Positive Caregiving: Helping Children to Experience Nurturing Care as their Right

By BEC members Alisa Phillips (World Vision), Viktorya Sargsyan (World Vision), Katelin Wilton (Save the Children), Julia McGeown (Humanity & Inclusion), and Susan Werner Orrin

It is the right of every young child to experience quality Early Childhood Care and Education (ECCE) from birth to 8 years of age[1]. Yet, according to UNICEF, pre -COVID pandemic data from 196 countries showed that ECCE enrollment for the population of children between age 3 and primary school entry was 54% globally, ranging from 21% in low-income countries to 79% (almost 4 times more) in high-income countries[2]. These income disparities between ECCE access in wealthier countries and the poorest countries also influences child development outcomes. Based on neuroscience we know that the learning and achievement gap can start as early as infancy and continue to widen throughout early childhood if not addressed. Factors such as access to quality early childhood education, nurturing care through positive caregiving, and exposure to stimulating environments play crucial roles in shaping a child's learning trajectory. Quality and inclusive ECE programs whose foundation addresses these factors can improve education, health, employment outcomes and reduce poverty[3].   

On this #WorldChildrensDay, we are reminded of the importance of nurturing care for all children as we are witnessing and continue responding to multiple crises (e.g. COVID-19, impacts of climate change) and conflicts directly impacting children across the Globe. This has created increased urgency and the need to invest in evidence-based quality, inclusive, and holistic early childhood development and early childhood education opportunities to provide “Nurturing Care” that supports the whole child.  When we refer to “Nurturing Care”, we refer to the 5 integral components including:

1. Good Health

2. Adequate Nutrition

3. Responsive Caregiving

4. Security and Safety

5. Opportunities for Early Learning

The focus of these programs is to support every child thriving throughout their childhood, in school and later in life. Investing in systems that support both private and public to uphold the right for children to experience nurturing care from caregivers early in life is one essential aspect of ECCE within the quality care package.

This #WorldChildrensDay we reaffirm the important role that caregivers play in children’s well-being and holistic development. We highlight three examples that emphasize positive caregiving principles and approaches and how these contribute towards whole child outcomes and ensuring children’s right to access quality early childhood care.     

Example 1: Save the Children Uganda’s Boost for the Youngest

This program integrates responsive caregiving and early learning into the Mother & Baby Areas (MBAs) which promote breastfeeding and good nutrition among pregnant and lactating women and caregivers of children under two years old.  As part of a project to operationalize nurturing care in humanitarian settings in Uganda, MBAs offer a warm and friendly space, with comfortable rocking chairs for breastfeeding mothers; soft, clean mats on the floor where they can rest; toys for the children to play with; and sympathetic staff. Linda (age 5, pictured here) is a member of the MBA intervention where she reports that she has learnt the alphabet, names of different things, counting from 1- 20 and is now speaking English at an early age. Her class performance has improved and she is very active in all class activities, which her family attributes to the time she spent around other children in the MBA when younger.

Example 2: World Vision’s Care and Comfort for Children (3c)[4]

3c was a study (quasi-experimental non-equivalent control group, post-test only) conducted in a humanitarian context to test an integrated positive parenting intervention aligned with the nurturing care framework to determine if different dosages of positive caregiving activities would benefit caregivers and young children in Rwanda’s refugee camps of Mugombwa, Kansi, and Kigeme and host communities compared to standard care. Using a socio-ecological approach and social and behavior change methods mainly through World Vision’s Go Baby Go model, the project deployed:

1. A high dosage (HD) package that included 12 group sessions and 4 home visits in 9 months and a radio program and delivery of SMS

2. A low dosage (LD) package that included 4 groups sessions and 2 home visits in 9 months and a radio program and delivery of SMS

3. A comparison area that received only the radio program 

WV together with Sesame Workshop implemented this social and behavior change project around the themes of sensitive and responsive caregiving; nurturing a holistic child development; play-based parenting; WASH social behavior change messaging, child growth (protection from infections, responsive feeding); positive discipline, creating safe home spaces, and protecting from violence; responding to children in crisis via responsive and loving care; father’s engagement; COVID-19; and caregiver self-care. 

