International Conference on Early Childhood development in Pakistan

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Background

1.     Background

Early Childhood Development (ECD) is the foundation to transform societies and generations. A good foundation starts right before conception,  makes a difference throughout a person’s life and gives the next generation a better start. Educated, healthy and skilled people participate in, and contribute to the financial and social wealth of their societies. Effective Early Childhood Development forms the basis of intelligence, personality, good health and well-being, social behavior, lifelong learning and the capacity to nurture oneself as an adult. The years starting from pre-conception to age 8 are not only critical for brain development, but also indispensable for the children’s holistic (cognitive, physical, social, emotional, spiritual, and language) development. However, for this, children need to be nurtured with responsive care, nourishing nutrition, good health, quality early learning opportunities, and safety and protection. These are all dimensions that scientific research has found to be crucial for laying sound foundations for future adult health and productivity.

Children who do not have the benefit of nurturing care in their early years lag behind in achieving age-appropriate milestones due to the difficulties they face in their development and learning.  This in turn limits their chances of success in life and impacts the well-being and prosperity of their families and societies.

Current estimates are that nearly 250 million children aged under five years in low- and middle-income countries – or more than four in every ten – risk missing critical development milestones due to poverty or stunting. Additionally, 40% of all three to six-year-olds do not have access to pre-primary education[i]. Optimal development requires an abundance of protective factors and the mitigation of specific risk factors. Extreme poverty, food insecurity, gender inequities, violence, environmental toxins, and poor mental health are the biggest threats to early childhood development[ii]. Caregivers’ capacity to support a child’s early development through responsive caregiving and stimulation are also impacted by these threats. Poverty often leads to a lack of adequate nutrition and limited access to healthcare. Negative experiences, including exposure to violence and conflict can slow down and modify how neural connections are made.[iii] Breathing in pollution can also negatively affect a child’s developing brain[iv] yet more than 90% of children breathe toxic air each day. Other risk factors related to birth include maternal mortality, low birthweight, adolescent birth rate, and preterm births. Violence may be in the form of neglect and injuries in the home and community[v]. Furthermore, threats to ECD often cluster – exposure to one risk factor often suggests exposure to other factors.

The ECD situation in Pakistan is fragmented with sectors working in silos. The situation has further deteriorated in the country due to multiple challenges, including a serious economic downturn, political instability, adverse climate change impact, and widening social, economic, and technological inequalities. All these challenges are exacerbated by a once-a-century global pandemic, COVID-19, for which the whole world and Pakistan was least prepared and still paying a high price. All these challenges have a direct impact on family well-being, particularly on women and young children. Millions of children are at risk of not meeting their developmental potential. Maternal and child malnutrition is widespread increasing the risk of childhood infections, mortality, and stunting even before birth, leading to long-term irreversible and detrimental cognitive, motor and health impairments[vi].

Countdown to 2030 Women’s, Children’s and Adolescent’s Health has developed “Country Profiles for Early Childhood Development” using the five components of the Nurturing Care Framework as indicators. According to this data, Pakistan’s profile is as under:

  • Health: 67/1000 under-five mortality, 16% preterm births, 54/1000 adolescents’ birth, 54% young children at risk of poor development
  • Nutrition: 37% under-five stunting, 20% early initiation of breastfeeding, 48% exclusive breastfeeding, 13% minimum acceptable diet, 46% suffer from anemia
  • Safety: 42% birth registration, 9% child poverty, 32% non-access to toilet facilities and lack of focus on baby WASH
  • Early learning opportunities: 44% out of School Children, 34% preschool attendance and untrained workforce
  • Responsive care- missing link: 30% early stimulation, 3% with 2+books at home and 3% father engagement
  • Services to children are in silos
  • Coverage: Most of Early Childhood Education and health services are given through Integrated Management of Neonatal and Childhood Illness (IMNCI) but limited services for < 3 years of age
  • Huge inequities (Age, gender, geographical)

The country has slipped to the bottom five countries in the world for education and skills development, with dismal rates of school enrollment, poor quality of pre-primary and primary education  increasing poverty, rural and urban divide, and widening gender gaps.  Pakistan is among the top three most vulnerable countries with high rates of undernutrition. Pakistan needs to reverse this situation and to do so it needs to implement the 2030 Transformative Agenda with a focus on the development of early childhood. ECD is a critical and central component of global and national transformation, and yet, in Pakistan, this sector has not been given due attention.

