ECD in nutrition
Being a global lead in maternal and child nutrition, PATH has used its presence in relevant national technical working groups to expand the scope of common nutritional interventions to also include care for child development.
Kenya Maternal, Infant, and Young Child Nutrition (MIYCN) Strategy (2023–2028) is one comprehensive national document on nutrition that PATH contributed to. It mandates developmental monitoring as part of growth monitoring activities; recommends dissemination of care for child development and nurturing care messages, alongside nutritional counseling; and supports free meals and nutritional services in ECD centers, among others.
The Mozambique Child Feeding Strategy (2019–2024) similarly recommends integration of developmental activities in nutritional interventions, as a result of PATH and other partner advocacy.
Since 2018, PATH has supported the Mozambique MOH Nutrition Program to revamp the content of its Nutritional Rehabilitation Program with regard to promotion of child development during treatment of acute malnutrition. The revisions placed greater emphasis on creating skills in caregivers, as opposed to simply promoting play; indicated age-appropriate activities and playthings; and suggested how to integrate stimulation into treatment routines. Both inpatient and outpatient treatment contexts were considered.
Building on this work, PATH has supported the revising of the Integrated Management of Acute Malnutrition guidelines in Kenya. Current guidelines reinforce the need for provider demonstration and practice of play activities with caregivers. Additionally, the PATH-adapted Care for Child Development poster is recommended as a counseling tool.
In Mozambique, PATH has worked with the World Bank ECD Fellow and UNICEF in 2018–2019 to develop implementation tools for the community growth monitoring and promotion program of the Ministry of Health, called PIN (Pacote de Intervenções Nutricionais). PIN was promoted as a part of the Global Financing Facility (GFF) investments in Mozambique.
As a result, counseling on child development was included both as a standalone session and as additional content in the sessions on antenatal health, child and family hygiene, and child feeding. At the same time, due to relatively late timing of tool design, it was not possible to integrate developmental monitoring alongside growth monitoring, and no ECD-related indicators were required to be collected. As the program is currently being reviewed, it will be necessary to consider some of these potential adjustments.
In 2020, PATH provided technical assistance to USAID Advancing Nutrition to use PIN materials and developed additional group sessions specifically on ECD to implement as a part of community nutrition intervention in the Nampula province of Mozambique.