UNITED NATIONS CONVENTION ON THE RIGHTS OF THE CHILD
Article 6 (Survival and development): Children have the right to live. Governments should ensure that children survive and develop healthily
Is it enough to be alive and to survive? Or it is as important, or perhaps more important to develop your faculties to the fullest, enjoy a reasonable state of health and education, strive and contribute to nation development. Survival alone is not enough. It is the quality of life that is important.
Living is a process, the end of which is not just survival, but physical, mental and social well-being. Thus, child survival can be defined more positively, being thought of as something more than simply avoiding death. Surviving children fall along a continuum running from near death through sickness to a healthy state. The further a child is along that continuum towards a healthy state, the better the chances are of continued survival. The process of surviving, then, can be thought of as actively seeking a healthy state, of moving towards the healthy end of the death-sickness-health spectrum rather than simply preventing or arresting the process of dying (Myers 1992).
Accepting this positive reconceptualisation of child survival—as a process of seeking a healthy state at birth and in the early months and years of life—requires looking beyond the analysis of causes of mortality and beyond programmes that reduce mortality. It means examining where children are along a health-growth-development continuum. It means searching for programmes that will improve their health. This requires clarity about what, in a positive sense, constitutes moving towards a healthy state which necessarily include seeking mental and social health as well as physical well-being for young children (Myers 1992).
3.1 Salience of Early Childhood Years
Early childhood sets the foundation for life. What happens—or does not happen—to children in the earliest years of their lives is of critical importance, both to their immediate well-being and to their future. Ensuring that young children have positive experiences and their needs for health, nutrition and stimulation are met is crucial for their development and well-being. If the child has received the best start in the earliest years of life, she is more likely to have grown healthy, developed language and learning capacities, gone to school and led a productive, rewarding life.
Research in the field of neuroscience, particularly on the brain, has provided very convincing evidence of the ‘critical periods’ located within these early years, particularly the first 3 years, for the formation of synaptic connections in the brain and for the full development of the brain’s potential. Research has also indicated that if these early years are not supported by, or embedded in, a stimulating and enriching physical and psychosocial environment, the chances of the child’s brain developing to its full potential are considerably, and often irreversibly, reduced. What follows logically is the crucial importance of investing in these early years to ensure an enabling environment for every child, and thereby a sound foundation for life, which is not only the right of every child but also something that will impact, in the long term, on the quality of human capital available to a country (National Council of Educational Research and Training 2006).
Brain architecture is constructed through an ongoing process that begins before birth and continues into adulthood. It is impossible to say that a certain percentage of brain development occurs before a certain age—it is not that simple. It is true that the early years are the most active period for establishing the neural connections that comprise our brain architecture—700 new connections form every second in the first 3 years of life. As it emerges, the quality of that architecture establishes either a sturdy or a fragile foundation for all the capabilities and behaviour that follow. Skill begets skill as brains are built in a hierarchical fashion, from the bottom up. Increasingly complex circuits and skills build on simpler circuits and skills over time. The interaction of genes and experience shapes the circuitry of the developing brain. Young children serve up frequent invitations to engage with adults, who are either responsive or unresponsive to their needs. This ‘serve and return’ process is fundamental to the wiring of the brain, especially in the early years. Although manageable levels of stress are normative and growth-promoting, toxic stress in the early years can damage developing brain architecture and lead to problems in learning and behaviour, as well as increased susceptibility to physical and mental illness. Precipitants of toxic stress may include severe poverty, serious parental mental health impairments, child maltreatment and/or exposure to violence, in the absence of stable, nurturing relationships with the adults in a child’s life (developingchild.harvard.edu/ retrieved 10 March 2014).
Early childhood is quoted by some as between birth and 6 years of age and by others between birth and 8 years (also includes early primary years along with pre-primary years). This period of life is characterised by most rapid growth and some of the most significant achievements—including talking, walking, forming attachments, encountering fear and pleasure and discovering oneself and the world beyond home. During this time, children learn to be autonomous and experiment with objects in the surrounding environment. They show a lively curiosity at what is going on around them, enjoy the company of other children and seek to imitate adult behaviour. At this stage, children play all the time. Play provides opportunities for the body to grow and chance to reflect, empathise, emote, discover, count, acquire self discipline, communicate and socialise. Play fosters creativity and develops higher order intellectual structures.
Early years are the golden years of learning and are also called as ‘windows of opportunity’. Very young infants need stimulation and active interactive initiatives from adults in their environment to develop their faculties. Early years are critical for the development of brain of the child. Most brain development happens before a child reaches 36 months of age. By 36 months of age, children develop their abilities to think and speak, learn and reason and lay the foundation for their values and social behaviour as adults. Factors such as adequate nutrition, good health, freedom from diseases, clean water and a safe environment free from violence, abuse, exploitation and discrimination, all contribute to how the child grows and develops.
