Schmidt Q and Orlando Scoppetta Díaz G. Cooperation Agreement 442, July 26, 2012, Early Childhood Compre- hensive Care. 2013

• “De Cero a Siempre”: Towards Systematizing the Construction Process Germán Mariño Solano Cooperation Agreement 442, July 26, 2012, Early Childhood Compre- hensive Care.

2012 27 Early Childhood Comprehensive Care Strategy

• Guidelines for Human Talent Qualification Nisme Yurani Pineda Báez, Leonor Isaza Merchán, Luz María Babativa, Fadua Kattah, Marina Camargo Abello, Cristina Álvarez, Ángela María Hernández, Carolina Ordóñez and Paula Quintero. Team of the Fundación Centro Internacional de Educación y Desarrollo Humano (CINDE) Cooperation Agreement 442, July 26, 2012, Early Childhood Compre- hensive Care. 2012

• Technical Guidance on Development Evaluation Alberto Vélez, Claudia Talero, Camilo Galvis, María Cristina Mariño, Eliana Ramírez, Jospe Amar Amar, Marina Llanos, Consuelo Angarita, Albero de Castro, Fabiola Mesa, Marina Begoña. Professionals from the Colombian Child Neurology Association, Colombian Pediatrics Association and Fundación Universidad del Norte, Barranquilla. Cooperation Agreement 442, July 26, 2012, Early Childhood Compre- hensive Care. 2012

28 This document highlights children’s voices from different regions of the country . Their opinions were gathered during the consultation exercise about their growing up experience, helping the team of the Early Childhood Comprehensive Care Strategy

realize whom they are working for1 .

1 The consultation was designed and developed by Jorge Camacho and Adriana Villa under Cooperation Agreement 442, July 26, 2012, Early Childhood Comprehensive Care.

Context for the Early Childhood Comprehensive Care Strategy in Colombia Early Childhood Comprehensive Care Strategy

he Early Childhood Comprehensive Care Strategy of Colombia is the result of a rigorous exercise that began by recognizing the Tsituation of girls of boys from the ages of zero to five, and to value progress made by the country in early childhood comprehensive care. Both contextual elements set out important and determining courses to design the Strategy and below is a synthesized perspective of both.

The first part includes some succinct figures to help the reader understand the current situation of the rights of the children under the age of six in Colombia, with demographic data and crucial matters for a holistic development at this stage of life. We will make a brief presentation of the background of early childhood public policy since the beginning of the XX century to date, detailing conceptual discussions on some affairs regarding holistic development, programmatic momentums and contributions from the sectors. Finally it presents the developments that the Early Childhood Comprehensive Care Strategy has compiled from the country’s experience and it identifies the main challenges.

32 Context for the Strategy

The Situation of Colombian Children under the Age of Six1

A clear picture of the situation of the rights of Colombian children in early childhood is the ground for planning priorities and actions to improve their daily living conditions.

The country has undergone efforts to determine clear and detailed information on who the children are and how they live in their environments. This effort, originated at a national level, was developed by different sectors and local authorities gradually improving their identification and registration methods in their own systems, in intersectoral proposals and in the planning and accountability exercises provided by the Law.

Nevertheless there are coverage gaps, as well as in the breakdown of information and in the currency of the information, especially for the ages running between zero and six, and also for ethnic groups, people with disabilities, children affected by the armed conflict and other types of violence. The country’s main challenge is to generate accurate information for the correct decisions to be made to contribute to overcome the inequality problems acting as barriers to the progress of many development indicators.

The Early Childhood Comprehensive Care Strategy understands it is compelling to rely on an information system accounting for all the children living in the country, their situation, where they live and their living conditions in order to profile the care and reach out effectively to each one meeting their needs. Precisely the third part of the document will refer to this.

Taking into consideration the country’s limitations on information, following is some demographic data available on children in their early

1 This section is based on the products prepared by Ángela Patricia Nocua Cubides and Jaime Vizcaíno under Cooperation Agreement 442, July 26, 2012, Early Childhood Comprehensive Care executed between the Ministry of National Education, the Ministry of Health and Social Protection, the Ministry of Culture the Colombian Family Welfare Institute, Saldarriaga Concha Foundation, Éxito Foundation, the United Nations Children’s Fund (Unicef), Bancolombia Foundation and Génesis Foundation.

33 Early Childhood Comprehensive Care Strategy

childhood and their families, and also some figures related to crucial matters for an holistic development during early childhood like caregiving and upbringing conditions, health, nutrition, education, recreation, participation and exercise of citizenship.

Demographic Data2

According to the forecast for 2013 based on the general census of 2005, in Colombia there are 5,150,797 girls and boys who are between zero and five years old, accounting for 10.9% of the country’s total population. Out of them, 48.8% are girls, and 51.2% are boys; 75.9% live in urban areas, while 24.1% live in rural areas.

In Colombia approximately 14.4% of the total children’s population between the ages of zero and five belong to an ethnic group. Afro descendants represent 9.8% of the total, with 507,272 people; out of which 3,679 are raizales; 663 are palenqueros and 502,930 and black and Afro Colombians3. On the other hand, 236,966 boys and girls belong to an indigenous community, accounting for 4.6%. Gypsy communities are estimated at 449 people, accounting for 0.0082%. Lastly the census identified a total of 96,273 children with disabilities between the ages of zero and five, representing 1.87% of the total population of the country in this age range.

The indicators for the ethnic groups and the rural area tend to be below the national average, so the Strategy realizes the importance of influencing the living conditions of the children from these groups.

Maybe the most dramatic figure which must necessarily catch our attention is the one provided by the Large Integrated Household Survey (Gran Encuesta Integrada de Hogares) of the National Statistics Agency (DANE ) in 2010, evidencing that 60.03% of the girls and boys in their early childhood live in poverty; and 23.36% in extreme poverty.

2 The demographic data corresponds to the population forecast prepared by DANE (National Statistics Agency) for 2013, based on the census of 2005, except when specified otherwise.

3 The denominations correspond to the ones used in DANE

34 Context for the Strategy

Poverty places children in a situation where they are at risk of violation of their rights from the rights-based approach. The World State of Childhood declared in 2005 that children living in poverty endure deprival of material, spiritual and emotional resources required to survive, develop and thrive. It prevents them from enjoying their rights, reaching their overall potential and participating as full members and under equal conditions in society1.

In addition to material deprival, poverty is associated to limitations or precarious access to basic services, food and nutrition safety, exposure and vulnerability concerning social risks, discrimination and social exclusion, among other situations affecting the children’s physical, psychological and social conditions, beyond family income.

Poverty and inequality conditions multiply the barriers for the exercise of rights therefore overcoming them is mandatory to progress towards their guarantee.

1 United Nations Children’s Fund (Unicef) (2005). World State of Childhood. 2005. New When the York, p. 18 people in our families, sisters and brothers, cousins, mom and dad, Caregiving and Upbringing grandmothers and Human condition directly depends on the construction of emotion- grandfathers al bonds and socialization. The family is the desirable social group a talk to us and person is born into. It is the first group a person belongs to and it is a cuddle us, we reference, wherefrom children become part of society. know they love us . The fact that home is the first environment means that as of the conception, they have a niche with relatives and caregivers awaiting their arrival ready to receive them and accompany them while they grow up and establish relationships with their environments under different contexts.

It is therefore essential for the State and society to focus on supporting and preparing the families to enhance their emotional bonds with their daughters and sons, and to provide enriched, protecting and safe environments where they participate significantly. Addition- ally the State, society and family must expand their responsibility as promoters and overseers of risk prevention and remove vulnerable situations affecting the wellbeing and physical and psychological integrity of the youngest.

Considering the main role played by the families, it is important to know that the National Demography and Health Survey (ENDS,

35 Early Childhood Comprehensive Care Strategy

acronym in Spanish) determined that out of 51,447 homes surveyed in 2010, 35% where formed by complete nuclear families; 12% by incomplete nuclear families due to the absence of the father or the mother; 14% by extended complete families (the couple lives with their children and other relatives); 3% by extended incomplete families (the bread winner without a spouse lives with his/her single children and other relatives) and 4% by families comprising relatives and non-relatives.

Average household numbers have been dropping; from 4.1 people in 2005 to 3.8 people in 2010; and this is greater in the rural areas (3.9) than in the urban areas (3.7).

Between 2005 and 2010, based on data provided by the Nation- al Demography and Health Survey, marital unions are occurring at younger ages: at 20 in rural areas and at 22.3 in urban areas. Also the percentages of women getting into relations before they are 15 (8.5% and 3.6%) and 18 (32.6% and 19.4%) are greater, so the ratio of marital unions in adolescents is increasing.

36 Context for the Strategy

Regarding the use of contraceptives, the survey indicates that it starts later in rural areas compared to urban ones. Only two out of five women (40.5%) start using them before they have their first child, while in the urban area it is the case of 1 out of 2 women (50.5%).

According to the National Demography and Health Survey in 2010, approximately 700,000 girls and boys are born every year in the country. Half those born in the last five years were planned and wanted babies, and one out of four was reported as un-wanted.

Pregnancy in adolescents is one of the country’s great concerns as well as of the Early Childhood Comprehensive Care Strategy, since 19% of the adolescents are mothers. In the rural area this figure reaches 26.7% while in the urban area it is 17.3%: There is a dormant context behind this, since inequality and lack of opportunities have an effect on poverty and social mobility.

Pregnancy at early ages is a risk to the protection of life and health of the girls, boys and their mothers, before, during and after birth. Preg- nancy in adolescence is associated to a greater probability of high blood pressure (preeclampsia), placental abruption, maternal anemia, low birth weight, premature births, newborn jaundice, respiratory distress syn- drome, sepsis, congenital malformations and other situations possibly resulting in life-long consequences for the children’s health and wellbeing.

Regarding the commitment of the State, society and family to the protection of early childhood rights, the country must become aware of the current effects and future impacts on the lives of children and their families when these rights are not guaranteed properly. Acknowledging this situation must only result in a profound mobilization for the protection of those people whose lives are starting.

In accordance with the Unique Registration of Displaced People (RUPD, acronym in Spanish), as a result of the exposure to the armed conflict, in 2011 in Colombia there were 397,080 children under the age of six victims of internal forced displacement4, representing 7.7% of the country’s population in those ages.

4 The RUPD is undergoing a restructuring process and doesn’t have updated figures on the forced displacement situation in the country. 37 Early Childhood Comprehensive Care Strategy

In connection with social violence the National Forensic Medi- cine and Sciences Institute (Forensis in Spanish) stated that in 2010, 2,796 cases of sexual violence against girls and boys under the age of four were reported. Fifty girls and boys between the ages of zero and four were homicide victims and three children between the ages of zero and five died as a result of violent actions. Regarding deaths resulting from external causes, Forensis has a record of 508 children between the ages of zero and four in 2011 broken down as follows: 58% accidental deaths, 18% in road accidents, 9% homicides and 15% from undetermined causes. It is noticeable that between 2005 and 2011, a 10% reduction has been preserved5.

Health, Food and Nutrition

Girl’s and boy’s physical, mental and social wellbeing results from the interaction between biological, social, political, economic, environmental and cultural factors set out by the circumstances they are born to, live and grow up in.

Children growing up and developing in excellent health conditions have a greater opportunity of enjoying their existence and contributing to the wellbeing of their communities.

Maternal and Child Health Following are the figures on maternal and child health understanding that they are linked. The National Demography and Health Survey (ENDS, acronym in Spanish) of 2010 shows that one out of five pregnant women does not go to a health center; and 97% of the women who did go, received

5 The National Forensic Medicine and Sciences Institute (in Spanish INMLCF/National Reference Center Group on Violence (in Spanish GCRNV). 2005-2006: Information System for Analysis of Violence and Accidents in Colombia (in Spanish SIAVAC)(Direct) and Consolidated Statistical Information by Region (Indirect). 2007-2008 Database Information Network System of Missing People and Corpses (in Spanish SIRDEC) (Direct) and Consolidated Statistical Information by Region (Indirect). 2009-2010 Database Information Network System of Missing People and Corpses (in Spanish SIRDEC) (Direct) and National Indirect Statistics System (SINEI)(Indirect), quoted in Report to the Citizens. Opting for Peace and Social Prosperity 2005-2012.

38 Context for the Strategy

specialized medical care during the pregnancy (91.7% by physicians and 5.3% by nurses). Prenatal medical care increased by 3.5% compared to 2005, with favorable perspectives for this to become universal in 2015.

The vital statistics of the National Statistics Agency (DANE, acronym in Spanish) for 2009 show that in 83.8% of the cases, births followed four or more prenatal medical care controls, a percentage growing since 1998, from 65%. Between 1990 and 2010 this indicator increased 20% especially among low income women. Nevertheless this result is still far from the Millennium Development Goals (MDG), where the goal for Colombia is at 90% by 2015.

The challenge is greater in the department6 of Amazon, where the percentage is below 50% and in the departments of Putumayo, La Gua- jira, Caquetá, Casanare, Cauca, Arauca, Meta, Córdoba and Nariño where the percentage is under 80%. The departments already at the goal are San Andrés, Huila, Quindío and Caldas.

Institutional care during the delivery has increased progressively in the country, from 93.1% in 1998 to 98.6% in 2010, exceeding the 95% proposed by the MDG. Many departments have surpassed 99% care for this indicator, although some regions like the Amazon or the departments of Arauca, Putumayo, Cauca and Chocó, where this percentage is below 96%.

According to the estimates of DANE based on vital statistics, maternal mortality has dropped from 100.14 deceased for every 100,000 children born alive in 1998 to 71.64 in 2010, representing a 25% reduction of this indicator over the last decade. It is a matter of concern as this indicator has not exhibited much progress since 2005, remain-

6 Colombia is unitary republic conformed by 32 departments, 1.123 municipalities and one Capital District as a political and administrative units.

39 Early Childhood Comprehensive Care Strategy

ing close to 73 maternal deaths for every 100,000 births. The situation in rural areas and in populated regions increases this concern since the rates there are more than double the MDG for 2015.

In connection with children’s health, the most recent figures presented by the DANE evidence a sustained reduction since 2005, of 20.4 deceases for every 100,000 infants born alive to 18.4 in 2010, representing a 10% reduction. At the department’s level, child mortality rates exhibit a downward trend, like the national average, and it is lower in Valle, Bogotá, Norte de Santander and Caldas.

To express According to the Ministry of Health and Social Protection, 59.5% what we like, of the child mortality cases are of perinatal origin, between the 28th we laugh, clap, jump, pull week of pregnancy and seven days after birth, so these causes must be faces, move overcome to achieve a significant impact on this indicator. our hands, According to the basic health indicators 2009-2010, respiratory scream, point with our diseases specific to the perinatal period (23.3%), congenital malfor- finger or touch mations, deformities and chromosome abnormalities (20.3%), oth- what we like . er diseases occurring during the perinatal stage (11.1%), newborn bacterial sepsis (8.7%) and acute respiratory diseases (7.2%) are the main causes of mortality in children under one year. It is important to highlight that the mortality due to acute diarrhea disease (EDA, acronym in Spanish) dropped by over 50% between 2005 and 2010, from 12.16 deaths for every 100,000 children under the age of five in 2005 to 5.26 deaths in 2010.

On health assurance, data from the Ministry of Health and National Protection indicate that in 2010, 3,697,151 girls and boys under the age of six were registered with the National Social Security Health System; 1,579,421 in the contributive regime; 15,884 in the exception regime and 2,101,846 in the subsidized regime. During 2011, 3,274,197 went for growth and development medical checkups.

The National Demography and Health Survey for 2010 estimated that 76% of the children under five were registered in health programs and went to an average of 2.6 appointments per year. Likewise, 79.9% of the girls and boys under the age of two had their complete vacci-

40 Context for the Strategy

nation program, comprising at least polio, DPT BCG and MMR at the dosage required for this age.

Nutrition This is another determining development factor. It refers to a process whereby the body assimilates and benefits from food nutrients. The nutritional condition impacts survival and life quality and therefore it is the perfect indicator to assess children’s health.

There is a lot of scientific evidence (The Lancet, 2007) clearly stating the negative and long lasting impacts of inadequate nourishment in girls and boys. Early malnutrition reduces learning skills, school performance, economic productivity in adulthood and the ability to take care of new generations. It traps people in a circle perpetuating malnutrition, poverty and slow development. Ensuring conditions for the children to receive appropriate food and nutrition helps prevent diseases and prepares the body and the mind to develop to its full potential.

Data related to the nutrition condition of expectant women shows that 16.2% were underweight for their weeks of pregnancy; the young ones being the most affected (13-18 years old, 28.6% and 19-24 years old, 20.8%). One out of two expectant women in the country were at the correct weight for their weeks of pregnancy, and 34.6% had a certain degree of excess weight (24.8% were overweight and 9.8% were obese).

About nursing as a privileged option for child development, breast milk is the only food providing all the nutrients required for optimal growth and development of children during their first months. It has cells, immunologic factors, anti-infectious factors and hormones improving health and protecting infants from a large number of common diseases, and it stimulates their physical, cognitive and psychosocial development (ENSIN, 2010:213). No other type of food is the only one required during a specific period of life, and so up until six months of age, it should be the only food given to infants; later it is necessary to provide the nutrients required with a variation of food.

41 Early Childhood Comprehensive Care Strategy

Breast milk is irreplaceable and impossible to replicate by chemical procedures; it doesn’t require any monetary compensation and it is easily available.

In breast feeding, 96% of the women started nursing their baby at birth; 56.6% of the women reported having breast fed their child in the first hour after birth; 19.7% started nursing the baby on the first day while 30.8% did so in the following three days after giving birth.

Yet on the whole breast feeding has decreased in the country since out of 97.1% of the women who at some point nursed their child in 2005, it shifted to 96.0% in 2010 an increase from 2.9% to 4.0% of women who never did breast feed.

In addition to the diminishing of this habit, extended breast feeding hasn’t progressed either. Its total duration increased importantly between 1995 and 2005, but it didn’t change for 2010. Currently it is at 14.9 months, while international recommendations are at 24 months.

The ENSIN results (p. 228) show that introducing supplementary food to breast milk in the country is precocious and the diet quality is unsatisfactory compared to early childhood nutrition requirements, especially between the ages of six to eight months.

The country is running risks on the nutrition of children under one year old, since they are nursed for a shorter period than rec- ommended, supplementary food is introduced prematurely and de- ficiently, and the food offered lacks the nutrients required to ensure their optimum development.

In accordance with the ENSIN, 13.2% of the children under the age of five suffer from chronic malnutrition (their height doesn’t match their age) and 30.2% is at risk of suffering it. And 3.4% have global malnutrition (low weight for their age) resulting in the risk of it becoming chronic if not treated timely. Although these conditions have dropped to half in the last 20 years, they are still above the MDG set at 8% and 2.6% correspondingly.

42 Context for the Strategy

In spite of the reduction noted in the malnutrition rates in the country, it is necessary to continue working very hard to ensure food safety and nutrition for the children from the beginning of their lives.

Initial Education

Colombia has seen many discussions and experiences resulting in the State’s commitment -both nationally and internationally- to an initial education acknowledging that learning begins from the very moment of birth; that the family, the community and the institutions are their agents and they are accountable, and also that the environment is determining ( Jomtien, 1990)7. Without intending to re- strict education to the settings and programs provided for this purpose, following are some figures of the country.

According to the National Demography and Health Survey, over one third (38%) of the children under the age of six were enrolled in an initial education program; 8% went and dropped out and 54% have never been. Out of the later, half (53%) don’t go because they are cared for at home. When the mothers go out, a quarter of the children go with them; 39% are taken care of by the grandparents; 11% by the spouse; 5% by the eldest girl in the family; 10% by other relatives and the rest by neighbors, friends or household help; and 4% goes to school, the ICBF or another institution.

In 2011, under early childhood comprehensive care, the national government provided initial education to 402,183 children, prioritizing

7 World Declaration on Education for All “Satisfying Basic Learning Needs” (Jomtien, Thailand, March 1990), p. 10.

43 Early Childhood Comprehensive Care Strategy

displaced and vulnerable population, and in SISBÉN8 levels I, II and III. In June 2013, the initial education operation was passed from the Ministry of National Education to the ICBF.

Recreation

Recreation is closely related to the education conception described in the paragraphs above. Providing opportunities to explore and interact with the environment, to enjoy playing, physical activity, recreation, art, literature and dialog between children and adults contribute to creative, thoughtful and caring human beings.

The National Demography and Health Survey (2010, 265) presents some figures on the recreation right in the country. It identifies the main activities carried out by caregivers with children at home, play (89%), followed by going out for walks (78%), sing songs or tell stories (74% each) and lastly, story reading (38%). There is a worrisome cor- relation between mothers in rural areas and lower education levels with less play and reading percentages.

8 SISBÉN is the information system designed by the national government to identify potential beneficiaries families of social programs.

44 Context for the Strategy

Also (p. 265) the survey shows that among the caregivers reading to the children, 28% have books at home, 3% gets them from the library, 2% from a play center and another 2% from the community center. And 82% of the children play with purchased toys, 31% with objects found outside the homes, 17% with household things and 5% with home- made toys. Also in 6% of the cases, the mother indicated that the boy or girl doesn’t play, and this is mainly for children under the age of one, for children whose mothers are under 20, with no education and with the lowest wealth index.

Undoubtedly for the country it is still a challenge to build settings to promote recreation as well as information showing different recreation activities and their benefits for the children’s development.

Participating in and Exercising Citizenship

Feeling a free and self-determined person and being aware of oneself is the result of the experience that the relations children may have per- sonally, and with others in their environments and multiple contexts. Identity allows for singularity and also to value diversity and to feel part of a family, a community and a nation.