To address this ECD situation in an organised manner, the Scaling Up Nutrition SUN Secretariat/Nutrition Section, Ministry of Planning, Development and Special Initiatives (MoPD&SIs) and UNICEF commissioned a country-wide mapping exercise in 2018. The mapping exercise included a series of consultations with diverse stakeholders at the federal, provincial, and regional levels for insight into the status, challenges, and opportunities for ECD in Pakistan. The key findings of the mapping study clearly indicated that most ECD services were functioning in silos and were fragmented in nature. Increasing the efficiency and effectiveness of child services and interventions therefore required strategic coordination.  The report highlights that the responsive caregiving component of the Nurturing Care Framework is the most important missing link.  No data was collected on responsive care and early learning. Indicators related to ECD in Pakistan show that the country’s performance lags behind that of its regional counterparts. There are also concerns related to equity, with substantial disparities based on gender, socioeconomic background, geographical location, and other factors.

The report further highlights that there is no unified ECD policy framework or shared understanding of the concept in the country. Hence UNICEF provided technical support to MoPD&SI for the development of the ECD Policy framework. With the devolution of key functions following the 18th Amendment to the Constitution, provincial and area administrations have developed their own policies, and strategies, hence provincial costed ECD plans derived from the ECD policy framework is the way forward.

Although there exists strong policy and service delivery frameworks for nutrition, health, and education at national and sub-national levels, they are not fully integrated, nor do they necessarily seek to address child development from a whole-of-early-childhood perspective, from conception to eight years of age. For example, since there is no constitutional provision for early learning, provinces and areas are at different stages of conceptualization. Other relevant sectors, such as those related to health, child protection, social protection, disaster risk management, and water and sanitation, are not coordinated through an ECD framework. Moreover, key elements of the Nurturing Care Framework are not currently addressed and not well understood by the policymakers. These include maternal mental health and support to families to provide responsive caregiving and support for early learning in the home.

The report recommends that the government and partners need to coordinate efforts on improving ECD systems in terms of policy, intersectoral coordination, financing, measurement and reporting, workforce, and regulation. With several actors providing multisectoral services to young children from conception to eight years of age, the key recommendation was the need for a regulatory overarching policy framework with clear roles and responsibilities of actors that could ensure the provision of quality integrated care for positive child development outcomes. Identifying appropriate delivery platforms to reach marginalized children at different stages of life with multisectoral services is critical for efficient and effective implementation. The study identifies existing and new delivery platforms that may be leveraged for effective ECD provision. It also proposed that frontline workers, such as Lady Health Workers, vaccinators, pre-primary teachers, and civil society representatives be engaged for the improvement of ECD outcomes. Following the recommendations of the mapping exercise, the MoPD&SIs and UNICEF developed an inclusive and multisector ECD Framework for Pakistan along with an ECD Index and standards. These key documents will be formally launched prior OR at the 4th International Conference on ECD in November 2022.

The Ministry of PD&SIs with support from WHO Pakistan also undertook a feasibility study to inform the development of a PC-1 on Early Childhood Development in Pakistan. It provides a detailed landscape analysis of  ECD interventions in the country over the past couple of decades. The study describes broad findings and recommendations that will support and strengthen a holistic approach to ECD in Pakistan. It also provides policy and programme areas where proactive action is needed, and processes must be implemented besides guidance on contextualization of evidence-based ECD interventions. Using the recommendations from this feasibility study, a proposal has been submitted officially to the Public Sector Development Program (PSDP) for initiating pilots (1 district in each province and area) on ECD implementation.

