Blog post by Sweta ShahSenior Early Childhood Development and Education professional, Bernard van Leer Foundation

It was a bright morning in Ayillo 2 camp in Uganda.  South Sudanese refugee children between 3-5 years were standing in a circle starting their daily routines in a Plan International supported space.  The day started with the morning circle where children came for a half day of play based learning activities. Halima and two other South Sudanese refugee caregivers led the children in songs and games about health, hygiene and topics that promoted literacy and numeracy.  Next came the game “news news”.  A little boy went to the centre of the circle to announce the day’s news.  Everyone clapped to applaud his efforts.

Three Child Friendly Spaces used as ECD centres in the morning and as spaces for adolescent and youth in the afternoon.

Three Child Friendly Spaces used as ECD centres in the morning and as spaces for adolescent and youth in the afternoon.

The children then went to one of three child friendly space tents - for 3, 4 and 5 year olds.  These tents were used in the morning for Early Childhood Development (ECD) activities and in the afternoon for adolescents and youth.  In each tent children were working in small groups led by a caregiver.  Some were using chalk and a slate to practice writing.  Others were playing a letter-sound game and others were sorting leaves, sticks and rocks into different piles.  Through research I conducted comparing children in Ayillo 2 (programme group) and Ayillo 1 (control group) refugee camps in Uganda, I found significant differences in children’s development.   

Parents participated in weekly peer to peer parent support group where they learned about child development, the nutritional value of local foods, good hygiene practices and how to support their children’s learning through every day play activities.  Some parents stayed for the whole half day to volunteer their time because they enjoyed learning about ways to support their children’s development.

This scene, which simultaneously supports children and families, stands in stark contrast to most humanitarian situations where there are not safe spaces such as these.  In many refugee situations across the globe, I have seen children that were idle, not being engaged, played or talked with.  This is not uncommon. I have seen young children from birth to 5 years regularly left out of humanitarian services.   

Why is this a problem?

1.    Children globally not reaching their developmental potential

The number of humanitarian crises is increasing, they are lasting longer and more children are being displaced[i].  The Lancet’s new ECD series estimated that 250 million children (43%) younger than 5 years in low and middle-income countries are at risk not reaching their developmental potential.[ii]  Emergencies add to children’s existing adversities, making it even more difficult to flourish.  Prior to the war, Syria’s literacy rate was high and now after six years of war and displacement, that rate has significantly decreased.  Doing nothing to solve humanitarian crises will impact the next generation of workers in the global economy.

2.    Unique Period of Brain Development

Humanitarians talk about survival, but not of the brain.  The brain survives and grows with stimulation.  If you looked inside the brain of an average small child, you would see more than 1,000,000 neurons firing away as the child explores, talks and plays.[iii]  This is because early childhood, the period between conception and 8 years, is the most critical time for developing neural connections in the brain and establishing the foundation for one’s life.  Approximately 90% of the brain’s growth occurs within the first 5 years of life and about 80% of the brain’s growth occurs within the first 2 years of life.[iv]  Research indicates that children who are not talked to or interacted with have smaller brains and fewer neural connections. 

Neural connections in the brain from birth to 14 years Source: Conel, JL. The postnatal development of the human cerebral cortex. Cambridge, Mass: Harvard University Press, 1959

Neural connections in the brain from birth to 14 years

Source: Conel, JL. The postnatal development of the human cerebral cortex. Cambridge, Mass: Harvard University Press, 1959

Emergency situations, where parents and caregivers may not be able to provide the same type of care and stimulation to their children as before, puts young children in a more precarious situation.  Research also shows that food alone, which is often a humanitarian priority, is also not enough for a brain – it craves stimulation and interaction.  Longitudinal research of stunted children in Jamaica showed more additive benefits of the early stimulation than it did for nutritional supplementation.[v] 

My research for South Sudanese refugees in Uganda clearly showed significant differences in child development scores and parental interaction among those enrolled in Plan International supported ECD activities in comparison to newly arrived refugees not receiving any services.  The programme participants had a mean child development score that was 15 points higher than the control group.  While I used rigorous research methods, the difference between the two groups was easily observable.