Fully living human condition entails expressing yourself through gestures, words and all the signs of language and communication. Interlo- cution places participation in a context of dialog, recognizing that from the beginning of their lives, the children have the ability to understand and contribute important elements to the purpose of their interest, and in acknowledging also that there are other people with the same capabilities who could be their peers or adults. This implies that adults play the interlocution role in a democratic manner and recognize children as active parts in the decisions affecting their lives and the community.

Colombia is a State under the rule of law, and the Constitution embraces its multiethnic and multicultural condition and promotes the enjoyment of “the same rights, liberties and opportunities without any discrimination for gender, race, national or family origin,

45 Early Childhood Comprehensive Care Strategy

language, religion, political or philosophical views” (Political Con- stitution, tit. I art. 13). These conditions pose significant challenges for those responsible for the comprehensive care of girls and boys. If the State and its institutions, in each of their decisions and in each of their actions, recognize that Colombia is an extremely diverse country, this would result in care allowing for the genuine participation and willingness to answer to the needs of every girl and boy at the right moment and in perfect proportions.

The birth certificate is the main instrument for the State to formalize citizenship, as it identifies children at birth and it grants them citizenship. It gives them legal birth and they can hold the access key to the State assets and services.

According to the National Registry of the Civil Status, between 2005 and 2012, 5,195,727 people between the ages of zero to five were registered and 524,228 from zero to one year old. The National Demography and Health Survey states that the percentage of children born over the last five years in the country and not registered reached 4%, and it is higher in the rural areas (5%).

After reviewing the information clearly the human development indicators in Colombia progress steadily, but rigidity associated to poverty and inequality is present. However this may be overcome by working intently with early childhood in all the sectors and at all government levels, having a positive impact on the whole society.

Consequently the Early Childhood Comprehensive Care Strategy is placing its bets on an ambitious long term process requiring commitment from all the stakeholders involved in the development of girls and boys.

46 Context for the Strategy

Early childhood public policy in Colombia: a path to continue building

At the end of the nineteen nineties, the country underwent a process to build an early childhood public policy as a result of significant social mobilization processes, international and national regulation changes and lessons learnt from the experiences of different sectors of the State in pursuing the country’s development. Its purpose is to fully guarantee the rights of children under the age of six. We like to go out every day: As customary in processes of this nature, the construction of this go to the park, policy has been facilitated by political circumstances, the contexts, the take a walk; discourses and daily habits of whom participated in this cause, marked see, hear and by their ways of thinking, perceiving and relating to children. feel what is out there, pick Being aware of the historic background of early childhood in soci- plants and ety makes it possible to act meaningfully and relevantly towards new touch the soil . policy horizons from a rights-based approach. Hence the Early Child- hood Comprehensive Care Strategy has considered it is important to understand the evolution of the country over the XX century and to date regarding its vision on children and consequently on how they understand, assist and steer actions towards this population.

This section will provide the readers with a general overview of the background and conditions enabling the construction of a public policy on early childhood comprehensive care and the grounds to build the Strategy.

Firstly we will address the changes experienced by early childhood comprehensive care during the XX century up until 1991, when the country’s Constitution was amended; undoubtedly a milestone in setting out a policy for children. The following paragraphs present the main contributions of the Constitution in this matter, followed by various events and transformations giving birth to the early childhood comprehensive care in the country. This historic synthesis concludes by presenting the

47 Early Childhood Comprehensive Care Strategy

events formalizing the policy’s framework describing the Early Child- hood Comprehensive Care Strategy we are addressing in this document.

Early Childhood Care Before the Constitution of 1991

Since this was a long period (from the beginning of the century until 1991), the actions on early childhood comprehensive care will be presented in three blocks: i) from the beginning of the century until 1968; ii) from 1969 to 1974 when the ICBF was created and rolled out; and iii) from 1975 to 1988 when early childhood care was deployed in the country.

From the Beginning of the Century until 1968

48 Context for the Strategy

Upon reading the literature on childhood in Colombia, especially studies carried out on the history of children’s education, until very recently –the beginning of the XX century- care provided to children was responsibility of hospices and shelters relying on religious communities taking in children under the age of seven who were orphans, abandoned or poor, to give them food, provide hygiene, care, protection and a bit of education.

Yet under the European influence on child pedagogy (Active School) the country experienced a transformation, and education played a leading role in early childhood comprehensive care when the first private kinder gardens were opened and working pedagogies were developed and guided specifically to this population.

From the legislative perspective, children’s education was defined for the first time under Decree 2101, 1939 as “received by a child between the ages of five and seven, and its main purpose is to create necessary life habits jointly with a coherent development of the personality”. (Cerda, 1996: 12).

Over 20 years had to go by before the government took over kinder gardens. Decree 1276, 1962 created six national working class kinder gardens under the Ministry of National Education hoping to give integral care to the children and to project the school’s education action towards the community through family education activities and to serve as guides for the private initiatives in pre-school education.

After their impact, the national government decided to increase the number of schools to 22.

One year later pre-school or kinder garden education fell under primary education for guidance and supervision purposes, and pre-school education was considered advisable but not mandatory. (Article 9, De- cree 1710, 1963).

Health wise, it is of essence to refer to the Children’s Code or to the Organic Law for Children’s Defense (Law 83, 1946) enacted together with the creation of the Colombian Social Security Institute and the

49 Early Childhood Comprehensive Care Strategy

Ministry of Hygiene to protect children from malnutrition, abuse and abandonment. Inspired in the hygienist model of the United States of America, it is founded on a health conception based on disease, and resulting from environmental conditions affecting the individual and requiring treatment from a hygienic interpretation.

Lastly we must refer to the creation in 1947 of the National Nutri- tion Institute. Their studies provided the country with the table on the composition of Colombian food, which served as the basis to characterize the diets and eating habits of Colombian citizens.

During the first half of the XX century, there was an emerging interest of a public policy to recognize the smaller children, even though with a view of exceptionality, and with insufficient clarity on holistic development and care.

Creation and Roll Out of the ICBF 1969 – 1974 The Colombian Family Welfare Institute (ICBF) was created in 1968, by Act 75. The Children’s Division of the Ministry of Justice and the National Health Institute were incorporated thereto. It became the first expression of a political will to protect those considered “children under irregular conditions” to ensure family stability and wellbeing.

The historic moment when the ICBF was created allowed for the reflections on women, the vindicating movements of their rights, their active and key role in society (the right to vote, work, access to education, to the labor market and to public matters, the expansion of their role beyond the intimate boundaries of the homes) when considering the families, to shift towards the smallest children, and towards women needing to provide the care required to their children.

Also nutrition accomplishments gave increasing visibility to children as a population segment requiring State actions to guarantee their care and protection.

Additionally movements of social groups, the academy and eco-

50 Context for the Strategy

nomics, history and sociology contributed renovated views on childhood and influenced the changing conceptions emerging and circu- lating in society.

Competences undertaken by the Ministry of National Education (MEN, acronym in Spanish) and the ICBF at the time opened a parallel story in early childhood care: The Ministry in accordance with the organization of the education system tended to pre-school education and focused its efforts on building pedagogic and curricular proposals contributing to the children’s holistic development.

Meanwhile the ICBF focused its attention on children under seven and their families, in creating Community Centers for Children (CCI, acronym in Spanish) for children under two, and the Pre-School Com- prehensive Care Centers (CAIP in Spanish), for children under seven (Law 27, 1974). With a holistic care conception, the objective was to protect the working mother and her family helping her taking care of

51 Early Childhood Comprehensive Care Strategy

her children while she worked. the companies contributed 2% of their payroll (additional fiscal contributions) to the ICBF.

Additionally the children’s daycare centers, under the direct responsibility of the ICBF’s trade union, made contributions to quality, edu- cating the people taking care of the children, to pedagogy and education of the youngest.

Expansion of Early Childhood Care 1975-1988 A very important discussion animated by social or community movements took place between 1975 and 1988; as well as important legal developments and programs on health and education making this I like to period relevant. play the bass drum and dance . Education Early childhood education in the country was guided and managed during this period by the Colombian Family Welfare Institute and the Ministry of National Education. By means of Decree 088, in 1976 the Ministry structured the education system and reorganized the Ministry by decentralizing and nationalizing primary and secondary education.

Pre-school was envisioned as the first level of formal education, although it was not mandatory. Its objectives were to “promote and foster physical, affective and spiritual development of the children, their social integration, their thoughtful perception and preparation for school activities, in coordination with the parents and the community” (Art. 6, Decree 088, 1976). This new administrative structure resulted in joint efforts between the Ministry of National Education and the ICBF: in the first case the Ministry prepared the curriculum with the cooperation of the ICBF; and in the second case the cooperation of the Minis- try of National Education with ICBF programs.

The creation of study plans for all the levels, areas and modalities of the education system were set up eight years later, in 1984, by Decree 1002. Article 2 of the decree stated that the objective of pre-school ed-

52 Context for the Strategy

ucation was “An integral and coherent development of biologic, sensor and motor, cognitive and social-affective matters, and particularly communication, autonomy and creativity to foster an adequate preparation for their enrolment in basic education”. After discussions, controversies and agreements, the Pre-School Curriculum (children between the ages of four and six) was published presenting four forms of work –community, free play, didactic unit and in group- as well as basic and daily activities.

Towards the end of the eighties, the Ministry of Education was committed to non-conventional programs developed in the country to improve the life quality of the children under seven, and two more were added with the conventional pre-school program: Pre-School Qualification and Articulation between pre-school and the first basic primary grade.

To ensure consistence and significance to the care of children in the CCI and the CAIP, the ICBF created a curriculum with contributions from the French model and the theories in force on early stimulation for development. While the construction of the curriculum for the institutional modalities of care evidenced the importance of child development, the ICBF carried out awareness processes.

In order to overcome the limitations identified in the CCI and the CAIP when delegating the responsibilities of the families on socialization and taking care of the children to these programs, the ICBF opened the doors for the communities to participate. Based on docu- mented participation on child care, it was supplemented by education and community care.

This resulted in changes to the CAIP program of the ICBF, and since 1979 they became the Children’s Daycare Centers giving priority to the participation of the families. The same year, Law 07, amending Law 27, 1974 was enacted, whereby to date the resources only allocated to the children of working mothers were also funneled to children of families in great need.

In 1985, the ICBF with the support of Unicef, published the Work Guide in Units for the Protection and Care to Children, compiling and

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rewriting texts and experiences achieved in the CAIP project in different parts of the country (the city of Bucaramanga and the Pacific Coast), capturing them in pedagogic guides for employees, directors, members of the community boards and parents to promote the maxi- mum development of the potentials of children under the age of seven in the care and protection process provided in the CAIP.

The community welfare homes were created the following year, a comprehensive human development strategy focused on early childhood comprehensive care. They were preceded by the children’s daycare strategy (former CAIP), and the recognition and drive of new less formal ways of promoting early childhood development in different parts of the country. Child development was the objective of the community welfare homes, with a pedagogic substrate and education intent favoring children’s interaction with their social, cultural and community environments, and an adequate organization for community self-management and family empowerment.

As a result of the community welfare homes, it was a priority to build a pedagogic model bringing together the experiences and lessons learnt from the institutional models of the ICBF and also projecting care to children from a community approach. Clearly child development was closely related to the socialization environments of the children and their daily interactions were recognized for their education potential.

In 1988 the ICBF accepted the challenge of creating one hundred thousand homes to provide care to one and a half million highly vulnerable children. The “community welfare homes” started to be operated and managed by the mothers and the community who started to organize child care and receive financial support and permanent pedagogic education from the ICBF. Enactment of Law 89, 1988 contributed by growing the budget of the ICBF increasing the contributions made by public and private companies from 2% to 3% solely for the community welfare homes.

Early childhood education in the nineteen eighties was marked by an opening towards conventional and non-conventional modalities,

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justified in three facts: progressive separation of the welfare State and the need to resort to community work strategies; emphasis on the participation and empowerment of the communities from the emancipat- ing and critical theoretic perspectives of the nineteen seventies; and strengthening early childhood education oriented towards a holistic development, and intended for future enrolment into school.

Health Primary healthcare is a concept arriving to the country through international declarations like Alma-Ata approved by the Internation- al Conference on Primary Healthcare in 1978 and summoned by the

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World Health Organization (WHO). The national health system was organized through primary, secondary and tertiary care.

Regarding early childhood, the leadership of the sector is visible in nutrition, pregnancy, pregnancy in adolescents, nursing and maternity. As presented below, programs like Sur- viving (Sobrevivir in Spanish) and the report of satisfactory indicators on health as a result of sanitary control and the expansion of the vaccination programs are especially outstanding.

Articulation Efforts between the Ministry of Education – the ICBF and the Ministry of Health One of these efforts was carried out in 1988 with non-conventional programs, guided towards providing better conditions for the development of children who were not covered by the formal education system. This contributed to enhance care perspectives beyond the formal education system and to conceive development more comprehensively. These include:

• Sobrevivir (National Plan for Survival and Child Development) for urban children from zero to six in the poorest sectors. It was carried out between 1984 and 1992 to promote better health and nutrition conditions for the development of children, to reduce mortality and morbidity due to controllable causes and to provide care to pregnant and fertile women. High school graduates from state and non-state schools participated under the social service program (Health Guards); through family visits they helped identify the risks of diseases of death of children under five or pregnant women. These health guards provided information to prevent or address health issues once they appeared, and offered guidance on health services available from the State, including vaccination programs.

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• Family Education Program for Child Development (Pefadi). It started in 1985 offering family education for intellectual and emotional development of children from zero to seven in the rural areas, environmental sanitation and undoubtedly improving the actions of responsible adults in caring for the children. It was supported by high school students doing social work and it was also intended for students from skill training schools as part of their practices.

This articulation endeavor was also present in Decree 088, 1976, and expressed in the nineteen eighties with the support of the Ministry of National Education to the pedagogic component in the community homes of the ICBF, with pre-school teachers and illustrating community mothers on education pedagogy for children.

Early Childhood Care in the Times of the Convention on the Rights of the Child, 1989 – 1990 The Declaration of the Convention on the Rights of the Child executed in 1989 took place at a very active time when a lot of summits and meetings of Ministers of Education were held and they drove many early childhood activities. Also during this period, various community activities were conducted, the Community Pedagogic Education Project (PPEC, acronym in Spanish) and the community homes (FAMI, acronym in Spanish) promoted by the ICBF that brought in all the experience gained from lessons learnt and promoted innovating and alternative conceptions and customs when working with early childhood. Following are the most important matters related to these three fields.

Convention on the Rights of the Child Adopted and up for execution and ratification by the United Nations General Assembly in Resolution 44/25, November 20, 1989, it became enforceable on September 2, 1990 in accordance with Article 49. Its staging is of paramount importance for early childhood throughout the world in giving visibility to the children, as well as the conceptions circulated, some of which are listed below:

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• Child means all human beings under the age of 18 (Article 1).

• Every person has all the rights and liberties listed in the Human Rights Universal Declaration, with no distinction of race, color, gender, language, religion, political opinion or of any other nature, of national or social origin, economic position, birth or any other condition (Preamble).

• Children are entitled to special care and care (Preamble).

• The family is considered “the fundamental group of society and the natural environment for all the members, and especially the children, to grow up and be well”. Consequently they “must receive necessary protection and care to fully undertake their responsibilities in the community”. (Preamble).

• Children are entitled to: 1) a name, a nationality, and whenever possible, to know their parents and be taken care of by them, from the moment they are born (Article 7); 2) to express themselves, with freedom of thought, conscience and religion, of association and to meet (Articles 13, 14 and 15); 3) to be brought up, to develop, to receive education under equal conditions and considering their highest interest (Articles 18 and 28); 4) to protection “against any type of damage or physical or mental abuse, neglect or negligent treatment, ill treatment or exploitation” (Article 19); 5) to special protection and care from the State when they may be deprived from their home temporarily or permanently (Article 20); 6) enjoyment at the most highest level of health (Article 24); 7) to an adequate life level for their physical, mental, spiritual, principles and social development (Article 27); 8) to rest and relax, to play and recreation activities as appropriate for their ages and to freely participate in the cultural life and in art (Article 31).

• Respect of the rights stated in the current Convention by the Member States to ensure their application for each child subject to their jurisdiction, with no distinction of any nature, regardless of race, color, gender, language, religion, political opinion or of

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any other nature, of national, ethnic or social origin, economic position, physical impediments, birth or any other condition of the child, the parents or their legal representatives (Article 2).

By Law 12, 1991, Colombia adopted the agreements executed in the Convention on the Rights of the Child, expressing its will to work for the children of the country. This occurred at a time when the Mi- nor’s Code had been recently approved (1989); and in the light of the rights-based approach set forth in the provisions of the Convention, the code was set aside. I like grown- International Summits and Meetings ups, teachers, mom and dad, The World Declaration on Education for All “Meeting Basic Learning grand-parents Needs” (Jomtien, Thailand, March 1990) is an important precedent for and aunts to the policy since the Government committed to work within the actions teach me how and recommendations framework resulting from the agreements among things work, to different countries. Article 5 of the Declaration explicitly refers to nation- draw and to go al education in the following words: head over heels .

Learning begins at birth. It requires early care and initial education since childhood. This can be achieved by mechanisms addressed to the family, the community or the institutions, as appropriate.

Creation of Relevant Programs to Promote Early Childhood Care Firstly the Community Pedagogic Education Project (PPEC, acronym in Spanish) was of great importance and it went back to 1990; followed by the creation of the Family, Women and Childhood Scheme with the community welfare homes FAMI, under Agreement 021, 1989.

The PPEC drives actions emphasizing on:

• Focus on child development and community development –family and community organization- as axes for human development and children’s education

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• Emphasize on interaction as the child development motor (with him/herself, with others and with the environment)

• Underscore building citizenship since early childhood

• Acknowledge local and regional experiences on early childhood care bringing insight to the project

• Promote collaborative and cooperation work among the people interacting with the children: parents and community

• Organize education activities pedagogically in six moments: welcome, let’s explore, let’s create, let’s play, let’s eat and we go home.

• Track the actions of educators, parents and community (scorecard).

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• Value child development with the Qualitative Development Valuation Scale

Meanwhile the community welfare homes FAMI of the ICBF are defined as:

A set of actions carried out by the State and the community intended to promote psychosocial and physical development and principles of children under seven in extreme poverty, by stimulating and supporting their socialization process, improving their nutrition and life conditions (ICBF 2009).

The objective is to strengthen the parent’s responsibility in upbringing and taking care of their children, with their solidary work as well as the community’s.

This scheme promotes an active participation of the organized community and strengthens the family’s capacity so together they can undertake the task of looking after the children and their socialization during the first years of life. It focuses on encouraging healthy lifestyles, access to basic health services and generating moments to strengthen emotional bonds. Additionally it offers care to expectant women and nursing children pursuing care of the babies during pregnancy and fostering nursing. It also provides a nutritional supplement and health checkups for the mother and children under the age of two. The objectives of this program progressively expand to encompass the country’s developments and needs.

Constitution of 1991 and Early Childhood

The Constitution of 1991 brought the country’s commitment to early childhood to the constitutional level, when children between the ages of zero and five became extremely visible from a rights-based approach. This new Constitution inaugurated a fruitful period of changes contributing to setting out child policy. Article 44 is of great importance as it establishes the importance of the fundamental rights of children and the role of the family, the State and society for their fulfillment and to ensure the holistic development of children:

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Children’s fundamental rights: life, physical integrity, health, social security, balanced diet, name and nationality, to have a family and not be separated from it, care and love, education and culture, recreation and free expression of their opinion…

Family, society and the State have the obligation of assisting and protecting the children to ensure their coherent and comprehensive development and the full exercise of their rights (Political Constitution, Chap II, Art. 44).

Likewise the constitutional principles acknowledge diversity. Ac- cording to Article 7, “the State recognizes and protects ethnical and cultural diversity of Colombia”. This mandate implies placing individual, social, economic, political, religious and cultural diversity discussions in the center of early childhood matters.

In addition to a legal event, the Constitution of 1991 is considered a cultural matter as it introduces important changes to the perspectives about girls and boys, setting aside their being considered as children, objects or miniature adults. Also as Article 67 states that at least one pre-school level is mandatory for all the children, it promotes reflection upon and care to early childhood.

Generating Conditions to Draw Up an Early Childhood Public Policy

Changes to the legislation, social mobilization and the lessons learnt from projects and experiences developed in the country set the foundations to outline the children’s policy. Following are some of the most significant achievements as of 1991.

The Education Sector: From Focusing on Pre- School to Initial Education The Constitution of 1991 gave way to Law 115, 1994 (General Edu- cation Law) and to the establishment of Pre-School education. Accord- ing to Article 15: “Pre-school education corresponds to the one offered to children for their development in biological, cognitive, psychomotor,

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social-affective and spiritual fields through pedagogic and recreation socialization experiences”.

On this basis, girls and boys over the age of five pass from daycare centers, community welfare homes and kinder gardens to public schools, and early childhood education begins to experience important developments. Provisions like the ones below and set forth in Law 115, contribute to this end:

• Article 6, Decree 1860, 1994: Provides that pre-school education is intended for children under the age of six, before starting basic education, and it comprises three levels; the two first ones are prior to mandatory schooling and the third one is compulsory.

• The same Article states that the Nation and the territorial governments need to specifically support this education, and the MEN has to organize and regulate a service providing education elements and instruments and create coordination actions among those participating in this education process.

• Resolution 2343, 1996: Sets forth the curricular achievement indicators for the three pre-school levels, considering the

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dimensions of human development (body, communication, cognitive, ethical, attitudes and values, aesthetic) and these differ from the indicators for the other levels in the education system presented by mandatory and fundamental areas. It also provides the pre-school pedagogic guidelines.

