The indicators of a child's development are influenced not only by biomedical and prenatal changes, but also by factors such as the environment in which he grows up, family relationships, acquired appropriate skills, which play a key role in the child's socialization. These indicators are closely related to each other, and if any of them is violated, developmental deviations are formed. In evaluating a child's development, in addition to the prenatal and biomedical history, the pediatrician must also consider the child's social environment. Improper organization of medical and psychological care, especially at an early age, increases the percentage of general morbidity and disability in the child population.
An eco-cultural approach to early childhood development
Quality early childhood development (ECD) programmes present an opportunity to drastically reduce early health and educational disadvantages for children in low-income and middle-income countries (LMICs). Studies have shown that interventions that build on existing and thus familiar community structures have a better chance of success. For instance, basing health and educational interventions on indigenous traditions such as the common African socialisation practices that assign pre-adolescent children to supervise and guide younger peers could enhance the acceptability and success of an intervention.
INTRODUCTION: In South Africa, early childhood development (ECD) in rural areas is challenged by the lack of a centre-based programme and because the ECD practitioners are inadequately trained. The Crosstrainer Programme (CTP) may be a centre-based early childhood development programme that could address this challenge. Consequently, the aim of this study is not to prove, but to determine the level of efficacy of the CTP on the development of three to four year old children in the rural Mahikeng areas METHOD: An experimental trial was conducted. The ECDC (Early Childhood Development Criteria) were used to test the children (49 from 17 ECD centres RESULTS: Both Section A: Cognitive SRRA (School Readiness Risk Areas) and Section B: Fine Motor Coordination were improved by the CTP. However, Section C: Gross Motor Coordination showed no improvement by the CTP CONCLUSIONS: The CTP proved valuable in the improvement of the Cognitive SRRA and even more so on the fine motor development of the population group. It is recommended that activities directed at gross motor development should be increased and amplified in the programme. Further studies on the CTP regarding the development of the children and the occupational enablement of the ECD practitioners are recommended Key words: Early childhood development; ECD; Crosstrainer Programme; CTP; occupational therapy; early learning programme; rural ECD centres; ECD practitioners
Danette de Villiers, Adeleigh Homan, Cornel van Rooyen
The likelihood of a newborn child dying before their fifth birthday (under-5 mortality rate) is universally acknowledged as a reflection of the social, economic, health, and environmental conditions in which children (and the rest of society) live, but little is known about the likelihood of a newborn child having a lifelong disability before their fifth birthday if he or she survives. Available data show that globally the likelihood of a child having a disability before their fifth birthday was ten times higher than the likelihood of dying (377·2 vs 38·2 per 1000 livebirths) in 2019. However, disability funding declined by 11·4% between 2007 and 2016, and only 2% of the estimated US$79·1 billion invested in early childhood development during this period was spent on disabilities. This funding pattern has not improved since 2016. This paper highlights the urgent need to prioritise early childhood development for the beneficiaries of global child survival initiatives who have lifelong disabilities, especially in low-income and middle-income countries, as envisioned by the Sustainable Development Goals agenda. This endeavour would entail disability-focused programming and monitoring approaches, economic analysis of interventions services, and substantial funding to redress the present inequalities among this cohort of children by 2030.
Bolajoko Olubukunola Olusanya, Nem Yun Boo, M.K.C. Nair et al.
This study investigates the socioeconomic determinants of early childhood development (ECD) in Pakistan by utilizing the data of sixth wave of the Multiple Indicator Cluster Survey (MICS) conducted in the four provinces of the country. The findings of the study reveal that mother's education, father's education, economic status of the household as measured by household's wealth index quintile, region of residence (province), child's gender, disability, nutrition and the practices used by the adult members of the household to discipline child are important determinants of ECD. The study highlights the crucial role of family background and importance of addressing the issue of malnutrition to foster child development.
Summary In China, low levels of early childhood development (ECD) in rural areas may inhibit economic development as the nation attempts to transition from a middle-income manufacturing-based economy to a high-income innovation economy. This paper surveys the recent literature on ECD among children ages 0-3 years in rural China, including rates of developmental delays, causes of delays, and implications for the future of China's economy. Recent studies have found high rates of developmental delays among young children in rural China and point to poor nutrition and psychosocial stimulation as the primary causes. This review highlights the need for large-scale ECD interventions in rural China to raise human capital and support future economic growth.
This article explores the evolving role of fathers in early childhood development through a child rights lens. Anchored in the United Nations Convention on the Rights of the Child (CRC)—particularly Articles 5, 18, and 27, which stress the best interests of the child—it challenges the enduring stereotype of fathers as solely financial providers. Employing a normative-analytical approach, the paper critically reviews international legal frameworks and scholarly literature to identify socio-cultural and institutional barriers to paternal involvement, especially within the Global South. Focusing on Indonesia—due to its recent legal reforms and entrenched gender norms—the study proposes a reconceptualisation of fatherhood across four key dimensions: emotional presence, hands-on caregiving, respectful dialogue, and cooperative co-parenting. It presents a set of evidence-informed policy and practice recommendations that position fathers as active, equal partners in nurturing and protecting young children. By offering a rights-based normative framework, this study contributes to global discourse on gender-transformative parenting and affirms every child’s right to balanced, nurturing care from both parents. This conceptual contribution connects legal, cultural, and policy domains, advancing a vision of fatherhood grounded in justice, equity, and the principles of the CRC.