While the study sought various areas of inquiry,  the main objective of the intervention was to strengthen family, caregiving and community environments for children 0-5. Some of the key research questions were:

• Will caregivers who receive intervention demonstrate improved caregiving practices for optimal ECD compared to caregivers who receive standard service (radio program only) as indexed by differences in (i) engagement with play activities (ii) quality of learning environment at home (iii) responsive feeding practices?

• Will there be a difference between the HD and LD intervention groups in caregiving practices?

World Vision assessed caregiver practices using the UNICEF Multiple Indicator Cluster Survey (MICS) which included how household members over 15 years engaged children in the last 3 days. These members were asked about reading books, looking at pictures together, singing songs, telling stories, taking the child outside of the compound, playing with the child, naming, counting or drawing with the child.  They also administered a questionnaire related to responsive feeding practices and to assess the learning environment.  While they assessed child outcomes using the Ages and Stages Questionnaire, there was only significant positive movement in the personal social domain among 25–48 month old children, which suggests that there is more we need to learn to create greater impacts for holistic child outcomes.  Related to improved caregiver practices the study pointed to several encouraging outcomes.   They saw a significant percentage of mothers engaged in either HD (211/67%) or LD (148/62%) showing engagement in early learning and stimulation compared to the control (66/37%). An interesting result was that findings for all play and stimulation items were significant. While NCF principles note the importance of positive caregiving by fathers, their engagement with young children is still a challenge. There was no difference in father engagement with play activities between the groups in any of the items. However, they saw significant outcomes with both HD and LD groups in responsive feeding. It was also encouraging to see that more children had homemade toys in the intervention groups than in the control group (90% HD, 88% LD and 60% control).  While they recognize that there were some limitations to the study, in 2 weeks World Vision is conducting a study that will target those children and their caregivers that were in the 3C project to assess the long term effect of parenting projects on outcomes such as child development, school readiness and school academic achievement.  They expect that this will further contribute to the evidence-base on holistic child outcomes in humanitarian contexts.  

Example 3: Humanity & Inclusion’s Democratic Republic of Congo Program

If caregivers can monitor their child’s development well, this can lead to earlier detection of any difficulties and consequently earlier intervention from services, which leads to better health and education outcomes in the long run.

Caregivers are best placed to observe how their child is developing, but they are often unaware of norms of child development. This leads to delays in seeking specialized help in assessing child development and consequent delays in the access to support for children with developmental delays.

Humanity & Inclusion (HI) implements early childhood development and education projects in countries as diverse as Rwanda, Democratic Republic of Congo (DRC), Egypt, and Jordan. Despite the differences in context, in all these countries a strong importance is given to supporting parents so that they understand more about child development.

For example, in DRC (as shown in this photograph), HI works with community workers who either organize community awareness sessions in key community spaces or one-to-one sessions at home.

Community sessions tackle topics such as child development milestones and how parents can support child development by promoting early learning activities (e.g. creating no-cost early learning materials using recycled materials). The sessions also have a holistic focus, including health and nutrition messages, how to give positive and responsive care, as well as educating parents about “red flags” for which they should seek specialized help and where to do so.

Home visits share the same knowledge and awareness messages but also focus on specific messages based on the individual family’s needs. Therefore, if children are deemed at risk of having developmental delays, or are living in vulnerable households, home visits are the preferred option. This allows for individual care and attention that is so important to caregivers, to allow them to truly promote early childhood development. 

This is just one small aspect of the work HI carries out in ECD and early education. In other projects, HI also supports local services too — for example, to ensure that developmental screenings and assessments are implemented following a family centered approach.

In summary, the Boost for the Youngest program (Save the Children), the Care and Comfort for Children program (World Vision), and Humanity & Inclusion’s work in the DRC offer opportunities for us to celebrate and find hope on this #WorldChildrensDay that integrated positive caregiving programs can improve behaviors for caregivers in humanitarian contexts where children are the most vulnerable to strengthen their resiliency and fulfill their right to experience nurturing care.

