In this section, you can find materials that support the promotion of early childhood development and maternal mental health in antenatal care, postnatal care, and care for small and sick newborns. These include job aids, take-home tools, capacity-building materials, and national guidelines.
Since child development begins at conception, PATH has been promoting developmental counseling in antenatal care (ANC) services. The simple practice of talking to the baby in utero is taught to women starting from the first ANC visit. When a partner is present, he is also encouraged to bond with his unborn child, since research shows that this increases father involvement in parenting after birth. Assessments from Mozambique and Kenya suggest that both delivery and recall of ECD counseling at ANC among caregivers is high.
Below you can find counseling posters used in ANC in Ethiopia, Kenya, and Mozambique, as well a brief summarizing intervention steps and results. An additional resource is an ANC register introduced by the MOH in Ethiopia as a result of PATH-supported work, which tracks counseling on child development. This is probably the only example of an ECD indicator in an ANC register in Africa.
PATH supported the introduction of ECD services in postnatal care (PNC) for the first time in Ethiopia in 2020. A simple poster guided nurses to check for key newborn reflexes and for signs of maternal depression, and to counsel on communication and baby massages. An indicator on ECD counseling was introduced into the PNC register.
In 2022, PATH took a deeper look at the opportunities for counseling present in maternity wards. Through human-centered design, specific moments for counseling and key ECD practices to be promoted in the first 24 hours after birth were identified and posters for maternity rooms were developed. Initial pilots in Mozambique and Kenya have suggested generally adequate delivery and uptake of these practices.
Additionally, in Mozambique, PATH has worked with the Mozambican Association of Pediatricians (Associação Moçambicana de Pediatras, AMOPE) to develop job aids to screen newborns for risk factors and abnormalities and to decide when to refer.
Finally, in Mozambique and Ethiopia, PATH has supported the MOH to pilot screening and initial counseling on perinatal depression, performed by maternal and child health (MCH) nurses (see more under Maternal Mental Health). The resulting protocol for screening and counseling was adopted as part of national postpartum and postnatal care guidelines in 2023 in Mozambique.
PATH has been supporting the MOH in Mozambique to integrate recent WHO guidance on family-centered and developmentally supportive care into national tools. Specifically, a training manual for NICU workers and a Kangaroo Mother Care (KMC) training guide have been revised to include guidance, such as clustering of care, positioning, monitoring noise and light, responsive stimulation, and minimizing family separation, among others.
Additionally, in response to government requests, PATH has created several patient-centered job aids, such as a KMC poster in Zambia and a take-home booklet on premature birth in Mozambique.
The practice of talking to the child from conception, bringing this into everyday life, was very positive, so much so that I took it as a personal agenda. I tried to take this message to more people, to friends, to leaders, to wake them up…
We’ve done a lot of child health trainings, but the ECD training was unique. The beautiful thing about ECD is that the results [of your actions] are almost immediate. You do one thing, you see the return. Like, I remember the mummy smiling at a baby, and then immediately baby smiles back. These are instant results.
