Abstract
The WHO-UNICEF nurturing care framework (NCF) for early childhood development provides a roadmap for action, focusing on pregnancy and the first three years of life. It emphasizes the need to invest in capacity building and empowerment of service providers, families and communities to create a conducive environment that promotes child development. We describe our experience of implementing nurturing care interventions, beginning with a pilot project in Maharashtra covering a population of 10000 to and scaling it up to a model called Aarambh (the beginning), catering to a population of 1,500,000. Opportunities available within the existing services across multiple sectors were used; Integrated Child Development Services (ICDS) scheme, the health sector, and others. It utilized multiple approaches for promoting NCF within families; home visits by frontline workers (FLWs), mothers’ meetings, growth monitoring and promotion sessions, and community-based events as key opportunities. Joint training for FLWs, establishing supervisors of FLWs as their trainers, and an interactive training curriculum were critical elements identified for the success of the model. An environment of appreciation for the FLWs and their supervisors helped build their confidence and helped them own the interventions.
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Acknowledgements
The India-specific ECD Package implemented during the pilot phase was developed by SWACH, Haryana in partnership with WHO and INTERVIDA, which was later implemented by two organizations — SWACH, Haryana and the Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sewagram. The scale-up phase (2017-2021) was implemented by two teams; MGIMS, Sewagram in Aurangabad and Yavatmal districts, Maharashtra and SAVE THE CHILDREN and Gram Mangal in Pune and Palghar, Maharashtra. The current paper describes the experiences of the team at MGIMS, Sewagram.
Funding
Funding: Pilot phase, 2011–2014, supported under the World Health Organization/INTERVIDA Collaborative project on Early Childhood Development. Scale-up phase, 2017–2021, supported by UNICEF, India.
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Note: The author is a staff member of the World Health Organization. The author alone is responsible for the views expressed in this paper and they do not necessarily represent the decisions, policy or views of the World Health Organization.
Critical inputs during the pilot project (2011-14) Mehta R - WHO Regional Office for South-East Asia New Delhi; Priyadarshini – Composite Regional Centre for Skill Development, Patna, Francis P - Independent Expert; Raina N - WHO Regional Office for South-East Asia, New Delhi; Cabral deMello M - Independent Expert; Fisher J – Monash university Australia; Lucas J - Independent Expert; Daelmans Bernadette MEG - WHO Headquarters Geneva
Critical inputs during the scale-up project (2017-20) Deshpande A - UNICEF Mumbai; Nair R - UNICEF Mumbai; Singh G UNICEF Delhi; Mukharji S - Independent Consultant Maharashtra; Mirkale P - Deputy CEO ICDS Aurangabad; Jadhao V - Deputy CEO ICDS Yavatmal; Chavhan S - District ASHA coordinator Aurangabad; Chauhan D - District Health Officer Yavatmal; Gite A - District Health Officer Aurangabad; Sharma J - CEO Zilla Parishad Yavatmal; Kaur P - CEO Zilla Parishad Aurangabad; Kundan IA - Department of Women and Child Development, Government of Maharashtra Mumbai
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Gupta, S.S., Raut, A.V., Kothekar, P. et al. Nurturing Care Interventions for Realizing the Development Potential of Every Child: From Pilot to Scale Up in Maharashtra. Indian Pediatr 58 (Suppl 1), 46–52 (2021). https://doi.org/10.1007/s13312-021-2356-6
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DOI: https://doi.org/10.1007/s13312-021-2356-6