BACKGROUND: Parenting health literacy is essential for effective caregiving, yet its impact on nurturing care ability remains insufficiently studied. This study aimed to investigate the association between parenting health literacy and nurturing care ability, with a focus on the mediating role of parenting stress. METHODS: A cross-sectional survey was conducted among 3623 caregivers of children aged 0-6 years in Yiwu, Zhejiang Province, China. Standardised instruments were used to assess parenting health literacy, parenting stress and nurturing care ability. Mediation analysis quantified the contribution of parenting stress to the association between health literacy and nurturing care ability, and domain-specific mediation effects were examined. RESULTS: Higher parenting health literacy was significantly associated with lower parenting stress (β=-0.12, p<0.001) and greater nurturing care ability (β=0.10, p<0.001). Parenting stress mediated 33.68% of the association between parenting health literacy and nurturing care ability. Domain-specific analyses revealed stronger mediation for parenting style (42.31%), play experience ability (37.81%) and responsive care (37.26%) compared with other domains. CONCLUSIONS: Parenting health literacy improves nurturing care ability both directly and indirectly by reducing parenting stress, with particularly pronounced effects in emotionally demanding domains. Interventions to enhance parenting outcomes should integrate health literacy promotion with stress management strategies.
Background: Despite increased global attention to early childhood development, children under 5 in low- and middle-income countries face heightened risks of poor developmental outcomes. In Indonesia, where innovative approaches to nurturing care are needed, video-based interventions show promise.Purpose: This study aimed to elevate maternal competence in parenting and contribute to the holistic development of children aged 0-3 years through video-based nurturing care education.Method: Non-equivalent quasi-experimental design with pre-post-test control groups was employed. This study used a consecutive sampling technique on 89 mothers with children 0-3 years old (intervention group = 40 and control group = 49). The intervention group was given health education using videos via a WhatsApp link, and the control group was given leaflets directly. Data was collected from May to August 2022, four weeks before the intervention (pre-test) and two weeks after the video and leaflets were given (post-test). The instrument was modified from the Knowledge, Attitude, and Practice (KAP) questionnaire developed by UNICEF. The effect of education was analyzed using Wilcoxon and independent t-test.Results: The group that received the intervention showed a notable and positive influence on their knowledge, attitudes, and practices (KAP levels) in contrast to the control group. This suggests the video-based intervention effectively enhanced participants' understanding, attitudes, and caregiving practices.Conclusion: The research emphasizes the positive outcomes of video-based nurturing care intervention for mothers with children aged 0-3 years. The intervention significantly improved maternal attitudes toward parenting, caregiving behaviors, and overall child development. These results emphasize the significance of employing video interventions to encourage effective nurturing care practices.
Fitri Haryanti, Lely Lusmilasari, Ema Madyaningrum et al.
We examine empirical and conceptual considerations related to the role of nurturing care for protecting human capital formation in the context of climate change. Climate change is a pressing global challenge. Heatwaves, wildfires, storms, and floods are becoming more frequent and severe, and their direct impact and aftermath can have long-lasting negative effects on employment, education, healthcare, and access to essential services. Children are particularly vulnerable to these harms due to their developmental immaturity and limited capacity to mitigate and avoid risks [1,2]. Consequently, parents and other adult primary caregivers - such as grandparents, relatives, and foster parents (hereafter "caregivers") - provide the primary buffer between climate hazards and adverse developmental outcomes. They do this through nurturing care, defined as the provision of stable environments that promote children's health and nutrition, safety and security, opportunities for learning, and emotionally supportive relationships [3]. Despite the central role of nurturing care for children's life outcomes, it rarely appears in climate change research and policy discourse.
BACKGROUND: Understanding donor, government and out-of-pocket funding for early child development (ECD) is important for tracking progress. We aimed to estimate a baseline for the WHO, UNICEF and World Bank Nurturing Care Framework (NCF) with a special focus on childhood disability. METHODS: To estimate development assistance spending, the Organisation for Economic Cooperation and Development's Creditor Reporting System (OECD-CRS) database was searched for 2007-2016, using key words derived from domains of the NCF (good health, nutrition and growth, responsive caregiving, security and safety, and early learning), plus disability. Associated funds were analysed by domain, donor, recipient and region. Trends of ECD/NCF were compared with reproductive, maternal, newborn and child health (RMNCH) disbursements. To assess domestic or out-of-pocket expenditure for ECD, we searched electronic databases of indexed and grey literature. RESULTS: US$79.1 billion of development assistance were disbursed, mostly for health and nutrition (US$61.9 billion, 78% of total) and least for disability (US$0.7 billion, 2% of total). US$2.3 per child per year were disbursed for non-health ECD activities. Total development assistance for ECD increased by 121% between 2007 and 2016, an average increase of 8.3% annually. Per child disbursements increased more in Africa and Asia, while minimally in Latin America and the Caribbean and Oceania. We could not find comparable sources for domestic funding and out-of-pocket expenditure. CONCLUSIONS: Estimated international donor disbursements for ECD remain small compared with RMNCH. Limitations include inconsistent donor terminology in OECD data. Increased investment will be required in the poorest countries and for childhood disability to ensure that progress is equitable.
Leonardo Arregocés-Castillo, Robert C Hughes, Kate Mackinnon Milner et al.