• Decree 2247, 1997: Provides the rules for offering pre-school services for public and private schools, specifying that:

–– Pre-school has three levels, pre-kinder, kinder and transition, for three, four and five year old children, We like to be correspondingly. bigger . Before we moved –– Grade 0 corresponds to transition and it is mandatory. around in the crib and we –– Integrality, participation and play are the principles for pre- fell in the play school education pen . Now we do many things . –– Curricular processes are carried out with the execution of play-pedagogic activities taking the integration of the human development dimensions into account.

Pre-school education was offered throughout the country, but following a separate path of the discussion taking place on the meaning of being a boy and a girl, their rights and initial education. Over the following ten years, the discussion of education for children between zero and six was held in other sectors of society and it was only until 2007 that the education sector addressed early childhood matters once again, not from a pre-school approach but from a holistic care view, as a result of Law 1098, 2006.

In the first decade of this century, initial education or early childhood education was addressed more profoundly. During the first years of the XXI century, it was debated and promoted and commitments to early childhood were made as a public policy matter. At an education level, there were great discussions about opening the education sector for younger children, and international commitments were made in the summits, at the Minister’s meetings and in multilateral agreements.

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At a regional level, and in preparation for the Dakar Forum in Santo Domingo, the countries in Latin America, the Caribbean and North America made evaluations on the achievement of the objectives and goals set out ten years earlier at the “World Conference Education for All” (Jomtien, 1990). At this meeting, the countries renovated their commitments for the following 15 years still acknowledging that in spite of the achievements of the decade, the challenges were still present and they included: “Increase social investment in early childhood, increase access to child development programs and improve coverage of initial education”.

During the World Forum on Education in Dakar, in April 2000, “Education for All:

Keeping our Collective Agreements”, Jomtien’s statements were ratified in that the first objective was to “develop and improve early childhood protection and education in all matters, emphasizing on the most vulnerable children in the worst conditions”.

Meanwhile the Summit of the Ministers of Education under the leadership of Colombia (between 2006 and 2007) in Cartagena de In- dias, education for the youngest children was part of the agenda, and the resulting hemispheric agreements were essential.

During the same period, with the creation of the Early Childhood Of- fice in the MEN –under the Vice-Ministry of Pre-School, Basic and Mid- dle Education- early childhood comprehensive education was motivated to define the education policy and to ensure its appropriate implementation. The objectives illustrate the partnership with the ICBF and the territory authorities for “quality comprehensive care, always seeking respect for diversity and the features of the families and the communities”.

To renovate the decennial 2006-2016 plan, the Ministry summoned a large mobilization process in the country, with forums, work groups and conferences, in a social pact for the right to education, commit- ting all the agents accountable for it (State, society, family), where early childhood was demanded persistently and with the greatest participation. Interestingly the objective of this plan related to child develop-

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ment and initial education was to: Guarantee universal comprehensive care for children from pregnancy until they reach the age of six, under a rights-based approach and for a full exercise of citizenship.

To differentiate early childhood education, initial education is em- phasized:

As a permanent and continuous process of quality, relevant and timely interactions and social relations, enabling children to potentiate their capacities and learn skills for their full development as human beings and holders of rights. As such, they require care and appropriate accompaniment from the adult promoting their growth and development in healthy and safe socialization environments (MEN, 2009:8).

And so towards the middle of the first decade in the XXI century, it included early childhood care in its policies and actions and it routed the discussion and orientation, differentiating it from pre-school.

The ICBF, Towards its Redefinition Regarding the changes to the construction of early childhood policies, during the first decade of the XXI century the ICBF reviewed and restated its action plans, resulting in an important production with careful, critical and rigorous understandings and discussions on early childhood, on children as right holders, the development dimensions, the importance of social-affective development, nutrition, play, the role of pedagogy and training community mothers.

This was achieved by placing the PPEC in a different setting and learning from experiences such as the Pedagogic Expedition.

In connection with the Community Education Pedagogic Project, new stakeholders and new forms of management and performance appeared in 1994. The State as contractor and organizations, whether public or not, as operators, replaced the ICBF’s technical teams and changed the direction of their work focusing more on supervision than on support.

Although towards the end of the nineties the PPEC was weakened and it became invisible in the country as a public policy, it still remains

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current in the regions preserving its intent and dynamics in accordance with the specific features each one gave it, and nurturing from the support of the ICBF and from other emerging processes under the policies laid out by the government in office.

This has also been complemented by strategies like: the “Fiesta de la Lectura”, Colombia grows in complying with human duties since early childhood, Household Vegetable Gardens, Pro-Social Behaviors and Best environmental practices for community welfare homes and daycare centers. It also became a sort of guideline to steer care and education for children in early childhood.

Experiences like the Early Childhood Pedagogic Expedition under the leadership of the ICBF showed important achievements and set out action routes and policy mobilization for early childhood in defining technical guidance, for example on comprehensive care from a rights- based approach.

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Early Childhood Health, Food and Nutrition In line with the Constitution of 1991, the laws and the CONPES (Na- tional Council on Economic and Social Policy) related to health, food and nutrition, the health sector has focused on seeing that early childhood has the highest possible health level, as provided in their rights.

To this end, a comprehensive view, taking into account all health related matters: food and nutrition, protection and initial education to provide children with the support required for their survival, growth, development and learning process has to be taken.

These developments occurred in the Pri- mary Healthcare (APS, acronym in Spanish), the core of the country’s health system and governed by the constitutional principles of universality, solidarity and efficiency, and by the principles of equality, quality, prevention, differential approach and social participation. This is essential sanitary care, accessible to all the individuals and families of the community through acceptable forms for them, with their full participation and at a reasonable price for the community and the country.

The APS is an assurance system where the guarantee of the protection for every person with no type of discrimination prevails, during all the moments of life. It offers special financing for the poorest and most vulnerable population; it generates conditions to protect and improve people’s health and it evolves around the user’s wellbeing and satisfaction. The APS is a comprehensive part of the community’s general socio-economic development; its main objective is to reach the highest health level possible and at the same time maximize equity and solidarity (PAHO, WHO, 2007).

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On children’s health –considered a national priority- the Ministry of Health and Social Protection considered that care during early childhood is essential for a healthy life; they placed their political bets on this and also the Ministry made a social commitment with the country. The national government made arrangements to fund and earmark resources so children in their early childhood would receive preferential and differential attention, under equal conditions, including expectant and breastfeeding women.

The children’s entrance door to the health system is the assurance through health promotion entities (EPS, acronym in Spanish), accountable for guaranteeing access to all the health services. The system offers multiple promotion strategies with other sectors, on disease prevention, services and attention, included in the Benefits Plan, intending to improve the health and life quality of children during their early childhood.

Mobilizing Civil Society Towards an Early Childhood Policy An important articulation effort took place at the end of the XX century between the national authorities and the Capital District favoring early childhood. This lasted four years and resulted in the amendment of the Minor’s Code by Law 1098, 2006 (Childhood and Adolescence Code) and it also set out the Early Childhood Policy.

It started by forming an Alliance for Colombian Children with the involvement of Fundación Restrepo Barco, CINDE, Save the Children, Plan International, Fundación Éxito and Unicef to position children’s matters in public policies. These joint efforts sought to change the political frame for early childhood since paradoxically, while Colom- bia executed the International Convention on the Rights of the Child, simultaneously

it was enacting the Minor’s Code, far from having a rights-based approach. The alliance helped materialize contributions to be incorporated in the Childhood and Adolescence Code replacing the Minor’s Code. At the beginning of the XXI century, although ear-

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ly childhood was not on the country’s agenda, an agreement was executed between the Social Welfare Administrative Department of the Capital District (DABS, acronym in Spanish), the ICBF, CINDE, Save the Children and Unicef. In 2003 this agreement prepared the international forum “Early Childhood, the Challenge of the Decade”. It involved over 2,000 people from various territorial authorities and local mayors and it was the first social mobilization for children from zero to six. This process collected experiences from the ICBF and DABS and simultaneously it generated the need for the evaluation of early childhood care in Bogotá, in an attempt to answer the question on the weight of the differences of the different types of initial education for children. In turn it triggered an important change to the care schemes available at daycare centers.

The “Program to Support the Formulation of Early Childhood Policy in Colombia” was created in 2005 to define an institutional framework and a local, regional and national management system to help guarantee early childhood rights, increase coverage, improve the program’s quality and pursue strategies to empower families and the community. With this objective in mind and by forming seven commissions or work groups, hopefully the content of an early childhood policy would be agreed to.

While this took place, the Second International Mobilization Fo- rum, “Early Childhood Mobilization” was held in 2005, coordinated by the ICBF with work groups on early childhood, with the participation of NGOs, the academia, foundations and the State.

The mobilization process of the forums and the work groups was systematized in a document serving as the basis for the preparation of CONPES 109, on early childhood public policy.

The early childhood agreement was extended to other entities in 2006 and 2009; its action became extremely strong in Bogotá. At the time there was nothing similar country wise, and it was an experience evidencing the scope and results of partnership actions.

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Childhood and Adolescence Code Law 1098 enacted in 2006 shifted the paradigm of the Colombian legislation in force, from the Minor’s Code where children were considered weak and incapable, to the Child- hood and Adolescence Code where they are acknowledged as right holders; and the statements of the Convention on the Rights of the Child are recognized and materialized. The current Code specifies that the rights cannot be postponed since what is not done in time, cannot be restored in the future.

This impossibility of postponement prevents matters related to early childhood from becoming a government program, and on the contrary they are necessarily converted into public policy intentions.

Article 204 of the Childhood and Adolescence Code, explicitly states that the president, governors and mayors are accountable for childhood and adolescence public policy; this responsibility cannot be delegated; if breached it is considered as misconduct and consequently it will result in dismissal, punishment and inability to hold public posts for 15 years, and it also implies public accountability.

The Childhood and Adolescence Code is coherent with the international guidelines and it is a legitimating instrument for the rights-based approach they postulate. Article 29, referring to the right to full early childhood development, defines the characteristics of this period and states that children’s rights to healthcare and nutrition, the complete vaccination scheme, initial education and protection against physical dan- gers cannot be postponed.

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Strategy of the Municipalities and Departments for Childhood, Adolescence and Youth Facts and Rights The Facts and Rights Strategy (Hechos y Derechos in Spanish) was created to offer tools and technical accompaniment to the governors in setting out, managing and in the evaluation of public policies related to children and adolescents in compliance with the obligations imposed on them by the regulations, and to perform preventive supervision and management control.

It works towards strengthening territorial capacities, forming an effective alliance between different kinds of entities (official, Public Min- istry, international cooperation, non-governmental organizations) and it has advocated for the inclusion of childhood and adolescent matters in the territorial planning agendas and instruments.

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CONPES 109, 2007, a Regulation Formalizing Public Policy The “Early Childhood National Public Policy, Colombia for Ear- ly Childhood” was approved by CONPES 109, 2007, resulting from the progress achieved and the participation of health, education and wellbeing sectors.

It promotes comprehensive development of children from pregnancy until the age of six, to answer to their needs and specific features, and to contribute to ensuring fairness and social inclusion.

This document from the National Council on Economic and Social Policy formalized an effort to build an early childhood public policy, as the starting step for developing a long term process. It presents the diagnosis of the rights of the children in the country and the priorities on their attention. The CONPES could also look deeply into a clear definition of the institutional responsibilities of its execution, to encourage the construction of local policies and to develop permanent evaluation processes on what has been determined as policy.

Fulfilling early childhood rights is considered to involve the families and society; and this falls on the State in that it is directly accountable for guaranteeing material, legal and institutional conditions to promote, guarantee and protect them as a whole, for they prevail over the rights of others. The State must have mechanisms to promote accessibility, availability, permanence and social accept- ability criteria.

Three investment lines for the CONPES were established in the country’s budget. Due to the diversity of the supply of the ICBF at the time, focusing on modalities of care9 it considered resorting to social kinder gardens for positioning purposes10.

9 The ICBF has guidelines for each of its modalities of care.

10 Although social kinder gardens go back to 1999, when they were conceived as mega kinder gardens to be located, under an urban reorganization rationale, next to a mega school and a mega park, the ICBF started talking about them between 2005 and 2006.

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Even though six years later the goals and resources provided in the CONPES may be considered outdated, the technical contents and their proposal remain relevant.

Law 1295, 2009 Law 1295, 2009 results from the fundamental agreements between civil society and the State on the principles, objectives, goals and strategies on education and comprehensive protection of the children during early childhood, and in regards to the rights stipulated in the Political Constitution and the laws ensuring their

Rights. It presents the State’s commitment to improvethe life quality of expectant women and children under the age of six in the sectors rated 1, 2 and 3 of the SISBÉN. Five strategies were proposed for its implementation:

• Access for children under the age of six to education care, within the comprehensive care framework since pregnancy.

• Construction of early childhood comprehensive care centers.

• Illustrate education agents accountable for initial education and early childhood comprehensive care with competences and inclusion approaches.

• Strengthen the territories on the implementation of the initial education policy, under a comprehensive early childhood care perspective.

• Certification and quality assurance system in providing initial education.

In summary, the Early Childhood Public Policy is the result of experience gained by the country thanks to the effort of many stakeholders from the State and society, laying the foundations to develop the policy on early childhood currently executed by the country through the Early Childhood Comprehensive Care Strategy.

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Early Childhood Comprehensive Care Strategy “De Cero a Siempre”

The preceding summary of the country’s progress on early childhood presents an overview of the knowledge acquired and the debates being held in Colombia, recognizing a legacy that should be put towards guaranteeing children’s comprehensive development.

The Strategy synthetized the main elements required to continue progressing down the path (as explained in the Introduction, to build on the foundations). It also presented the vital challenges Colombia needs to address to answer to the ethic mandate of caring for and offering the appropriate conditions so children under the age of six in our country develop in full. Only then will it be possible to maintain that the Early Childhood Comprehensive Care Strategy is committed to Colombian early childhood.

Following is a description of the progress made in this field in the country, encompassed in the Strategy to continue progressing, and also the challenges being tackled.

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Country Developments Compiled by the Strategy to Carry On

This section comprises some elements presented above, grouped to present future paths and lines of work. In some cases the debates held are made explicit and they must be held to ensure the holistic development of early childhood.

Education Development Steered by the MEN and the ICBF The Strategy recognized education as a right and the relevant debate on educability of children from zero to six, and the meaning of an educable individual from a rights-based approach and coherently with initial education.

It also considers the actions taken jointly by the Ministry of National Education and the ICBF, which may not be of cross-functional nature, but they do aim to a future construction in this sense since they allow for the distribution of roles, to share budgets and to answer to the competences each sector is accountable for.

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Development of the Early Childhood Comprehensive Care Plan (PAIPI) This program intended to provide care to 400,000 children between 2006 and 2010, under three dimensions: an institutional one in urban areas for children from six months old to five years of age; a community one addressed to children cared for in community welfare homes supplementing the care with an education component, and a family one, for children under two, and expectant and nursing families in rural areas.

The experience evidences two important lessons: the first one related to the integrality required from cross-functional efforts involving the MEN, the ICBF and also the health, culture and recreation sectors. The second evidences the need of decentralizing care to the territories.

One of the debates in this program underscores how an increase of early childhood care will be more relevant for the country: Through pre-school by hiring teachers? By means of non-formal education with community mothers and education agents? Via an initial education articulating experiences from both sectors and building a path to improve the quality of initial education? The country will need to address this dilemma under the current Strategy.

Developments in the Health Sector This sector is prosperous in early childhood policy, with a comprehensive care approach, including mother-child health, healthy habits, food safety and safe environments.11

On the other hand, the health sector has developed primary healthcare conditions involving characterizing the population, tracking and monitoring the health processes and results, inspection and supervision, tracking and monitoring and information systems of great value.

11 The Strategy for a Comprehensive Care for Prevailing Diseases in Childhood –AIEPI and the Strategy of Women and Child Friendly Institutions stand out.

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It is extremely helpful to track each family and the supply and demand articulation scheme to reach out to every family through complete and reliable monitoring, even if there are updating limitations. Focusing on the poorer families and on ethnical inclusion are two very important fields of progress, and it is necessary to continue working on them.

The above poses a large challenge to the Strategy: transforming the idea that comprehensive care relates exclusively to access to services, and focusing it directly towards advocating for human, social and material conditions, with a direct impact on their development possibilities.

Finally the definition of primary healthcare presented in Law 1438, 2011 amending the General Social Security System considers that intersectoral coordination contributes to overcome the health services frag- mentation, it helps transition to comprehensive and integrated healthcare and it also proposes integrated health services networks (RISS, acronym in Spanish) to operate and materialize core matters on primary healthcare such as coverage, universal access, the first contact, integrated and continuous healthcare and appropriate care, among others.

Basic health teams were created to strengthen primary healthcare services and as a functional, organizational and system based alternative to strengthen and facilitate access to health services, and their action axe revolves around extramural work and care at home.

Development on Progressive and Comprehensive Access to Health, Nutrition and Education To fulfill the obligations set forth after enactment of Law 1295, 2009 regulating comprehensive care for children during their early childhood, the ministries of Finance, National Education, Health and Social Protection and the Colombian Family Welfare Institute, coordinated by the National Planning Department, prepared a proposal on comprehensive care to ensure progressive and comprehensive access to health, nutrition and education for expectant women, and children under six in SISBÉN levels I, II and III as provided by the law.

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Early Childhood Policy Accomplishments in the Territories Experiences in the cities of Bogotá and Medellín on initial education, quality education and early childhood Comprehensive Care reveal important achievements that need to be revisited.

Lessons extracted from these experiences, together with the lessons from the socialization and preparation process of the Strategy in the territories evidence multiple and diverse headways, developments, stories and practices that need to be taken into account in its implementation.

Early Childhood International Accomplishments To incorporate these achievements, the Strategy intended to become acquainted with and share international experiences, and by reading them through the expectations and national reality they could contribute analysis elements and strengthen the design of the strategy for the country.

Canada contributed thoughts towards understanding that an early childhood national policy enables human development growth process in the country.

Cuba’s influence was determining in defining the PAIPI at the time, supporting the initial education conception on family, and deepen- ing the reflection on family and community participation in education processes and in child care.

The Child Protection System “Chile Crece Contigo” showed the Strategy that health is the entrance door to comprehensive care; it provided indications on the child by child tracking system and empha-

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sized on the importance of strengthening the territories, not only on the attention capacity but also in reporting and tracking.

Mexico’s experience brought the Strategy up to the standard, design and implementation of different social services oriented towards integrality and quality care, and Brazil shed light on alliances and involvement of civil society.

Progress on health supported by the Pan American Health Orga- nization (PAHO) has inspired schemes and strategies on what the Comprehensive Care Roadmap currently is, and the child by child tracking system.

Colombia has learnt from the experiences mentioned and has set up its own design, consistent with how people are, understanding

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and living reality, achieving accomplishments that can be made available to other countries.

Conceptual Accomplishments on Early Childhood, Child Development, Comprehensive Care and Management Although these concepts will be described in detail in the second part of this document, it is of utter importance to mention them here when underpinning the core matters that the Strategy collected from the country’s history on this matter. Therefore the Strategy recognizes:

• Every child’s differences, in accordance with the life moment of their development.

• Neuroscience contributions on implications for children born in vulnerable conditions, without the conditions and guaranties to ensure their full development.

• Economic studies highlighting the importance of investing in early childhood since these investments yield high return rates and they are cost-effective for the country.

• Acknowledgement of children as holders of rights and the center of action.

• Diversity as a social value resulting from culture, ethnical belonging, context, conditions, specific dimensions or permanent or temporary situations of the children.

• The need and importance to realize the comprehensive attention to early childhood and become the engine of child development.

• The need to go from a model focused on offering services, divided into sectors and actions not articulated, to a comprehensive cross-sectorial model, which takes into account girls and boys as holders of rights

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• The cross sectorial action knowing that comprehensive care cannot be developed by a single sector and that intersectoral work opens up possibilities to several of them, and at the same time strengthen its specificity.

All these aspects point finally, to give life to a strategy that builds on the already constructed and advances on key issues to respond to the challenge of ensuring comprehensive care to children from pregnancy until reaching the age of six.

Challenges posed by the Strategy

The Strategy poses major challenges among which are the following:

Formulation of a Sustainable and Long-Term Early Childhood Public Policy This means to transcend from the sectorial public policies to a population where early childhood children become the center of their management, comprehensive development, and the comprehensive care which is the means to achieve it.

The design, implementation and evaluation of this public policy requires of all sectors and their coordinated action. Therefore it is essential to:

• Recognize the role of each stakeholder involved and put into action their knowledge, institutional structure, actions, resources, capabilities and openness to change.

• Recognize and value the role, competencies and resources from the Government, the civil society organizations and the family.

• Promote the construction of a supportive management in which resources, responsibilities and processes interact with each other and with the opportunity required to ensure that children fully enjoy their rights.

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Provide Comprehensive Care to Early Childhood Children The challenge of the Strategy is to reach children as comprehensive beings and not as a sum of services that are diffused as assistance center.

Comprehensive care, recognized as the means through which the stakeholders responsible for guaranteeing the right to full development of children in early childhood materialized in a comprehensive protection, involves meaningful, coherent, and consistent steps towards the structuring factors that shape it and organize it ensuring that actions of those involved converge around each girl and boy, in a relevant, timely, flexible, differential, continuous, complementary way and with quality.

Including the Differential Approach in Early Childhood Care For the Early Childhood Comprehensive Care Strategy is a challenge to advance in the visibility and recognition of heterogeneity, non-linearity of child development and their specificities in their life cycle. Also, it is a challenge to take into account the diversity of children and families because of their culture, ethnicity, context, conditions, particular dimensions or tran- sitional effects. Only as such it will be possible for every Colombian girl and boy to be subject of approximation, support and relevant assistance.

