Health & Nutrition

Early childhood development (ECD) services have a strong, positive impact on children’s development. Research from diverse contexts shows that interventions that promote nurturing care in early learning environments significantly improve childhood development and later adult outcomes. Despite increasing knowledge on the benefits of ECD, however, much remains unknown about the early childhood workforce, the range of individuals across paid and unpaid roles who provide services to young children and their caregivers across the health, nutrition, education, and social and child protection sectors. Research supports that the workforce is one of the most important factors influencing the quality of ECD services. However, key questions remain unanswered, including:

• What does the early childhood workforce need to know and be able to do in order to carry out their roles?
  
• What types of training opportunities are most effective for building the knowledge and skills that the workforce needs?
  
• What types of feedback does the workforce receive on their work on a daily basis?
  
• What financial and non-financial incentives impact the job satisfaction of personnel?

In an effort to address these questions, the Early Childhood Workforce Initiative (ECWI), a multi-stakeholder global initiative co-led by Results for Development (R4D) and the International Step by Step Association (ISSA) that works to support and empower those who work directly with young children, is carrying out a series of global landscape analyses to illustrate the size and scope of the challenges faced by the early childhood workforce, while also highlighting promising practices countries have adopted in response to these challenges. Spanning a range of roles including professionals and paraprofessionals, paid and unpaid workers, and frontline workers, supervisors, and managers, from the education, health and nutrition, social protection and child protection sectors, these analyses aim to provide a comprehensive overview of the current status of the workforce worldwide.

Vidya Putcha and Denise Bonsu at Results for Development

2020

This Guide accompanies the Home Visiting Workforce Needs Assessment Tool, which aims to help Ministries and government agencies reflect on the ways in which they can support personnel delivering home visiting programs across sectors for pregnant mothers and caregivers with children under 3. 



Drawing inspiration from the UNICEF Pre-Primary Diagnostic and Planning Tool, this tool is intended for countries with home visiting programs at either the sub-national or national levels. The scope of the Tool includes home visitors who work directly with young children and their families, as well as supervisors and trainers.

 

The newly completed User's Guide completes the Tool's package. It includes supporting materials, as well as editable handouts and annexes. It is easy to download, translate and adapt to your context. The User's Guide lays out the steps needed to:

• Prepare for the application of the Tool,
• Organize and facilitate a workshop with stakeholders at both the national and sub-national levels, and
• Take action on findings generated from the workshop.


Below, you can find two versions of the User's Guide: 

Version 1: a downloadable PDF
Version 2: a ZIP file for Print, which contains:

• A Print version of the User Guide
• 11 editable handouts and annexes that can be adapted for implementation
• A slide deck, which presents an overview of the Tool

Access the Tool here.

Mihaela Ionescu and Zorica Trikic (International Step by Step Association) and Denise Bonsu, Kavita Hatipoglu, Michelle Neuman, and Vidya Putcha (Results for Development).

2020

The Home Visiting Workforce Needs Assessment Tool aims to help Ministries and government agencies reflect on the ways in which they can support personnel delivering home visiting programs across sectors for pregnant mothers and caregivers with children under 3. Drawing inspiration from the UNICEF Pre-Primary Diagnostic and Planning Tool, this tool is intended for countries with home visiting programs at either the sub-national or national levels. The scope of this tool includes home visitors who work directly with young children and their families, as well as supervisors and trainers.

You can also download the accompanying User's Guide here.

Denise Bonsu, Kavita Hatipoglu, Michelle Neuman, Vidya Putcha, Mark Roland, and Jon Korfmacher

2020

It is anticipated that COVID-19 (the disease caused by the novel coronavirus named SAR-CoV-2) will occur in most, if not all countries.

A key fact about COVID-19 is that the vast majority of infections will result in very mild or no symptoms. Not everybody is at risk of severe disease. Persons of advancing age and those with existing respiratory, cardiac and/or metabolic disorders and immunodeficiencies are at higher risk of moderate to severe disease1. There is limited evidence on the impact of COVID-19 on pregnancy and the newborn. A recent US based study reported that pregnant women with COVID-19 are more likely to need hospital admission and are at increased risk for intensive care admission and mechanical ventilation compared with nonpregnant women2. However, the evidence is still very sparse and much remains unknown about this disease.

