Early child development - nurturing care: A nation’s pride
No abstract available Sri Lanka Journal of Child Health, 2023: 52(2): 202-203
A. Priya Margaret, Sandeep Kumar
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No abstract available Sri Lanka Journal of Child Health, 2023: 52(2): 202-203
A. Priya Margaret, Sandeep Kumar
INTRODUCTION: Children who are HIV-exposed and uninfected (CHEU) are a growing population at potential risk of poor neurocognitive development. We tested a nurturing care intervention on children's neurocognitive development and maternal depressive symptoms (primary) with mediation through caregiving activities (secondary). METHODS: This study was conducted among six intervention and nine comparison antenatal-care/prevention of vertical transmission (ANC/PVT) HIV clinics in eSwatini. We enrolled pregnant women and measured infant development at 9 and 18 months. mothers2mothers (m2m) designed and implemented the clinic-home-community-based intervention. We measured infants' neurodevelopment, maternal depressive symptoms and caregiving activities with the Mullen Scales of Early Learning (MSEL), Edinburgh Postnatal Depression Scale, HOME Inventory and Family Care Indicators. We fitted linear mixed effects regression models with clinic random effects to compare intervention versus comparison arms, and generalised structural equation models to evaluate mediation, adjusting for confounders. RESULTS: Mother-infant pairs (n = 429) participated between January 2016 through May 2018. Socio-demographic characteristics were balanced between arms except for higher rates of peri-urban versus rural residence and single versus married mothers in the comparison group. The 18 month retention was 82% (180/220) intervention, 79% (166/209) comparison arm, with 25 infant deaths. Intervention MSEL scores were significantly, and modestly, higher in receptive language (55.7 [95% CI 54.6, 56.9] vs. 53.7 [95% CI 52.6, 54.8]), expressive language (42.5 [95% CI 41.6, 39.8] vs. 40.8 [95% CI 39.8, 41.7]) and composite MSEL (85.4 [95% CI 83.7, 84.5] vs. 82.7 [95% CI 81.0, 84.5]), with no difference in maternal depressive symptoms or in observations of mother-child interactions. Intervention book-sharing scores were higher (0.63 vs. 0.41) and mediated the effect on MSEL scores (indirect effect, p-values ≤ 0.024). The direct effects on visual reception and expressive language scores were significantly higher in the intervention compared to the comparison arm (coefficients 1.93 [95% CI 0.26, 3.60] and 1.66 [95% CI 0.51, 2.79, respectively]). CONCLUSIONS: Nurturing care interventions can be integrated into ANC/PVT clinic-home-community programmes. The intervention, mediated through interactive caregiving activities, increased language development scores among CHEU. Partnering with a local team, m2m, to design and implement a culturally relevant intervention illustrates the ability to impact parent-child play and learning activities that are associated with children's neurodevelopment.
Andrea Ruff, Xolisile Dlamini, Bareng A. S. Nonyane et al.
BACKGROUND: Zip codes classified by the Food Insecurity Index with moderate and high food insecurity (FI) risk can be a threat to the health and well-being of children during the first 1,000 days (from pregnancy to 2 years). The presence of nurturing care assets (i.e., stable environments that promote health and nutrition, learning opportunities, security and safety, and responsive relationships) can contribute to supporting families and their communities, and ultimately reduce systemic barriers to food security. We aimed to identify and characterize nurturing care assets in under-resourced communities with moderate and high FI risk. METHODS: Four steps were used to conduct a Community Asset Mapping (CAM): (1) review of community documents across five zip codes in Clark County, Nevada (2), engagement of community members in identifying community assets (3), definition of the assets providing nurturing care services, and (4) classification of assets to nurturing care components, i.e., good health, adequate nutrition, safety and security, opportunities for early learning, and responsive caregiving. The Food Insecurity Index was used to determine FI risk in each zip code. Analyses explored whether disparities in nurturing care assets across zip codes with moderate and high FI exist. RESULTS: We identified 353 nurturing care assets across zip codes. A more significant number of nurturing care assets were present in zip codes with high FI risk. The adequate nutrition component had the most assets overall (n = 218, 61.8%), while the responsive caregiving category had the least (n = 26, 7.4%). Most of the adequate nutrition resources consisted of convenience stores (n = 96), food pantries (n = 33), and grocery stores (n = 33). Disparities in the number and type of good health, early learning, and security and safety assets were identified within zip codes with high FI risk compared to moderate FI risk. CONCLUSIONS: The quantity and type of nurturing care assets can exacerbate existing demographic disparities across zip codes, which are tied to barriers to access to food in under-resourced communities in Clark County, Nevada. Co-creating a nurturing care asset-based zip code strategy to address high FI risk will require strengthening systems across existing nurturing care assets.
Gabriela Buccini, Kaelia Lynn Saniatan, Ana Paula Poblacion et al.
