Early Childhood Development in Humanitarian Crises

South Sudanese Refugees in Uganda

Sweta Shah

• Publisher: Routledge
• Year: 2019
• eBook ISBN: 9781000701142
• Edition: 1
• Topic: Education
• Subtopic: Education General

This book provides an analysis of Early Childhood Development (ECD) in South Sudanese refugee camps in Uganda, making the case for the design and implementation of programmes for ECD in emergency situations.

Illustrating the current place of ECD in the humanitarian landscape and the environment in which South Sudanese refugees in Uganda currently live, this book combines child and human development perspectives to underpin the importance of ECD in emergencies. Developing an ECD tool specific to the cultural context and emergency situation, the author examines the outcomes of an ECD programme focused on refugee children and provides evidence for increased investment into ECD in emergencies.

Contributing to the evidence base for Early Childhood Development, this book will be of interest to students, scholars and practitioners who conduct research on ECD, education or humanitarianism in developing countries.

Part I

Background and context

The first part, which includes Chapters 1–5, lays the foundational background and context for this book. I start with tracing generally the unfolding global trends and evidence for Early Childhood Development (ECD). ECD is a long-standing field that regularly encounters new evidence and approaches to programming. Understanding the latest evidence and the state of the field will illustrate the gaps in knowledge in the humanitarian context. Chapter 2 answers the question of why ECD is particularly important during emergencies, delving deeper into the particular risks and adversities children and families experience during crisis contexts, and the existing obstacles faced when the ECD and humanitarian sectors come together. Chapter 3 provides an overview of the humanitarian landscape, in particular the current state of emergency situations around the world, the increase in professionalisation over the years and the humanitarian aid structure and financing mechanisms. Chapter 4 illustrates the decades-long struggle faced by South Sudan, from the time it was part of Sudan to today’s uncertainty. Chapter 5 analyses the nexus of child and human development and how theoretical perspectives from each area provide a lens for understanding ECD in emergency programming for South Sudanese refugees in Uganda.

1 Global trends in Early Childhood Development

ECD focuses on the development of a person from conception to his/her eighth year of life (The Consultative Group on Early Childhood Care and Development, ND; UNICEF, ND; World Bank, ND). ECD encompasses more than just childcare: it is a multi-sectoral, programmatic approach that helps children develop physically, cognitively, socio-emotionally and linguistically. It therefore provides the support for young children in the following sectors: health, nutrition, early education and stimulation, recreational and psychosocial support activities and opportunities to learn one or more languages (ibid.).

The earliest traces of work focused on ECD can be found in sources from the seventeenth and eighteenth centuries (Bruer, 1999; Gray and Mac Blain, 2015; Thomas, 2005). Over the years, it has become more professionalised, through the use of research, theories, programming models and workforce development programmes. The evolution of this field continues with new learning. This chapter reviews the global trends and understanding of this field as it stands today.

The most recent framing of ECD is illustrated in Figure 1.1 (the Nurturing Care Framework). This framework highlights young children’s multiple needs: good health (health sector), adequate nutrition (nutrition sector), opportunities for early learning (education sector), security and safety (child-protection sector) and responsive caregiving (The Lancet, 2016; WHO, UNICEF and World Bank, 2018). Responsive caregiving does not neatly fit into one sector and can be integral to any of the aforementioned sectors. While the elements included in the Nurturing Care Framework are not new to scholars of ECD, this is the first time that responsive caregiving has been highlighted as a distinct element: this assertion is based on the growing evidence and momentum of the critical role that parents and primary caregivers play in establishing secure attachments and relationships with adults in order to help children thrive (ibid., Center on the Developing Child at Harvard University, NDa, NDb).

Programmatically, ECD includes activities from all aspects of the Nurturing Care Framework. For example, the element of opportunities for early learning includes activities such as early childcare, pre-school education, transition to primary school and neighbourhood play groups. In emergencies, these activities might be conducted in tents, under trees, in temporary shelters or through mobile visits by caregivers who lead the activities.

Figure 1.1 Nurturing Care Framework.