Abstract To reach global immunization goals, national programs need to balance routine immunization at health facilities with vaccination campaigns and other outreach activities (e.g. vaccination weeks), which boost coverage at particular times and help reduce geographic inequalities. However, where routine immunization is weak, an overreliance on vaccination campaigns may lead to heterogeneous coverage. Here, we assessed the impact of a health system strengthening (HSS) intervention on the relative contribution of routine immunization and outreach activities to reach immunization goals in rural Madagascar.We obtained data from health centers in Ifanadiana district on the monthly number of recommended vaccines (BCG, measles, DTP and Polio) delivered to children, during 2014-2018. We also analyzed data from a district-representative cohort carried out every two years in over 1500 households in 2014-2018. We compared changes inside and outside the HSS catchment in the delivery of recommended vaccines, population-level vaccination coverage, geographic and economic inequalities in coverage, and timeliness of vaccination. The impact of HSS was quantified via mixed-effects logistic regressions. The HSS intervention was associated with a significant increase in immunization rates (Odds Ratio between 1.22 for measles and 1.49 for DTP), which diminished over time. Outreach activities were associated with a doubling in immunization rates, but their effect was smaller in the HSS catchment. Analysis of cohort data revealed that HSS was associated with higher vaccination coverage (Odds Ratio between 1.18 per year of HSS for measles and 1.43 for BCG), a reduction in economic inequality, and a higher proportion of timely vaccinations. Yet, the lower contribution of outreach activities in the HSS catchment was associated with persistent inequalities in geographic coverage, which prevented achieving international coverage targets. Investment in stronger primary care systems can improve vaccination coverage, reduce inequalities and improve the timeliness of vaccination via increases in routine immunizations. Key questions What is already known? - Reaching the minimum recommended vaccination coverage of 90% for childhood illnesses remains a substantial challenge for low and middle income countries (LMICs). - Understanding how vaccine delivery strategies can be improved to achieve coverage targets in rural areas of LMICs is essential due to the fragility of health systems and associated health budgets. - While evidence exists on the impact of outreach activities and other targeted interventions aimed at improving immunization coverage, it is unclear how strengthening local health systems can help improve key indicators of vaccination coverage, via its different impacts on routine and outreach immunizations. What are the new findings? - A health systems strengthening (HSS) intervention in a rural district of Madagascar improved overall vaccination coverage, reduced economic inequalities in vaccination coverage, and increased the proportion of timely vaccinations via an increase in routine immunizations. - The contribution of outreach activities was lower in the HSS catchment area than in the rest of the district, which was associated with a persistence of geographic inequalities in vaccination coverage. What do the new findings imply? - Strengthening local health systems can help improve key indicators of vaccination coverage in rural, low resource settings, even when those interventions do not target specifically vaccine improvements themselves. - Explicit efforts are still necessary in areas undergoing HSS to vaccinate children in remote areas so that immunization goals can be reached.
Elinambinina Rajaonarifara, Matthew H. Bonds, Ann C Miller et al.
Examining the role of the law in early childhood development is not new; several legal scholars have engaged in such an inquiry, including scholars at this symposium. But this engagement has not led to a sustained debate about how the legal system can foster early childhood development, nor has it yet led to the integration of legal scholars into the interdisciplinary research on, and policy debates about, early childhood. I have argued that the creation of a new subdiscipline in family law — early childhood development and the law — would achieve these goals, sparking debate within law, bringing a legal perspective to interdisciplinary research, and involving legal scholars in policy debates about supporting early childhood development. As I elaborate below, this symposium and the preceding national summit are promising steps in the creation of this new subdiscipline, highlighting the theoretical and practical benefits of this focused inquiry and generating a research agenda. Drawing on this momentum, this essay also identifies the next steps for building the subdiscipline, with the ultimate goal of reorienting the legal system to nurture early childhood development.
Abstract This paper aims to analyze the effect of inequality of opportunity on early childhood development in Togo. To achieve this objective, we use a logit model to obtain the conditional probabilities of the study circumstances. Based on these probabilities, we construct dissimilarity indices with the parametric approach and then apply Shapley decomposition using data from the Multiple Indicator Cluster Survey (MICS) conducted in Togo in 2017. The results obtained show that inequalities in opportunities slow early childhood development. The Shapley decomposition reveals that region of residence, ownership of agricultural land and mother's education contribute most to inequalities in early childhood development dimensions at 57.58%, 25.50% and 28.77%, respectively. Additionally, the return to an equal situation between children characterized by good health, better nutrition and good social and emotional cognitive development and those in poor condition is conditioned by the reallocation of 12.4% of the inequalities of the first group of children to the second group. Strengthening the coordination of agricultural activities and the provision of safe water to rural households is essential to improve the level of the early childhood development indicator. JEL Classification: D30, D63, I14, I15
