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Nurturing Care for Children Living in Humanitarian Settings

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Nurturing Care for Children Living in Humanitarian Settings THEMATIC BRIEF Nurturing care for children living in humanitarian settings What is nurturing care? What happens during early childhood (pregnancy to age 8) lays the foundation for a lifetime. We have made great strides in improving child survival, but we also need to create the conditions to help children thrive as they grow and develop. This requires providing children with nurturing care, especially in the earliest years (pregnancy to age 3). Nurturing care comprises of five interrelated and indivisible components: good health, adequate nutrition, safety and security, responsive caregiving and opportunities for early learning. Nurturing care protects children from the worst effects of adversity and produces lifelong and intergenerational benefits for health, Why is nurturing of displacement and conflict. productivity and social cohesion. When children are deprived of Nurturing care happens when we care important in opportunities to develop, the maximize every interaction with a ability of families, communities and humanitarian settings? child. Every moment, small or large, economies to flourish is limited. structured or unstructured, is an More than 29 million children were opportunity to ensure children are born into conflict-affected areas healthy, receive nutritious food, are in 2018 (2). Young children in these The early years in a child’s safe and learning about themselves, situations face compounded risks to others and their world. What we life are critical in building their development stemming from do matters, but how we do it a foundation for optimal a continuum of experiences which matters more. development through a stable may include forced displacement, and nurturing environment, migration and resettlement in a new setting, such as a refugee This brief summarizes actions as described in the Nurturing camp, or integration within host that programme planners and Care Framework (1). communities. These experiences implementers should take are likely to result in mothers, to minimize the impact that However, infants and young infants and young children having emergencies have on the lives of children in humanitarian settings limited access to preventive and young children and their families. It face massive challenges to survive curative health services; high risk calls upon all relevant stakeholders and, even more so, to thrive. As the for malnutrition; elevated levels of to invest in evidence-based policies number of crisis-affected people insecurity, violence and stress; and and interventions that have been continues to rise, so does the other potential effects arising from shown to build resilience and proportion of future generations socioeconomic adversity mitigate the harmful effects who experience the severe distress or extreme poverty. of emergencies. 01 Photo credit: © UNICEF/UNI337473 Defining ‘emergencies’ What are the nurturing The needs of women and children affected by emergencies have reached care components? an unprecedented scale. An emergency is defined as a humanitarian crisis in a country, region or society demanding decisions and follow-up in terms of extraordinary measures that exceed the ability of the affected community or society to cope using its own resources, and therefore requiring urgent GOOD HEALTH action to save lives as well as prevent additional morbidity and mortality. An emergency may be caused by conflict; disease outbreaks (such as Refers to the health and well-being COVID-19); or other events, such as massive food contamination, chemical of children and their caregivers. or radionuclear spills, extreme weather and geological events. The Why both? We know that the emergency may be of varying length and severity, and the situation physical and mental health of may change from day to day. We use the phrase humanitarian settings caregivers can affect their ability to express the variety of circumstances that affect families and young to care for the child. children who are confronted with an emergency. ADEQUATE Key facts and best To meet these different needs, NUTRITION services should include a mix of practices interventions of different intensity Refers to maternal and child The disruption of essential services (see Table). Attention to children nutrition. Why both? We know that can be severely detrimental to with developmental difficulties and the nutritional status of the mother young children and their families. disabilities is particularly important, during pregnancy affects her Morbidity and mortality rates as they are often the least likely to health and well-being and that for children under 5 years of age receive appropriate care. Provision of her unborn child. After birth, among crisis-affected populations of interventions may also differ at the mother’s nutritional status may be as high as twenty times the onset of a crisis versus during a affects her ability to provide that of children living in less fragile protracted crisis. adequate care to her young child. contexts (3). And when children When attention is paid to meeting do survive, an estimated 43% of the developmental needs of children, under 5s in low- and middle-income populations will build resilience SAFETY AND countries—inclusive of humanitarian against adversity and strengthen SECURITY contexts—are at risk of not reaching their ability to achieve their full Refers to safe and secure their developmental potential (4). human potential. Investing in early environments for children and their For parents and caregivers in conflict childhood development programmes families. Includes physical dangers, settings there is an increased risk of in the uncertainty and instability of emotional stress, environmental mental health challenges, including protracted crises and displacement anxiety and depression, paired risks (e.g. pollution), and access lays a foundation for life-long success to food and water. with a lack of support services and resilience, social cohesion, and (5-8). These effects have been linked sustainable and peaceful societies to a reduced capacity to provide (12-15). Prioritization of responsive consistent, responsive care, a caregiving ensures that parents and OPPORTUNITIES FOR paramount component of any child’s caregivers provide the necessary EARLY LEARNING health and development (9-11). forms of intervention, helping to Refers to any opportunity for the formulate long-term buffers from Reflective of these challenges, an infant or child to interact with a conflict and crisis. On a macro scale, integrated set of crisis-sensitive person, place, or object in their investments in early childhood services across health, nutrition, environment. Recognizes that every development can produce up to education, sanitation and child interaction (positive or negative) 13% return per year by improving protection sectors is needed. These or absence of an interaction is health, growth and development services must be designed, planned contributing to the child’s brain outcomes, and boosting learning and costed to be adaptable when development and laying the and productivity in later life, thereby responding to emergencies, starting foundation for later learning. during pregnancy and continuing improving social cohesion and the throughout a young child’s life. In prosperity of nations (12). order to maximize the well-being To advance well-being and RESPONSIVE of children, humanitarian response reduce inequities around the CAREGIVING must also adopt a multi-generational world, leadership is needed to approach that allows for ‘caring for drive early childhood development Refers to the ability of the caregiver the caregivers’. Some families will in emergencies. Global and to notice, understand, and respond need only limited assistance while national stakeholders should come to their child’s signals in a timely others will require intensive support, together behind a comprehensive and appropriate manner. especially when they are affected by approach for preparedness Considered the foundational significant trauma as well as basic and response, requiring robust component because responsive health and survival issues. investments and continued caregivers are better able to support prioritization across development the other four components. and humanitarian settings. 02 Table. Examples of interventions according to different levels of implementation intensity SERVICE/ LOW-INTENSITY MEDIUM-INTENSITY HIGH-INTENSITY PROGRAMME (UNIVERSAL SUPPORT) (TARGETED SUPPORT) (INDICATED SUPPORT) TARGET Interventions Key messages focused on Parenting support groups Intensive home visiting, for caregivers responsive caregiving, early that include a focus on typically conducted weekly and families learning and caregivers’ responsive caregiving, early or bi-weekly for at least mental health. Delivered learning and caregivers’ 6 months to one year. through in-person mental health. Visits include psychosocial interactions, telehealth, support for caregivers, Integration of early digital messages, text guidance on responsive childhood development messages, phone calls, caregiving, and tailored support within existing pamphlets, posters or support for early learning caregiver groups, such as other media. Distributed activities depending on the mother-to-mother feeding at registration points, child’s developmental stage support groups, parent distribution centres, health and abilities. committees and others. clinics, community centres Individual or small group and other safe spaces. support for caregivers Mass media content with disabilities
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