Early childhood is a period in life when the individual is particularly open to new experiences and especially able to take advantage of them. When children do not get the care they need during developmental prime times, or if they experience starvation, abuse or neglect, their survival, growth and development may be compromised. Early care and nurture have a decisive and lasting impact on how children grow to adulthood and how they develop their ability to learn and their capacity to regulate their emotions. The love, care and nurturance children receive in their first years—or the lack of these critical experiences—leave lasting imprints on young minds, hence underscoring the importance of early years in determining the life of an individual.
When the key ingredients for healthy, positive development are not present, the early years become a time of vulnerability rather than promise. Persistent environmental stress from unstable housing, an absence of adequate nutrition and high parental stress, coupled with few opportunities for rich early learning experiences, can be toxic to early brain development. Children with risk factors, such as living in low-income households, abuse or neglect, prenatal exposure to alcohol or other substances and low parental education, have a higher incidence of developmental delays and disabilities than the general population. Disparities emerge as early as 9 months and widen by 24 months of age (Halle et al. 2009). Divergence in language abilities begins to emerge before a child’s first birthday and widens by age 3 (Hart and Risley 1995). Infants and toddlers who experience or are at risk for maltreatment are most vulnerable. More than half of children under age 2 who have any contact with the child welfare system—regardless of substantiation of abuse or neglect—are considered at high risk for developmental delays or neurological impairment (U.S. Department of Health and Human Services 2007).
In this context, it is important to consider if children in India are having a stimulating and enriching early childhood experience or is the childhood in India embedded in deprivation, distress and disease.
3.2 Early Childhood Development
Arguments in favour of providing enriched opportunities for Early Childhood Development (ECD) are varied and numerous. They range from the economic argument of greater productivity, and the ethical argument of the right to live and develop potential to the fullest, to the social argument of greater equality between classes and sexes, to the scientific argument of greater intelligence and more balanced social behaviour and to the political argument of greater participation in society. The CRC focuses on four sets of rights—survival, development, protection and participation. By and large, all these rights are interdependent and cannot be dealt in isolation. They have to be applied and implemented simultaneously if at all the rights of every child are to be respected. ECCE is a child’s right. It is a major contributor to the survival, growth and development of children. Building on the CRC, the World Declaration on ‘Education for All’ was adopted at Jomtien, Thailand, in 1990. It highlights that ‘learning begins at birth’ and encourages providing for ECCE. Children being naive and young cannot take action on their own, they have to be dependent on the actions of others for realising their rights.
The question in point is what are the programmes which would foster early childhood development?
It has been demonstrated that the most effective programmes are those which ‘integrate’ health, education, nutrition, social and economic development, and that younger children benefit from such interventions more than older children. The latest research on the relationship between health, nutrition and stimulation argues convincingly that an adequate food supply is not enough to ensure a child’s survival, neither is access to micro-nutrients, neither is education, nor absence of disease. Children’s growth and development is fostered when all these variables are present, within a caring environment.
UNICEF Model of Care
(Source Engle et al. 1997)
The UNICEF model for care which presents the determinants of child survival and development can now be examined in the context of the above discussion. It draws a direct relationship between survival, growth and development of children with the care of the infant and the mother. Further it points to a give and take between dietary intake and health of children. Causal relationship between community resources, health environment and education and the impact of economic resources and political ideology is also drawn.
There is an intricate and implicit relationship between the quality and nature of care received by the pregnant mother, infant and the young child and the chances of survival and proper development of the child. When the practices are examined, these day to day activities which look quite simple can make the life of the child.
Initiate breast feeding within 1 h of birth
Exclusively breast feed till 6 months
Do not give pre-lacteals (Say, giving honey to the baby immediately after birth)
Give colostrum to the new born
Introduce complementary feeding at 6 months
Increase breast feeding when sick
Give one seasonal fruit/vegetable daily.
Clean the baby soon after s/he passes stool
Wash hands before feeding
Teach children to wash hands before and after eating food
Children to wash hands with soap after defecating
Take bath daily, cut nails regularly
Keeping surroundings clean
Drinking clean water
Wash fruits before eating and wash vegetables before eating/cooking
Keeping food and water covered.
Look at infant/make eye contact while breast feeding
Touch, caress, stroke the baby
Play with child, and allow child to play
Point out objects in the child’s environment
Talk to the child
Massage the infant
Answer child’s questions.
Weigh infant once a month till she is 3 months of age and every 3 months subsequently
Immunise infants and children
If high fever, keep wet cloth on child’s fore head to bring down temperature
Give more liquids during diarrhoea
Regular health check up.
It is obvious that the care of children directly affects the infant health and well-being. Good feeding practices, immunisation and clean environment all impact the infant. Further, provision of childcare and health services is paramount to the child’s health. These services are directly impacted by the government of that time and its concern for children, i.e. its political ideology and programmes. Education opportunities and the resources allocated for it are a decision which the political bosses take. How safe the children are is also affected by the laws, which are enacted by the government. So, the infant survival, growth and development are not a product of the immediate family, but is affected by the society, government and other forces around the child.
