Towards nurturing care: advancing early childhood development in 2018

  • 18th June 2018
  • 7 minute read

The launch of the Nurturing Care Framework at the World Health Assembly in May represents a critically important step in the continuing efforts to shine a spotlight on the needs of young children and families. Simply put, the call for nurturing care underscores the fact that young children need responsive caregiving, good health and nutrition, safety and security, and opportunities for early learning. The core elements of nurturing care build on what we have known for years about the nature of child development: that physical, social, emotional and cognitive development are integrated and indivisible, one domain of development influencing the other.

This year also marks the 20th anniversary of the first issue of Early Childhood Matters. In 1998, after publishing more than 80 editions of an in-house newsletter addressed solely to Foundation projects and staff, the Bernard van Leer Foundation published a more outwardly facing publication addressed primarily to the practitioners in the field of early childhood development (Van Gendt, 1998: 3–4).

Since the publication of that first issue, there have been significant advances in both our understanding of the science of child development and the importance of investing in the early years. While we now have much more information on ‘why’ early childhood matters, we are still seeking answers to the ‘how’. How can we assure ‘effective’ services and policies? – a theme that was discussed some two decades ago.

The key elements of good programming that were included in the very first article of Early Childhood Matters, by Judith Evans (1998: 8–11), have stood the test of time. In her article ‘Effectiveness: the state of the art’ she listed key principles to achieve maximum benefits. These included, among others: building on what exists, being flexible, developing programmes with families and with an understanding of the wider community, reflecting diversity, providing equity in access, assuring quality, and being cost-effective. Moreover, the article pointed out that effectiveness calls for a multidimensional approach that combines health, nutrition, education, and social actions. This same comprehensive strategy has been the hallmark of good programming from the establishment of Head Start in the 1960s to the recent launch of the Nurturing Care Framework. Now we have to move to bring these concepts to scale, particularly for the youngest children around the world.

Faced with this challenge, we focus this issue on the voices of leadership standing up for young children and families; highlight examples from countries around the world which are moving to scale services; include innovations and breakthrough solutions; and provide snapshots of some of the current issues that still must be addressed.


As we have said in the past, moving to scale does not just happen, it takes strong and decisive leadership. We are honoured to launch the 2018 issue of Early Childhood Matters with the views from great champions for young children.

The issue opens with an article by Juan Manuel Santos Calderón, President of Colombia and 2016 Nobel Peace Prize Laureate, whose commitment to young children and families is reflected in the groundbreaking initiative ‘De Cero a Siempre’. This initiative is a prime example of how a country can promote coordination and scale-up services throughout the early years. We then move to the Director-General of the World Health Organization, Tedros Adhanom Ghebreyesus, a critically important voice for young children. Dr Tedros reflects on nurturing care as a core element to improve child health and development. He reminds us of the rationale behind this focus on holistic development when he says: ‘children need nurturing care for their innate capacities to flourish’.

We complete this set of articles on leadership with two pressing and related issues: the humanitarian crisis facing children living in conflict, and the importance of violence prevention in the early years. David Miliband, President and CEO of the International Rescue Committee, and his colleagues from the IRC, Sarah Smith and Katie Murphy, provide insight into the tragedy unfolding around the world as children and families suffer from war and forced migration, and call for stepped-up efforts to address their needs as a key part of humanitarian response. Marta Santos Pais, United Nations Special Representative of the Secretary-General on Violence against Children, underscores the necessity of nurturing care in the early years and the critical role of violence prevention. Together these two articles remind us all of the links we must make between early childhood services and child protection. Keeping children safe and secure must start with the youngest children around the world.


Leadership leads to scaling. We begin this section with three articles that paint a picture of scaling efforts going on around the world. First we hear from Halim Antonio Girade who discusses ‘Criança Feliz’, the landmark effort to scale home visiting programmes in Brazil. From there we move to Bhutan, as Karma Gayleg describes efforts to blend child well-being and Gross National Happiness to promote holistic early childhood services with a focus on parenting. Moving to Africa, Katelin Gray, Matthew Frey and Debjeet Sen discuss PATH’s work to scale services that integrate nutrition and responsive parenting. All three of these articles reflect important efforts to promote nurturing care.

