Early Childhood Development

Promotion of Reproduction and Newborn Health through Training of TBAs (Dais) in Bihars

The Government of India committed to achieving "Health for All" by the year 2000 following the Alma Ata declaration on Primary Health Care. Efforts have been made to strengthen health infrastructure, with a focus on children and women. Since then, the country witnessed a number of National Programmes and progressive strengthening of health infrastructure with emphasis on the vulnerable groups i.e. children and women. The Child Survival and Safe Motherhood (CSSM) Project, supported by World Bank and international agencies, was expanded to include Reproductive Child Health (RCH). In certain states with high maternal and infant mortality rates, the majority of deliveries were conducted by Traditional Birth Attendants (TBAs). TBA is an individual who helps women during their pregnancy, labour, delivery and puerperium. The TBA also handles the care of newborn. TBA performs the functions of a midwife, often without having had any formal training. TBAs exist in the majority of developing countries of the world. In many countries, she is illiterate. She learns her skills from an older TBA or by trial and error. While TBAs provide valuable services, they may lack hygiene knowledge and reproductive facts, leading to serious problems and even deaths. TBAs also serve as a link to health services and are consulted for various health issues. Due to lack of training and resources, the safety of services provided by TBAs is not guaranteed. Keeping this in mind, it was proposed to carry out training of TBAs in 3 community development blocks (Rajauli, Narhat and Saraiyahat) of 2 districts (Nawadah and Dumka) in Bihar.

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Strategies for Implementation of Care for Child Development

Strategies for Implementation of Care for Child Development at community level- A feasibility study


Care for Child Development (CCD), is an evidence-based approach aimed at promoting early learning and responsive caregiving. The approach is integrated into existing services in sectors such as health, nutrition, education, and child protection. CCD focuses on guiding parents and caregivers on how to engage in play and communication activities that promote motor, cognitive-language, and social-emotional skills in young children. It also aims to strengthen responsive caregiving skills by coaching parents and caregivers to observe, interpret, and appropriately respond to their child's signals during play and interaction.

Scientific evidence shows that the ongoing interaction between genes, environment, and experience during the first 1000 days of life (from conception to 2 years old) plays a significant role in childhood development. This period is considered the best window of opportunity for maximum development, as it influences survival, physical growth, learning, and adult productivity. More than 80% of brain development occurs during the first 1000 days, and nurturing interventions during this period can have a significant impact on the child's development. The nurturing interventions should be matched with the programmed development of the brain, which starts from simple structures to more complicated cognitive functioning. However, many children do not reach their full potential due to inadequate nurturing and care.

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