It is thought that supporting the early childhood period, which is of critical importance in terms of cognitive, social, emotional and physical development in children, with the components of the developmental care scope will increase the peace and welfare levels of future generations.In addition to the applications carried out in this context in our country, there is also a need for applications that we need to add to our health practice.The purpose of the review is to talk about the scope of nurturing care and nurturing care practices in our country in the light of current information and to offer suggestions to further develop the scope.
Nurturing care interventions postulated on strengthening caregiver-child relationships have proven to be effective for improving early childhood development outcomes in low- and middle-income countries. Hence, a scale-up of the interventions has been recommended with an emphasis on the health sector given the contact with families in the critical first 3 years of life. However, an effective scale-up of an integrated intervention through healthcare requires a theory of change approach elucidating pathways of sustainable change. From this viewpoint, I reflect on my experience of scaling the intervention in a private pediatric care setting. I realized that buy-in from the health sector required realization of benefits to include health outcomes framed as the potential to improve the quality of life and the process of recovery; sustainable behavior change required a culture that promoted nurturing care highlighting the role of leadership; subsequently improving the experience of frontline staff and at an individual level, this could be achieved through the provision of supportive supervision-rooted in a framework of compassion. The lessons learned are shared to be considered for future integration efforts.
A comprehensive evidence-based framework is needed to guide policies and programmes that enable children and adolescents to accrue the human capital required to meet the Sustainable Development Goals (SDGs). This paper proposes a comprehensive, multisectoral, multilevel life-course conceptualisation of human capital development by building on the Nurturing Care Framework (NCF), originally developed for the foundational period of growth and development through the age 3 years. Nurturing care (NC) comprises stable environments that promote children's health and nutrition, protect from threats, and provide opportunities for learning and responsive, emotionally supportive and developmentally enriching relationships. NC is fostered by families, communities, services, national policies and beyond. The principles apply across the life course, endorse equity and human rights, and promote long-term human capital. This paper presents an evidence-based argument for the extension of the NCF from preconception through adolescence (0-20 years), organised into six developmental periods: preconception/prenatal, newborn/birth, infancy/toddlerhood, preschool, middle childhood and adolescence. The proposed framework advances human capital within each developmental period by promoting resilience and adaptive developmental trajectories while mitigating negative consequences of adversities.Attaining the SDGs depends on strengthening human capital formation, extending throughout childhood and adolescence and supported by NC. Embedded in enabling laws, policies and services, the dynamic NCF components can mitigate adversities, enhance resilience and promote the well-being of marginalised groups. The life-course extension of the NCF is strategically positioned to enhance human capital, to attain the SDGs and to ensure that children or adolescents are not left behind in reaching their developmental potential.
Maureen M. Black, Jere Richard Behrman, Bernadette M. E. G. Daelmans et al.
At the halfway mark for implementation of the Sustainable Development Agenda, progress towards achieving targets centred on child health and development has decelerated, impeding the survival and potential of many children. The Lancet Series on optimising child and adolescent health and development called for renewed efforts to nurture the health and development of all children.1 To accomplish this, it is necessary to expand implementation of evidence-based interventions that address factors jeopardising optimal outcomes, spanning from pre-conception into adulthood.
Children are disproportionately impacted by humanitarian disasters, which cause toxic stress. When a crisis overwhelms the capacity of health and social systems to meet the needs of a population, external crisis response teams working in a range of sectors may offer support to save lives and meet the affected populations' basic needs. Gaps have been identified in health sector interventions for children in humanitarian contexts, including lack of routine interventions to protect and promote early child development (ECD). To address this gap and improve the quality of humanitarian responses for girls and boys, the Global Health Cluster, Child Health Task Force, and the Inter-Agency Network for Education in Emergencies held a webinar series on Strengthening Nurturing Care in Humanitarian Response. It concluded that incorporating interventions to support nurturing care for ECD into health responses in acute phase emergencies is lifesaving. In crisis contexts, even simple interventions can be the difference between life and death, and when systematically applied, they can dramatically improve a child's life opportunities as well as national recovery and economic growth.
Ayesha Kadir, Linda Doull, James McQuen Patterson et al.
Child-focused education and nurturing care interventions provide learning support directly to the child. In line with the International Standard Classification of Education (ISCED Level 0), the support is typically provided by either centre- or home-based Early Childhood Education and Care (ECEC) services outside the child’s family and includes an educative and caring component with an active child development element. The 35 child-focused interventions in this review (of a total of 109 studies; see further details under background) occurred in 29 countries in five regions – the widest geographical spread of all intervention types under consideration. The most frequently represented countries were China (five studies) and Bangladesh (four studies) while three interventions occurred in Indonesia and Ethiopia. The child-focused interventions targeted three groups, namely preschool for children in the one or two years before starting school (20 studies), programs for younger children and programs without an explicit educational focus (11 studies) and short-term interventions for disadvantaged children (4 studies). Twenty-seven of the 35 interventions had positive effects on learning. The impact of these interventions – one of six types of interventions in the review – confirmed previous results showing the largest effects for child focused interventions compared with other ECEC interventions (Rao et al., 2017).
Jen Jackson, Syeda Kashfee Ahmed, Toby Carslake et al.
