Peer-reviewed article
Workforce preparation for delivery of nurturing care in low‐ and middle‐income countries: Expert consensus on critical multisectoral training needs
Emma Claire Pearson, Nirmala Rao, Iram Siraj, Frances E. Aboud, Caroline Horton et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study identifies critical training needs for early childhood development workers in low- and middle-income countries. Using expert consensus through a Delphi methodology, researchers identified shared training priorities across health workers, community paraprofessionals, and education professionals. Key training needs include nurturing dispositions, skills for responsive programme delivery, and systems for ongoing mentoring and professional support in resource-constrained settings.
Key points
- Shared training needs across all three workforce groups include nurturing dispositions, knowledge and skills for responsive ECD programme delivery, and systems for ongoing mentoring
- The early childhood workforce in low- and middle-income countries is diverse and complex, facing significant challenges in delivering quality services
- The study addresses a critical gap in evidence on training needs for ECD workers in low-resource contexts
- Effective training systems must prioritise professional pathways and ongoing support rather than one-off interventions
- Training must be adaptable to extremely diverse geographical and social settings
Limitations
This is an expert consensus study rather than an empirical evaluation, so it reflects expert opinion rather than direct evidence of what training actually improves child outcomes. The document does not provide data on implementation costs, feasibility, or effectiveness of the identified training approaches in real-world settings.
Abstract
BACKGROUND: Services to support nurturing care through early childhood development (ECD) in low- and middle-income countries are hampered by significant workforce challenges. The global early childhood workforce is both diverse and complex, and it supports the delivery of a wide range of services in extremely diverse geographical and social settings. In the context of contemporary global goals for the universal provision of quality early childhood provision, there is an urgent need to build appropriate platforms for strengthening and supporting this workforce. However, the evidence base to support this work is severely limited. METHODS: To contribute to evidence on how to strengthen the ECD workforce in low- and middle-income countries, this study used a Delphi methodology involving three rounds of data collection with 14 global experts, to reach consensus on the most critical training needs of three key early childhood workforce groups: (i) health; (ii) community-based paraprofessionals, and (iii) educational professionals working across ECD programmes. RESULTS: The study identified a comprehensive set of shared, as well as distinct, training needs across the three groups. Shared training needs include the following: (i) nurturing dispositions that facilitate work with children and families in complex settings; (ii) knowledge and skills to support responsive, adaptable delivery of ECD programmes; and (iii) systems for ECD training and professional pathways that prioritise ongoing mentoring and support. CONCLUSIONS: The study's detailed findings help to address a critical gap in the evidence on training needs for ECD workers in low-resource contexts. They provide insights into how to strengthen content, systems, and methods of training to support intersectoral ECD work in resource-constrained contexts.