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[1] UNESCO Tashkent Declaration  

[2] McCoy et al., 2021

[3] Tashkent Declaration

[4] Sargsyan, V., Tenorio, A., Uwera, M., Gasirikare, A., Habyarimana, J.A., Salcido, J.S., Felner, C., Rasheed, M.A., (2023). The benefits of nurturing care interventions on early child development and care: findings from a quasi-experimental study in a humanitarian setting. BMC Pediatrics.

Considerations for Artificial Intelligence (AI) and Human-Centered Design

Written by Jody Britten, Ph.D. | Team4Tech Foundation | Basic Education Coalition member

Jody is a member of BEC’s EdTech working group. Stood up in 2020, this working group has held regular technical exchanges with BEC’s members to share best practices, challenges, and lessons learned from the EdTech space. The group has collaborated on conference presentations and panels, organized and shared at Fail Fests and webinars, and carried out a BEC-wide EdTech survey “Governments’ Organizational Responses to COVID-19”.

Generative Artificial Intelligence (AI) has significantly impacted global education in the past year. From advanced algorithms and personalized learning materials to data analysis and automation of administrative tasks; generative AI has brought positive changes to education. Even with all the advances and opportunities, there is still work to do to ensure that generative AI is developed and used ethically and transparently.

Team4Tech is a nonprofit impact accelerator that leverages technology to drive positive change in education. By combining the power of technology, education, and collaboration, we use human-centered design to ensure technology solutions are developed with the aspirational needs of our network of education-focused nonprofit organizations at the forefront. Through our collaborative efforts, we have successfully implemented training and created resources that help global partners harness the potential of generative AI to enhance learning experiences and support educators.

Over the past ten years, we have witnessed first hand how human-centered design can play a crucial role in supporting the inclusive design and development of educational technologies. As a multidisciplinary approach that places user needs, behaviors, and experiences at the epicenter of the design and development process, human-centered design is rooted in a deep researcher base that goes beyond mere usability to foster meaningful interactions and sustainable engagement.

With members of our community of practice representing more than 85 countries and 500 unique non-government organizations (NGOs), Team4Tech has engaged our community in meaningful conversations and training opportunities around generative AI. Through that process over the past six months, we have identified five salient considerations for developers and users alike which have the potential to positively impact the use, design, and development of these tools as we move forward.

• Consideration 1: Ethical Implications of Autonomy

• Incorporate ethical considerations from the outset, bringing accessibility and equity to the table during initial design and pro-typing. 

• Utilize frameworks like Ethical-by-Design or Value-Sensitive Design to support design teams that lack global experiences or perspectives.

• Address questions about agency, consent, and data privacy and be transparent with where, how, and when data is shared, stored, and used for AI training.

• Consideration 2: User-Centric Personalization

• Balance personalized experiences with user cognitive load, cultural context, and privacy expectations.

• Ensure pathways to delete data and validate personalization techniques.

• Prioritize equity in personalization practices, being diligent and transparent about how users can customize, adapt, and train generative AI tools to better meet their needs.

• Consideration 3: Interdisciplinary Collaboration

• Adopt an interdisciplinary approach to integrate generative AI with human-centered design.

• Include domain experts in machine learning, UX design, ethics, and behavioral psychology.

• Foster open community conversations about AI by involving diverse stakeholders and generate opportunities for feedback loops with end-users.

• Consideration 4: Algorithmic Transparency

• Strive for transparency in decision-making processes without compromising intellectual property.

• Address questions about algorithm training and the inclusion of diverse global audiences.

• Test algorithms with specific audiences in mind and share the test-user demographics to demonstrate attention and awareness of bias.

• Consideration 5: Usability and Accessibility

• Conduct rigorous usability testing to ensure broad accessibility and transparency in how population differences have been accounted for in AI training.

• Prioritize accessibility features and involve end-users in collecting continual feedback.

• Routinely address the data and power consumption that is needed to use and build generative AI tools and applications.

As we continue to navigate the intersection of generative AI and human-centered design in education, it is crucial that we foster an ongoing dialogue and collaboration among users and developers. By working together, we can ensure that generative AI tools are designed and used equitably, promoting inclusive learning experiences for all.

