The Early Years: Building an early childhood intervention ecosystem in India

The number of children under the age of six years in India is estimated at 158.79 million. Research indicates that about 20 per cent of children in this age group display developmental delays and or disabilities.

By Abha Ranjan Khanna

“It has been suggested that the first question the Indian Prime Minister should ask his ministers is not ‘how is the economy growing?’ but rather ‘how are the children growing?’” – Citizens Initiative for the Rights of Children under Six (CIRCUS) (2005)

The demographic profile from “Children in India 2012 – A Statistical Appraisal – MoSPI” shows that the number of children under the age of six years in India is 158.79 million. Research indicates that about 20 per cent of children in this age group display developmental delays and or disabilities. Evidence exists to show that if these children are identified at the earliest and are provided appropriate interventions, the effects of the delays and or disabilities can be reduced significantly.

To achieve this, a number of steps need to be built into communities by training the community stakeholders. Local NGO functionaries, health care workers in the community like the ASHA and Anganwadi worker and parents of children 0-6 years of age need support and high quality skills training to be able to identify the developmental needs of very young children. This initiative has been established in eight north Karnataka districts already and a unique eco-system has evolved there with extensive networking between various stake holders.

Trans-disciplinary workers from local NGOs visit the Primary Health Care Centres on the days that immunisation is scheduled. Here they screen every child that comes in for routine immunisations and identify any delays in developmental milestones.  Once the children are identified the trans-disciplinary workers visit the child and family at home and coach the parents on how to meet the developmental needs of their child in a play way manner.

Similar initiatives are being undertaken by various NGOs in Delhi NCR and Punjab. These NGOs are working together in urban slums and with Delhi-based orphanages. The NGOs Astha, Samarth, Samarpan and Hope Foundation from Delhi and Ashirwad–North India Cerebral Palsy Association from Ludhiana are training community-based workers and parents to reach every child that is identified during screening.

Samarth Trust, based in Okhla has a team of dedicated professionals—psychologists, administrators, speech therapists and occupational therapists working as MECII (Movement in Early Childhood Intervention and Inclusion) that are collaborating with various NGOs to ensure evidence-based training for the staff such that the highest quality of intervention reaches the identified children.

These NGOs aiming to develop the ecosystem for supporting children (0-6) and their families  have this understanding at the core of their work that when they  work with a child with a disability, their job is to support them, as far as possible, to overcome difficulties in their day-to-day living which prevent them from realising their rights. To do this, they have developed a positive way of thinking, about opportunities and not problems; about strengths and not weaknesses; and see hope and not despair. Their work includes ways to help children with disabilities and their families to avoid isolation, exclusion and the possibility of the child being placed in formal or informal alternative care.

If you would like more information regarding their work, please do google these NGOs!

(The writer is an occupational therapist.)

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