The impact on acute care services in settings with under-resourced health systems is likely to be substantial. Maternity services should continue to be prioritized as an essential core health service, and other sexual and reproductive health care such as family planning, emergency contraception, treatment of sexually transmitted diseases, post-abortion care and where legal, safe abortion services to the full extent of the law, also need to remain available as core health services. Early data suggests a drop in facility-based care in many countries and projections of rising maternal mortality. We need to actively reach out to women and encourage continued health seeking behaviours, taking every chance to provide respectful compassionate and meaningful care.

Maternity care providers (including midwives and all other health care workers providing maternal and newborn care), whether based in health facilities or within the community, are essential health care workers and must be protected and prioritized to continue providing care to childbearing women and their babies.

Deploying maternity care workers away from providing maternity care to work in public health or general medical areas during this pandemic is likely to increase poor maternal and newborn outcomes. Maternity care providers have the right to full access for all personal protective equipment (PPE), sanitation and a safe and respectful working environment.

Maintaining a healthy workforce will ensure ongoing quality care for women and their newborns; without healthy midwives and other maternity care providers there will be limited care for women and newborns 3.

The UNFPA response to the COVID-19 pandemic within maternity care involves a 3-pronged approach:

1. Protect maternity care providers and the maternal health workforce

2. Provide safe and effective maternity care to women

3. Maintain and protect maternal health systems

Download it here.

UNFPA

2020

Information on the impact of COVID-19 on early pregnancy outcomes remains unavailable at the time of writing. Non-pregnant women of childbearing age are also at low risk of severe disease. The impact on acute care services in settings with under-resourced health systems is likely to be substantial. Maternity services should continue to be prioritized as an essential core health service, and other sexual and reproductive health care such as family planning, emergency contraception, treatment of sexually transmitted infections, and where legal safe abortion services, to the fullextent of the law, also need to remain available as core health services.

Maternity care providers (including midwives and all other health care workers providing maternal and newborn care), whether based in health facilities or within the community, are essential health care workers and must be protected and prioritized to continue providing care to childbearing women and their babies. Deploying maternity care workers away from providing maternity care to work in public health or general medical areas during Covid-19 pandemic is likely to increase poor maternal and newborn outcomes.

Maternity care providers have the right to full access for all personal protective equipment (PPE), sanitation and a safe and respectful working environment [2]. Maintaining a healthy workforce will ensure ongoing quality care for women and their newborns; without healthy midwives and other maternity care providers there will be limited care for women and newborns.
As part of COVID-19 Pandemic UNFPA Global Response Plan, the UNFPA response involves a 3-pronged approach for Maternity care:

1. Protect maternity care providers and the maternal health workforce
2. Provide safe and effective maternity care to women
3. Maintain and protect maternal health systems

Detailed practical recommendations across these 3 prongs for antenatal care, intrapartum and postnatal care have been outlined in: UNFPA COVID-19 Technical Brief for Maternity Services Interim Guidance, April 2020 This document serves as an adjunct to the UNFPA COVID-19 Technical Brief for Maternity Services to provide interim guidance on providing phone based antenatal care (ANC) in the immediate clinical situation during COVID-19. These recommendations are provided asa resource for UNFPA staff based on a combination of WHO guidelines, good practice and expert advice based on the latest scientific evidence

UNFPA

2020

The United States Agency for International Development (USAID) Flagship Community Health Worker (CHW) Resource Package compiles priority resources for strengthening CHW programs developed through USAID’s Bureau for Global Health (BGH) investments, as well as what USAID BGH’s flagship partners have produced and prioritized. It includes tools, research, guides, approaches, and best practices recommended by USAID’s flagship project community health experts through a series of convenings and reviews. The rationale for the development of this package was to showcase these priority resources for greater internal and external dissemination and agenda setting, including the Community Roadmap and the WHO CHW Hub. It is a living document*, and we expect to update it periodically as emergent state-of-the-art resources are recommended by flagship experts.

