How can the early childhood workforce foster nurturing care?

How can the early childhood workforce foster nurturing care?

How can the early childhood workforce foster nurturing care

Components of nurturing care

by Kavita Hatipoglu and Michelle Neuman

This year’s World Health Assembly marked a turning point for young children around the world with the launch of the Nurturing Care for Early Childhood Development Framework. Developed by the WHO, UNICEF and the World Bank, in collaboration with many partners, the framework provides both a call to action for governments and other stakeholders to invest in early childhood development and an emerging roadmap for how to do so. Central to the framework is the concept of nurturing care, which encompasses five critical components that enable young children to “survive and thrive.” The framework identifies five strategic actions to support nurturing care and contribute to efforts to reach national and global early childhood development targets.
As policymakers and program managers consider how to operationalize this framework in their own countries and contexts, they will need to turn their attention to the early childhood workforce. The practitioners who work directly with young children and their families as well as those who train, supervise and support them are essential for making nurturing care a reality. For that reason, the framework calls for all countries to “strengthen the capacity for the workforce to support responsive caregiving and early learning among all families and children, including those with additional needs.”

We offer three suggestions for readying the workforce to support nurturing care:

1. Build consensus around the concept of nurturing care within and across workforces

The early childhood workforce is very diverse and includes highly trained professionals as well as community volunteers or paraprofessionals — community health workers, preschool teachers, home visitors, social workers — working in clinics, centers, schools and homes. Although these workers share a focus on young children, a recent landscape analysis developed under the Early Childhood Workforce Initiative (ECWI) found that there is no common set of expectations of what practitioners working in the education, health, and social protection sectors should know and be able do. Furthermore, in South Africa, ECWI research suggests that nurturing care may not be a familiar concept or considered part of the health practitioners’ scope. Often the emphasis remains on ensuring survival and monitoring children’s health and growth, rather than comprehensive attention to responsive caregiving or early stimulation to support their development.

The Nurturing Care Framework provides an opportunity to build bridges across workers, including those who may not view themselves as part of the early childhood workforce, and generate consensus around what nurturing care means, why it is relevant for each type of provider, and how it can be applied or adapted. This may require clarification of job profiles and professional competences to take into account the importance of nurturing care. If done collaboratively, implementation should foster a sense of community and increase vitally important communication within and across sectors and workforces.


2. Enhance training and professional development to integrate nurturing care

The framework recommends building off existing resources and platforms by integrating support for responsive caregiving and early learning within a range of existing government and non-governmental services. It will be important to expand and reinforce the existing skills of early childhood workers so that they are equipped to support young children’s development and strengthen the knowledge and practices of their parents or caregivers. The health sector is particularly well positioned to support nurturing care given that pregnant women and mothers with young children frequently interact with health providers and services during the first 1,000 days. For example, PATH is working with multiple countries to integrate early childhood development messages into health systems by providing training and support for community health workers and clinicians.

In many cases, training and ongoing professional development will need to be updated to include an emphasis on nurturing care, and it will be important to align training with professional and program standards. One lesson we learned from ECWI studies of the workforce in Peru and other countries is the importance of extending training beyond the frontline providers, so that these practices are reinforced by those who supervise or mentor them. Furthermore, there is often a need to ensure coordination between the departments responsible for developing training materials and tools with those departments directly overseeing early childhood practitioners and utilizing the tools in their day-to-day work.

3. Address working conditions that constrain early childhood practitioners in supporting families

Early childhood workers understandably may be concerned that nurturing care is a new task to add to their long list of responsibilities. However, if done well, it should strengthen existing services and enable workers to better respond to the needs of children and families. We have learned from focus groups of early childhood practitioners in Peru, South Africa and Ukraine that frontline workers are motivated to do their work, even under difficult circumstances, because of their positive influence in the lives of children and families. Shifting to a more integrated comprehensive, family-centered approach can amplify the impact of practitioners’ existing work, which may help further strengthen workers’ commitment to their important and challenging roles.

That said, the practical consequences of integrating nurturing care should not be overlooked as many early childhood workers are already overstretched and underpaid. Some questions that will need to be addressed include: What kinds of support do workers need to better incorporate nurturing care? Should caseloads be reduced to support greater intensity of their work with children and families? Given that the successful implementation of the Framework depends on the workforce, this is a critical moment to consider and address the persistent poor remuneration and working conditions and community visits with families. The new policy is a meaningful step to address nurturing the early childhood field more generally.

Movements in this direction are already happening. In South Africa, the recent National Integrated Early Childhood Development Policy (NIECDP) calls for the integration of early stimulation messages and activities into home and community visits with families. The new policy is a meaningful step to address nurturing care across sectors, however, reforms to already-stretched community health worker programs can be difficult to implement and sustain without more comprehensive data to understand the level of training, tasks, or caseloads of the present workforce. Thus, the framework may provide an opportunity to help reduce the isolation of paraprofessionals by connecting them to a common effort, elevating their status, as well as providing them a greater system of support.

On the journey to foster nurturing care together

It is heartening to see diverse stakeholders unite behind the concept of nurturing care. As the workforce is at the center of providing nurturing care, the framework has enormous potential to bring diverse early childhood practitioners under a single umbrella, with a common vision and terminology to connect and amplify their work. Through our involvement with the Early Childhood Workforce Initiative, co-hosted by ISSA and R4D, we also look forward to supporting countries in their efforts to operationalize the framework.

Images: World Health Organization, United Nations Children’s Fund, World Bank Group. Nurturing care for early childhood development: a framework for helping children survive and thrive to transform health and human potential. Geneva: World Health Organization; 2018. License: CC BY-NC-SA 3.0 IGO.

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