Background The Nurturing Care Framework (NCF), which has been emphasized by the World Health Organization (WHO) in recent years and is among the United Nations Sustainable Development Goals (SDGs), expresses the conditions created to promote early childhood development (ECD). These conditions aim to provide opportunities for children in the Good Health, Adequate Nutrition, Responsive Caregiving, Security and Safety, and Opportunities for Early Learning (5 Components) by caregivers, primarily from low and middle-income countries (LMICs). The aim of this study is to examine the knowledge and awareness of expectant mothers and fathers in Turkey, about the NCF. Methods In this study, a cross-sectional, analytical research design was used. Nurturing Care (NC) knowledge and awareness levels of expectant mothers and fathers in the 2nd and 3rd trimesters of pregnancy were determined via the online form of “The Knowledge of Nurturing Care Inventory (KNCI)” prepared by the researchers. This form consists of 60 questions describing the 5 components mentioned above. The sample contains a total of 103 people, 91 (88.3%) women, and 12 (11.7%) men. Results Among the findings, the highest mean of knowledge level (13.76 ± 1.22) was found in Responsive Caregiving, and the lowest mean of knowledge level (4.35 ± 1.83) was found in Opportunities for Early Learning. The general level of knowledge on NC was found to vary statistically significantly depending on gender in favor of the women [t(101) = 3.27, p < .05], depending on educational status in favor of those with university and graduate education [F(2, 100) = 3.481, p < .05], depending on participation in pregnancy school training in favor of those who attended [t(101) = 2.349, p < .05], and depending on knowledge on how to support development in favor of those who know how to support [t(101) = 2.370, p < .05]. Conclusions As a result, expectant parents need information and support about the period when children can acquire the basic developmental milestones and about the developmental risk indicators. More research is needed to implement the NCF starting from the preconception period, especially in LMICs, so that the opportunities in early childhood (which is the time period when the brain architecture is shaped, and development is the fastest) are not missed.
Hafize Soysal Cimen, Bedriye Tuğba Karaaslan
Dietary guidelines provide advice on what to eat to different subsets of the population but often do not take into account the "how" to eat. Responsive feeding is a key dimension of responsive parenting involving reciprocity between the child and caregiver during the feeding process and is characterized by caregiver guidance and recognition of the child's cues of hunger and satiety. Evidence indicates that providing responsive feeding guidance to mothers on how to recognize and respond appropriately to children's hunger and satiety cues can lead to improved feeding practices and weight status and developmental outcomes among infants and young children. In addition, early and nurturing exposures to foods with different tastes and textures and positive role modelling help children to learn to eat healthy foods. The importance of improving caregiver's responsive feeding behaviours to ensure the adequate introduction of complementary foods is becoming increasing recognized, but responsive feeding principles have not been taken into account in a comprehensive way in the development of dietary guidelines. The incorporation of all responsive feeding principles into dietary guidelines has a strong potential to enhance their impact on early childhood development outcomes for infants and young children but will require adaptation to the different contexts across countries to ensure that they are culturally sensitive and grounded in a deep understanding of the types of foods and other resources available to diverse communities.
Rafael Pérez‐Escamilla, Sofía Segura‐Pérez, Victoria Hall Morán
The nurturing care framework (NCF) for early childhood development (ECD) launched at the 2018 World Health Assembly opens a range of opportunities and challenges for child neurodisability professionals. The United Nations Convention on the Rights of the Child and Convention on the Rights of People with Disabilities frame these pathways for collaboration and progress. This overview of the NCF and its contexts in inclusive ECD identifies avenues for innovation and collaboration in harmony with the field's clinical, scientific, and advocacy agendas. One avenue involves enhancing the alignment between health systems and human rights. A second avenue involves neurodisability professionals engaging with nurturing care as leaders, partners, and implementers. WHAT THIS PAPER ADDS: Participation and leadership by neurodisability professionals can enhance quality and impact. A rights-based framework that includes young children with disabilities and their families is widely encouraged.
Donald L. Wertlieb
The next 1,000 days of a child's life (spanning from the age of two to five years) offer a crucial opportunity to build on early gains and sustain or improve trajectories of healthy development. This period is vital for cognitive, motor, and socio-emotional growth. Consequently, it emphasizes nurturing care, which refers to the conditions established by public policies, programs, and services that enable caregivers and communities to ensure good health, adequate nutrition, responsive caregiving, opportunities for early learning, and safety and security. While Early Childcare and Development (ECD) interventions are not new in the Philippines, the next 1,000 days underscore the importance of continuity of care, emphasizing that the responsibility for ECD extends beyond parent-child relationships and the silos of the health and nutrition sectors. However, research involving disaggregated data during this period is limited among low- to middle-income countries, including the Philippines. Additionally, efforts to promote development in the next 1,000 days are often inadequate or not effectively translated into policies. This report aims to provide a baseline assessment of relevant outcomes during this critical period through the lens of the nurturing care framework, using population-level data covering children under the age of five. This assessment will guide the formulation of policy recommendations to enhance and build on these efforts, maximizing this golden opportunity for early child development.
Ma. Norma Thea Madeline Conjares, Danielle Lois Carreon, Lyle Daryll Casas et al.
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.
Yuechong Cui, Shuting Si, Lingchen Li et al.
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.
Jorge A. Cuartas, Francis Vergunst