Promote Integrated Management that Recognizes the Knowledge, Practices and Developments of the Territories The Early Childhood Comprehensive Care Strategy requires management to reach the territories, to recognize its diversity and con-

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texts, exchanging knowledge to enrich the proposal and to generate consistent, relevant and empathic answers. The territories – its villag- ers and public servers have tailored proposals, relevant to their particular conditions, which are worth to be valued by the institutions and used in all its richness.

To recognize communities as legitimate partners with knowledge to contribute is a challenge for the construction of roads that will guarantee the realization of children’s rights from a differential approach.

A public policy of this kind commits different decision-making levels and technical schemes compatible with the specificities and capacities of human potential and of the institutions existing in the territories, as well as a joint construction of work and horizontal cooperation that allows mutual learning, exchange of knowledge and experiences.

Promote the National Family Welfare System The sustainability and governance of the Strategy require a location to construct public policy, nation-territory balance, articulation of sec-

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tors and cross-sectoral linkages, as well as criteria and unified action lines, participation and citizen mobilization. To achieve it the Strategy is challenged to count with institutional framework and governance as the policy achieving recognition of territorial realities and a greater balance of territory-nation, for which it is necessary to sign up and strengthen institutions, namely: the National Family

Welfare System, the social policy council boards and the Intersec- toral Commission for Comprehensive Early Childhood Care.

* * * * * * *

The brief presentation of the context that gave origin to the Ear- ly Childhood Comprehensive Care Strategy of Colombia provides a clear idea of the current conditions in which children under six are in Colombia, about their sectoral and intersectoral learning experiences, and the courses the State must consider to obtain comprehensive care with quality and pertinence. The State poses objectives, priority action lines and instruments for managing the Strategy, which in an articulated way between entities with direct competence regarding that population and other sectors that have an impact on the generation of welfare conditions, will allow it to make of the comprehensive care the way to express prosperity for early childhood. This information will be developed in detail in part three. The next part will focus on the technical basis of the Early Childhood Comprehensive Care Strat- egy both in regards to the conceptual foundations of early childhood as well as of comprehensive care.

Technical Grounds for Early Childhood Comprehensive Care Strategy Early Childhood Comprehensive Care Strategy

he Early Childhood Comprehensive Care Strategy results from the study, and deliberation of the role of the State and society Tin guaranteeing comprehensive development of those beginning life. Thus, the country now has a clear focus for its actions in two broad areas: early childhood and comprehensive care within the rights protection framework.

This second part describes the technical or conceptual bases to support the Strategy, in line with the country’s development introduced in the first part. With that in mind we hope the readers thor- oughly understand the meaning of the Strategy’s components presented in the third part.

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Conceptual Grounds for the Early Childhood1 Strategy

Following are the main concepts guiding the Early Childhood Com- prehensive Care Strategy, including understanding children from zero to five, their comprehensive development, the family role and their environment. Each concept specifies the position assumed and gives meaning to the Strategy and its development.

Understanding Girls and Boys in Early Childhood from a Rights-Based Approach

The Strategy is built on the conviction that the children are citizens holders of rights; they are social and singular beings and immensely diverse. This understanding has specific implications regarding the comprehensive attention given to them and characterizes the Strategy; those responsible for their comprehensive development must ensure that this early childhood perspective marks every decision and behavior.

Children, Citizens Holders of Rights By acknowledging that children are holders of rights due to their human nature, the Convention on the Rights of the Child set a milestone that triggered important changes on how childhood was seen and in the ways society relates and interacts with children from their early years.

Perhaps one of the most important changes was to stop seeing them as small adults, as incomplete beings waiting for the adults’ actions to develop themselves, and therefore deemed invisible because they do not exist other than to the extent that adults act on them.

1 This section was built on the reference document Technical Fundamentals of Comprehensive Early Childhood Care written by Marina Camargo Abello and Adriana Lucia Castro Rojas, by request of the Intersectoral Commission for Comprehensive Early Childhood Care (2012)

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To be a holder of rights since early childhood is to declare that the nature of a social being is inherent to mankind at the onset of life. Thanks to such nature and their capacities, children participate in society and develop by interacting with others.

To understand children as beings who participate in social life by interacting with people surrounding them and who grow up pursuing greater autonomy means they need adults, guaranteeing their development to assure quality conditions relevant to the vital moment they are in, and in agreement with the children’s characteristics and capabilities.

As holders of rights exercising citizenship, children need to be considered valid speakers, able to express and build the meaning of their lives, their existence, with particular ways of relating to peers, adults, families and development environments. They are capable of making decisions about topics that affect them as well as of expressing their feelings according to the moments of life they are going through.

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These citizens have the right to grow and develop in participatory environments, guaranteeing optimum conditions to potentiate their capabilities and achieve their wellbeing.

Children, Social Beings From the moment of birth, girls and boys become part of a family immersed in a given social and cultural context, and enter an existing society. As stakeholders, they interact with society through adults and the institutions representing it. Children use their capabilities to solve the main needs of their existence and to begin a growth process for their integration into social life as protagonists of their own development.

This means that children are born with the ability to learn, participate and actively explore the physical and social world, and to develop their autonomy progressively. From birth they have physical, psychological and social skills supporting the ongoing interaction principles they establish with themselves, with others and with their environment, all of which are mutually interdependent.

Children, Unique Beings As holders of rights children are unique, singular and unrepeatable. From birth they undergo a process of individualization and differenti- ation that develops their particular characteristics, their own rhythms and styles, their preferences, their different capacities, qualities and potentials. All children journey through life developing in accordance with their characteristics, their own care process, their interactions with peers and adults, and the opportunities that the environment and context have offered.

Children, Beings in Diversity Processes related to the beginning of life, specifics of social life, and cultural variability, help understand how the personality of children from zero to five manifest.

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Children mature at different paces and therefore they don’t all learn to walk and talk at the same time. While some totter others run, some use words to communicate and others don’t. Some live in rural areas, others in big cities, and their families are made up differently, and likewise the role of the adults surrounding them differ. Additionally, during early childhood children are exposed to cultural, ethnic and religious values transmitted from generation to generation, within their groups, communities and relations.

Recognizing the differences, not only takes into account the diverse culture in the country, but also considers age, gender, the specificities of each individual and the conditions in which children and their families live.

• From the individual point of view, early childhood covers different moments in child development, showing learning processes and achievements impossible to homogenize, given the ways in which each individual participates in his/her development according to children’s own characteristics and gender.

• On a social scale, the characteristics of the family, the district, the city, the rural context, the living conditions of the population, determine how entering to society affects the processes of growing, developing and belonging.

• From the cultural point of view how communities live, think, act and feel, allow to talk about territory, ethnicity, beliefs, values, customs, languages, and artistic expressions, among others. In Colombia these differences are present in indigenous groups, Afro-descendants, black, raizal, palenqueros and gypsies, and therefore the country needs to assess, preserve and strengthen the heritage of this diversity from early childhood, essential to take a differential approach2.

2 In accordance with human rights ethics, “The differential approach involves the recognition of personal and community characteristics of those who have historically suffered social exclusion either by their participation or way of life, because of ethnicity, gender, life cycle, disability, displacement due to armed conflict or natural disasters, violence, etc., as well as the differential response that these individuals and groups must receive from State institutions and society in general. In: “Differential approach guideline for the effective enjoyment of rights of displaced and people with disabilities in Colombia”. Ministry of Social Protection, UNHCR, 2011: 27-29.

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The same is true from the gender equality approach, avoiding dom- inance of one gender over the other and recognizing singularities on ways to grow, mature and develop.

Diversity is a challenge and an opportunity for children, for those who contribute to their development and for policymakers and public policy advisors.

These aspects recognize, value, and respect human dignity as of birth, and acknowledge that their rights depend on ensuring affective, social and material conditions, which are optimal and indispensable for their realization.

The State, family and society share this responsibility. Within the framework of comprehensive protection they need to create real and concrete opportunities to materialize them and make them true.

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Early Childhood Development3

Understanding children as holders of rights (social beings, cultural, unique and diverse, active and able to build their subjectivity, as participants and citizens) is realizing that early childhood development has important implications, and requires meaningful experiences ensuring that all the boys and girls in early childhood in the country have necessary and suffi- cient conditions for their full and optimum development.

Development of the Human Being Ideas about human being development have changed throughout history, and very significantly since the end of the 20th century, thanks to the dissemination and scientific research findings, and by acknowledging children as holders of rights.

According to the current conceptions of child development, as of birth children have the ability to relate actively with whom they share life and welcome them, as well as to learn and solve problems of their immediate environment and identify opportunities needed for their development. Also the society they are born into presents them with changing and differentiated demands resulting from historical, cultural and social specific moments.

Human being development is a process of transformations and changes that allow innovative and orderly behaviors, generated over

3 This section was developed thanks to the contributions of Olga Alicia Carbonell, Leonor Isaza Merchán and Mariela Orozco, who actively participated in the discussions on developments proposed by the Early Childhood Comprehensive Care Strategy. 94 Technical Grounds for the Strategy

time and due to the activity of children, their capacity to organize themselves, their experiences and the resulting information.

This process is continuous. It starts in the womb and only concludes when life ends, and includes biological and psychological aspects, but also social, historical and cultural ones. Through out life individuals permanently grow, learn, mature and structure their individual and social personality. Their functions and processes become increasingly more autonomous and complex.

In short this process:

• Is experienced by an active human being who becomes the center and primary holder of rights.

• Is shaped by the dynamic and continuous interaction between biology (Genetics) and the experience of the individual interacting in social and cultural environments,.

• Extends the capabilities of reflection and internalizes experiences, contributing to the decision making process with greater autonomy.

• Is comprehensive, active, participatory and it is promoted through rich and loving interactions with other human beings and the environment.

• Is constructed in special environments where life unfolds, becoming a diverse and differential development that can’t be standardized4.

• Increases life options for all the people in a country or region in various fields (education, labor, material, recreational, cultural, social and political among others.)

4 Three aspects characterize the current conception of development. First, the cognitive, linguistic, social and emotional development of children is not a linear process. Conversely, it is characterized by irregular advances and setbacks. Second, the development does not have a definite and clear beginning, i.e., does not start from scratch. And third, development does not seem to have a final moment, in other words, it never ends (MEN, 2009:) 18).

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• Involves creating conditions for progressively changing the life quality of all human beings enabling their overall wellbeing.

• Tends towards sustainable human development, satisfaction of human needs and promotion of economic growth with social equity providing opportunities for people to improve their quality of life.

• Starts with conception and birth and ends with old age and death.

Comprehensive Development of Children from 0 to 6 A complex process of permanent change characterizes early childhood development similar to what happens during the rest of the life. This change does not happen in a linear, sequential, cumulative, always ascending, homogeneous, prescriptive and identical way for all boys and girls; it is expressed in the specificities of each one, in an equally wide variety of contexts and conditions.

Thus, development moves between the singularities of each girl or boy, however their different rhythms and styles bear some relation with the characteristics of their peers’ processes, and with the features offered by the environments they live in: home, health and educational environment and public space.

The recognition of the importance of early childhood has increased, as noted in the introduction, thanks to the numerous research on human development that show how, although this occurs throughout the life cycle, it is during the early years where the foundations for further development of the individual are placed, where their capabilities skills and potential become very complex. Recent studies have shown the influence of good care and assistance of children from pregnancy by the primary caregivers adults (both relatives and initial teachers), because it impacts a greater number of cerebral connections, the development of basic language skills, mobility, symbolic thought, ways to learn, to relate, to communicate, to

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play and to transform their environment. Similarly, their social interactions bases are highly developed before they start their formal education.

These decisive years for all human beings are built using a process that has an irregular performance - complex, dynamic and discontinu- ous, with changes and setbacks-, without a beginning or an end defined, that for every girl or boy is specific and differentiated as time passes. Even in a same period we can find varied developments of the same boy or girl. These variations occur in all cultures and in no way are signs of back- wardness, rather show that from birth, children have capabilities specific to each one and may appear differently throughout their life.

As children are unique, unrepeatable and considered in a holistic sense, its development is understood as a comprehensive process, im- We like people possible to break in areas or dimensions. All psychological and social to give us processes are interrelated and influence each other in the active con- toys, dolls and struction of the individual and its reality where each one is its own candies . main character and architect. The active interaction of children with those who surround them and what surrounds them and the orientation of development to the organization or structuring of increasingly varied and complex abilities, leads them to progressively construct their autonomy. It is so that initially the development is achieved through interaction with others, and subsequently, it can be achieved also without their support through their own means.

While development occurs throughout the life cycle, it is demonstrated that there are particularly sensitive moments, windows of opportunities to act on behalf of health, nutrition, growth, development and welfare of children, which should be considered when identifying actions to undertake comprehensive care.

Play, Art, Literature and Environment Exploration during Child Development Play, art, literature and environment exploration are early childhood activities, as those help children to build and represent their reality, as well as to interact with the world, with their peers and with adults.

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Play Play reflects culture and society representing constructions and developments of environments and contexts. Children play representing what they see and when they play what they live they redefine their reality. Therefore, play is a means of interpreting the adult’s world and culture, initiating children in the society life.

In play there is great pleasure to represent what they have gone through in their own view, and to have the control to modify such reality. Children represent the culture they grow in and thrive. Through play children get acquainted with their reality.

Literature Children are particularly sensitive to the sounds and meanings of words. They need to play with them, be nurtured, wrapped, lulled and figured out with words and symbols carrying emotion and affection. That is why literature is also one of the guiding activities of childhood.

People closer to smaller children regular- ly note that playing with words – breaking them apart, signing them, pronouncing them, repeating them, exploring them - is a way of appropriating language. Perhaps that is the rea- son why they say that children resemble poets in the way they “release” and marvel at words, connecting them with their life experience.

Generally literature in early childhood encompasses not only written literary works, but also oral tradition and picture books, showing the art of playing and representing experiences through verbal and pictorial symbols.

The need to give sense inherent to human condition encourages from the earliest childhood to work with words, to inhabit possible worlds, and to operate with invisible contents. 98 Technical Grounds for the Strategy

The wealth of oral repertoire represented by the lulling, rounds, songs, personal stories, plays on words, stories and legends, make part of the cultural heritage which together with children’s traditional and contemporary literature, are a varied and polyphonic wealth where children discover other ways of structuring language linked to their emotional life.

Art To watch the rounds and oral tradition games allows to see how literature, music, drama, choreography and movement are combined. From this point of view, the artistic experiences - plastic arts, literature, music, dramatic and corporal expression - can not be seen as separated com- partments in early childhood, but as forms of inhabiting the world at these ages, and as languages which the children use to express themselves in many ways, to know the world and to decode themselves.

Within the life cycle it is in early childhood when human beings are more eager and more willing to those forms of interacting with the world. The fact of “discovering it for the first time”, to feel and question every thing, to merge understanding with emotion and with what passes through the senses makes the artistic experience a guiding activity of childhood.

Exploring the Environment Children are born into a constructed world. A physical, biological, social, and cultural world they need to adapt to and that needs them to transform itself. In this world they find elements and possibilities to interact with their own specificities and capacities.

Senses - taste, touch, see, smell, hear - play a fundamental role in instrumental exploration because they come closer to the environment in different ways. To explore empowers children to question, solve problems, interact, use their body, investigate, meet, rehearse, persevere, and gain independence. This experience gives them a sense of what is happening in the world and what it means to be part of it.

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Play, literature, art and exploration of the environment are often interdependent activities. Thus for example, when a child plays or ex- plores, she/he can do it by manipulating plastic materials such as paint or clay, coming closer to an artistic experience. Sometimes play is combined with literary and musical expression.

Adults Mediation for Achieving Comprehensive Development While adults are the mediators of cultural tools and together with some peers help children carry out activities that are beyond their capabilities (scaffolding), as researcher Jerome Bruner has pointed out, it is required to have quality interactions providing them with secure attachment links and trust relations with people who show them they can count on them both in moments of exploration and curiosity, as well as in stressful or difficult situations. .

Studies have shown that a sensitive care relationship creates a link for secure attachment between those who established it. To be able to interact with a caretaker who is present not only physically, but emo- tionally and psychologically available for care, physical, emotional and affective contact, accompaniment of interests, channeling of emotions and building of meaningful relationships, allow children to feel loved, recognized and valued; i.e., it allows them to build their emotional security and as they develop their ability to symbolize and represent the environment they live in, create a representation of themselves as valuable, capable and deservers of affection.

Thus, children are able to see the caregiver as a reliable person, someone to count on when in need and that will lead them to feel themselves in a predictable world where their actions are effective. Also to experience and grow up in a family and social atmosphere with care relationships characterized by empathy, affection and satisfactorily ne- gotiating goals regarding conflict, helping adult caregivers and children to build a representation of others and of the social world with confidence and security.

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Primary caregiver - basis of children security - helps them organize their behavior, explore and learn from their environment, makes them feel protected in stressful situations, and teaches them to regulate their emotions and affections.

Consequently, children do not access alone the meanings of culture. Meanings are built from their relationships with each other. This implies that all institutions and persons in charged of their assistance and education recognize that they are responsible for providing them with opportunities to build them, considering them as valid speakers, and consequently favoring scenarios where they can express themselves and be heard. Therefore we insist that the main function of early childhood education is to encourage child development - rather than transmitting knowledge, care for or entertain - through meaningful experiences, which mobilize their capabilities and facilitate the exploration and understanding of the world and the moment they are living.

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Towards a Sustainable Human Development The purpose of sustainable human development is to increase the population levels of well being. For that economic growth is needed through increasing production and productivity, with an imperative: conservation of natural resources. In other words, sustainable human development meets the needs of a country and strengthens the development of present generations without damaging or compromising that of future generations.

Therefore it depends on the individual and collective responsibility of all human beings to preserve the environment and to have a well-balanced relationship with the surroundings, core elements of sustainable development. For example, the threat to ethnic, cultural, biological and geographical diversity of the country requires that people and communities democratically decide and build what is produced and how to produce it, together with their right to survival and the realization of themselves in agreement with their own life projects.

To make development sustainable it requires cross-sectorial multiple ways progressively ensuring all people the benefit of drinking water, sanitation, suitable housing, energy systems, health care, safety, food sovereignty and biological diversity protection.

Specifically, that all of the above is guaranteed to early childhood children for the fulfillment of their rights. Education plays a fundamental role promoting human being relations with its environment in a more harmonious way.

A childhood comprehensive care policy should include the construction of scenarios and processes of participation of children and adults for

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the creation of alternatives to take care of their environment, ecosystem conservation, good consumption practices and environmentally friendly forms of relationship with nature. If the natural and cultural diversity of the environment is protected, it becomes more secure and protective for all people living there.

The Family’s Role

It is in society where early childhood is made possible. In it and in its institutions materialize the actual conditions of children existence determined by historical, political, social, economic and cultural contexts that are transformed with the passing of time and mainly by the action of the social stakeholders involved.

Children enter society under specific conditions through the family. At the same time, environments frame children’s development through processes of interaction; influence their lives, the acquiring of significant experiences and conversely children also transform the environments through the ways they adopt them, represent and act upon them. This mutual transformation creates important differences in child development.

Family Concept Approach The family is a social institution, a social system, a basic cell of society, a social group, and a social unit. Family belongs to society, exists and develops under its influence and, reciprocally, affects it.

The social character implies it to be formed by individuals who are not isolated; the relationship of permanence, solidarity, affection and bond between its members to carry out specific functions, makes it different from any other group of society.

From an anthropological point of view, the family has a universal character. Indeed, it is referenced throughout the history of the world in a good part of societies. What makes it different is the culture that

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comes to life, through beliefs, values, rules, rituals, traditions and ways of life, allowing to recognize different types or forms over time and according to societies (matriarchal, patriarchal, large, nuclear, among others), as well as various forms of kinship relations and relationships with other social groups (classes, clans and tribes). Some key aspects to understand the family are found in the cultural attributes identifying it and giving meaning to a society and its members. The family as a specific element of society can be considered a primary group whose members relate to each other according to roles and functions, creating specific dynamics, as well as changes and transformations that make up moments in their development cycle.

Considered as a general aspect of society, the family is seen as an institution responsible for the socialization of its individuals, and for transmitting the culture, to reproduce, recreate and maintain the society over time.

From a psychological point of view the family is a space for training and development of the individual and collective personality of its members. It is good to recall that the family exerts a decisive influence during their first years, given the ability its members have to provide meaningful experiences for constructing the children’s identity through its dynamic interrelations.

The family is a complex network of permanent and stable relations based on affective bonds and functions and roles of its members. It provides them with experiences that contribute to their development and individual and social identity as well as the construction of ways of seeing the world and entering to it by acquiring elements of the culture in which it is registered.

Now, the meaning of these experiences is different for everyone. The way and intensity with which the family members relate to each other and with the environment and the contexts it belongs to varies and affects each member differently. The family promotes the construction of personal and social identity and when it is conceived in the difference and generates important experiences for its members, related to the

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ability to recognize others, arrange, solve conflicts, recognize that existence is incomprehensible without the other.

Thus, the family provides an identity reference. Norms, values, cultural elements, among others, contain meanings to be internalized making part of what every human being is and those environment and contexts to which it belongs. Thus, the family becomes a mediator of processes of inclusion of its members in society, and generates the required line so they can carry out their personal projects, and collabo- rates in the construction of the projects of others and of society itself.

In short, it can be said that a good comprehensive development for children is possible through family socialization, providing them with rewarding experiences to develop their capacity to feel unique, safe, willing to recognize each other and with suitable resources to live in society.

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Family Characteristics The family has a set of attributes, making reference to its condition of collective holder of rights, to its dynamic system, and to the set of functions and roles that its members follow.

