Early Childhood Development

As typically defined, early childhood development (ECD) encompasses the cognitive, social, emotional, and physical development of children from the prenatal period to age five. For any parent, there is perhaps no greater concern and source of dignity than ensuring a child’s healthy development—and for good reason: the effects of early childhood on a person’s long-term health, educational attainment, income, and other key welfare outcomes have been shown to be enormous.,,, Unfortunately, in developing countries, these integral dimensions of child well-being are too often neglected by health care systems at the expense of a too-narrow focus on treating episodes of acute illness. To address this gap, we are, to our knowledge, the first organization in the world to attempt to provide ECD services through community health workers using mobile technology.

Community health workers are well-positioned for this role, given that they regularly meet with families in the natural home environment. We are developing a mobile phone application in which CHWs will conduct longitudinal developmental assessments of children using locally validated screening tools. In concert with the screening tool, the app will contain a phone-based library of locally filmed counseling videos on positive care practices. Thus, for example, if a child is not meeting age-specific cognitive milestones, the CHW will be able to show and discuss with the child’s parents a video on cognitive stimulation exercises such as drawing, playing with toys, and asking the child to name objects. In our early piloting, parents have been delighted by the opportunity to discuss aspects of their children’s well-being that go beyond “negative” topics related to disease.