The government of Pakistan and its key ECD allies including but not limited to the Pakistan Alliance for Early Childhood (PAFEC), Allama Iqbal Open University (AIOU), UNICEF, WHO, UNESCO, Rupani Foundation, Aga Khan Development Network, World Bank and many other key stakeholders from the private sector along with SUN Networks such as Civil Society, Business and Academia etc. have been taking initiatives to promote holistic ECD in the country. These initiatives cover a range of areas such as policy, governance, and programming. In this regard, the ECD Policy Framework, Index & standards are being finalised.  Other key initiatives include the establishment of governance structures at national and provincial/area levels, annual conferences, seminars, webinars, advocacy, mass awareness initiatives,  capacity building of key stakeholders, workforce development, developing and conducting courses on ECD, development of Key Family Care Practices/Parental Packages, IEC material development, networking and knowledge management.

Continuing the same momentum, the organizers are planning to hold the 4th International Conference on ECD this year on 29th and 30th November 2022 on “Nurturing for Transforming Lives-The Power of Early Childhood Development”. As with the previous conferences, this will also bring together key stakeholders from across the world to share research-based knowledge and  best practices in ECD, to deliberate upon and reach a joint commitment to take the holistic ECD agenda forward. For details, please refer to the concept note and draft conference program attached.  

The conference will bring together over 400 participants, including legislators and policymakers responsible for health, nutrition, child protection, education, and social welfare, ECD professionals/experts from private and public sectors, practitioners, researchers, civil society, UN agencies, donors, academicians, aspiring ECD professionals, and parent representatives.

2.     Conference Theme:

The conference theme “Nurturing for Transforming Lives: The Power of Early Childhood Development” reflects both the ground reality that the majority of children lack a nurturing environment, and the opportunity that the knowledge, resources and the political will now exist, to change that equation. The conference theme has been divided into sub-themes, as highlighted below.

  • Sub-themes of the Conference:
  1. Good Health:
  • Care before and during Pregnancy – practices, opportunities and challenges. The rooming-in of mother and baby, skin-to-skin care, early initiation of breastfeeding
  • Postpartum Depression- and its impact on mother & child health 
  • Mental Health of Parents and other Caregivers – Its impact on child Care & development.
  1. Adequate Nutrition:
  • Undernutrition (stunting, wasting, and overweight/obesity):
  • Scaling up Nutrition (multisectoral approach) – coverage, scale & challenges
  • Impact of Urban Settings on Children’s Health and Nutrition
  • Ensuring Food and Nutrition Security for Every Child – current status, opportunities & challenges
  • Maternal Nutrition – problem, its impact & solutions
  • Infant and Young Child Feeding – What are adverse/sub-optimal feeding practices and the possible solutions to address them? How to ensure responsive feeding and care.

  • Early Learning & Development Opportunities:
  • Ensuring Quality Early Childhood Development Services – A strategy to develop the ECD Workforce
  • Professional Development of ECD Teachers – innovative pedagogical practices
  • Promoting Playful and Positive Parenting for Nurturing Children
  • Impact of Play-based Learning on Child Development
  • The New Dynamics of Online Teaching-  Ed-Tech and its impact on young children
  • The Role of Home, School, and Communities in Early Childhood Development
  • Urbanization and Early Childhood Development
  1. Security & Safety:
  • The Importance of Positive Parenting Practices versus Adverse Childhood Experiences (neglect, violence, early & forced marriages, child labour and displacement)
  • Creating Safe & Conducive environments for promoting Early Childhood Development Warning Signs of Child Abuse and Neglect- how teachers and parents and other caregivers can play their role in sensitizing and protecting children
  • Child Rights Interventions in Pakistan: Advocacy, Policies, and Implementation
  1. Responsive Caregiving:
  • The Role of Secure Emotional Relations- between children and their caregivers for ECD
  • Building the Capacity of Parents and Caregivers – to recognize the danger signs/red flags in the holistic development of their children from 0 to age 8 to timely respond their needs
  • What do Parents and other Caregivers Need to Know- to ensure responsive caregiving in the context of COVID-19?
  1. Early Childhood Development in Emergencies:
  • Impact of COVID-19 on Early Childhood Development – How parents and teachers dealt with the situation   
  • Supporting & building Capacities of Parents & Caregivers- Ensuring Early Childhood Development during and beyond COVID-19
  • Early Childhood Development in the age of Climate Change
  • Government initiatives for ECD in emergencies