The Family as a Collective Group The collective condition makes it possible to recognize the family We like to jump on the as a unit with self-determination, with characteristics, capabilities, and bellies of large own vital moments. Also to appreciate its different forms and organiza- people, ride on tion as an expression of diversity, and to value the advantages of each their backs or of them to exercise its functions of affection, support, solidarity and balance us on survival of its members. their legs; hide, show our face and make bu! Families Live in Permanent Transformation and get them The family is characterized by its openness to the environment very much with its own development activity. Both elements make it an entity scared . We also in permanent transformation impacting its environment. Both chang- like to play with toys, but less . es caused by internal and external factors manifest in different ways and having different intensities depending on the moment they occur; some are more critical than others, deserve different positions and lead to reconfigurations in the family to overcome the crises caused. The family confronts all this in different ways according to their resources.

The family is transformed with the arrival or departure of its members; with changes in their functions and roles, with the way of conforming, with the improvement or loss of income, with the consequences of favorable or adverse conditions. When these changes are made in a proactive manner, they enrich the family life and relations between its members.

Families have Different Compositions The Early Childhood Comprehensive Care Strategy recognizes the diversity in the composition of families in Colombia: there are nuclear families - composed of father, mother and children - and there are single

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parent families where there is only one of the parents, called families with female or male headship; there are also extensive families, those consisting in addition to parents and children, of grandparents, uncles or cousins. There are polygenetic, or reconstituted families composed of children who come from previous biological families of the spouses, and there are also families formed by same-gender couples.

Family Members Play Various Roles Indeed. Family members play different and complementary roles: father, daughter, grandmother, uncle, which in turn are combined with the roles they play in society: student, worker, leader. Roles create commitments and responsibilities to individuals with themselves and with others, causing feelings of complacency or dissatisfaction, impacting directly on domestic relations.

Some roles within the family are clearly identified because they match the conceptions and expectations of society regarding the family. However, there are changes like the ones having to do with gender, where aspects such as tasks distribution at home, responsibility for economic provision, or the type of relations established with the children, have greater diversity.

Similar is the case of children conception; it has an impact on how to relate to them, on rearing practices at home, on how to promote their comprehensive development.

Family Functions The family has three functions: sexual and reproductive, survival or pursuit of economic or material welfare, and socialization. Regarding the first one it stands out that even though the family is still one of the main sources to ensure the biological reproduction, there are other mechanisms such as assisted reproduction, which at present means that this characteristic is no longer exclusive to family structure. Sim- ilarly, it is necessary to highlight that sexuality also transcends the reproductive function.

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The survival and material and economic welfare function ensures the physical survival of its members and allow them to satisfy their biological needs. However, meeting these needs is not enough for human development. Living together requires - affective, social, communica- tive life - to provide binding experiences.

Therefore the third function acquires meaning: socialization of children in order to foster their development as individuals and as social individuals. This function enables the creation of affective links from relationships that generate attachment and provide affective and emotional security allowing them to be accepted and recognized as valuable and worthy of being loved.

The family is responsible for transmitting culture to children, to in- troduce them to its different expressions, social relations and language codes, and their various standards, guidelines and values.

Not to forget that the family is the first social group they belong to and serves as reference, the closest and most intimate one that children have at birth and from which they depart to start living and develop in other various social groups. Thus the importance that family has for the Strategy and to be considered as subject of comprehensive care.

Environments where Children Develop5

The environments (Entornos in Spanish)6 , are physical, social, and cultural spaces inhabited by human beings, in which there is intense and continuous interaction between them and the context that surrounds them (biological and physical space, ecosystem, community, culture, and society in general).

5 This section was developed based on elements provided by the reference study for the “ Technical Guidelines of Environments Promoting Development “ developed by Ernesto Durán Strauch, Intersectoral Commission for Early Childhood Comprehensive Care with the coordination of the Ministry of Health and Social Protection and the support of the Inter American Development Bank (2012).

6 In Spanish there is a difference between the words “ambiente” (environment), and “entorno”, while in English the same word is used. In education, environment has a particular connotation that is not used by the Strategy. Therefore it is essential to take into account the meaning that the Strategy gives to the environments as a broader concept that is fully explained in this chapter. 108 Technical Grounds for the Strategy

It is characterized for having precise and visible contours, people with defined roles and an organizational structure. Its wealth lies in the ability to promote the development of children, to promote the construction of its subjective and daily life and to link them with the social, historical, cultural, political and economic life of the society they belong. This is why for the Strategy environments are vital and as we will see in the third part are important organizers of comprehensive care to early childhood.

The Strategy recognizes that environments are different as it is the territorial wealth of the country in terms of physical, social, and cultural conditions in departments, municipalities, the municipal seat, and rural areas. All affect, in one-way or another the development of early childhood. It is important to emphasize that those who favor development are those who promote and guarantee the comprehensive protection of children’s rights, to:

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• promote and care for their physical, emotional and social integrity;

• generate confidence and trust in children;

• be sensitive to their interests, concerns and capabilities;

• enhance their development;

• facilitate the inclusion of children from different cultures, ethnic groups and children with disabilities, and

• promote social equity, peace and harmony between people and the environment.

The children’s life within different environments is influenced by a set of factors affecting directly their welfare and development. These conditions are recognized as different types of determinants: biological, social, political, economic, environmental, and cultural. Its power to impact on children’s lives since pregnancy and during their first years demands actions to protect them under favorable conditions or modify them otherwise.

To grow surrounded by affection, attention, assistance, respect and recognition, enables children to feel loved, accepted and valued,

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to have high self-esteem, to better develop their autonomy and identity, to better face the difficulties, to be able to live with others and to establish relations of coexistence, and to have more tools to participate in society.

Adverse determinants are the basis of inequalities and inequities, injustice, exclusion, discrimination, violence and poverty. Overcoming it involves not only the development of processes allowing individuals, families and communities to exercise more control over them and full compliance with individual and family responsibilities; commitment of political and social order is also required to implement political, economic, environmental, social and cultural transformations ensuring environments that guarantee dignified living conditions to all Colombians.

The environments where children’s daily lives take place during their early childhood have been expanded to the extent that society has become more complex. Similarly has happened to institutions, the roles of social stakeholders that constitute them and attributes required of them. Thus, for example, increase of women participation in the labor, political and social world has made it necessary to have different spaces to accommodate children and look for qualified care, to be timely and relevant.

In order to organize comprehensive care to early childhood, the Strategy has highlighted four environments needed to ensure those human, material and social conditions that make development possible and full exercise of rights according to the life cycle they are in:

• Home

• Health environment

• Educational environment

• Public space

Although these are not the only environments where the children’s lives take place, the Early Childhood Comprehensive Care Strategy

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takes them into account so that the country guarantees its quality, including the development promotion through simultaneous and concurrent assistance to girls and boys.

The Home Environment The home is the closest environment to the children thanks to the crucial role the family plays, (and even the community in the peasants’ case, indigenous groups and some, African descent and black people, raizales, palenqueros and gypsies where family has a leading role in the upbringing). Home, in its wider sense, represents acceptance and affection; it is a space where they spend most of their time from early childhood providing them with basic social and cultural references with which they start moving through society.

Starting from pregnancy, the home begins to be transformed. New roles, relationships and dynamics are looking to give form to life of the new member. Expectations, affections and emotions that accompany pregnancy produces close ties of the new being with adults surrounding him/her. Thus the importance that pregnant women have adequate and safe support provided by those who accompany them.

Different spaces at home also undergo transformations in trying to admit children. New elements, new dispositions, new glances on the conditions of security that the small ones require, concur along with the relational elements trying to provide a favorable development environment..

From birth and beyond care and upbringing are actions owned by those who accompany children at home. Significant adults in the life of the new family member - not only the mother as it has been the traditional role-, take part in those chores and provides accompaniment.

If adults involved are sensitive to interests, feelings, and capabilities, and as a result respond in a timely and adequate way to its manifestations, i.e. if they build meaningful relationships, these actions will help make the home a beneficial environment for children.

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Since the home is a gathering place, it is an environment where conflicts are present. To this extent, mechanisms must also be present to achieve their resolution by avoiding the use of physical, emotional or moral violence. Screaming, threatening, insulting, mocking, hitting, humiliating, among others, bring adverse consequences for children: resentment, pain, fear, sadness, hopelessness, confusion, insecurity, and revenge desires.

Finally, the home has to be a safe environment. So its spaces, elements and surroundings have to be modified to prevent accidents, emergencies or disasters and help defend life in case of a hazardous event.

Health Environment At the start of the life cycle, this setting also understood in a broader sense, occupies a fundamental place because it is the first institution that welcomes children. It accompa- nies the process of preconception, pregnancy, birth and onwards, with the fundamental aim of preserving the existence of children in conditions of full dignity.

Quality and warmth are qualities that must stand out in those who accompany children in the health environment in order to be beneficial for them. Then suitable and competent health personnel is required, who are also interested in people, ready to listen, to communicate with simplicity, committed and supportive of life, able to interact with each pregnant women, each girl, each boy and their families, and ready to have empathic and genuine relations, sensible, respectful and amiable personal treatment, that goes beyond assistance. It is urgent that actions in this environment be the example of a humanized health.

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The health environment also plays a very important role in the promotion of good treatment and in the prevention and protection against domestic violence and any other form of violence against women, boys and girls, as well as in the prevention and protection against abuse and exploitation.

A health institution protective of girls and boys welcomes them with priority, it has no access barriers, is capable of interacting with its contexts, to respect the differences, to recognize and assume human diversity as a value and make of it an opportunity for a comprehensive development. It also has suitable spaces to accommodate safe and comfortably pregnant women, children and their families. These environments recognized and made possible are the way to be in the world during early childhood.

The Educational Environment This environment deliberately encourages pedagogical actions allowing children to experience and go deeper in their condition of holders of rights, participative citizens, transformers of themselves and of reality, creators of culture and knowledge. These relations between peers, teachers, and other agents, play a crucial role. This is a privileged environment to explore in depth the experience of living together, to meet and to respect each other, to gradually internalize and steadily construct basic rules of coexistence.

By guaranteeing human, material and spatial conditions, pertinent, timely and of quality mediated by pedagogical intention, the educational environment is one of the first scenarios where they encounter diversity in an ongoing process of cultural and social relations that offer

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them confidence and security. So the educational environment is the place to express emotions and ideas through different languages, to explore the physical, social and cultural world, to pose questions and possibly to gamble hypothesis, all those elements that contribute to strengthen their identity and autonomy.

However, all these possibilities will contribute to comprehensive development if marked by intrinsic education care practices characterized by interaction, exchange and affection. As said, the educational environment requires an intentional work by, especially by experienced teachers, educational agents, and trained officers to do so, who should lead to challenging situations promoting interactions and activities that enrich the spontaneous and natural contact of children with themselves, with the environment, with adults and with their peers. All this in the context of welcoming environments, safe and protective, ensuring favorable conditions of location, infrastructure, security, accessibility and comfort.

The educational environment needs to combine actions related to health, food and nutrition, with care and upbringing by families and caregivers, with recreation, protection and participation of children in early childhood. Only then can comprehensive care be guaranteed in this environment and thus contribute to construct of a more equitable country.

This certainly implies the promotion of learning processes aimed at all stakeholders (parents, mothers, caregivers, educators and community in general) to qualify their performance in the promotion of comprehensive development of children. It is possible to emphasize that the educational environment carries out a fundamental work in education and accompaniment of families in their experience to welcome, take care and up bring their daughters and sons.

The Public Space Environment This environment is composed of free access open spaces (plazas, parks, roads) and places in infrastructures to which the community gives political, historical, cultural or sacred value (libraries, playgrounds, hous-

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es of culture, museums, theatres, temples, Malocas, participation scenarios). The first are sites of intense social activity, the second preserve the inherent common good values, keep the collective memory, and protect the venerable. Both express the collective will of social assets.

This environment has a vital role in children’s identity, citizenship and democratic education, as it constitutes a vital and humanizing space to integrate their condition as living, social and cultural beings. A public space that provides early childhood development has fundamental social and cultural elements for building sense of belonging, is a source of relational experiences to establish ties with others, allows contact with a historic past, contributes to the development of creativity, aesthetic sense, and enjoyment of art and cultural property.

The public space contributes significantly in the socialization of children because there they see the organization and how society works, interact with people of different ages and characteristics, appropriate cultural heritage, build their identity, and learn from the world.

The design of the public space that welcomes children and promotes its development makes them visible, recognizes them, listens to them and takes them into account. It promotes and ensures good treatment, social inclusion and non-discrimination. It establishes solidarity, respect, acceptance and valuation of differences, and prevents all forms of violence against them.

The diversity of environments and stimuli that public space provides demand to take into account different aspects in its maintenance, accident prevention, preparation and action in case of emergency and disaster and to guarantee mobility and information for people with disabilities. Due to public spaces characteristics and its teachings, it is important to encourage environment protection and ecosystems conservation.

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Comprehensive Care Fundamentals7

The first part of the Strategy was dedicated to present advancements and reflections of the country regarding understanding childhood, comprehensive development, the role of the family, its context, and environments promoting development. Upon entering this second part, these concepts are linked with action through a setting in the doctrine of comprehensive protection, emerging from international regulations framework and is the guiding reference of the State management to make comprehensive care for early childhood true. When our mothers are Comprehensive Protection, an Action happy and Framework for the Strategy calm, we are too . When they are The Comprehensive Protection doctrine collects philosophical and sad or angry we stay very quiet . ethical ideas, and political and regulatory developments to consider how to conceive, assume, recognize and guarantee the children’s rights from a rights-based approach.

The United Nations doctrine on comprehensive protection, involves the total universe of the child-juvenile population. This doctrine includes all individual and collective rights of future generations, i.e. all rights for all children. This situation makes every child and every adolescent a holder of rights to be enforced. For us adults, recognition of this condition results in the need for the rules of the democratic State to work for childhood8.

This doctrine was picked up by the Convention on the Rights of the Child and is part of the regulatory and political internal adjustment process of Colombia. It has been incorporated as a central tenet of the Code

7 . This section is developed from elements provided by the reference study for the “Technical Guidelines for the Comprehensive Protection of Children’s Rights since Early Childhood”, prepared by Martha Lorena Padrón, Intersectoral Commission for Early Childhood Comprehensive Care coordinated by ICBF (2012).

8 Emilio Garcia Méndez (1984). Rights to Childhood and Adolescence in Latin America: From irregular situation to comprehensive protection. Santa Fe de Bogota: Forum Pacis, p. 11.

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of Childhood and Adolescence9; it is a reference that guides the design and implementation of the Early Childhood Comprehensive Care Strategy.

The Code of Children and Adolescents (Article 7) contains the comprehensive protection in four imperatives regarding the children’s rights:

• recognition of ownership,

• warranty and fulfillment of their rights,

• prevention of threat or violation, and

• full restoration when they have been violated.

In turn, the Code complements saying that regarding management:

Comprehensive protection is embodied in the set of policies, plans, programs and actions at national, departmental, district and municipal levels

9 . Law 1098 of 2006

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with the corresponding allocation of financial, physical and human resources (Art. 7, Code of Childhood and Adolescence).

Similarly, the code defines that the responsibility of actions condu- cive to ensuring the exercise of the rights of children is shared between different State stakeholders, the family and society, and that these must happen concurrently.

Summarizing we could say that comprehensive protection leads to a transformative role of conceptions about children, their place within society and adults roles. It also raises the manner and type of actions through which the guarantors of rights (State, family and society) should perform responsibilities regarding comprehensive development resulting in comprehensive care to early childhood, guaranteeing the development of children from the rights-based approach.

The comprehensive protection principles of Law 1098 of 2006 are:

• Higher Interest. “Forcing everyone to ensure comprehensive and simultaneous satisfaction” of children’s rights (Article 8, Law 1098 of 2006). It implies that the measures to be taken to fully protect a girl or a boy should be based on the legislation that gives effectiveness and enforceability for their rights (Cillero, 1999).

• Prevalence. Locates the children’s rights in supremacy over the rights of other persons, because are classified as fundamental and of higher level. Thus, in any act, decision or administrative, judicial or of any kind to be taken in relation to the children, will dominate their rights, especially if there is conflict between these and those of any other person (Article 9, Law 1098 of 2006).

• Co-responsibility. Refers to the concurrence of actions by the State, the family and society in accordance with their specific competences, for the promotion and guarantee of the fulfillment of rights as well as prevention of non-compliance situations, threat or violation and its restoration. Actions must be concomitant, coordinated and articulated (Article 10, Law 1098 of 2006).

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• Enforceability. It empowers anyone to demand from the competent authority compliance and restoration of children’s rights, establishes the unavoidable responsibility of the State to respond with appropriate actions at all levels and through each of its agents, guaranteeing achievement, protection and restoration of children’s rights (Article 11, Law 1098 of 1996).

• Equity. Guide actions to achieve justice towards children, taking into account that everyone should enjoy equal opportunities and conditions for the exercise of rights, regardless of their social status, race, gender or age.

• Social Inclusion. Actions to ensure that all girls and boys can enjoy those conditions that ensure their full protection.

• Solidarity. All stakeholders must cooperate to create conditions that favor the development of chidren10.

• Complementarity. Recognizes the specificity of each stakeholder and the relationship of interdependence that their actions hold in favor of the public interest regarding others actions. The relationship based on this principle strengthens the creation of a collective awareness of what is public, expanding the cultural consensus among human groups, social and culturally diverse, and strengthens the management capacity of local politics in favor of early childhood.

• Subsidiarity. Ensures compliance and restoration of children’s rights when the titleholders cannot do so, through regulation or allocation of competencies to certain authorities or stakeholders by the State.

10 In accordance with the jurisprudence of the Constitutional Court, it can be said that there are three statements of the solidarity principle: (i) as a pattern of behavior; (ii) as a criterion for interpretation in the analysis of acts or omissions of individuals who violate or threaten fundamental rights, and (iii) as limit to own rights. (Cf. Technical guidelines for the general framework and guidelines for public policies and territorial plans regarding childhood and adolescence. ICBF, May 7, 2007).

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It is worth highlighting that according to the Code of Childhood and Adolescence, these principles are not optional. They are mandatory to those responsible for guaranteeing the rights of children; in such a way that their actions and decisions correspond to what is most appropriate for comprehensive protection. As it will be discussed later the comprehensive care to early childhood Strategy has been designed entirely in coherence with this doctrine.

Children’s Rights and their Realizations: The Strategy’s Commitment

The comprehensive protection central element is to guarantee the child’s rights. Its raison d’être. In addition the law delves into its features and defines rights as:

• Universal, that is, applicable to all mankind, in all time and places, without distinction of age, gender, race, culture, ideas, social or political status.

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• Indivisible, because it cannot be shatter, separated into parts, or distributed or shared among several people.

• Interdependent, as they relate among themselves not in a hierarchical or subordination way that implies that one is more important or that may become effective at the expense of others.

• Irreversible, because rights are lasting and irrevocable. Once recognized, they acquire the status of inherent human dignity and are not lost in the course of time.

• Progressive, considering that they become complex and expands as the human being develops and that new social conditions will be determining the validity of other rights.

• Demandable, given that compliance must be guaranteed, effectively carried out and in case of violation, restored.

• Unrenounceable, because is not possible to decline them, transfer or separate them from the person.

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As a breakthrough of the country regarding the children’s rights in early childhood, the Intersectoral Commission has raised a horizon of meaning to the Strategy that focuses on the concept of Realiza- tions (Realizaciones in Spanish). This refers to conditions and states that materialize in the life children, making possible their comprehensive development.

The realizations raised in singular for each girl and boy and in present tense, imply that:

1. Has a parent or primary caregivers who welcome it and put into practice parenting guidelines that promote their integral development.

2. Live and enjoy the highest attainable standard of health.

3. Enjoys and maintains an adequate nutritional status.

4. Grows in environments that promote their development.

5. Build its identity in a context of diversity.

6. Expresses feelings, ideas and opinions in their everyday environments and these are taken into account.

7. Grows in environments that promote their rights and act upon exposure to situations of risk or violation.

Thus, each realization show evidence that children’s rights are exer- cised. At the same time call for all stakeholders involved in the promotion of integral development to make rights a reality; to be present in everyday environment, to permeate their contexts and interactions and to express them in their lives.

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Early Childhood Comprehensive Care

When referring to comprehensive care, the Strategy raises the challenge of collectively defining their structuring factors (estructur- antes in Spanish), to be meaningful, coherent, and consistent. Also organized between levels of government, sectors and institutions to ensure that actions reach children in a concurrent, complementary, harmonic, relevant and timely way.

What is it about? Comprehensive care, recognized as the means for the stakeholders responsible for guaranteeing children’s rights to full development in early childhood, to materialize in an articulated way the comprehensive protection. To make this so, actions must be cross-sectorial and take place at national and territorial level.

In turn it includes social, political, programmatic and budgetary fields, and they are intentional, planned, continuous, relational and effective. These actions attributes allows an interest to ensure that in each environment children live in there are human, social and material conditions ensuring promotion and enhancement of their development. In effect:

• To say that comprehensive care is intentional, highlights that its actions are directed to conscious and valued purposes showing how to interact significantly and in a timely manner with the child and with their environments, in order to contribute to their overall development.

• When saying that it is relational it is understood as a result of a process of social interaction that occurs in environments with particular conditions and contexts, where the stakeholders involved are recognized and influence each other.

• Its effectiveness is given by its orientation to concrete results in the children’s life. In this sense comprehensive care reaches its intentions.

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Comprehensive care has the following additional attributes ensuring that the quality is intrinsic to its nature:

• Relevant: It responds to interests, characteristics and potentialities of the children at the time of their life cycle, and the characteristics of their environments.

• Timely: Means that it occurs at the right moment and in the place that corresponds. It is effective in the right time.

• Flexible: It ensures that it is open to adapt to persons, contexts and environments characteristics.

