ECD through additional platforms

In 2016, PATH partnered with provincial services of gender, children, and social action in the Maputo province and with nongovernmental organizations, VIDA and CESAL, to pilot a parenting education program for caregivers of children aged 0 to 5. This intervention built on the parenting education program pioneered by the Directorate of Adult Literacy and Education of the Ministry of Education and Human Development in 2011.

The program addressed the holistic needs of children, from health, nutrition, and hygiene to child development and protection, and the roles of the caregivers, including fathers in particular. It was designed to be interactive, by engaging participants through discussions of pictures, games, and practical exercises. The initial pilot with caregivers that were part of agricultural associations indicated increased father involvement in childcare, resulted in greater use of positive discipline and communication with children, and improved child feeding.

In Kenya, PATH partnered with Minderoo Foundation and Homabay County to supplement government-led counseling in health facilities and communities that relies on information in the Mother and Child Health Handbook, with activities undertaken by volunteers from community-based organizations.  Counseling cards have been adapted from Minderoo’s Thrive by Five App, and are used during sensitization meetings and in parenting groups.

Finally, in Ethiopia PATH has supported Addis Ababa’s City Administration to optimize its flagship parental coaching program.  With support from the Van Leer Foundation, PATH developed a mini guide for parental coaches to address the gaps in the coach’s current counseling tool, conducted refresher trainings, and developed a parenting app.

From 2017–2019, as a part of a consortium in a USAID-funded COVida project supporting orphans and vulnerable children in Mozambique, PATH provided technical assistance to the Ministry of Gender, Children, and Social Action to develop a set of tools for nonformal community preschools. These included a Community Preschool Manual, Technical Guidelines for Community Preschools, and a Guide for Establishing and Functioning of Community Preschools. PATH, furthermore, supported the testing of these materials in all three regions of the country. These materials have been reproduced by UNICEF for nationwide use, and subsequently informed the design of the community preschool educator preservice training accredited by the National Professional Education Authority (ANEP). 

The community preschool manual was later used by PATH to quickly develop a playgroup manual and training guide to support young children in conflict-affected settings in the Amhara region of Ethiopia in 2022. Results suggested quick uptake and good fidelity of implementation in areas with limited resources and showed initial impact on caregiver engagement in play at home.

In Ghana, PATH partnered with the Bainum Family Foundation, Ghana Health Service, and Ghana Education Service to develop and pilot a model for improved health and nutrition services in ECD programs, as a way to offer comprehensive nurturing care to children. The pilot ran in 24 public and private schools with kindergarten programs in two districts of greater Accra. The intervention resulted in positive changes whereby children began consuming healthier foods and drinks, schools received more regular and more comprehensive health services, children’s and parents’ knowledge of health and nutrition content improved, and teachers grew in their understanding of child development milestones. PATH developed storybooks, learning games, child school health records, and training manuals for this initiative.

In 2020, in connection with the Ministry of Gender, Children, and Social Action pilot of the Child Subsidy program for caregivers of children under 2, PATH was requested by UNICEF to adapt contents from the community package of nutritional interventions (PIN) of the Ministry of Health into a short manual that the staff from the National Institute of Social Action (INAS) could use to conduct educational sessions for caregivers waiting to receive child subsidies. Such educational sessions were meant to be a part of the “care” component of the program, while subsidies were part of the “cash” component. While the manual was designed and approved, it has not yet been fully implemented due to the logistical challenges related to the roll out of the child subsidy program.

From 2016 to 2019, PATH was a part of a consortium in a USAID-funded and FHI 360-primed COVida project supporting orphans and vulnerable children in Mozambique, responsible for the early childhood development component. PATH supported ECD integration into the COVida project through over 60 community-based organizations covering every province of Mozambique, which reached an average of 40,000 children under 5 every year. 

A standardized set of job aids was developed, including tools for monitoring developmental milestones and counseling on responsive care and early learning, and sessions for group dialogues. A competency-based observational checklist was designed to check whether desired practices were promoted during household visits. Finally, training modules consisting of practice scenarios were developed for use with community volunteers. Additional interventions included training CBO volunteers in book-reading and storytelling with children using Books for Africa.

PATH has partnered with the Aga Khan Foundation and USAID Advancing Nutrition project in Mozambique to adapt and deliver a Science of ECD course for technical managers and decision-makers at the national and subnational level. The adaptations included the use of national data on child development, examples of in-country ECD programming, and images and practical exercises reflecting the context of Mozambique. Adapted 3-day and 1-day courses were then offered to provincial and district leadership—program leads, governor, and first lady offices—in two provinces of the country, in partnership with the Aga Khan Foundation. 

Additionally, an advocacy brief was developed to guide decision-makers as they think of actions to take to promote ECD after the training. The trainings and advocacy activities resulted in the development of provincial multisectoral ECD plans and a series of activities undertaken by program leads and first lady offices. 

In Kenya, PATH has collaborated with KMET to mobilize executive commitment (including the governor and first lady) in Siaya County, leading to the creation of the Siaya County Nurturing Care Strategic Plan in 2020. This included influencing policies, securing budget allocations, and establishing Nurturing Care for ECD as a county program. Similar advocacy efforts were extended across six counties in the Lake Region Economic Block. As a part of this work PATH and KMET trained policymakers, including county assembly members and executive committees, on the science of ECD.

Based on the ECD messages developed by PATH for the Department of Health Promotion at the Ministry of Health of Mozambique, PATH has engaged, first, with selected community-based organizations, and, later, with a local health communications organization, h2n, to produce a variety of radio and video products on early childhood development, child nutrition, and the use of health services. The peak of this work coincided with the COVID-19 epidemic, which influenced the messages in some of these products but also allowed for streamlined approval from the Ministry for nationwide dissemination. 

Video clips were played on national TV, as well as on the MOH Facebook channel, while radio skits were broadcast by community radios in northern Mozambique during USAID Advancing Nutrition project and in central Mozambique during a World Food Program project. Additionally, radio skits were played on portable radios in health facility waiting rooms and in community meetings run by community health actors. Videos and radio skits were well received and pilot assessments suggested adoption of practices by caregivers when radio sessions were conducted in the community.

A series of songs in the local Emakua language of northern Mozambique were produced and recorded in collaboration with a talented PATH intern, ECD educator Anita Paulino, and h2n. Some of the songs encourage parents to play and talk with their young children and to teach them about handwashing and nutritious local foods. Other songs are aimed directly at children and teach them colors by looking at things they can see around them, help them learn about body parts, etc. These songs were disseminated on portable radios in the health facility waiting rooms and in the communities.

PATH staff participated in a children’s book writing workshop organized by UNICEF in 2019 and contributed to developing two children’s story books which were subsequently illustrated and printed for use by the ECD community. The story books deal with feelings of loss and fear sometimes experienced by small children and how caregivers can support their children in such moments.

During COVID-19, PATH also collaborated with CODE, Associação PROGRESSO, and the Ministry of Health to develop one of the first online games on myths and truths about COVID-19 and produced the first Mozambican children’s story on COVID-19, titled Vania and Coronavirus. The story was approved for use by the three Ministries: the Ministry of Health; the Ministry of Gender, Children, and Social Action; and the Ministry of Education, and was distributed in schools and ECD centers, as well as played on community radios.