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5. Family Education for Early Childhood Development
5.1 The situation » Up
In Cambodia, the infant mortality rate is very high at 95 per 1000 live births. The under-five mortality rate is even higher at 125 per 1000. Chronically malnourished children under five are estimated at forty percent, including almost 20 percent who suffer from severe malnutrition. In addition, roughly 70 percent of the population has no access to safe water and roughly 85 percent have inadequate sanitation. The population growth rate is estimated at 2.5 percent. Also, an estimated 26 percent of households are headed by a single mother. Maternal mortality is also high at 437 per 100,000 live births. For children above two years of age, especially those who come from impoverished families, almost no structured pre-school education opportunities are available. Currently, fifteen NGOs are piloting the program..
5.2 The rationale » Up
The health and nutrition status of a mother significantly influences whether a baby will be born healthy both physically and mentally. The most critical period for optimal growth and development of a child is during the first two years of life. Many babies do not survive infancy. Among those who survive, half are irreversibly stunted before they reach their second birthday. Malnutrition starting early in life has serious implications for psychological and mental development of children. Deficiencies of iodine, iron and vitamin A can also have serious health consequences for both mothers and children. The causes of malnutrition include diseases, inadequate food intake, poor caring practices such as bottle feeding, lack of access to health services as well as poverty. Even when food availability may be adequate, nutrition is as much about the status and care of women as the care of children by women.
In addition to malnutrition, four critical diseases also cause high mortality and morbidity among under-three year olds. These are: malaria, dengue fever, respiratory infections and diarrhea. These diseases can be greatly alleviated through learning of simple practices such as breastfeeding, getting rid of standing water near the home, sleeping under mosquito nets, avoiding exposure to respiratory infection from others, washing hands, and ways to ensure safe drinking water and adequate sanitation. Malnutrition can be avoided by training parents how to better protect and feed their children.
5.3 The vision » Up
This program is focused on effective care and learning of young children thought education of parents. It arms at holistically dealing with nurturing, nutrition and mental stimulation. Children learn better when better nourished, and receive nourishment better when it is in a caring environment. It focuses on providing parents with new skills and knowledge, as well
as social networks in order to facilitate the psycho-social development of children as well as their general health and nutrition.
5.4 Long-term objective » Up
To ensure that one million parents who live under the poverty line will have become more effective care-givers and their children will have benefited from better nutrition and health by 2015.
5.5 Medium-term objective » Up
To ensure that 350,000 parents who live under the poverty line will have become more effective care-givers and their children will have benefited from better nutrition and health by 2010.
5.6 Short-term objective » Up
In partnership between all relevant ministries, departments and NGOs, to ensure that 50,000 parents who live under the poverty line will have become more effective care-givers and their children will have benefited from better nutrition and health by 2005;
5.7 Program modalities » Up
The program began as an intervention to help parents recognize the value of communicating more actively with their children: asking questions and telling stories, engaging in skills-based play and demonstrating healthy behaviours. It now incorporates a family literacy dimension, information on health and nutrition and a food-incentive program.
The program works with families (whoever the primary caregiver - parent, grandparent, relative) to teach them how to meet children's needs. Children's needs include: adequate nutrition and health care; protection from danger (e.g. disease); things to look at, touch, hear, smell and taste; a chance to develop some independence; opportunities to begin to learn to care for themselves; opportunities to play with a variety of objects; opportunities to develop motor skills; encouragement of language through conversation, storytelling and singing; opportunities to learn cooperation and sharing; hands-on exploration for learning through action; opportunities for taking responsibility and making choices; encouragement to develop self-control and persistence in completing tasks; support for their sense of self-worth and pride in accomplishments; and opportunities for self-expression and creativity.
Currently, there is a fifteen-modules pilot curriculum with a total instructional time of 150 hours. Normally, 25 adults form the core of participants although children are also frequently part of the learning. Currently being run 2 hours per day for 5 days per week by part-time local instructors and volunteers (total time approx. 3 months).
Again, the role of the national level will be to train, facilitate and support the provincial level. Actual planning will take place at the provincial, district and commune level, in cooperation with non-governmental organizations. The majority of implementation will take place at the commune and village level.
5.8 Key tasks » Up
Build partnerships between governmental and non-governmental agencies to:
- Develop decentralized planning and implementation: Train provincial, district and commune authorities how to plan, implement and monitor the family education program, including how to identify, target and "map" villages according to established priorities (poverty, age, gender, ethnicity, social group);
- Revise materials: Revise the family education learning and teaching materials to add more elements. Materials must continue to be "modular" for flexibility of delivery according to learner needs; must incorporate adult learning methodologies; and be highly visual (not dense written text);
- Promote family action: Parents or care-givers will be trained to select food of high protein and mineral content for children. Using growth monitoring charts, they will be trained to weigh the child monthly.
- Select and train trainers: Develop guidelines and training materials for selecting and training (provincial/district) trainers, who should reflect gender equality. Trainers must be exposed to all NFE and development training programs available or planned for their area as a way of building horizontal integration. Ongoing in-service training should also be developed in cooperation with monitoring activities;
- Select and train local facilitators: In a similar manner, develop guidelines and training materials for selecting and training local family education facilitators (with gender balance). Local instructors must be exposed to the full range of NFE and development training programs available or planned for their community. ;
- Monitor functional literacy activities: With local authorities and community representatives, undertake selective on-site case studies of selected family education activities to determine more precisely who is being reached and how effectively. Develop systems for monitoring performance of trainers and instructors. Short-term objectives will be revised each year depending upon progress.
5.9 Indicators » Up
- Improved nutrition and health among the under-five year olds;
- Decreased mortality rate among under-five year olds;
- Increased number of participants who complete the course;
- Increased number of trainers and trained family education facilitators;
- Instructional materials tested and revised for pro-poor relevance and adult learning methodology;
- Increased number of governmental and non-governmental partnered family education activities;
- Increased demand for, and participation in, family education activities by the most disadvantaged and women;
- Evidence of participants applying improved knowledge and skills in caring for and educating their children;
- Increased numbers of women from poverty areas and ethnic minorities trained and deployed as trainers and facilitators.
5.10 Indicative financial requirements » Up
Costs are estimated at approximately $20 for each person who completes the 150 hour course.
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Khmer