Elements of good health and adequate nutrition include health check-ups for children, pre- and post-natal care for women, play corners in community health centres, home visits by community health workers, pregnant women’s group discussions, adolescent mother and baby parenting and playgroups, infant and young child feeding, support for breastfeeding, sessions on how to use local produce to prepare nutritious foods for children at different ages and more. UNICEF and WHO have developed the Care for Child Development training package which targets health workers (UNICEF and WHO, 2012). This package has been adapted and used in many countries around the world to strengthen the capacity of health workers to support young children and families. In humanitarian contexts, many of these approaches related to good health and adequate nutrition can be adapted, including the Care for Child Development training package. Whereas in non-humanitarian contexts, community health centres could be used, if these do not exist during an emergency situation, mobile health clinics and support could be used.

The security and safety element includes birth registration, providing support to parents in instilling positive discipline and dealing with violence in the family as a way to prevent abuse, exploitation and neglect of children, establishing referral mechanisms for child victims of abuse, neglect and exploitation, and psychosocial support for children and families. All of these activities can be adapted and implemented in emergency situations. The location and duration may differ; there might be a stronger focus on psychosocial support and the need to provide assistance for parents to manage stress. As separation happens during humanitarian situations, child-protection actors may focus on tracing family members and reunification.

As mentioned previously, responsive caregiving is one element that does not fit within a particular sector; critical activities include strengthening the capacity of parents and primary caregivers to protect, nurture and support their children’s development. Parenting support can be through small group sessions, 1:1 counselling (via home visits or during health check-ups), mass communication messages (i.e. parenting apps, billboards, radio spots, or WhatsApp groups). Parenting happens wherever parents are—village-savings loan groups, supermarkets, water points. While conducting parenting sessions focused on child development, some programmes also include education on savings and loans, vocational training and literacy activities. By strengthening parents’ and primary caregivers’ overall knowledge and capabilities, these programmes can potentially extend support to their children (Center on the Developing Child at Harvard University, NDa, NDb). By providing opportunities for parents to come together to talk and exchange ideas about childcare, learning and development, they not only learn from each other but can also support each other psychologically and emotionally (Britto et al., 2016). It can help families communicate better within themselves, and help communities understand and respect their differences. Therefore, ECD can also contribute to social cohesion, peace and economic prosperity. In addition, these programmes support the establishment of government policies for young children (ibid.). Parenting support programmes can easily be integrated into emergency programmes once the content, duration of the sessions and approach are adapted to meet the needs and realities of a humanitarian context.

Ideally, programmes will include all aspects of nurturing care. However, in reality, and especially in emergency contexts, this can be difficult, especially when funding mechanisms work in siloes.

Why Early Childhood Development (ECD)?

There are six key reasons why ECD is critical. This section delves more deeply into the science and evidence behind these reasons. These six key reasons are that ECD:

1. is critical for brain development;
2. can help tackle poverty and gender inequality;
3. can help promote peace, disaster risk reduction (DRR) and environmental protection;
4. is cost effective;
5. can be crucial for children with disabilities; and
6. is recognised as a human right.

Critical window of opportunity for brain development

The first eight years of a child’s life are the most formative, with the greatest rapid cognitive, physical, social and emotional developments (Fox et al., 2010). Some of the earliest neuroscientific research found that on average 700 new neural connections are made in a child’s brain every second (Conel, 1959). Harvard University’s Center on the Developing Child has now updated this figure to indicate that there can be up to 1,000,000 neural connections made in the child’s brain per second (Center on the Developing Child at Harvard University, 2009). The rapid growth of neurons peaks during the period of early childhood; those that are not used consistently disappear, thereby decreasing the overall neural connections in the brain as we age (Conel, 1959). Babies are therefore the best learning machines in the world. Through exploration and play, they are the world’s best innovators.

Early childhood is the time when the brain is most flexible, and when external inputs can have positive or negative effects on children’s development and influence their life’s trajectory (Fox et al., 2010). The brain’s architecture is built from conception through to adulthood, but there are certain “sensitive periods” where brain development is accelerated. Early childhood is one of the key “sensitive periods” that builds the foundation for future growth and development. The brain builds on itself, so the foundation needs to be strong (Bruer, 1999; Fox et al., 2010). A strong foundation during a child’s earliest years increases the likelihood of positive outcomes and development, while a weak foundation increases the probability of future physical, mental and other difficulties (National Scientific Council on the Developing Child, 2007). Figure 1.2, from the Center on the Developing Child, illustrates how the brain develops over the span of a lifetime, and how the first five years have the greatest growth.

