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Linking Health And Educations Measures To Improve Early Childhood Development Programmes: Kyrgyzstan.

Author(s) Anara Doolotova1, Jypara Ergeshbaeva2
Affiliation(s) 1Health department, Aga Khan Foundation, Bishkek, Kyrgyzstan, 2Health, Mountain Society Development Support Program, Osh, Kyrgyzstan.
Country - ies of focus Kyrgyzstan
Relevant to the conference tracks Women and Children
Summary Since 2005 AKF has been implementing an early childhood development (ECD) program targeting caregivers and preschool age children in three districts of Osh province. The focus of the programme has been to provide different models of preschool education, from government kindergartens to private, home-based care facilities and even yurt-based kindergartens in high pastures during the summer (jailoo). This programme develops cognitive, social and intellectual skills of children 0 to 8 but mainly focuses on the older age group, from 4 to 8. Beginning in 2013 the Health Program introduced health components in the education formats to protect and promote the health of pregnant women and children under 5.
What challenges does your project address and why is it of importance? According to DHS-KG (2012), only 56% of infants are exclusively breastfed, more than 18 % of children under 5 are stunted, and 33 percent of women of reproductive age and 39% of children age 6 to 59 months have some level of anemia. The integration of health elements with the cognitive components of education is designed to increase health promoting practices and to reduce the prevalence of poor health practices. The Kyrgyz Republic has not recognized a formal ECD agenda for children 0 to 3 years old. Policy-makers and caregivers/parents are not fully aware that promoting the health of the mother and investing in the early years of a child’s development generate a substantial return later in life. While such an investment is a rational for a low-income country like the Kyrgyz Republic, most communities believe that children do not need to be educated in the early years because they are too young to learn. Also, while women generally support measures to promote the development of the young child through health and education initiatives, most men do not understand and are not involved in the care and development of the young child.
How have you addressed these challenges? Do you see a solution? AKF implements programs in 35 pilot villages of three districts. It is a community based approach and relies on involving volunteers of parent support groups and health providers. Integrating the health initiatives in the existing early child development programmes enables women and their families to have full knowledge of the care needed during pregnancy, delivery and the postpartum period, and promotes practices such as exclusive breastfeeding, proper nutrition, parenting and nurturing that promote the development of the young child. To address these challenges AKF, KR has adapted an integrated health and education model that uses a multi-partner approach based on community involvement and innovative implementation techniques such as home-visits of parent support groups, involving instructors of mothers schools to work with young parents, addressing ECD and health issues to men and partners, developing IEC materials on ECD and other initiatives which were not presented in the country.
How do you know whether you have made a difference? The study will measure the project implementation results between ECD indicators of integrated health and education programs in 35 pilot village communities and non-pilot villages where only the education component is being implemented.
Annual M&E data will be compared against the baseline. The following indicators will be tracked to monitor progress and impact: % of caregivers practicing at least five responsive parenting techniques; % of families with access to Parent Resource Centers (PRC) services; % of M/F children 0-6 months who are exclusively breastfed in project areas; and % of mothers with children under 5 who know at least 3 ways to prevent enteric infections which includes the % of M/F community members who know that breastfeeding should be initiated at birth.
Have you or the project mobilized others and if so, who, why and how? To reach mothers-to-be, new mothers and very young children, AKF KR works through Mother Schools. These are ‘sessions’ that take place largely in health facilities where the ’pregnancy to parenting approach’ is provided for pregnant women and family members during antenatal visit at birth preparedness schools (Mother schools) which are a part of primary health care facilities. Mothers Schools teach couples about antenatal, childbirth and postpartum care but also the early needs of the young child during the first days of life. Mother schools instructors will be trained on measures to ensure proper growth and development in the earliest years of a Child’s life. Parents will be educated by trained physicians to take proper care of the young child, not only physical development but cognitive and social development as well. Trained health providers provide sessions to young parents. Parental Resource Centres address the developmental needs of somewhat older children, i.e., 0 to 8 years. The families of these children are encouraged to visit a village-based centre in village or school libraries where trained facilitators, e.g. librarians and facilitators, provide special learning sessions for parents. Health messages and other interventions are incorporated. These measures inform parents about good health and nutrition practices and contribute to the healthy development of children between 4 to 8 years old. The material developed reaches parents with children aged 0 to 8 and a wide range of topics are included as breastfeeding and complementary feeding, danger signs during first years of childhood, immunization, how to take properly care of children in addition to ECD day to day development. To improve the health status of WRA the following topics are presented: postpartum nutrition, contraception and depression, danger signs of postpartum period and the role of family members. Finally, all parents with children 0-8 are informed of methods to prevent anemia and micronutrient deficiency, which is very common among local communities, how to adopt good nutrition habits, how to use safe water and maintain proper hygiene and sanitation in the family. The libraries of the PRCs have a space where parents and children can have access to information and can adopt/adapt practical lessons and plays, read IEC materials and watch DVDs. The health unit will provide health IEC materials to complement Education program. Home Visits will be carried out to reach families who cannot attend the PRCs.
When your donor funding runs out how will your idea continue to live? When the AKF program ends, the community will continue to implement the activities because the local personnel of the parent resource centers, mother schools, community leaders, district authorities will have already built their capacity and will continue their duties in order to benefit families.

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