3.    Higher Risk of Toxic Stress and Permanent Damage

Everyone experiences stress and it is not always bad.  However, when it is prolonged and severe and there are few protective factors such as relationship with a caregiver, it can become toxic.[vi]  Children in emergencies are at a higher risk of experiencing toxic stress as they may be facing the loss of a parent, friends, may be injured, may have lost their homes and daily routines.  The destabilising effect of emergencies can greatly increase a child’s ability to fight against the accumulating effects of stress.  Harvard University found that a significant increase in toxic stress, even when temporary, can negatively influence brain development that can lead to permanent damage for multiple generations.[vii]

But there’s hope: Children are Resilient

Children are resilient and science tells us that a child’s experience can shift the scale from negative outcomes to positive ones.[viii] ECD in emergency programmes can support children’s resilience and tip that balance when they include nurturing care.[ix]  Nurturing care includes health, nutrition, safety and security, which are prioritised in humanitarian settings, and responsive caregiving and early learning, which are not prioritised. 

Momentum, but challenges remain

Halima playing a literacy game with 5 year old children.

Halima playing a literacy game with 5 year old children.

The Syria Regional Response Plan mentions early learning and parenting support, one of the few emergency plans to explicitly do so.  The Lancet ECD series includes new evidence and data. Language around ECD is now a part of the Sustainable Development Goals.  Education Cannot Wait, a new funding mechanism for Education in emergencies, recognises the importance of early learning.  Momentum has started to build for aspects of ECD in emergencies.

While these are all positive trends, challenges in the humanitarian sector remain.  What has yet to follow is the financing and programming to support young children through various types of humanitarian services whether they are through education, child protection, nutrition, health, cash transfer, or economic support.  Education in emergencies is the worst funded sector in humanitarian response along with child protection.  In 2016, 1.4% of all humanitarian funds went toward education (which often includes early learning and parenting support).[x]   There is currently no data collected on what percentage of the 1.4% of education funding or other sectors’ funding goes toward the various aspects of nurturing care.

ECD is cross-sectoral and should be integrated into all major sectors.  However, the humanitarian system works in silos, created by the IASC clusters.  Agencies that lead multiple sectors in the same country often do not collaborate.  Coordination for ECD is also a challenge – which sector should host it?  Can it be a stand-alone sector? There is no IASC group for ECD so it could sit under education, which it often does, under child protection or health. However, rarely are all aspects of nurturing care supported by one sector.  Additionally, needs assessments often do not include all key questions related to young children and if some questions are included, it is often through one sector.  A multi-sectoral needs assessment for young children could ensure key data is collected.

Lastly, even when health and nutrition receive more funding than education many projects on the ground do not focus on the youngest children.  There is no mechanism with which implementing agencies and donors are forced to consider the needs of the youngest children.  Just as the Gender Marker has increased funding for programming focused on gender, an Age Marker that forces inclusion of support to young children is needed.

Promising Practices and Solutions

While there are many challenges, there are many promising practices and inexpensive solutions.  Here are some ways that young children are already being supported in humanitarian situations.

1.    Integrating parent support with education, nutrition, health and child protection activities.  Research says that if parents have the knowledge, skills and tools, they will be the best and most important teachers in a child’s life. 

2.    Bundling services together such as parenting and early stimulation with existing health care support.  Evidence suggests that bundling services into existing structures where additional staff are not needed is cost effective and scalable.

3.    Starting community-based, mobile or centre based early learning through play activities. Engage parents and children to make toys out of existing materials in their environment.

4.    Using the power of media combined with support for parents and children to spread key messages more widely.  Using puppets and videos as Sesame Workshop is doing in Jordan makes this fun.  Applications such as Vroom provide regular child development updates to parents on phones.

With a little bit of investment and re-framing of programmes, we can collectively make a huge impact.  We can ensure the youngest refugee and IDP children do not fall through the cracks.  Our investment today can result in success in school, better health outcomes and greater GDP for a country. It all starts in early childhood.

 

[i] UN OCHA, 2014

[ii] Lancet, 2016

[iii] Harvard University, Centre on the Developing Child, http://developingchild.harvard.edu/resources/five-numbers-to-remember-about-early-childhood-development/

[iv] Ibid.

[v] Gertler et al., 2014

[vi] Shonkoff et al, 2012

[vii] National Scientific Council on the Developing Children, 2007; Shonkoff et al., 2012

[viii] Harvard University, Center on the Developing Child, 2015

[ix] Lancet, 2016

[x] UNOCHA FTS 2016