The Nurturing Care Framework (NCF) calls for establishing a global monitoring and accountability systems for early childhood development (ECD). Major gaps to build low-cost and large-scale ECD monitoring systems at the local level remain. In this manuscript, we describe the process of selecting nurturing care indicators at the municipal level from existing routine information systems to develop the Brazilian Early Childhood Friendly Index (IMAPI). Three methodological steps developed through a participatory decision-making process were followed. First, a literature review identified potential indicators to translate the NCF domains. Four technical panels composed of stakeholders from federal, state and municipal levels were consulted to identify data sources, their availability at the municipal level and the strengths and weakness of each potential indicator. Second, national and international ECD experts participated in two surveys to score, following a SMART approach, the expected performance of each nurturing care indicator. This information was used to develop analytical weights for each indicator. Third, informed by strengths and weaknesses pointed out in the previous steps, the IMAPI team reached consensus on 31 nurturing care indicators across the five NCF domains (Good health [n = 14], Adequate nutrition [4], Responsive caregiving [1], Opportunities for early learning [7] and Security and safety [4]). IMAPI represents the first attempt to select nurturing care indicators at the municipal level using data from existing routine information systems.
Gabriela Buccini, Jéssica Pedroso, Stefanie Eugênia dos Anjos Campos COELHO et al.
ABSTRACT Objective: To understand the interfaces of family care for preterm infants at home with the domains of good health, adequate nutrition, responsive care, safety and protection, and early learning opportunities, from the Nurturing Care Framework (NCF). Method: This is a qualitative study guided by the theoretical framework of Nurturing Care Framework. Data were collected between August 2023 and March 2024, in the homes of 12 preterm infants, with 27 family members, followed by a high-risk newborn follow-up service. During the visits, dyadic or group family interviews were conducted, and records were kept in field diaries. In parallel, two researchers performed blind coding of the data and inter-coder verification, using software-assisted deductive thematic analysis guided by a code dictionary. Results: The results showed: prevention of illness and promotion of physical health in preterm infants; early introduction of solid foods and breastfeeding-related weaknesses; caregiver responsiveness to the needs of preterm infants; intrafamily safety and prevention of domestic accidents; Early learning opportunities, limited to motor stimulation. Conclusion: It became evident that caregivers have a limited understanding of the domains of Nurturing Care Framework (NCF), a reflection of the current healthcare model in the research setting. It is expected that families, upon receiving nursing care and guidance based on the NCF, will be able to broaden their understanding and applicability of the model in their daily lives, which would be aligned with the objectives for sustainable development.
Maria Luiza Cunha Da Fonseca, Bruna da Silva Calderaro, Larissa Alves de Souza 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.
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.
Providing an enabling nurturing care environment for early childhood development (ECD) that cuts across the five domains of the Nurturing Care Framework (i.e., good health, adequate nutrition, opportunities for early learning, security and safety and responsive caregiving) has become a global priority. Brazil is home to approximately 18.5 million children under 5 years of age, of which 13% are at risk of poor development due to socio-economic inequalities. We explored whether the Early Childhood Friendly Municipal Index (IMAPI) can detect inequities in nurturing care ECD environments across the 5570 Brazilian municipalities. We examined the validity of the IMAPI scores and conducted descriptive analyses for assessing sociodemographic inequities by nurturing care domains and between and within regions. The strong correlations between school achievement (positive) and socially vulnerable children (negative) confirmed the IMAPI as a multidimensional nurturing care indicator. Low IMAPI scores were more frequent in the North (72.7%) and Northeast (63.3%) regions and in small (47.7%) and medium (43.3%) size municipalities. Conversely, high IMAPI scores were more frequent in the more prosperous South (52.9%) and Southeast (41.2%) regions and in metropolitan areas (41.2%). The security and safety domain had the lowest mean differences (MDs) among Brazilian regions (MD = 5) and population size (MD = 3). Between-region analyses confirmed inequities between the North/Northeast and South/Southeast. The biggest within-region inequity gaps were found in the Northeast (from -22 to 15) and the North (-21 to 19). The IMAPI distinguished the nurturing care ECD environments across Brazilian municipalities and can inform equitable and intersectoral multilevel decision making.
Gabriela Buccini, Stefanie Eugênia dos Anjos Coelho Kubo, Jéssica Pedroso et al.
This cross-sectional study examines whether provision of nurturing care in 31 countries over 10 years was associated with improvements in countries’ child development outcomes.
Dana Charles McCoy, Jorge A. Cuartas, Jonathan Seiden
Millions of children are subjected to abuse, neglect, and displacement, and millions more are at risk for not achieving their developmental potential. Although there is a global movement to change this, driven by children's rights, progress is slow and impeded by political considerations. The United Nations Convention on the Rights of the Child, a global comprehensive commitment to children's rights ratified by all countries in the world except the United States (because of concerns about impingement on sovereignty and parental authority), has a special General Comment on "Implementing Child Rights in Early Childhood." More recently, the World Health Organization and United Nations Children's Fund have launched the Nurturing Care Framework for Early Childhood Development (ECD), which calls for public policies that promote nurturing care interventions and addresses 5 interrelated components that are necessary for optimal ECD. This move is also complemented by the Human Capital Project of the World Bank, providing a focus on the need for investments in child health and nutrition and their long-term benefits. In this article, we outline children's rights under international law, the underlying scientific evidence supporting attention to ECD, and the philosophy of nurturing care that ensures that children's rights are respected, protected, and fulfilled. We also provide pediatricians anywhere with the policy and rights-based frameworks that are essential for them to care for and advocate for children and families to ensure optimal developmental, health, and socioemotional outcomes. These recommendations do not necessarily reflect American Academy of Pediatrics policy.
Julie Uchitel, Errol R. Alden, Zulfiqar Ahmed Bhutta et al.
Regional scholars in the Caribbean context have long advocated for quality early childhood education. The majority of their contributions however, focus primarily on curriculum, policy, and to a lesser extent, teaching practices. In this article, we broaden the scope of extant literature by conceptualizing a model for Caribbean early childhood education, one which draws on and supports an anti-colonial and decolonizing perspective. Specifically, we interrogate the enduring legacy of colonialism on teaching and learning practices—and illustrate how these manifest in contemporary schooling processes. Equally significant, we examine and critique underlying epistemologies that frame current regional approaches, and offer an alternative framework that accents cultural knowledges in curriculum, pedagogy and teacher education. In response, we foreground childhood decolonization as integral to the development of positive racial and cultural identity, and in such vein, offer curricula, pedagogical and institutional (i.e., teacher education) suggestions consonant with an anti-colonial and decolonizing approach to early childhood education in the English-speaking Caribbean.
This paper is a response to multiculturalism’s reductionist and othering constructions of Black presence in Canadian early childhood research and practice. We engage in possibilities for creating movement away from multiculturalism as the primary way of responding to anti-Blackness in Canadian early childhood education. We put forward orientations that emerge when we imagine the abolition of Canadian early childhood education pedagogies and curriculum that are shaped by neoliberal multiculturalism. We organize our abolitionist praxis in relation to what kinds of stories and modes of storytelling of Black life might be needed in early childhood education in Canada. We focus our attention on three interconnected pedagogical orientations: storying abolition geographies, storying Black ecologies, and storying Black aliveness.
Decolonizing Place in Early Childhood Education encourages readers to consider how the entanglements of settler colonialism, anti-Blackness, and anthropogenic climate change shape pedagogical encou...