Moving back to Latin America, Cecilia Vaca Jones and Leonardo Yánez highlight the potential of the Nurturing Care Framework for the region. They remind us of the history and advances in Latin America as they underscore the significance of the current moment.

Along with these examples from a range of countries and different regions, we include four articles that reinforce the importance of both promoting new champions and building key elements of infrastructure so essential to effective implementation at scale. We start with Nana Taona Kuo, highlighting Every Women Every Child, a key mechanism for championing issues facing young children and families and their link to sustainable development. Turning then to research, Kate Milner, Pia Britto, Tarun Dua, Karlee Silver and Joy E. Lawn share the main lessons from Saving Brains to inform the policy process. We conclude this section with two related needs: for a well-supported workforce and continued financing. Michelle Neuman and Mark Roland share lessons learned about the early childhood workforce from scale-up in Peru, South Africa and the Ukraine. Christin McConnell provides insight into the emerging role of the Global Partnership for Education in promoting increased investments in the early years.


One of the most exciting aspects of the early childhood field today is not just witnessing efforts to scale services, but the continued focus on innovation and attempts to find breakthrough solutions. We include seven articles that illustrate the range of innovations emerging around the world to address both the changing conditions facing children and their ongoing needs. New ideas are particularly crucial in cases where there are pressing issues and new challenges facing families, and where the responses to those issues are just beginning to gain attention.

We highlight innovations in three such areas: supporting refugee and displaced families, supporting families with children with disabilities, and training for health workers to address maternal depression. Ghassan Issa, Lara Aoudeh, Cosette Maalouf and Youssef Hajjar describe a noteworthy model, the Health, Early Learning and Protection Parenting Programme (HEPPP), which is being implemented for refugees, internally displaced and marginalised host communities in the Arab region. Erica Salomone, Brian Reichow, Laura Pacione, Stephanie Shire, Andy Shih and Chiara Servili describe a new training package to support caregivers of children with disabilities. And Shamsa Zafar highlights the work in Pakistan to train health workers to address maternal depression at scale using technology.

We then turn to a new trend that we see emerging across the world as the focus moves from single programmes to an approach focusing on young children and families across multiple programmes in a community. Chris Cuthbert highlights A Better Start (ABS), a ten-year investment by the National Lottery into five economically disadvantaged communities in England. Next we move on to Patrin Watanatada’s description of Urban95, the groundbreaking Bernard van Leer Foundation initiative to put a focus on the needs of children under age 3 as part of urban planning across a number of cities around the world. Daniella Ben-Attar provides an illustration of such a planning process which is taking place in Tel Aviv. This section closes with an article by Jaap Seidell and Jutka Halberstadt, who remind us of the importance of early nutrition. An example of Amsterdam’s efforts to address this critical issue is highlighted separately after the article.

Short takes on current issues

In this final section, we address other pressing issues currently facing young children and families. These include the increasing challenge of pollution and its effects on child development, outlined by Philip J. Landrigan, and the critical imperative of clean water, sanitation and hygiene, highlighted by Amy Keegan.

Next up are two significant efforts to focus on childcare for working families around the world, a topic that needs much more attention. Carmen Niethammer and Roshika Singh talk about ‘moving the needle’ on employer-supported childcare and Rachel Moussié highlights the work of Women in Informal Employment: Globalizing and Organizing (WIEGO). This important organisation focuses on securing livelihoods for the working poor, especially women in the informal economy. Her article shines a spotlight on the childcare needs of this major segment of the workforce.

Turning towards the issue of assessment, which continues to be discussed in the field, Sara Poehlman, Amy Jo Dowd and Lauren Pisani describe IDELA, one instrument being used to change policy and practice. The last article moves us into the future. Sonja Giese describes the Think Future Conference and the efforts of Innovation Edge to break new ground and move us towards the next phase of innovation.

As we conclude this issue of Early Childhood Matters, reflecting back over the past 20 years since the first was published in 1998, we see both progress and challenges. If we look across the world we see a tapestry of support emerging for young children and families. Yet there is so much more to do to make sure all young children grow up with nurturing care and an environment of support for their families. While the challenges ahead remain daunting, hope is in the air.

References can be found in the PDF version of the article.

Joan Lombardi Guest editor, Early Childhood Matters
Topics Integrated services Leadership

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