Figure 1.2 Human brain development: neural connections over time.

The growth of the neural connections in the brain depends on a few key things, including sufficient nutrition in the first 1,000 days after conception, and the stimulation of the brain through human interaction, known as “serve and return” (National Scientific Council on the Developing Child, 2007). When any child interacts with the world, and especially with his/her parents and family members, he/she learns a lot about how humans act, behave and communicate. He/she begins to understand how to be a social being in his/her cultural context. A child feels safe, loved and important when his/her parents and family members interact with him/her by talking, smiling, hugging, kissing and through eye contact. It is during this time that a child develops attachment with primary caregivers, which is an important part of his/her development (Bowlby, 1988; Gordon et al., 2011; Masten, 2014). Hormones such as oxytocin are released during early attachment between parents and their babies (Gordon et al., 2011). This feeling of safety, love and lack of anxiety is what propels a child to explore the world around him/her, which allows for even greater neural connections (Bowlby, 1988; Gordon et al., 2011; Masten, 2014). In contrast, children’s nervous systems can be negatively impacted when they do not have regular, secure and loving relationships and an attachment with parents or other caregivers, or when there is neglect or exposure to violence and severe stress (Teicher, 2000). This can, in turn, affect the child’s ability to trust, bond and relate with others, and his/her interest in exploring the world around (ibid.). Without these critical inputs, and the chance for the child to explore his/her world, the child’s brain development and physical growth could be stunted. The effects of this can last a lifetime (Bryce et al., 2008; Teicher, 2000; Victora et al., 2008). Evidence from many developing countries points to investing in the early years as being even more critical for the most vulnerable children, as such investment can provide support that families may not be able to provide (Mingat, 2006; Sen, 1999). Early-years support brings tremendous benefits to all children, but in particular to those from lower socio-economic classes, those with disabilities and those that face other vulnerabilities (including those impacted by humanitarian crises) (Hertzman, 2010).

While there is overwhelming scientific evidence that the majority of brain development occurs during the early years, the brain continues to develop throughout a person’s life. Additional neuroscientific evidence on adolescent brain development over the last ten years has shown that this period is a second window of opportunity (Blakemore and Choudhury, 2006; Center on the Developing Child at Harvard University, NDb; Dahl, 2004) as illustrated in Figure 1.3. The development of the pre-frontal cortex, where executive function and self-regulation occur, continues through adolescence and early adulthood (ibid.). Executive function, which includes higher-order thinking such as planning, decision-making, goal-setting, multi-tasking, reflection, emotional control and metacognition, is seen as critical to success in adulthood (Center on the Developing Child at Harvard University, NDb; Diamond, 2006). Based on this evidence, The Center on the Developing Child at Harvard University is now promoting a two-generation approach to ECD, which focuses on supporting children and their parents, especially those who are adolescents or young adults up to late twenties, in order to take advantage of the second sensitive period in brain development (Center on the Developing Child at Harvard University, NDb).

Figure 1.3 Development of executive function over a lifetime.

Tackle poverty and gender inequality

The early years are also the critical time for forming identities and stereotypes, so services for children and families can help tackle socio-economic and gender inequalities (Irwin et al., 2007). There is evidence that ECD services can be a great equaliser, helping the most vulnerable children (i.e. those from low-income families, ethnic or religious minorities, children affected by conflict and emergencies) get to similar levels of development and well-being, academic achievement, and income parity as more well-off children (ibid.).

Today, 836 million people live on less than US$1.25 per day, a situation which is considered “extreme poverty” (MDG Report, 2015). Children experience poverty differently from adults. While an adult may fall into poverty temporarily, a small child who falls into poverty may be stuck in the lowest socio-economic group for life, because even short periods without essential services or appropriate care in early childhood can be detrimental to long-term development. Young people often feel the effects of poverty directly, when they may be forced to go hungry or leave school early to work a...

Table of contents

• Cover
• Half Title
• Series Page
• Title Page
• Copyright Page
• Table of Contents
• List of illustrations
• Foreword: a call for action to support young children and families in crises
• Acknowledgements
• Introduction
• Part I Background and context
• Part II Early Childhood Development in emergency programming
• Part III Evidence for Early Childhood Development in emergencies
• Conclusion: the way forward
• Index