• Differential: Values children as beings that are built and live in different ways. It is sensitive to their particular characteristics because of the diversity of situations, conditions and contexts, and intentionally acts on the environments to transform situations of discrimination.

• Continuous: Occurs on a regular basis and thus guarantees the time that children require for their individual development process.

• Complementary: Their actions contribute to attention comprehensiveness as a result of joint interaction and articulation between the stakeholders responsible for the comprehensive protection of children in early childhood.

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Early Childhood Comprehensive Care Structuring Factors

The National agreement11 reached regarding what comprehensive care encompasses and that it should be guaranteed to all children to ensure their comprehensive development is focused on five Structuring Factors namely:

• Care and upbringing

• Health, food and nutrition We grow when • Initial education we can play with adults • Recreation and especially if they tickle • Citizenship and participation us . That is the remedy against Consequent to the qualities of comprehensive care established, all sadness . these structuring factors materialize thanks to the concurrence of stakeholders responsible for the comprehensive protection of children, taking into account their specificities and daily lives experiences.

This section contains technical guidelines cross-sectoral and ter- ritorially12 agreed that provide all stakeholders involved, conceptual and operational criteria to implement each structure and favor the realizations of children in a context of completeness. Allow stakeholders involved to reflect on the work; that the sense and intent of

11 This agreement is the result of the Intersectoral Commission for Comprehensive Early Childhood Care that included the process of social mobilization for territorial feedback, and experts from the Comprehensive Care Road-map (Ruta Integral de Atenciones) in 2011 and documents based on technical guidelines in 2012 attended by nearly three thousand people of recognized suitability in relation to Early Childhood Comprehensive Care, belonging to public entities, private organizations of the civil or community society present in the country and who share the responsibility to ensure the children’s development

12 To carry out the collective construction of these guidelines the Intersectoral Commission for Comprehensive Early Childhood Care looked at three moments: First the preparation of reference studies on each of the structuring factors of comprehensive care, second to develop a process of social mobilization that would allow its territorial feedback and with experts and third to produce the guidelines. The social mobilization process involved 17 territories representing the various regions of the country.

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comprehensive care are shared and materialized in practice, regardless of who or which entity developed them, and that they contribute to the national purpose of ensuring full development of children during early childhood.

Following are the framework guidelines developed for each structuring factor. It should be noted that the Strategy has a number of tools (guides, manuals, protocols, etc.) that technically orient each structure own actions.

Care and Upbringing This structuring factor seeks to promote and strengthen the links between children with their family and with the persons responsible for their assistance through by creating rich, safe, protective, inclusive, participatory and democratic environments.

The development of the structuring factor technical line has two large fields of action. The first related with training and support to families by its leading role in this aspect, and the second relating to the restoration of rights, on the understanding that care is also related to aspects of prevention and protection to safeguard the integrity of children.

Training and Accompanying Families13 The fact that home is the first environment where children interact and that the family and nearby community are social determinants and stakeholders par excellence of this environment, it is necessary that within the Early Childhood Comprehensive Care Strategy to contem-

13 This section is developed from elements provided by document “ Analysis of the Most Significant Experiences Developed and Guided Towards Strengthening the Family for Full Development of Children and Adolescents”, developed by Leonor Isaza Merchán together with Carmen Midaglia [Uruguay] and Héctor Rodríguez [Mexico]) (2011) and the reference study for the “Technical Guidelines on Education and Accompaniment for Families of Children in Early Childhood” by Ángela Patricia Nocua Cubides (2012), both produced for the Intersectoral Commission for Comprehensive Early Childhood Care coordinated by the Colombian Institute of Family Welfare, as a result of technical cooperation between the Inter American Children and Adolescents Institute, and the Government of Colombia.

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plate actions to support and prepare families to have all the elements required to strengthen emotional ties with its members in early childhood, and to contribute in the configuration of homes as rich, safe and participating environments14.

This means having a solidly structured component of work with them, prompting permanent education and accompaniment processes to strengthen the leading role in the development of children.

• Training consists of a series of actions with educational intent aimed at facilitating families’ reflection on their dynamics, openness to alternatives and the construction and enrichment of new practices and patterns of relationship.

• Accompaniment on the other hand, is a process intended to be next to the families in their development processes. Both training and accompaniment can be carried out with personalized methods per household or using mechanisms to group several families, and in any case must be guided by a few guiding principles (Isaza, 2011).

Taking into account the various forms of family organization as well as the cultural and social contexts of the country, the overall purpose of the training and accompaniment is the building, transformation or strengthening of family dynamics that are oriented to- ward affectionate, warm, caring, friendly, equitable and participatory interaction patterns among different members of the family particularly children from early childhood, giving priority to enrich the following processes:

• Expressions of affection, solidarity and configuration of playful and pleasant moments, promoting a sense of belonging in the families and the inclusion of children as an important part of them.

14 Studies of neuroscience, development psychology and related disciplines, coincide in declaring the convenience of favoring the children’s care during the first five years and emphasize the importance of qualifying the assistance they receive in the family environment, as a factor that guarantees the sustainability of adequate comprehensive care.

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• Democratic power relations between genders and generations, that facilitates conflict resolution and support in open and constructive communication styles.

• Involvement of children in decisions affecting them as individuals or as family members.

• Family environments promoting physical and social security for children, their health and nutrition and the development of their capabilities and potential.

• Empowerment of families to access services that guarantee the rights of its members and also their rights as a social group.

• The construction and strengthening of family or community support networks in which families actively participate to strengthen relations and projects in favor of children.

Following are some criteria to take into account when designing training and accompaniment programs15:

15 Idem

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• To recognize families as collective holders of rights and not only as guarantors of the rights of children in early childhood. The condition of collective family subject, makes it possible to conceive it as a unit, with its own characteristics, capabilities and vital moments, which must be met at the time of accompanying it while exercising its responsibility of developing its early childhood members. This implies:

–– To appreciate its distinct conformations and organization as an expression of diversity, and evaluate its advantages to exercise their functions of affection, support, solidarity and survival of its members.

–– To involve them as individuals with self- determination in the structuring and development of accompaniment and education processes considering its knowledge and practices.

–– To be sensitive towards the relationship developed between the vital moment of the family and its members in early childhood.

• To consider the resources families have to act in search of the welfare of its members. In addition to their skills and abilities, family groups develop strengths resulting from facing domestic and external pressures16 they are exposed to when searching for a good achievement of their purposes. The first have a great emotional burden for their members and are difficult to perceive. The latter originate in other social systems and expose it to confront limitations. Skills, abilities and strengths are the

16 Among domestic pressures are tensions inherent in relationships, the performance of roles, the vital moments of its members. External pressures are the armed conflict, the conditions of poverty and exclusion, and natural disasters among others. To these, we can add a long tradition of patriarchal models or violence affecting families, as well as pressure from the media for keeping life status impose even higher pressure to adults, or just the confrontation of internal family changes like the birth of children.

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best capital to leverage processes oriented to qualify family dynamics, in a context of dialogue and exchange of knowledge between families, communities, educational agents and other social stakeholders.

• To have a gender equality approach that guide the relations between men and women without predominance of either one. This equitable approach wants that care and upbringing responsibility be shared by men and women, leading to strengthening everyone’s capabilities. Gender equity involves the pursuit of agreements regarding male and female roles. It assumes the valuation of gender difference to be able to complement.

To make visible and include the cultural diversity of the regions, ethnic groups or areas of settlement as well as the different capacities of children, and families. In addition, in a multi-ethnic and multicultural country like Colombia, education and accompaniment to families must take into account ethnic, cultural, regional diversities and (urban, rural) settlement area to develop differential processes that take into account beliefs, repre- sentations on the family and ways to relate as well as the early childhood conceptions.

It is important to consider families with children with disabilities, to have a particular way of fortifying them and their family, to have access to assistance according to their age, specificity and context, and to recognize their human value and the possibilities of capacity development.

• To accept that changes or transformations of family systems are complex and require long-term systematic processes. This means that education activities should be continuous and suitable so families can make required changes in a sustainable way. In this sense, it is necessary to promote the accompaniment processes to supplement the education scope and guide the families according to their specific characteristics.

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As part of the Strategy design, the country has a set of working guidelines directing the attention of this structuring factor concerning education and accompaniment of families, expressing , the priority processes that must be enriched, outlining elements to be taken into account in the design of programs and methodologies most appropriate to work with families.

Reestablishment of Rights17 According to Article 50 of the Code of Childhood and Adoles- cence (Law 1098 of 2006), the restoration of the children’s rights make reference to “the restoration of their dignity and integrity” as individuals and the ability to effectively exercise the rights those violated to them18.

In this sense the Colombian Institute of Family Welfare established technical guidelines to regulate the routes, management and attention model for the restoration of rights19, in situations that may affect them by non-compliance, threat or violation of these.

• Non-observance consists of failure to comply, omission or denial of access to a service, or of duties and unavoidable responsibilities of those who are responsible for ensuring the full exercise of rights of Colombian or foreigner children in the country or nationals living abroad.

• Threat refers to the situation of imminent danger or risk for children to exercise their rights.

17 This section is developed from elements provided by the reference study “Technical Guidelines for the Comprehensive Protection in the Exercise of Children’s Rights since Early Childhood”, prepared by Martha Lorena Padrón, Intersectoral Commission for Comprehensive Early Childhood Care coordinated by ICBF (2012).

18 According with ICBF guidelines. Resolution 2785 of July 10, 2009 “Technical guidelines for the administrative process of re-establishment of rights is added, approved by resolution 911 of May 7, 2007 added by resolution 4104 of September 29, 2008.”

19 Resolution 5929 of December 27, 2010, “Technical Administrative Road-map and Actions Guidelines, and Assistance Models for Restoring Rights of Children, Adolescents and of Age with disabilities, threatened, not observed and violated rights “, modified by the Resolution 707 of February 28, 2011, and added by Resolution 2850 of 2012.

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• Violation denotes any situation of damage, harm or injury that prevents children from exercising their full rights.

The children may be in an unprotected situation to exercise their rights when their basic needs are neglected long enough to cause them serious damage to their welfare and development, either by the behavior of family members, by the conditions in which it is, or by difficulties or circumstances external to this (Cantabria 2011).

An unprotected situation occurs when three conditions are combined:

1. A person or service responsible for ensuring the satisfaction of one or more basic needs of a child does not meet its responsibility (because it cannot or don’t want to). Or certain external conditions are given that prevent that person or service from satisfying them.

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2. There is no external agent capable of counteracting this situation and to satisfy the needs, or actions of these agents is not enough.

3. As a result of this situation, the child has suffered or is likely to suffer significant health damage, welfare or development (Cantabria, 2011).

The violation of rights is associated to all those environments where children’s life happens. The home, the institutions where they are cared for and comprehensively assessed, public space, etc. The State, the family and society must act immediately, generating alerts to support the restoration of children’s rights and the implementation of measures by competent authorities.

To identify violation situations, threat or non-observance, the institutional or community stakeholders may rely on physical, behavioral and family signals seen in them and in their families. There are indicators that according to the particular area in which they act are more or less visible. The health personnel, for example, has greater facility to detect physical signs that go unnoticed to other people; In addi-

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tion, teachers and other educational workers have privileged access to children’s development and everyday behavior characteristics , their families or caregivers.

The restoration of rights includes actions and comprehensive efforts to restore them fully and effectively, and if needed with the implementation of measures by the competent authorities in the interests of providing assistance, care and immediate protection to children.

The restoration actions demand from the State, to act in a coordinated, concurrent, and articulated way with the family, institutions and the community, to create alternative solutions. Given the impact of situations of violation on children’s development, the country’s effort is that all the instances and people who must take part to restore their rights act in a sensible and empathic way with those who have undergone such situation. It is also essential to enrich the environments and shelters through which children must move over the course of the restoration of their rights so that they are an example of dignity and warmth.

Health, Food and Nutrition20 This structuring factor seeks to preserve the existence of children with full dignity promoting their welfare, preventing of conditions that alter it, treating diseases with quality and warmth, and rehabilitating their emotional and functional stability for an autonomous and active existence.

Health, food and nutrition are fundamental rights, which are closely related and are part of the social determinants of child development.

• Health is defined as the physical, mental and social welfare of people, enabling them to lead productive, social and economic

20 This section is developed from elements provided by the reference study “Technical Health Guidelines in Early Childhood”, and the “Technical Food and Nutrition Guidelines for Early Childhood”, developed by Blanca Luz Hoyos Henao and Nora Corredor Martinez respectively, for the Intersectoral Commission for Comprehensive Early Childhood Care with the coordination of the Ministry of Health and Social Protection (2012).

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lives (WHO, 1946, 1977). This concept goes beyond the absence of disease and involves conditions that favor the development of capabilities to fully exercise their freedom in decent living conditions. When it comes to children in early childhood, this welfare depends significantly on adults who surround them.

• Nourishment is a biopsychosocial and cultural process, related to the consumption of food that helps human beings get the nutrients they need to fulfill their vital functions and achieve a full life. Food is essential to stay alive and healthy, and is object of ritual and symbolic interpretation, and economic, social, political and cultural manipulation (Pelto and Pelto, s. f., in Romero, 1993).

Nourishment is the first event in children lives that attracts the attention of mothers, parents, caregivers and those who are around the child. It is a social event, and also a factor involved in the construction of identity and sense of belonging to a family and a community.

During the first thousand days, from pregnancy and up to two, nourishment plays a crucial role since the formation of billions of nerve cells occurs during this period and 85% of the communication network between them is established, allowing the transmission and reception of information between brain, body and environment.

• Nutrition, refers to a fundamental process for the development of children, where the body assimilates and takes advantage of nutrients coming from food. Nutritional status affects the survival and quality of life, therefore is one of the best indicators to assess the children’s health condition.

Health conditions, as well as those of nutrition, are the result of interaction of biological, social, political, economic, environmental and cultural decisive factors that shape the circumstances in which the child is born, grows and lives.

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Based on this framework and based on decisive factors as a perspective of analysis and organization, the Strategy identifies the following as actions related to health, nourishment and nutrition:

• Promotion and Protection of Welfare seeking to empower children from early childhood and their families in the exercise of their right to health, and the promotion of equitable conditions guaranteed from preconception, so human beings begin their lives under conditions that enable them to achieve a comprehensive development regardless of their social, cultural or economic circumstances. We like to celebrate • Prevention, which purpose is to reduce the likelihood of our birthday conditions affecting the well being of children through its early because we now detection and intervention. we grow up that day . We also • Treatment and Care of health changes oriented to impact with like to go to the quality, warmth and comprehensiveness the effect on the welfare swimming pool, of children and their families in accordance with their own needs, look ourselves in pursuit of self-improvement. in the mirror and see that we • Rehabilitation seeks to promote and restore emotional and functional are growing . stability of pregnant women, children and their families, needed to ensure the continuity of its process of development and construction of an autonomous existence at the highest possible level of wellness.

In short, health, nourishment and nutrition assistance, in the framework of comprehensive care, comprises a series of political actions, intentional, and effective, that generate conditions and promote individual, family and social capacities to protect the comprehensive development of children. It develops its potential and specificities and context, anticipating health risks, addressing shortcomings in development and providing assistance with quality and warmth to those who are affected in their nutritional and health condition.

Through the promotion and protection of welfare, prevention, treatment and assistance of alterations of health and rehabilitation, it should reassure pregnant women, and children:

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• A healthy atmosphere - which means protective and promotional environments of development, favoring and promoting quality of life of present and future generations, through the positive transformation of social, sanitary and environmental decisive factors.

• A family, social and community coexistence free from violence, with strong links with caregivers, as well as social and cultural capacity of the latter to assist in all settings where their lives happen.

• The right to a healthy diet, appropriate, timely, secure, and consistent with the territorial and cultural specificities.

• Social, economic, political and cultural conditions that allow women and men exercise free, autonomous and informed sexuality as a human right.

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• Healthy lifestyles, modes, and conditions as well as access to comprehensive care during situations, conditions, and contagious21 and non-contagious22 diseases.

• Individual and collective protection against emergency risks or disasters, seeking to reduce damage affecting human and environmental health thus contributing to safety, welfare and quality of life.

In view of this health, nourishment and nutrition structuring factor, comprehensive care to early childhood:

• Tends to guarantee the rights to health, nourishment and nutrition of all women in fertile age, pregnant women and children from 0 to 5, in different environments, to ensure comprehensive development in early childhood.

• Looks to preserve the existence of children in conditions of full dignity, through the promotion of their welfare and development, prevention and early detection of conditions that alter it, treatment and assistance of disease with quality and warmth, and the rehabilitation and promotion of its emotional and functional stability to have an active life according to their cultural specificities and autonomous existence and territorial identity.

• Aims to impact the biological, social, political, economic, environmental and cultural determinants affecting health conditions, nourishment and nutrition of women in fertile age, pregnant and children from zero to five.

• Recognizes the responsibility of social stakeholders as a condition to manage the social decisive factors of health, nourishment and nutrition.

21 Emerging, re-emerging and neglected diseases; transmitted by air and by direct contact; immune preventable, and transmitted by vectors (etv) and zoonoses.

22 Non-contagious diseases (NCD) refer among others to the cardiocerebrovascular, cancer, diabetes, respiratory diseases of lower tract, chronic renal disease, and disorders affecting oral, visual, hearing and communication health.

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• Recognizes primary assistance in health23 as a fundamental part of comprehensive care to early childhood.

• It is consistent with the Strategy of Integrated Management of Childhood Illness (AIEPI, acronym in Spanish), with the initiative of Institutions friends of women and children (IAMI, acronym in Spanish), and Safe Maternity and Healthy Environments, among others. It behaves like orientation of actions in harmony with the public health ten-year plan in the territorial scope, and recognizes that children’s guarantee of health, nourishment and nutrition involves the participation of all stakeholders and sectors.

In turn from the perspective of health, food and nutrition structuring factor the Strategy provides precise information on the conditions that every woman should have in fertile age, pregnant women, and children. Next are some of the most significant topics for each population group clarifying that the Strategy has very precise guidelines and protocols.

Women’s Health and Nutrition • Health and nutrition condition

• Physical and emotional condition

• Eating habits and proper nutrition

• Reduction or temporary increase in vitamins and minerals. Consumption of folic acid to reduce neural tube defects

23 “Primary assistance uses methods, technologies and scientifically informed, socially accepted practices that contribute to equity, solidarity, and cost-effectiveness of health services” (Art. 12, Law 1438 of 2011). “The Primary Health Care Strategy consists of three integrated and interdependent components: health services, the cross-sectorial /trans-sectorial action for health, and social, community and citizen participation;” and shall be governed by the principles of universality, multiculturalism, equality and differential approach, comprehensive and comprehensive care, cross-sectorial action for health, community social participation and decision-making and joint citizenship, quality, sustainability, efficiency, transparency, escalation and irreversibility”(msps in agreement with the Centre for the Development and Evaluation of Policies and Technologies in Public Health (Cedetes), Universidad del Valle 2012).

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• Prior to pregnancy stop consumption of substances harmful to health

• Control of diseases or risk factors (diabetes, heart diseases, hepatitis B, rubella, chicken pox, HIV - AIDS, etc.)

Pregnant Women’s Health, Food and Nutrition • Health and nutrition condition

• Physical and emotional condition

• Personal hygiene

• Refrain from the use of psychoactive substances

• Antenatal periodic control before twelve weeks pregnancy, full and comprehensive coverage and warmth

• Inclusion in nutritional recovery programs if required.

• Consumption of micronutrients (ferrous sulfate, folic acid and calcium) from the beginning of pregnancy

• Full vaccination scheme during pregnancy

• Access without barriers to antenatal care and health services in general (dentistry, psychology, nutrition, laboratory)

• Early detection of conditions affecting the pregnant woman’s health and the newborn

• Prevention of mother to child transmission of infections diseases, including STDs (syphilis, HIV)

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• Active participation of the pregnant woman’s family in caring for the woman and the baby to be born, guaranteeing their protection and security

• Accompaniment of the couple or a significant person during childbirth process

• Humanized priority assistance and access to skilled birth assistance

• Respect, privacy and avoidance of physical, verbal and psychological aggression of women during childbirth

• Clamping of umbilical cord when it stops beating, contact skin- to-skin and initiation of breastfeeding in the first hour after birth

• Counseling about healthy lifestyles, alarm signs and symptoms of breastfeeding, sexuality, and violence based on gender, preparation for childbirth, and oral health

• Counseling about woman health self-care, her baby, breastfeeding and family planning: importance of birth spacing of at least 24 months

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• Comprehensive assessment of women before hospital discharge

• Home visits after birth, in the following month

Newborn’s Health and Nutrition • Health and nutrition condition

• Exclusive mother breastfeeding

• Neonatal screening in the first seven days

• Assessment of the development

• Vaccination full scheme according to age

• Iron supplement, vitamins A, D, E, K, and calcium for the infant with low weight at birth or with risk factors24

• Prevention and early detection, diagnosis and treatment in children with risk of blindness by prematurity and low weight

• Monitoring oxygen management

• Outpatient and hospital treatment of premature children and with low weight at birth25

• Counseling to parents and caregivers about danger signs, basic care of the newborn baby and the appropriate civil registry

• Comprehensive assessment of neonate before hospital discharge

• Home visits during the first month of life

24 Resolution 412 of 2000.

25 The Kangaroo program has demonstrated its ability to significantly reduce morbidity and mortality in a particularly vulnerable group of newborns. The body heat of the mother, exclusive breastfeeding and the Kangaroo (nestled between the breasts of mother), position are the basic principles of the methodology; However, above all, it is the loving and close relationship between mother and child that allows to improve the survival of children. The main characters are mother, father, baby and family and not doctors or hospital.

