Community-Based Early Childhood Development Centers for Reaching OVC: Considerations & Challenges

"Intervening during the early childhood years with high-quality early childhood development (ECD) programs is critical to ensure positive outcomes for vulnerable and at-risk children....When done well, these programs can be sustainable because of their emphasis on engaging caregivers, parents, and the family in programming, as well as fostering community ownership."

This issue paper from the United States Agency for International Development (USAID)'s AIDSTAR-One (AIDS Support and Technical Assistance Resources, Sector 1, Task Order 1) is intended to provide those who work with orphans and vulnerable children (OVC) with examples of best practices in community-based ECD centre programming to meet the ECD needs of children they serve. Established at the community level, these centres work toward the holistic development (i.e., physical, socioemotional, and cognitive) of young children, age 0 to primary school-aged, to meet their needs and those of their caregivers, family, and community through a childcare setting. While this paper focuses specifically on children affected by and living with HIV, as per the United States President’s Emergency Plan for AIDS Relief (PEPFAR)'s OVC guidance, in areas with greater than 5% HIV prevalence, all children are considered vulnerable.

Four case studies are provided (see pages 5 and 13, and Appendix 1 and 2) as examples of how OVC programmes have integrated aspects of community-based ECD. For example, Integrated Child Development Services (ICDS) in India offers over 40,000 community-wide day care and maternal care centres nationwide. Children aged 0 to 6 and pregnant and lactating women receive integrated services, including immunisation, growth monitoring, and supplementary nutrition; children 3 to 6 years old receive preschool education through a programme that aims to provide "a natural, joyful, and stimulating environment for optimal growth and development through such activities as singing and storytelling." A survey of 16,000 children found that children who attend ICDS centers were less likely to be severely malnourished and more likely to attend school than children who do not attend the centres. Another study found that children at ICDS centers aged 3 to 5 years performed better on measures of child development than the matched nonparticipants.

An excerpt from the report follows, with references removed:
"Quality community-based ECD centers for OVC foster a childcare setting that:

• Serves as an effective community focal point around which a portfolio of services benefiting children, caregivers, and households can be organized and delivered. Community-based centers can meet the needs of young children and their families or caregivers by providing comprehensive, child-friendly services (e.g., education, nutrition, health, HIV care and treatment, and water and sanitation) through a central location. This includes incorporating strategies that involve parents, caregivers, and community members in the healthy development of young children....These centers can also serve as a gathering point for community meetings, classes, and health services (e.g., growth monitoring and vaccinations).
• Trains staff to deliver age-appropriate and developmentally appropriate curricula that address HIV and nurture children's cognitive and linguistic skills and socioemotional health. Curricula should also allow for flexibility so that teachers can tailor their approaches to be responsive to children's needs and circumstances....Quality ECD curricula are relevant to the cultural context, centered on the child's needs, and rooted in children's rights. The curricula should also emphasize verbal expression and be based on play, interaction, exploration, and discovery using all five senses including learning through movement; use culturally relevant materials; and respect diversity and individuality...
• Includes linkages to the caregivers and households. Evidence suggests that programs that combine children's cognitive enrichment with caregiver engagement, including helping caregivers learn various skills for supporting young children, have more benefits than either approach used alone.... Community-based ECD centers should create a strong link to the household and involve caregivers...
• Educates caregivers and ECD center caretakers on issues pertinent to the young HIV-positive and HIV-affected children in their care and what they face on a daily basis (including HIV, adherence to treatment, and stigma and discrimination), and how to respond to these issues.
• Mobilizes and generates commitment from caregivers, local authorities, and community leaders....Engaging volunteers, other community members, and such groups as parent-teacher associations has proven successful for ensuring effective management of ECD centers...
• Carries out community education to increase men's involvement in meeting the needs of young children. This includes encouraging fathers to register their children so they can access services and engaging men as active participants in caring for children in their community...
• Incorporates child-centered activities into the curriculum. This includes providing opportunities for children to choose some activities that they are most interested in, and building the confidence and skills of teachers so they can adapt their activities to suit the flow of children's choices when appropriate...
• Hires teachers committed to ECD who receive frequent training (both preservice and in-service) in child-centered teaching skills and use of a variety of learning materials, receive acceptable financial rewards, and have opportunities for professional growth and networking...
• Is healthy, safe, and hygienic with periodic checkups...
• Builds ECD teacher competence in child protection to understand and address physical and sexual abuse and neglect as well as stigma. Community-based ECD center staff should be able to identify and appropriately intervene in cases of child abuse, exploitation, neglect, and violence. Staff should be able to make referrals for specialized care and psychosocial support, and monitor progress at home, while supporting the child at the center...
• Ensures that ECD center staff know how to access legal services and that community members understand how these services can assist them and the children under their care. The center has referral relationships with paralegals and holds training and awareness campaigns on child rights for ECD staff, caregivers, and local and traditional leaders that include how to identify child abuse and neglect and how to access services for effective intervention...
• Offers specialized support to children with unique needs such as physical, learning, emotional, and other disabilities. Community-based ECD center staff should be able to support children with disabilities and be able to make referrals for specialized care and psychosocial support. They should also have the knowledge, attitudes, and skills to minimize stigma and help other children and adults engage with all children positively."

The issue paper includes also a list of considerations when planning for quality community-based ECD centres.