Engaging govt.primary health service delivery to implement ECD interventions promises a brighter future – study shows

Dhaka, 28 May 2019: Today, icddr,b’s Child Development Unit held a dissemination seminar at its Sasakawa Auditorium in Mohakhali, Dhaka to share major findings of a randomised controlled trial on generating evidence of a scalable early childhood development (ECD) model to integrate into existing health services in Bangladesh.  The study showed that capacity building of primary health service within the existing Government system is possible and could result in a brighter future.

ECD is fundamental for the health, well-being and life opportunities for every child, everywhere. However, poor ECD in low- and middle-income countries is a major concern. In these countries including Bangladesh, around 250 million children under 5 years of age are failing to reach their maximum developmental potential.  Multiple risk factors are at play - poverty, malnutrition and lack of a stimulating environment. There are calls to universalise access to ECD interventions through integrating them into existing government services but little evidence on the medium- or long-term effects of such scalable models are available. Addressing ECD during critical development periods is essential to meet many of the Sustainable Development Goals (SDGs).

icddr,b’s Child Development Unit has  worked for the last two decades on ECD and has already developed  a ‘Comprehensive Early Stimulation Package’ to benefit development of underprivileged children, such as children with malnutrition, anaemia, and/or poverty.  This will be scaled-up through the Government health system. The present study is a feasibility study titled “Scaling up of early childhood development intervention by integrating into health services in Bangladesh” to evaluate if the government health supervisors can successfully train and supervise front line clinic staff on ECD service delivery.

icddr,b’s Dr Jena Derakhshani Hamadani, Emeritus Scientist, Maternal and Child Health Division, Dr Fahmida Tofail, Scientist, Nutrition and Clinical Services Division and Mr Bidhan Krishna Sarker, Assistant Scientist, Maternal and Child Health Division presented the study findings.

The study involved capacity building of 19 Health and Family Planning Inspectors in two Upazilas of Mymensingh (Trishal and Bhaluka), who have subsequently trained 58 frontline health workers including Community Health Care Providers, Health Assistants and Family Welfare Assistants to provide ECD services to 576 children through responsive parenting training. In a preliminary assessment, the study found that families showed significant improvement in the quality of home stimulation that is considered a proxy for child development and the effect size was 0.3 SD (standard deviation).

Mr Sheikh Rafiqul Islam, Additional Secretary, Ministry of Women and Children Affairs, Bangladesh appreciated the findings and said “The early childhood development interventions model applied in Trishal and Bhaluka should be scaled up across the country”.

Dr Makhduma Nargis, Vice-President, Community Clinic Health Support Trust and Dr Md Younus Ali Pramanik, Managing Director of Community Clinic Health Support Trust, Ministry of Health and Family Welfare were also present at the seminar among others.

In the seminar, a publication series titled ‘Informing design and implementation for early child development programmes’ published by the Archives of Disease in Childhood was officially launched in Bangladesh.

The series comprised of five papers and an editorial developed by over 30 authors including Dr Jena Hamadani and Dr Fahmida Tofail from icddr,b to provide practical, evidence-based information on implementation for early child development. This will help guiding policymakers and programmers regarding key decisions points: where, what and how to implement in varying contexts? Who is paying for what?

To read the publication, please visit here.