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Children’s Health, Food and Nutrition • Health and nutrition condition

• Physical and emotional condition

• Exclusive breastfeeding up to six months and complementary feeding up to two years

• Adequate and balanced diet

• Use of vitamins and minerals (vitamin A, iron, zinc)

• Vaccination full scheme according to age

• Child development follow-up

• Counseling to parents mothers, caregivers, and children about danger warning signs, accident prevention and key practices.

Initial Education26 As an unpostponable right of early childhood, initial education is a structuring factor of comprehensive care aimed to intentionally promote comprehensive development of children from birth to six, recognizing their characteristics and specificities of the contexts in which they live and favoring interactions generated in environments enriched through educational and practical experiences of assistance.

Initial education is valid in itself because the pedagogical work there discussed starts with interests, concerns, capacities and knowledge of children. This initial education does not search as ultimate preparation for primary school, but offering them challenging experiences that drive their development; they play, explore their environment, express themselves through art and enjoy literature.

26 This section is developed from elements provided by the reference study for Pedagogic Guidelines on National Initial Education, prepared by Graciela Fandiño, Yolanda Reyes, Sandra Durán and María Consuelo Martín, for the Intersectoral Commission for Comprehensive Early Childhood Care with the coordination of the Ministry of National Education and the support of the Inter- American Development Bank (2012). 144 Technical Grounds for the Strategy

Now, play, art, literature, and exploration of the environment as guiding activities of early childhood, point the way to create a “culture of initial education”. The foregoing means that far from being tools or teaching strategies, “used as a means to achieve other learning experiences”, they enable learning. The approach, which Garvey makes about play helps to explain this idea, saying that: “The child does not play to learn but learn when playing”, the same could be said regarding art, literature, and environment exploration. Painting and drawing, for example, appear in the context of initial education as activities that children use to express themselves, to build symbolic worlds, to make appropriation of real-world objects, among others, and not as a strategy to develop their fine motor skills, which does not exclude that master- ing brushes or crayons contribute to this.

The following are some guidelines listed which provide elements for pedagogical work in the framework of initial education.

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Play in Initial Education Conceived as a cultural phenomenon and a social practice play opens a new path on the moments of initial education that is recognized and understood beyond the instrumental.

Play becomes children’s natural form of language; they can express to others their intentions, desires, emotions, feelings. When playing, children can propose new rules to the game and they learn to wait for their turn and to share with others.

Play mobilizes structuring thinking factors allowing children to wonder about the use of objects and propose different ways to use Fish and them or transform them. These interactions help them to develop ob- yucca… servation and investigation skills, to be surprised, to give objects and Yummy environments a new meaning, to solve daily life situations. Children from zero to five play with their body, play traditional games, play to explore, play roles, play to build. Adults can accompany these playful activities through observation allowing the teacher, and educational agent, to know the children, to identify the right time to interact, to propose or to keep a distance. Also through interaction, that means to assume a role within the game that echoes with games proposed by them and enhances them with new ideas that contribute to building the playful universe.

Literature in Initial Education Understood as the art of working with words from the particular and subjective experience of children and of exploring other meanings that transcend the conventional use of language, literature is part of the fundamental artistic expressions in early childhood given the approach to verbal language.

Literature in initial education means to unconditionally support the desire of children to express themselves, to communicate, to be fasci- nated with fantastic worlds described by adults, of moving or lull to the rhythm of songs and lullabies, of playing with spoken and written words and of telling their own stories. 146 Technical Grounds for the Strategy

Books shape the existential questions and inspire and enrich the desire to learn. To respect children’s choices, give them importance and talk spontaneously about what was the reading about without forcing them to answer questions addressed by adults, is a source of knowledge about who these early readers are and arouses deep conversations about life that people need to know to get to know themselves and others, to name their own emotions, to imagine with empathy and sensitivity those of others, to think critically and to connect with mankind.

Although the literary experience is fundamental to approach written language, it is important to clarify that in initial education (and in general in all aspects of life), to read has the broad sense of vital decipher- ment, of exploration of symbolic worlds and interpretative possibilities, which means that reading cannot be associated or restricted to teach lyrics out of context, to write endlessly or teach prematurely.

Also, learn to communicate in writing is not simply to transpose oral language to a few signs on paper or other media, but to learn to think otherwise and, as a result, literature in initial education offers fertile ground to progressively be familiar with that other language: the written language.

For children, the teacher, educational agents, and family members, are the model for appropriating the complexities of their native tongue: its tones, their linkages and rhymes they sing and read, give rise to multiple interpretations and provide them with an ear training, which helps them feel and think about the functioning of their language through the possibility of changing, recompose and play with words (Reyes, 2007).

The same happens with the story or read stories that reveal how is time organized in a story, how are events structured and how there is a different way other than language, beyond the one daily spoken: a rich, poetic and symbolic language that is the ancestor of the written language.

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Art in Initial Education In initial education to “make art” means to make sound, to dance, to sing, to paint and to express emotions and thoughts with the body. It is an activity enjoyed by girls and boys devoting much time.

More than teaching art, initial education creates an environment of freedom and gratitude suitable for artistic expression, without filling the time with directed activities because art requires a special time: the time taken by children to start a painting until they say, I’m done.

It is then to boost its forms of expression, accompany them while interest lasts, engaging in expressive and creative process, and to assess those moments when each recognizes and learn about itself.

That doesn’t mean to stop accompanying with sensitivity and availability all what children express through their paintings and body, but being there, listening to what they say, sing, scribble, or represent, respecting their times and their compositional sense.

Artistic proposals in initial education are oriented in two directions: firstly, to nourish and enrich sensitivity, perception and enjoyment, making works of art - plastic, visual, musical and dramatic available - that expand the repertoire. Therefore a function of initial education is linking children with cultural experiences, which propose a dialogue with what has been invented by others in different times and latitudes, to enrich its ways of listening, looking, and feeling.

Furthermore, art is aimed at fostering experimentation, expression and creativity, through the construction of spaces where it is possible to “make art”.

Music, plastic arts and dramatic or body expression are the multiple languages children use to express themselves to connect, first of all with their body and senses, to talk in many ways, to understand and rework its reality and to begin that endless task of representing and sharing their experiences. In addition these are spaces for meeting, exploring and recognizing what makes them unique, to link them with each other, and above all, are channels to experience joy, happiness, laughter and humor.

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Exploring the Environment in Initial Education Exploring the environment in initial education is focused from the life learning perspective. It is a process that invites to know physical objects, natural and man made, to unveil the natural phenomena, to understand rituals or practices of a community. Indeed, exploring the environment in initial education supposes to begin to understand that the social and the natural are in permanent interaction.

It is through the senses that children interact with objects discovering its properties: they touch them, smell them, taste them, and give them different uses. Experimenting with them they go from manipulation to experiential knowledge, from abstraction to construction of knowledge.

Guided by the desire to know and understand how the world works they raised concerns, hypotheses and explanations, expressed through

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actions, language and graphic presentations. All these ideas are tested through experimentation, observation, direct contact with the object of their attention, but also in conversation with others, where they con- trast ideas and enrich their idea about life. Thus exploring the environment promotes the construction of consciousness and knowledge, constitutes an ongoing process of creation. Every time they discover the laws of nature and logic in which social and cultural world moves, “is as if it were for the first time” (Hohmann and Weikart, Epstein, 2010, p.) (16).

In contexts of interaction with objects, environment, adults and peers, there are possibilities for children to build the sense of the world, which is imperative to accompany to develop their curiosity and initiative in the framework of initial education. Hence the importance that the teacher, and educational agent foster experiences of observation, organization of reality, encouraging that desire to quest, to be able to check and compare their actions with others, allowing them to participate in the construction of the physical, social and cultural world they are part of.

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When asking for exploration in initial education is necessary to refer to the first approaches of the pedagogical movement Active School whose emphasis is on “life entering school and school going to life” approach inviting to review the place of near and distant in educational work. The near would have to do with what children live, what is ordi- nary, what does not imply to address certain issues in a homogenizing way. In terms of access to the distant, children are exposed to communication media, therefore, events like the Olympics and the World Cup, or earthquakes or floods, lead us to think of places and people who are in distant locations but which in turn are very “close” and awaken a great attraction to be known. Certainly, initial education is also con- tacting children with the cultural heritage created by humanity.

The Purpose of Pedagogical Work In order for initial education actions to contribute to children’s comprehensive development it needs teachers, and educational agents to organize and plan the environment, select materials and design educational experiences. They are participant observers that accompany, ask questions enriching children’s actions, and create security conditions where they can act calmly.

The pedagogical work in initial education is flexible, not homogenizing, by responding to a deliberate planning and by enabling performance and participation of children and thus recognizing the uniqueness of each.

The way education environments are arranged and decorated is crucial to preserve cultures as an identity seal encouraging children to identify themselves with their history, their customs, beliefs and habits.

These approaches invite to reflect and enrich the initial education proposals so play, art, literature and environment exploration be part of the pedagogical practices of teachers, and educational workers. It is essential to recognize that these proposals will always be re-contex- tualized, redeveloped and enriched according to interests, needs and expectations of children, their families and communities. Finally, it is

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necessary to be aware that the relevant and with quality initial education contributes to close the country’s gaps and effectively promotes equity in development opportunities for children and early childhood.

Recreation27 This structuring factor seeks to promote children’s autonomy and self-determination through the promotion of meaningful experiences that privilege and promote enjoyment, leisure, free creative expression and desire to be in relationship with the world.

Early childhood recreation focuses on development of playfulness, so through free will and creativity children can build an enjoyment relationship with their environment.

To make of recreation a structuring factor of comprehensive care to early childhood opens up possibilities in the construction of enriched environments that generate concrete options for free and independent participation, oriented to their comprehensive development.

Leisure responds to the human need to have spare time free of obligations in which to set up autonomous and specific experiences of enjoyment, relaxation and fun.

As a result, leisure is satisfied in everyday life when children challenge barriers and limitations imposed by their reality, to be and to freely choose what they want to do besides their inherent obligations in certain activities. In this sense, it is a possibility to experience using freedom in an autonomous way, to build new understanding of the world and of them.

It is necessary to understand that genuine exercise of freedom and self-determination involved in leisure is part of contexts and environment’s decisive factors.

27 This section is developed from elements provided by the reference study “Recreation Guidelines” prepared by Esperanza Osorio Correa, of Funlibre, for the Intersectoral Commission for Comprehensive Early Childhood Care with the coordination of the Administrative Department of Sports, Recreation, Physical Activity and the use of free time. Coldeportes (2013).

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The law recognizes recreation as a necessity and as a human right.

• As necessity it is:

–– Basic: The United Nations General Assembly declared in 1980 that for humans “after nutrition, health, education, housing, work and social security, recreation should be considered a basic, fundamental need for its development”.

–– Fundamental: The Conference of the United Nations on Human Settlements, Habitat and Environment unanimously declared that, “…recreation is a fundamental necessity of contemporary man…”.

–– Unsatisfied: Law 136 of 1994 which dictates standards aimed at modernizing the organization and functioning of the municipalities, establishes in Article 3 that these should address, among other things, the unmet need for recreation, with special emphasis on children.

• As a right it is individual and inalienable: Article 24 of the Universal Declaration of Human Rights States: “Every person has the right to rest, to enjoy free time, to a reasonable limitation of working hours and to periodic paid holidays”.

–– Article 15 of the American Declaration of the Rights and Duties of Man states that: “Everyone has the right to rest, to honest recreation and the opportunity to usefully

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employ the free time, for the benefit of its spiritual, cultural and physical improvement”.

–– The International Convention on the Rights of the Child issued by the United Nations and whose agreements were ratified by Colombia, expressed in its preamble, and later in Article 31:

States parties recognize the right of the child to rest and leisure, to engage in playful and recreational activities appropriate to their age and to participate freely in cultural life and the arts.

States parties will respect and promote the right of the children to participate fully in cultural and artistic life and will lead to appropriate opportunities, in conditions of equality, participate in cultural, artistic, recreational and leisure.

–– Article 44 of the Constitution expresses: “The fundamental rights of children are: the life [...] education and culture, recreation and free expression of opinion”.

In turn from a social point of view, Article 4 of Law 181 of 1995, by means of which sport, recreation and use of leisure time are encouraged, expresses:

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Social right. Sports, recreation and the use of leisure time, are fundamental to education and a basic factor in the education of the person. Its promotion, development, and practice are a comprehensive part of the public education service...

To be recognized as a fundamental necessity and a human right, regardless of gender, age, race, creed, or conditions they are in, all children must have the possibility to enjoy recreation. Because they are holders of rights, recreation cannot be subordinated to other conditions, on the contrary, it urges and mobilizes other rights, enables the expression and recreation of human beings, and helps to integrate efforts and cross-sectorial actions by virtue of its benefits in development.

Now, as a socially constructed phenomenon, the meanings and senses that adults and society give to recreation, influence the subjec- tivities that children in early childhood set in their lives in relation to being, thinking and doing in leisure time.

From this perspective to provide a place for recreation in the lives of the children and their families means to give them the opportunity to be part of environments where they have the possibility of being. Seen in this way recreation transcends the functional aspect in children’s life.

On the other hand, even though recreation benefits child’s development, it must ensure - beyond the specific pedagogic intentions – to maintain the vital purpose of freedom and autonomy.

Leisure, recreation and play are phenomena crossed by a non instrumental purpose, mediated by a purpose or motivation of enjoyment and creative expression, and can be structured or not, i.e. its manifestations may derive naturally from exploratory and discovery activities, or be permeated by cultural experiences.

To talk about leisure and recreation necessarily refers to a society approach that assumes conditions of freedom and autonomy so that children achieve the life they want, and complicates the human being concept that puts above the transcendence and spiritual and affective development, the training for work, productivity and efficiency, bridg-

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ing its historical construction of present under a vision of future cen- tered in human talent for competitiveness.

As stated by McLean, Hurd and Rogers (2008), although it is considered that recreation and play can overlap, they are not the same.

Play is an expression of human beings marked by exploration and fiction, taking place from birth throughout its life. It is the leading activity of childhood allowing children to represent, understand and transform reality. From this perspective, even though play is present in recreation, this involves activities such as travel, reading, going to museums, and other cultural and intellectual activities that go beyond play itself.

Recreation as a structuring factor of comprehensive care for children in early childhood is then to create spaces where they can “be”, through visions and relationships. From this perspective the playful activity appears as fundamental given that the aim is to stimulate the ability of children to establish a relationship with the world, with knowledge and relationships, through enjoyment allowing them to be structured as critical individuals, able to become excited and to get uncomfortable.

In this way, recreation as a space for real participation allows children to learn about freedom; It invites them to make simulated or real decisions through the creation of parallel realities, but also related to their daily life.

As an alternative space for the expression of languages and ways of seeing the world, which contradicts what has been given by society and question it, recreation opens many possibilities using art, play and creativity through creation, imagination, and even a replica of practices and standards of the real world.

Insofar as the subjective construction of time for children in early childhood is not modulated from pedagogical work but routines of their environments, then recreation is possible and has greater resonance to their daily lives if it is presented as a proposal for education and during their leisure time to have impact on families and caregivers.

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Rojeck, Shaw and Veal (2006) pose that to take children’s percep- tions about quality of time helps to better know the ways they value their families leisure time, and for them to assume the ways they want to spend their leisure time. Leisure pedagogy seek that people, learn to build their leisure contexts through experiencing leisure.

According to Puig and Trilla (1996) the principles of leisure pedagogy are:

• Respect for autonomy and freedom of choice. We grow up if our mothers • Harmonize fun, creation and learning in times of leisure, and fathers individually as well as collectively. share lots of time with us, • Value leisure time and respect observation vs. activism. Children if they don’t have the right to do nothing. Idleness resulting from not doing any leave us alone . When they are activity opens the possibility for observation to start becoming home and watch part of a vital necessity and be a source of learning. us play and do mockeries, we • Stimulate the value of the everyday life. know we are important for • Develop the extraordinary, offering the opportunity to carry out them . activities that get out of daily routine.

• Release time for rewarding and instructive leisure time.

• Participate in trainings given by different institutions organizing activities for leisure time.

• Combine individual and collective leisure to enable satisfactory engaging with oneself and with others.

• Identify harmful leisure and raise awareness about its consequences.

Education for recreation, meant as an education for freedom and autonomy, raises the need for spaces where children can assess to what extent this contributes to their own welfare, to achieve their personal and social life projects. (Osorio, 2009).

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The construction of an approach based on the principle of equity and equality, the recognition of difference, would be the task of what Henderson called “fair leisure”, which relates to the notion that leisure and recreation contribute to social justice helping others to make appropriate and ethical choices.

Recreation for children takes into account in their designs and space their social and cultural realities, their knowledge, their visions of the world; makes possible their participation in the construction of their own styles for recreation and to create experiences that reaffirm them individually and collectively.

A proposal for recreation focused on early childhood education requires involving adults in that building since it implies to:

• Give a new meaning and sense to leisure and to self-referenced and referenced recreation, with a human being vision that surpasses the stand of economic productivity as axis of development.

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• Identify and overcome barriers (perceptual, economic, geographical, physical), hindering leisure.

• Favor creative and exploration opportunities for children, enabling them to develop talents, abilities and interests related to arts, play and knowledge, that serve as a basis for establishing autonomous interests, preferences, attitudes and habits.

Citizenship and Participation28 This early childhood comprehensive care structuring factor promotes a personal and collective identity in diversity, making children wanting to participate in their environments, as an exercise of freedom and inclusion in accordance with life cycles, recognizing its multiple forms of expression and various manifestations of what it means to be heard, perceived, taken into account and take an active part in decisions about their own lives and of the groups and communities to which they belong.

As mentioned, children become citizen at birth, i.e. are valid and legitimate speakers, knowing that participation is built in action inherent to citizenship.

Early childhood participation requires environments for socialization and daily interaction that respect the uniqueness and diversity of children and promote dialogues according to their skills and individu- alities, taking into consideration their territory, ethnicity, and gender in order to ensure the vital experience of belonging to a group, a community, a family, and of being unique and singular.

The relationship between the public and the private, the collective and the individual, is defined by the heritage values of people and places, which become community property. Thus, when a family shares

28 This section is developed from elements provided by the reference study Technical Guidelines for Participation and Citizenship of Citizen Rights in Early Childhood” prepared by Elsa Castañeda and María Victoria Estrada for the Intersectoral Commission on Early Childhood, with the coordination of the Ministry of Culture (2012).

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its knowledge on participation with the children during the rearing period, the individual and the collective are linked by means of this heritage value.

Equally as important is participation in the community’s cultural life to forge an individual, collective and cultural identity29 during early childhood. Thus, group membership and mutual acceptance are necessary exercises in democratic participation that contribute to the enjoyment of full citizenship (Castañeda and Cáceres, 2012).

Children’s participation during early childhood is determined by their life cycle period, and by the skills of adults in reading the expressions and meanings they communicate. The deeper the level of participation, the greater its influence on what happens to them, on the strengthening of a democratic culture, and on their opportunities for personal development.

Participatory processes must be continuous and enable children to develop confidence, recognize and build their own communication channels, and perform with autonomy in the community.

He that respects himself does not require that others like him or that they accept him, or that he agree with others in order to feel fine, rather he has no difficulty in being loved or loving the other. He that respects himself is independent and autonomous without being in opposition; respect for himself does not lie in being different from the other, but in the acceptance of his own legitimacy (Maturana and Sima, l998: 29).

In addition to reflecting on the relationships we build with children, we require a teaching that allows participation in the act of knowing, that takes into account the individual, the group, the collective and the diverse.

Exercising citizenship and participation is linked to child development, becomes complex, and requires opportunity. Some guidelines for care actions are identified below:

29 “Cultural identity is a sense of ‘belonging to the same community’ experienced by a group of people. It incorporates the feelings that each individual has of belonging to a group or culture or being subject to its influence” (Nsamenang, 2008: 16)

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• Protection, rearing and care of children: the starting point for participation

From the beginning of their lives humans communicate their interests. Re- petitive sounds such as gurgling, crying, babbling and gestures, smiles, frowns and body movements such as stretching, yawning, and reaching with arms and legs invite people to join the child, to mobilize in response.

In this everyday interaction, the adult plays an important role in children’s participation. Being sensitive, responsive and respectful allows children to experience being recognized, valued, and considered, and to develop skills for participating with more and more autonomy in community life. Thanks to that sensitive relationship they will gradually develop certain actions by themselves, make decisions about their movements, their hobbies, their likes, their games, and their company.

• Communication: a key element of participation

Communication is the stage for sharing the meanings that children transmit as carriers of information, history and culture. Consequently, in children’s participation, it is not enough to meet their needs. We must learn to communicate with them, to listen, to read the meanings of their expressions, to take them into account, to speak, inform, and explain to them.

Children are communicators who use a variety of languages skill- fully, according to their abilities, to express their unique opinions and experiences. Similarly, the words, gestures and other expressions of the adult who is narrating, singing, informing, explain-

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ing and consulting become powerful forms of communication with children from the time they are in the womb.

In the explanation given to them about everyday life--with siblings, grandparents, neighbors, even with themselves, with their development, rules, routines, boundaries--lies one of the first levels of participation: information, which together with lullabies, songs, children’s tales, stories of oral tradition, and literature, have an effect on their emotions, psyche, and imagination. “This body of words, sounds, voices, and rhythms delivered by adults to children in early childhood becomes a res- ervoir for life” (Robledo, 2010: 49).

• Cultural life as an expression of participation

The provisions in Article 30 of the Code of Childhood and Ad- olescence30 entitle children to the tangible and intangible cul-

30 “Children, girls and adolescents have the right to rest, play and other recreational activities appropriate to their life cycles (SIC) and to participate in cultural life and the arts. Similarly, they have the right to be recognized, respected and supported in the knowledge and experience of the culture to which they belong “(Article 30, Law 1098 of 2006).

