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Early Childhood Development and Programme in the communities

Forbes Marshall has implemented the Early Childhood Development Programme for the past 3 years with Ummeed, our training partner.

The reason for undertaking this programme was that there is ample research that documents why young children in low and middle income countries do not develop optimally due to multiple risk factors like malnutrition, anemia and poor awareness amongst caregivers about early child development (ECD) and it was thought that with right kind of training to our Community Health Workers we could certainly make a difference.

Early intervention for children at risk of and with developmental disabilities (DDs) leads to improved developmental outcomes for the children as well as benefits for the community in terms of maximizing human potential and return on investment.

In India, the best access to families with children under the age of 3 is through community health workers (CHWs) who have direct contact with them. Ummeed designed and piloted a prototype intervention in collaboration with Forbes Marshall, with CHWs in urban slums in Pune.

This project had several objectives. These were, to create a training programme that gives CHWs the skills to promote and monitor ECD in their community, identify children with disabilities early, teach families simple play and communication based interventions to address developmental delays, identify local resource base for referral of children with DD and to actively advocate for children with disabilities.

There was a pilot training programme with 15 CHWs and their supervisors in 3 communities in PCMC. The CHWs individually were very happy to receive the training and to work with the families. It gave them an identity, status in the community and knowledge on development of children. One of the CHWs said that she should have received the training when she was a parent, as she could have become a good parent. Another said that though it was late to get this training as a parent, it has made her a very good grand parent.

The results obtained through the programme were heartening. The CHWs have monitored and supported the development of 717 children under the age of 3, by visiting their homes regularly over the past 18 months. 28 children under the age of 3 and 6 older children were identified to have significant delays. 10 children requiring further assessment and treatment were sent to locally identified resource centers. Qualitative changes were seen in the communities’ attitude and practices related to Early Childhood Development (ECD).

Communities included ECD as part of the agenda for community meetings and events and proactively sought CHWs for advice and support related to children. The CHWs have become strong advocates for ECD and for children with disabilities. Dr Vibha Krishnamurthy of Ummeed presented a paper in an international conference of World Health Organization in Geneva, based on which, Yale University has given a grant to Ummeed to re-establish the findings by doing a research project with Forbes Marshall’s new Community Health Workers team.

The potential of the FM Ummeed ECDD prototype is that it provides a model that can be used for ECD interventions for children at risk and with developmental disabilities. This can be replicated anywhere and even if there is no doctor available to diagnose the developmental disabilities, trained CHWs can help the communities to a great extent.

It will be a very good and sustainable initiative to reach out to the communities and help the resource-poor families that have children with developmental disabilities.