  • Government Initiatives for Early Childhood Development:
  • ECD Policy Framework – Multi-sector Approach for Holistic Early Childhood Development
  • ECD Governance Structure
  • Programme Development (Key Family Care Practices) & Budget Allocation, Capacity Building, Resource mobilization, ECD data Collection and Management System
  •  ECD Standards, ECD Index Pakistan

  • Themes for Plenaries:
  • Why ECD is essential – Neuroscience, environment & behavior, its impact and returns
  • Nurturing Care Framework – Plans, Advocacy and Implementation in Pakistan- how this compares with the region, South Asia
  • Social and Behavior Change for promoting holistic ECD during emergencies and developments
  • Economic Empowerment of Mothers and Adolescent Girls for promoting holistic ECD

3.     Conference Objectives and expected outcomes:

The International ECD Conference objectives and expected outcomes are to:

  • Disseminate the National ECD Policy Framework, ECD Index and standards prepared by the MoPD&SI and UNICEF, in collaboration with key ECD stakeholders
  • Provide opportunities to participants to understand how inaction for ECD affects, family wellbeing, young children and the overall society and what role each stakeholder could play to give due attention to ECD
  • Share research-based knowledge on how COVID-19, climate change and the economic down-turn has affected ECD sector in Pakistan, and solutions and plans to address the issues
  • Share research-based knowledge on brain development, its contributors to mother & child health, early stimulation, adequate nutrition, safety, play-based learning and the role of positive and responsive parenting/caregiving
  • Share the status of Nurturing Care Framework implementation in the country and the bottle necks that hamper progress
  • Advocate for holistic, inclusive and multi-sector ECD from pre-conception to 8 years in the country.

4.     Conference Organisers:

The conference is organised by the Pakistan Alliance for Early Childhood, SUN Secretariat/ Nutrition Section, Ministry of Planning, Development, & Special Initiatives, UNICEF, Rupani Foundation, Allama Iqbal Open University, Aga Khan Foundation, Aga Khan University, WHO and UNESCO. Other key relevant stakeholders both from public and private sectors include SUN Business, SUN Civil Society and SUN Academia and Research institutions.

5.     Conference Format:

The conference will have:

  • An opening and closing session
  • Plenary sessions with International ECD experts as keynote speakers and concurrent session covering the theme and sub-themes of the conference
  • Exhibition of ECD Models and learning materials

6.     Conference Venue:

The conference venue is Allama Iqbal Open University, Islamabad.

References

  1. Devercelli A. Early childhood development. Worldbank.org. Updated March 30, 2022. Accessed June 2022. https://www.worldbank.org/en/topic/earlychildhooddevelopment#1

  2. Black MM, Walker SP, Fernald LCH, et al. Early childhood development coming of age: science through the life course. The Lancet. 2017;389(10064):77-90. doi:10.1016/S0140-6736(16)31389-
  • Britto PR., et al. Nurturing Care: Promoting early childhood development. The Lancet, vol. 389, no.10064, January 2017, pp. 91–102, www.sciencedirect.com/science/article/pii/S0140673616313903
  1. Rees N. Clear the air for children: The impact of air pollution on children. UNICEF. Published October 2016. Accessed June 2022. https://www.unicef.org/media/49966/file/UNICEF_Clear_the_Air_for_Children_30_Oct_2016.pdf
  2. World Health Organization, United Nations Children’s Fund, World Bank Group. Nurturing care for early childhood development: a framework for helping children survive and thrive to transform health and human potential. Geneva: World Health Organization; 2018. License: CC BY-NC-SA 3.0 IGO
  3. Dr Almina Pardhan, Global & Regional Trends on ECD & ECE, Aga Khan University – Institute for Educational Development Karachi