Early Childhood Development
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Early Childhood Development Child development reinforced in health services for the first time in Nampula Province Monapo, Nampula Province, Mozambique, October 23, 2018 – The first training of trainers for monitoring and promoting child development in maternal and child health services was carried out in Nampula Province on September 17–21. The training followed the signing of the memorandum of understanding between the Provincial Directorate of Health of Nampula Province and PATH in August 2018, and was organized together with key government child health partners UNICEF, ICAP, and the Maternal and Child Survival Program (MCSP). The event served as a starting point for the Nurturing Care for Child Development initiative, which is implemented jointly with the District Health Services of Monapo District, and relies on additional community partners such as COVida project and nongovernmental organizations Collaborating Center for Health (CCS) and H2N. The Nurturing Care initiative makes Nampula the second province in Mozambique, after Maputo Province, where child development interventions at health services receive special reinforcement through partnership between government, PATH, and other health partners. Furthermore, Nampula will be the first province where a collective action model for early childhood development that unites diverse partners is being deployed and tested. Twenty-four trainers representing Provincial Health Directorate and Monapo District Health Services, heads of selected health facilities, and trainers from ICAP and MCSP took part in the workshop. The participants learned to monitor developmental milestones and counsel in stimulating activities— according to well-baby clinic norms and the IMCI protocol among other tools—in touchpoints ranging from maternity wards to pediatric ART consultations, with special attention to children at risk for poor development. The training also reinforced the desired flow of referrals for children with identified developmental delays. For the participants, five training days were essential to understand that child consultations are meant to do much more than just deal with childhood illnesses. According to the chief medical officer of Monapo District, Mutombo Kahemba, to monitor child development is to “prepare the future, because if we do not pay attention to the first three years of life, we lose the possibility to correct any type of delays.” There are close to 45,000 children aged between 0 and 3 years in Monapo District, according to projections based on the 2017 census. Based on the high prevalence of chronic and acute malnutrition in Nampula Province and on global indices of developmental delays and disabilities in the first years (WHO, 2012), it can be estimated that at least five percent of these children would have some type of developmental delay that would require an intervention. However, the data show that almost no referrals of cases of developmental delays have been made in the last three months. The current absence of referrals was seen by the participants as related to the lack of regular developmental monitoring within the health services. Momade Intata-Intata, a nutritionist at MCSP, mentioned that until now, during consultations “we just evaluated anthropometric measures including weight, to find out if the child suffers from malnutrition...” Besides learning to regularly monitor child development, the trainers practiced counseling caregivers about playing and talking with their children, from pregnancy onwards, to stimulate their development. MOH-approved materials, such as posters showing age-appropriate stimulation activities, were reproduced for each health facility for this purpose. “[This counseling activity] will guarantee that the caregivers will have well-developed children in the community,” said Rosa Celina, general medicine technician and focal point for ICAP. For Joaquina António, deputy head of maternal child health in the district, the counseling will also “help reinforce emotional bonds between the children and their parents.” This event will be followed by additional facility and community training and mentoring activities and a mass communication campaign, which will aim to cover the whole Monapo District over the next two years. Nelton Camões de Rosário, a doctor at the First team of trainers in developmental monitoring and counseling in Nampula Province (Monapo). Carapira Health Facility, demonstrates baby massage to the mother at the maternity ward. World Health Organization (WHO). Developmental difficulties in early childhood: prevention, early identification, assessment and intervention in low- and middle-income countries—a review. Geneva: WHO; 2012. Photo: PATH/Mariolina Ulisses To learn more about PATH’s integrated ECD work, please email us at: [email protected] PATH’s integrated Early Child Development program in Maputo Province is jointly funded by PEPFAR through the US Agency for International Development, and the Conrad N. Hilton Foundation, and is implemented in partnership with district and provincial health and social action services. This newsflash, published by PATH, was made possible with the support of the PEPFAR through the US Agency for International Development. This is not an official USAID or U.S. Government publication. The contents of this e-newsletter are the sole responsibility of the authors and do not necessarily reflect the views of USAID or the U.S. Government. .