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tural31 goods that are part of their of their family, community, people, city, and country heritage, and of humanity.

Children’s access during early childhood to cultural centers, museums, palpable and impalpable heritage items, libraries, Malocas and sacred places enables their appropriation of the public, and thus encourages participation.

• Children’s identity: a key issue in heritage management

In policies, heritage plays a pivotal role in building a local, regional and national identity, which characterizes a specific group of individuals that differs from others in their ways of viewing the world. Unique goods and values are transmitted from generation to generation through storytelling: everyday life, habits, death, life, music, dance, arts, etc. Such adoptions occur in childhood during the first level of learning: the family order, where all members transmit their worldview.

The beginning of cultural heritage is to protect, display, and safeguard customs as testimony for present and future generations. The integration of natural, urban, ancestral knowledge, socio-cultural, economic and political landscapes is a critical factor in the school-child-family interaction. Heritage relates to children from the time of their gestation and when they are cared for according to the cultural practices of their environment; the first transfer of heritage occurs during the mother’s preparation for childbirth. The transmission of local knowledge varies according to context and practice. It should be natural and allow children to recognize and embrace their environment.

31 Intangible assets are those intangible manifestations, expressions, knowledge and practices that give a community and a group of people a sense of identity, belonging and historical continuity. These events are transmitted from generation to generation (cf. Law 1185 of 2008). Lullabies, songs, oral narratives, poems, tongue-twisters, riddles, traditional games, proverbs, incantations and spells are part of cultural property.

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* * * * * * *

This second part of the document has disclosed the technical bases, which sustain the Strategy, both related to early childhood and referring to comprehensive attention to children just beginning their lives. The following were considered structuring factors of care: protection and upbringing, health, food and nutrition, early education, recreation, and exercise of citizenship and participation. The third part of this document will present the enhanced role of these structural factors in the Comprehensive Care Roadmap, a crucial tool in the Strategy to be presented with other management elements.

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165

3 Management of Comprehensive Care Strategy for Early Childhood: Institutions, Comprehensive Care Road-map, and Lines of Action Early Childhood Comprehensive Care Strategy

ll that has been discussed here would be of no use to pregnant women, girls and boys in early childhood if not made a reality Ain the present time, in each of the territories of the country and in each of the environments where they find themselves. This led the Intersectoral Commission for Comprehensive Early Childhood Care to an institutional architecture that would materialize the Strategy’s proposal, and to summon the various sectors of society to define skills, set avenues of action and design specific instruments.

Readers will find here the results of this joint effort, among which is the Comprehensive Care Road-map (RIA, Spanish acronym), a powerful tool that guides the territories in ordering and reviewing their performance, and setting clear paths to achievement.

The technical line and the RIA are deepened and put into operation through tools (guides, manuals, guidelines, protocols, etc.) built by the different sectors, nationally and locally, according to their competencies. These tools facilitate services, programs, or other forms of care and attention by developing specific actions for pregnant women and children, consistent with territorial conditions.

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Comprehensive Management Favoring Child Development

Comprehensive Strategy management is the intersectoral, concurrent and coordinated manner in which the state sectors (education, health, culture, welfare, planning, etc.) and other stakeholders in society (families, community, civil society, academia, private sector, NGOs, etc.), act in coordination, nationally and locally, to achieve comprehensive care for pregnant women and children based on their needs and requirements.

Understanding this approach is vital, since management is where the Strategy’s full importance comes alive. A comprehensive Strategy must run consistently in two directions: as a condition inherent in children’s development and rights, understanding specifically how their rights manifest at this moment in their life cycle; and as the attribute resulting from its structuring factors, which make concurrency an imperative under the Comprehensive Care Roadmap.

A comprehensive management consistent with the spirit of the Strat- egy calls for authorities and entities to break the sectoral paradigm, and move towards a unified construction of the technical line that needs coordination and synergy. This requires a major effort by the institutions and sectors, as well as real humbleness to understand that no entity, sector or stakeholder can respond by itself to the challenge of ensuring a comprehensive development during early childhood.

The fundamental challenge of the Strategy is to place pregnant women and children at the center of action, transcending the conventional sum of atomized and sectored measures. Each stakeholder should execute it from their specific expertise, but in a way that is complementary with the expertise of others, as a result of collective and concerted construction.

A consensus by stakeholders on the policy in each territory, its intent regarding early childhood, and management of its RIA help define the scope, commitments and responsibilities of each stakeholder and sector, national and local, and add value to the parts that would be managed separately.

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Comprehensive management requires that each stakeholder recognize its role in the development of children and provide its knowledge, institutional structure, policy actions, resources and capabilities. It also requires a willingness to change their orientation, planning, conditions, coordination or tracking of comprehensive care.

Thus, sectoral coordination becomes one of the Strategy’s main attributes for comprehensive management. This is joint management with a common ethical, political and technical framework, where resources, responsibilities and processes are coordinated to ensure that girls and boys enjoy their rights fully.

An example of this type of management is the Intersectoral Commission for Comprehen- sive Early Childhood Care, which itself has operated successfully at the national level, and is a reference point for coordination of early childhood public policy in the territories.

The Commission’s experience has shown that it is possible to work across sectors and that through this work a collegial management proposal can be achieved in the country today.

Another attribute of a comprehensive management of children’s rights is territorial coordination. Early childhood public policy requires alignment, concurrency and technical cooperation between the national, departmental and municipal levels. This cooperation should comprise planning processes, strengthening of capacities, specialized institutional architecture, technical and financial resources, and policy monitoring, among others.

Additionally, the authorities, technical teams and social sectors should commit at all levels (national, departmental and municipal), to evidence-based decision-making, social mobilization, high quality standards of care, and monitor progress in early childhood care. The

170 Management of the Strategy

commitment should be complemented with work on other sectors such as water, basic sanitation, road networks, transportation, and access to food and housing.

This requires management that synchronizes actions at the national, departmental and municipal levels, and coordinates the responsibilities of State sectors and other stakeholders involved with early childhood.

The Strategy of Comprehensive Early Childhood Care: Relationship with Various State Agencies

The Strategy for Comprehensive Early Childhood Care falls under the framework of the National Family Welfare System (SNBF). Its objectives are universality, quality and territoriality, as well as becoming a sustainable state policy that lays the foundations on which the country can continue the program for the next ten years or longer.

A detailed look at the Strategy’s institutional framework follows, beginning with the SNBF. Then, the legal basis and functions of the In- tersectoral Commission for Comprehensive Early Childhood Care are reviewed. Finally, we examine its presence in the territories and the role of various authorities in comprehensive protection.

The National Family Welfare System (SNBF)

The SNBF (Spanish acronym) is the set of agents, coordination bodies, and relationships that comply with the comprehensive protection of children and adolescents and strengthening of families at the levels of nation, province, district, municipality, and safeguard areas or indigenous territories. Its objectives are1:

1 Decree 936 of May 9, 2013.

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• Achieving comprehensive protection of early childhood, childhood and adolescence and promoting family strengthening through coordinated and timely responses from the State, under the principle of shared responsibility with family and society.

• Promoting the development, implementation, monitoring and evaluation of policies for early childhood, childhood and adolescence, and strengthening of families, at the national and territorial levels, with a differential focus.

• Making early childhood, childhood and adolescence and family strengthening a social, political, technical and financial priority at the national and territorial levels.

• Improving participation and social mobilization for the comprehensive protection of early infancy, childhood, adolescence and strengthening of family, at national and regional levels.

• Assessing and monitoring the implementation of children’s and adolescents’ rights.

The SNBF coordinates early childhood, childhood and adolescence policy with other public policies to achieve interconnection and interdependence of rights during the entire life cycle.

The Intersectoral Commission for Comprehensive Early Childhood Care

Under the SNBF, the country achieved institutional and technical specialization progress, related to early childhood. Then, Decree 4875 of 2011 from the Administrative Department of the Office of the President created the Intersectoral Commission for Comprehen- sive Early Childhood Care, composed of the Ministry of Health and Social Protection, the Ministry of National Education, the Ministry of Culture, the National Planning Department (DNP), the Department for Social Prosperity (DPS) and the Colombian Family Welfare Insti-

172 Management of the Strategy

tute (ICBF), under the coordination of the High Council for Special Programs of the Office of the President.

According to this decree, the Commission aims to “coordinate and harmonize the policies, plans, programs and actions necessary to implement comprehensive early childhood care, and be the forum for dialogue between the different stakeholders involved” (Art. 2).

The general functions of the Commission are (i) the direction of national policy regarding comprehensive early childhood care, (ii) coordinating implementation of the Strategy, (iii) definition of guidelines and mechanisms for institutional and financial sustainability, and (iv) coordination of public, private, cooperative and civil society stakeholders around common goals for early childhood.

In order to advance in the creation of an intersectoral, sustainable, I like to play viable and universally visionary working scheme, the mandates of each soccer sector it comprises were clearly defined, as follows:

• Ministry of Health and Social Protection: Defines policies, plans, programs and projects for maternal and child health, disease prevention and public health surveillance. It also provides guidelines for primary care health services for the family group, defines quality standards, regulates the delivery of services, and performs inspection, supervision and control of the General Social Security System for Health through local authorities. It emphasizes its action under the First Thousand Days of Life Scheme (pregnancy and first two years of life)

• Ministry of Education: Defines policies, plans, programs and projects for initial education as a fundamental right of children in early childhood, as part of comprehensive care. It also issues guidelines on the qualification of human talent in all areas within the framework of comprehensive early childhood care. Structures and commissions the child by child tracking system and Quality Management System for early education modalities through guidelines and quality standards.

173 Early Childhood Comprehensive Care Strategy

• Ministry of Culture: Defines policies, plans, programs and projects to preserve, promote and recognize the cultural rights of children and their families as part of the Strategy, based on diversity of population, territorial ethnicity, linguistic and social life in the country, which requires a differential action without harm. Provides guidelines for the promotion of language and artistic expression, early childhood literature and reading in, and child participation and citizenship. Develops processes for quality care in public places such as libraries, cultural centers and museums.

• Department for Social Prosperity: Supports territorialization processes, joint actions with government programs aimed at eradicating extreme poverty, and the management of victims, among others.

• Colombian Institute of Family Welfare: The Role of the ICBF (Spanish acronym) within the framework of the Strategy is defined by its

174 Management of the Strategy

institutional nature. The SNBF promotes early childhood policy in the context of territorial management, ensuring its specificities and technical line as defined by the Strategy. It aligns all its areas, units, programs and services with the political, technical and management framework of the Strategy. It also coordinates and implements early childhood education with a comprehensive care approach, and provides technical assistance and support to providers of services. Similarly, it defines guidelines for comprehensive protection, guarantee, and prevention of breaches and restoration of the rights of children with the joint responsibility of society and the family, and contributes training and orientation guidelines for families.

• National Planning Department: Gives technical support to the formulation, implementation and evaluation of the Strategy in its financial, territorial and policy components.

• Office of the President: Chairs the Intersectoral Commission for Comprehensive Early Childhood Care, serves as its technical secretariat and coordinates the design, implementation, monitoring and evaluation of actions envisaged in the action plan of the early childhood policy.

National and regional bodies coordinated in favor of comprehensive early childhood development

As noted herein, Law 1098 of 2006 established the obligation of national, departmental and municipal authorities to design, implement and evaluate public policies aimed at all children and adolescents. In the field of early childhood, the Act requires giving full scope to the provisions of Article 29, which defines the right to comprehensive development. Under the mandate of the SNBF, there must be in each jurisdiction a coordinating body for early childhood, in which everything relevant to comprehensive care is discussed and built across sectors.

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Its viability will depend on the national, departmental, district and municipal development plans, as well as the life plans of the indigenous peoples, explicitly incorporating strategies and programs for comprehensive early childhood care, supported by the necessary economic resources. Also, the nation, departments, districts and municipalities need the institutional will for dialogue and intersectoral building between territorial levels, around criteria for the common purpose of comprehensive protection in early childhood.

Both at the national and the territorial levels, public policy objectives on early childhood require functional coordination by the Na- tional Family Welfare System in each jurisdiction. This task is fulfilled by the national, provincial, district and municipal Councils on Social Policy, and by special ethnic groups jurisdictions that comprise public, private, and third sector agents for decision-making, operation, technical development and participation, and the national and international cooperation that is part of said third sector.2

In general, these bodies are responsible for establishing annual action plans to meet SNBF objectives. Strengthening of institutional capacities and territorial autonomy in early childhood topics are sought at the local level, developed by the Intersectoral Commission for Com- prehensive Early Childhood Care.

In the SNBF, the National Strategy for Comprehensive Early Child- hood Care responds to the guidelines defined by the councils on social policy. The SNBF entities responsible for developing and harmonizing public policies for early childhood, childhood and adolescence, and particularly early childhood, are:

• Nationally

–– The National Council of Social Policy, which is the highest decision-making and guidance body in the SNBF.

–– The IntersectoralCommission for Early Childhood which

2 Decree 936 of May 9, 2013, Article 6.

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guides and defines intersectoral public policy actions for early childhood at the national and regional levels .

• At the departmental level:

–– The Departmental Council on Social Policy, the highest authority for decision and guidance of social policies, including those for early childhood.

–– Technical Development Bureaus for comprehensive early childhood care.

–– Regional Operational Structures in other administrative systems with expertise or interest in early childhood conditions3 and in technical development.

Each department must define which bodies and strategies will promote participation, and link them into the SNBF institutional scheme.

• In districts and municipalities:

–– The municipal or district councils for social policy will be the highest entities within the SNBF. Their aim is to coordinate and monitor implementation of plans, programs and projects developed by each entity in social policy matters, with a comprehensive management model.

–– Population and Thematic Bureaus, as well as district or municipal operational structures in other administrative systems will offer technical support to address early childhood

3 Decree 936 of May 9, 2013, Article 8.

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conditions4. The Council must ensure that there is at least one technical committee focused on specific management of comprehensive protection for children in early childhood. It shall also promote participation and social mobilization by children in this age group, to guarantee their rights.

The Comprehensive Care Roadmap: We like Guidance for Management water: in erritories being in the T bath, being placed in We have looked at the situation of pregnant women and children in the shower, early childhood, the country’s background in public policy for this pop- when they ulation group, the concepts of early childhood, child development, and take us to the family environments, the reasons for focusing on comprehensive care, river and let its main structuring factors and characteristics, and the placement of us play with the Strategy within the country’s institutions. The key question now is the hose . how to materialize comprehensive care for them in the territories.

This section describes a tool developed by the technical team of the Intersectoral Commission for Comprehensive Early Childhood Care that answers the above question. The Intersectoral Commission received feedback on it from various teams and stakeholders across the country as well as some international experts. It is the Comprehensive Care Roadmap (RIA, Spanish acronym), which guides local authorities and other stakeholders responsible for implementing the Strategy for Comprehensive Early Childhood Care, regarding actions to ensure the full development of each and every girl and boy. Thus, the RIA will be the instrument par excellence that allows integration of operational ideas into a comprehensive, concrete form.

This is a tool to organize comprehensive care consistently with the situation and characteristics of children in each territory and their

4 Decree 936 of May 9, 2013, Article 8.

178 Management of the Strategy

respective contexts, and is applicable at any moment in the public policy cycle.

As a tool for intersectoral management, the Comprehensive Care Roadmap calls on all stakeholders in the National Family Welfare System with competencies and presence in the territory. It is not an exclusive tool for the mayor or governor. Within the framework of the SNBF, it is available to the coordinating body managing comprehensive early childhood care policy, according to the particular dynamics of each territory.

The Intersectoral Commission for Comprehensive Early Childhood Care in full brought together the intended and effective care actions so that each child’s environment has the human, social and material conditions for his or her growth.

The care actions in the Comprehensive Care Roadmap emerged when the Intersectoral Commission for Comprehensive Early Child- hood Care established, taking into account the rights of children, these structuring factors for comprehensive care: attention and upbringing, health, food and nutrition, early education, recreation, and exercise of citizenship and participation (see pages 141-187). Readers will not find within the Roadmap which specific care actions correspond to which structuring factors, as some may respond to two or more and thus give rise to confusion. The important thing is to know what is necessary to ensure care from preconception until the child is six years old.

RIA classifying criteria

Time frames or age groups Because the care actions that should be given to men and women of childbearing age, pregnant women, and children for the comprehensive development of the latter vary according to age, the Intersectoral Com- mission for Comprehensive Early Childhood Care agreed to organize the care actions as follows:

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• Preconception

• Gestation

• Birth to one month

• First month to three years

• Three to six years

These time frames are the first classifying criteria for the Comprehen- sive Care Roadmap shown on the following pages. Readers can identify:

Recipients of care For each age group or time frame, different care actions are provided, which vary according to the type of recipient, namely:

1. Men, women, families and caregivers.

2. Girls or boys in early childhood.

Environments where care is provided Once care recipients are located in the time frame or age group being attended to, the list of necessary actions appears, with the environments in which these will materialize as the last classifying criterion.

Recall how the Commission envisions the main environments in which the lives of girls and boys elapse:

• The home environment: Is the space of welcome and affection in which most early childhood occurs, which provides them with basic social and cultural references they use to begin moving in society.

• The health environment: This is the first institutional expression that welcomes children. It supports the process of preconception,

180 Management of the Strategy

pregnancy, birth and thereafter, to preserve their existence and autonomy in conditions of full dignity.

• The educational environment: Promotes educational activities for children to experience themselves as owners of rights, participatory citizens, transformers of reality, and creators of culture and knowledge. It deepens the experience of living together, understanding and respecting other people, internalizing and gradually building basic rules of coexistence.

• Public space environment: Consists of open accessible spaces (squares, beaches, parks, roads) to which the community attributes political, historical, cultural or sacred value (libraries, play centers, cultural centers, museums, theaters, temples, malocas, participative scenarios). Plays a key role in the construction

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of identity and in the exercise of citizenship and democratic education, allowing children to experience themselves as living, social and cultural beings.

For more details readers can refer to pages 122-131, where a more extended description of these environments is found.

Specialized and differential attention One of the most valuable aspects of the roadmap is its focus on specificity. Setting every boy and girl at the center of each care ac- As we grow, tion makes their individual characteristics relevant. Thus, in addition our moms will to universal care by age group, differential attention, specialized care, know what we and respectful and appropriate approaches, accompaniments and at- like and what tentions are required from caregivers. we don’t like, by the way we Differential attention arises from recognizing diversity in character- move in their istics, conditions, or situations of individuals and their interaction with bellies . the environment, not only from conditions of vulnerability.

Thus, culture, ethnicity, disability, specific experiences or dimensions, and permanent or temporary effects in the lives of children and their families become relevant in the RIA, as well as territorial context (rural area, urban, jungle, access paths, the zone affected by armed conflict, etc.). They invite caregivers to approach, accompany and at- tend recipients sensitively and in an appropriate manner.

The Strategy takes diversity into account, respecting and contributing to the reinforcement of the population’s own characteristics and helping surmount situations that infringe upon rights.

Differential attention actions are therefore the concrete embodiment of universal attention, considering the children as unique and singular human beings.

This is not different care, but a supportive, sensitive and appropriate approach by caregivers. Thus, specific differential care actions do not appear in the RIA. These will be part of a complementary recommen-

182 Management of the Strategy

dations guide that specifies how universal care should be developed according to population categories and types of approaches, support and care depending on what each child or family requires, and joint work with different population groups.

Specialized care actions are those designed to respond to specific situations of infringement or risk. The RIA provides a list of situations that trigger specialized care for each age group, so each territory can identify the specific actions to develop in safeguarding the rights of pregnant women and children in early childhood. These include detection, benchmarking, monitoring, treatment, rehabilitation and restoration of rights.

From now on both the use and the scope of the RIA will not be linear or flat. The individual care focus will allow the RIA to contextualize care, contribute to the quality of interventions, and every girl and boy to receive the care they need for their comprehensive development.

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The RIA, a Collective Production

The RIA was developed by the technical team of the Intersectoral Commission for Comprehensive Early Childhood Care and received feedback from many teams and individuals across the country, as well as some international experts. It is a collective construction by the nation made available to departments and municipalities to guide management of early childhood programs.

The roadmap serves as a reference for local authorities and other stakeholders responsible for the Strategy implementation on the actions included in the comprehensive care structuring factors, their attributes, and their relations, to ensure the full development of every child. Thus the RIA allows concepts to become interrelated and embodied, giving life to the comprehensive nature of the Strategy.

It is a tool to organize comprehensive care management in a manner consistent with the situation and characteristics of children in each territory, and is applicable at any time in the public policy cycle.

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Ruta Integral de Atenciones –RIA– Comprehensive Care Road-map –RIA–

185 Care actions destined to each woman and man in fertile age

Home Health Educational Public Environment Environment 1 Space

Guide and support each woman and man in:

 The exercise of their sexual and reproductive rights.

 The shared parental responsibility acquired when making the decision to become a mother or a father.

 Recognition of each girl and each boy as a holder of rights.

 Conditions that favor or alter the comprehensive development of each child, from the time of preconception.

 Understanding the importance for each boy and each girl of establishing solid aﬀectionate bonds and quality relationships between adults and with them.

 Development of leisure and recreational activities as self-care practices and healthy lifestyle habits.

 Recognizing the right of the new member of the family to have a name and a civil birth registration, and belonging to a culture in which to participate.

Valuing the emotional, social, physical and nutritional health of each woman and each man in fertile age, and preparing them for pregnancy and, if required, Preconception carrying out speciﬁc intervention actions in each case. Always provide folic acid as a supplement.

Promote healthy habits in each man and woman in fertile age.

Valuing the oral health of each woman who has decided to have a child, and giving her timely and comprehensive care if required.

1 The care actions speciﬁed here correspond to the educational environment, and are speciﬁc to middle and secondary schooling.

186 Care actions destined to each woman and man in fertile age