Promoting Holistic Child Development : Opportunities for Synergistic Investments in Early Years in Nepal

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作者：

World Bank

来源地址：

http://hdl.handle.net/10986/33897

关键词：

CHILD HEALTH;  MATERNAL HEALTH;  EARLY CHILDHOOD DEVELOPMENT;  PRIMARY HEALTH CARE;  INFANT AND YOUNG CHILD NUTRITION;  HEALTHCARE INTERVENTION;  HEALTH SYSTEM;  ADOLESCENT HEALTH;  Report;  Rapport;  Informe; 

年份：

2019

出版地：

Washington,USA

语种：

English

摘要：

The global development community has recognized holistic investments in early years as a sound foundation to achieve at least seven Sustainable Development Goals (SDGs) on poverty, hunger, health, education, gender, water and sanitation, and inequality. In Nepal, the 2005–2015 Early Childhood Development (ECD) Strategy, a Thematic Working Group on ECD in the National Planning Commission (NPC), and a Parliamentary ECD Caucus—all indicate a strong political will to prioritize the ECD agenda. Recent programming from development partners has also provided a substantive push toward a holistic, integrated approach to ECD in the country. However, ECD is still understood by stakeholders mainly as an 'education' agenda, and programs that comprise the various ECD dimensions, including nutrition, stimulation, and social protection, are not coordinated. A transition to federalism offers unprecedented opportunities for integrating and packaging ECD interventions at the local level. As such, this review aims to (a) build a common definition and framework to guide the integrated approach in investing in early years (b) identify current successes and gaps in current programming, and (c) explore actionable opportunities to integrate services in early childhood to ensure that every child gets a healthy start in life. The study consisted of four phases, starting with a desk study, followed by national-level discussions and field-level discussions and then evidence synthesis to design a framework for synergizing investments in early years. An analytical framework (AF) was formulated based on the findings of desk reviews to guide the consequent discussions and selection of respondents for national-level consultations from relevant government agencies, donor partners, and nongovernmental organizations (NGOs). The team conducted field visits to further deep dive into specific cases, challenges, and potential opportunities in scoping for work in ECD. Field visit sites were chosen through purposive sampling aimed at iteratively filling the information gaps in the AF and improving the accuracy of data already collected. To this end, about 18 key informant interviews (KIIs) and nine focus group discussions (FGDs) were conducted in Mahottari, Mugu, Lalitpur, and Kathmandu Districts. The consultations at both the national and field level generated critical lessons, considerations, and potential entry points for increasing delivery efficiency of ECD services offered across the three thematic pillars of health and nutrition, learning and stimulation (L&S), and social protection. The study offered critical insights into the current policies, priorities, and programming, including a spectrum of interventions in ECD and care. It also provided the necessary background to explore current definitions and scope of 'integration'. For consistency purposes, hereafter, the report defines the concept as a synergy of (a) goals (objectives that can be met only through multisectoral approaches); (b) processes (implementation modalities, client-engagement models, communication activities, and information systems); and (c) resources (financial, human, and technical) to enable holistic development of the individual child over the life course.