To contribute to this dialogue, users and developers can engage in open conversations and advocate for ethical guidelines. Participate in online forums, communities, and conferences dedicated to discussing generative AI and human-centered design in education. Share insights, ask questions, and learn from others to enrich the collective understanding of equitable design practices. And encourage the development and adoption of ethical guidelines and standards for generative AI in education. Advocate for transparency, fairness, and inclusion in AI algorithms and decision-making processes. By promoting ethical considerations, we can shape the future of generative AI to prioritize the well-being and empowerment of learners and educators.

Team4Tech is continually exploring the possibilities of generative AI while ensuring that it aligns with the principles of human-centered design and equity. By embracing these important considerations and taking action, we are doing what we can to pave the way for a future where technology truly enhances education for everyone.

You can see cataloged resources focused on AI in global education that are continually curated by Team4Tech’s Director of Learning Technologies here.

BEC Celebrates the Global Day of Parents

In honor of the Global Day of Parents (June 1, 2023), let’s take a look at research by BEC member Food for the Hungry (FH) that analyzes communities strengthened through education across 10 countries. Below, FH’s Lisa Easterbrooks, Director of Education Programs, outlines the most recent findings on their community-based “care group” interventions.

The United Nations reported that 1.6 billion learners in more than 190 countries were affected by the closure of educational institutions at the peak of the COVID-19 pandemic. Between February 2020 and February 2022, educational systems were fully closed for in-person schooling for an average 141 days.

As a result, the World Bank estimates the percentage of children who cannot read a simple story by age 10 has increased to 70% since onset of the pandemic. All progress that was achieved toward mitigating learning poverty in low- and middle-income countries since 2000 has been lost.

Millions of children and youth now face the challenge of catching up on lost learning. Food for the Hungry (FH) is working with caregivers, teachers, and communities to improve child learning and development through social behavior change interventions.

FH recognizes that school-based approaches alone are not sufficient in many low- and middle-income countries to reach the goal of young children learning foundational skills. As a result, broadening the scope of education interventions beyond the school is a necessary step. This is where FH’s Education Care Groups come into play.

Care Groups consist of 10–15 community-based volunteer educators who meet regularly with project staff for training. They then facilitate behavior-change lessons to their neighbors in group settings and through household visits. Care Groups build caregiver capacity to support their children’s early child development and early-grade success.

FH staff involved in Care Groups for education have seen caregivers receive the information and use it in their own lives, in addition to the everyday lives of their children. One FH staff member said, “Before, they (caregivers) didn’t have time to think about their children’s studies. But since joining Care Groups, they are always trying to find time to help children.”

A staff member observed during a home visit that a father was carving a toy helicopter for his child. This shows that parents have learned the importance of play for child development and have found ways to make toys with locally available materials. FH staff is encouraged by this and say they “have hope that children will have their future with education. I think this program helps us to achieve our goal in every corner.”

Recent research by FH and Boston College’s School of Social Work has shown promising results of the impact of Care Groups on child learning outcomes. Researchers analyzed data sets from 10 countries that included data from a caregiver survey, as well as child learning outcomes measured by the International Development and Early Learning Assessment (IDELA) for children 3-6 yrs, and the Citizen Led Assessment (CLA) for children 7-15 yrs.

Researchers first compared two groups - caregivers who participated in Care Groups for education and those who did not, and correlated that with a caregiver behavior score, which was a sum score of multiple targeted learning support behaviors. These behaviors included:

-       Setting a specific space for study in the home

-       Reading with your child every day

-       Meeting with your child’s teachers

-       Singing songs and telling stories with your children

-       Playing with your children

-       Checking your children’s homework

-       Enrolling your children in school at the recommended age

The correlation analysis revealed a statistically significant positive association between participation in Care Groups and caregiver behavior scores.

Researchers also analyzed the learning outcomes of children of the caregivers who participated in Care Groups and found that these children had higher scores on IDELA and CLA than children of caregivers who did not participate. Additionally, researchers found stronger correlations between caregiver behavior scores and child learning outcomes, when compared to participation alone. 

In summary, caregivers who participate in community-based platforms that integrate social behavior change science, such as Care Groups, and adopt the early learning support behaviors have children who tend to score higher on learning assessments. Caregivers continue to be an important partner in the learning and development process.