The resources can be used to integrate CHWs within the broader health workforce and to promote their professionalization. For this reason, some resources may support broader health workforce development and strengthening, policy, program implementation, or financing, but can be applied to CHW programs. Professionalizing CHWs is a key step for ensuring the effective role of community health within primary health care, critical for achieving health for all and global health goals. Resources may be cross-cutting or technically specific, and all are relevant to optimizing CHWs in a health systems context.

The resources are presented according to the WHO guideline on health policy and system support to optimize community health worker programs using the HRH2030 lifecycle approach and the main categories of WHO’s recommendations:

• CHW policy implementation enablers (cross-cutting)
• Build
• Manage
• Optimize

USAID

2020

Health workers are at the front line of the COVID-19 outbreak response and as such are exposed to hazards that put them at risk of infection. Hazards include pathogen exposure, long working hours, psychological distress, fatigue, occupational burnout, stigma, and physical and psychological violence. This document highlights the rights and responsibilities of health workers, including the specific measures needed to protect occupational safety and health.

WHO

2020

Informing and guiding the development of a Framework to Strengthen the Capacity of “Tipat Halav” nurses in Israel is a qualitative research study on behalf of Goshen Institute, with the overall objective to generate in-depth data that unveil effective processes and strategies which need to be in place in order to achieve a practice-change among Parent and Child Health ("Tipat Halav") nurses in Israel. Specifically, the study, which is part of a larger initiative pursued by Bernard Van Leer Foundation, the Rothschild Foundation Foundation and Israel’s Ministry of Health, aimed at mapping:

1. the strategies and processes that need to be in place in order to successfully achieve a practice-change among nurses in working with parents;
2. the common elements among successful programs;
3. the barriers and challenges in program implementation.

Interviews with 9 training providers and practitioners from across 6 countries, highlighted the complexity of the field and of nurses’ role and revealed the necessary knowledge, skills and attributes that effective nurses should possess. In addition, the interviews revealed the key challenges faced by the profession, the professionals and the training programs, as well as the success factors and recommendations about how challenges can be tackled. Research results highlight that practice-change is inseparably linked to the system in which practitioners operate and that in order for practice change to be achieved it is important to recognize the importance of the field as well as the uniqueness of this field. Thus, interviewees highlighted the need to focus on the social aspects of health and move beyond hospital-oriented practices and theory as well as the need for more innovative, practice-based approaches and experiential learning and for common standards of practice and common standards among training providers.  

2020

If there is one silver lining to the COVID-19 crisis, it’s probably the growing appreciation of childcare as an essential service and backbone to the growth and development of our economies. Maniza Ntekim, UNICEF’s Regional Advisor for East and Southern Africa, reminds us of the impor- tance of early childhood services, noting particularly that “If we leave early childhood education behind, we leave learning behind. If we are serious about tackling inequality, addressing the learning crisis, and making education systems work better, we have to scale up investment in early childhood education during and after this pandemic.” Early childhood services are even more important to parents now because to be productive and engaged in economic activities, they need safe, stimulating, and nurturing environments for their children. A focus on early childhood services is therefore critical in the broader plan to build back better.

Despite the well-established evidence that early childhood services are essential to human capital formation, socio-economic development, women’s employment, and increased equality, its workforce is one of the most undervalued in the world. This blog focuses on the early years’ workforce in Africa, calling for action to support them to keep services running.

AfECN

2020

There is mounting evidence on the positive link between high quality early childhood development (ECD) personnel and the physical, social, and cognitive development of young children.

To bring light to these challenges, and potential responses to them, the Early Childhood Workforce Initiative (ECWI) has developed 6 country briefs which highlight efforts to support the workforce across different geographies and services.

These country briefs were informed by desk reviews and information collected through key informant interviews (KII) with country experts from implementing NGOs, multilaterals, and research institutions, as well as program managers and government officials across 15 countries. After identifying six promising country approaches to highlight, we conducted further desk research and interviews to inform the country briefs. These interviews were particularly helpful for clarifying the key enablers and barriers to implementation in each country as well as the policy lessons for other countries.

The sixth of these briefs focuses on Singapore. Developing Career Pathways for Early Childhood Care and Education Workers highlights the Government of Singapore’s efforts to support career advancement in the early childhood care and education profession by creating and investing in competency-based trainings, professional development frameworks, and career pathways.

Michelle Neuman, Results for Development

2019