Family centered early childhood development: a case of Rongo Subcounty, Migori Kenya

Teresa Mwoma, Phillip Omondi, S. Mudhune, Erick Auko, Mercy Ongono, L. Njoki, Hellen Kerubo, Jane Wamae, Lou L. Goore, Stephen Okong, Mumma Edelquinn, Ash Rogers
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Abstract

The early childhood period from conception to three years is critical in a child’s health, well-being and brain development. Proper care and stimulation therefore, contributes to a child’s productivity that lasts through childhood to adulthood. It is estimated that globally, 43% of children under five years are at risk of failing to achieve their developmental potential. In Sub-Saharan Africa (SSA), this portion is approximately 66%. The Kenya Demographic Health Survey (KDHS) 2022 revealed that 21% of children in Kenya aged 24-59 months are not developmentally on track. A higher percentage of children in urban (87%) than rural (73%) areas are developmentally on track. The percentage of children developmentally on track increases with increasing mothers’ education from 51% among children whose mothers have no education to 91% among those whose mothers have more than secondary education. The percentage of children developmentally on track also increases with increasing household wealth from 61% among children in the lowest wealth quantile to 93% among those in the highest quantile. This therefore calls for parenting/caregiving programmes that targets parents/caregivers from the lowest household wealth index as well as those with mothers having lowest education levels. Lwala Community Alliance with funding from Comic Relief piloted a Family Centered earlcy childhood development (ECD) program in North Kamagambo ward, Rongo Subcounty, Migori County Kenya in 2021. The long-term goal of the program was to ensure that children under the age of five years reach their developmental potential in a nurturing care environment supported by responsive and sensitive men and women caregivers. The community health volunteers (CHW) through household visitation, group parenting sessions, and facility-based education sessions implemented the program. This was meant to improve outcomes across child health, caregiver support, health worker capacity, and the enabling environment. Building on the success of the pilot, an evaluation and baseline study was conducted to explore the outcome of the pilot intervention and to upscale the program into three new wards in Rongo Subcounty. In order to accomplish this, baseline data was collected in three areas (East Kamagambo, Central Kamagambo and South Kamagambo) where scaling up of the program will happen before commencement of intervention activities. Findings revealed that the primary caregiver plays a critical role in caring for young children during the day by providing care for children’s basic needs. It was noted that households in North Kamagambo introduced complementary foods after the recommended six months as compared to the other three wards where other foods were introduced to babies before six months are over. Findings further revealed that there was a significant increase in knowledge especially on child rights and abuse from baseline, midline and end line in North Kamagambo with 86%, 90% and 91%, respectively. Caregivers’ ability to identify signs of a child who has been abused seemed good across the four locations. Caregivers in North Kamagambo provided higher levels of nurturing care to their children compared to caregivers in other wards
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以家庭为中心的儿童早期发展:以肯尼亚米戈里县朗戈县为例
从怀孕到三岁的幼儿期对儿童的健康、福祉和大脑发育至关重要。因此,适当的照顾和刺激有助于儿童从童年持续到成年的生产力。据估计,全球有43%的五岁以下儿童面临无法实现其发展潜力的风险。在撒哈拉以南非洲(SSA),这一比例约为66%。2022年肯尼亚人口健康调查(KDHS)显示,在肯尼亚,年龄在24-59个月的儿童中,有21%没有走上发育轨道。城市儿童(87%)比农村儿童(73%)发展正常的比例更高。随着母亲受教育程度的提高,发育正常的儿童比例也随之增加,母亲未受教育的儿童比例为51%,母亲受过中等以上教育的儿童比例为91%。随着家庭财富的增加,发育正常的儿童比例也在增加,从最低财富分位数儿童的61%上升到最高财富分位数儿童的93%。因此,需要针对家庭财富指数最低的父母/照料者以及母亲受教育程度最低的父母/照料者制定养育/照料规划。2021年,在Comic Relief的资助下,Lwala社区联盟在肯尼亚米戈里县朗戈县北卡马甘博区试点了一个以家庭为中心的儿童早期发展(ECD)项目。该方案的长期目标是确保五岁以下儿童在由反应灵敏和敏感的男女照料者支持的养育照料环境中实现其发展潜力。社区卫生志愿者(CHW)通过家庭访问、小组育儿会议和以设施为基础的教育会议来实施该计划。这是为了改善儿童健康、照料者支持、卫生工作者能力和有利环境方面的结果。在试点成功的基础上,开展了一项评估和基线研究,以探索试点干预措施的结果,并将该项目扩展到朗戈县的三个新病房。为了实现这一目标,在三个地区(东卡马甘博、中卡马甘博和南卡马甘博)收集了基线数据,这些地区将在开始干预活动之前扩大方案的规模。调查结果显示,主要照顾者通过提供儿童的基本需求,在日间照顾幼儿方面发挥着关键作用。有人指出,北卡马甘博的家庭在建议的6个月后才引入辅食,而其他三个区在婴儿6个月前就引入了其他食物。调查结果进一步显示,北卡马甘博的基线、中线和终点的儿童权利和虐待知识显著增加,分别为86%、90%和91%。在这四个地方,看护人识别受虐儿童迹象的能力似乎都很好。与其他病房的护理人员相比,北卡马甘博的护理人员为其儿童提供了更高水平的养育护理
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