Early childhood development approach are a range of activities and commitment on part of the parents, family, community and nation with an aim of providing a healthy physical, social, emotional and stimulating environment to children in very early years of life. It enables them to blossom and realise their best potential, laying a strong foundation for them to grow as a useful member of the family and the society, and a valuable human resource for the country.
ECD activities generally cover children between birth to the time that they join a formal school, which is normally 6 years. It also includes care of pregnant woman, because safe prenatal beginnings are the first sure steps towards healthy newborns. ECD also includes improving community awareness on infant care, mother care and childcare. Thus, ECD programmes include:
Early stimulation and care of 0–2-year-old infants and toddlers at home, in crèches and in balwadis.
Preschool education for 3–6 year olds fostering development of body, intellect, social-emotional skills and language and communication abilities.
Care of pregnant women in the family and community.
Parent education and improving awareness in community on positive childcare practices (Chopra n.d.).
As mentioned, Early Childhood Development includes infant care. Although developmentally most critical, the under-3 age group is the most neglected age group. Infant care includes infant feeding, weaning, immunisation, health and nutrition care, psychosocial care and protection from diseases among others. ECD also encompasses preschool education. In the preschool programme, children learn through manipulating objects and learn by doing. They acquire the concept of shapes, sizes, numbers, space and relationships. Their body grows and muscles strengthen. The finger muscles also gain strength which help them to colour, scribble and then write. Preschool experience provides tremendous developmental opportunities to young children and also lays the foundation for the rigours of formal schooling. Good quality ECD programmes necessarily address both care and education of children. Pregnant women, families and communities are also part of ECD as their skills and knowledge about safe motherhood and childcare practices determines what the children will receive from them.
The ECCE programme should ensure ‘holistic development’ of the child and reflect the inseparable nature of care and education by comprehensively addressing the need for care, nutrition, health and well-being of young children and parent counselling along with supporting the development of all domains.
Objectives and Components of ECCE
The general objective of Early Childhood Care and Education is to facilitate optimum development of the child’s full potential and lay the foundation for all round development and lifelong learning. ECCE compensates for environmental deprivations that children face in the early years. ECCE experiences are to be provided to ALL children, including the children with disabilities, who have a right to equitable opportunities. The specific objectives of ECCE are:
Establish a sound foundation for a good physique, adequate muscular coordination and basic motor skills.
Imbibe good health habits and independence.
Enhance language and communication skills: improve vocabulary and expression of thoughts and feelings in fluent, correct, clear speech.
Develop the five senses and cognitive skills and concepts which are foundation for higher order thinking and reasoning.
Provide opportunities for play, active exploration, investigation and experimentation.
Develop emotional maturity by guiding the child to express, understand, accept and control feelings and emotions.
Develop independence, aesthetic appreciation and creativity by providing child with sufficient opportunities for self-expression.
Make a smooth transition from preschool to primary through development of emergent literacy and school readiness.
As mentioned, ECCE focuses on programmes for children between birth and 6 years. But is a 1-month-old infant same as a 4-years old? The answer off course, is NO! As the infant and the preschooler are developmentally different, the related programmes for children of these age groups also have to be different.
Components of the programme for 0–3 years olds
People everywhere feel that the care of the infant is the responsibility of the parents and is naturally happening. This kind of expectation is not really wrong as that is how it should be. But in poor families or where mothers are working with tenuous childcare arrangements in her absence, families may not be able to take adequate care of the infants. In such a case, it becomes important on the part of the state to assume the responsibility of childcare and have alternative childcare programmes. The broad objectives and components of ECCE programme for 0–3 years olds are as follows:
Adopt age appropriate feeding practices, that is, start breast feeding within 1 h of birth, exclusive breast feeding till 6 months and continue to breast feed till 2 years. Introduction of complementary feeding at 6 months and making available nutritious and balanced food to the child;
Monitor the growth of the child, identifying malnourished children and providing them necessary help;
Keep the surroundings and the child clean;
Immunise the child against vaccine preventable diseases;
Protect the child from physical dangers and accidents;
Interact with infants, nurture them and provide warmth and psychosocial care;
Provide for ample sleep and rest;
Talk and play with the child and give opportunities to explore and discover;
Provide crèche services, especially if the parents are working;
Strengthen the knowledge and skills of parents and community on better infant and childcare practices and beliefs.
Components of programme for 3–6 years olds
The broad objectives and components of programme for 3–6 years olds include the following:
Ensure that 3–6 years old children are attending a preschool;
Provide proper nutrition and health care;
Provide opportunities for the child to develop good physique and muscular coordination;
Provide opportunities to play, as play gives unlimited possibilities to learn about the world and the people;
Give them a suitable environment where children can socialise and interact with peers;
Enable them to develop desirable habits, discipline and self help skills;
Foster cognitive development and encourage intellectual curiosity and creativity;
Encourage language and communication skills;
Provide an environment where the child is allowed to express, understand and control emotions;
Offer daycare facilities for children who have working parents;
Strengthen parents and communities through regular contact with them by organising community meetings, bal melas etc;
Lay the foundation for formal schooling through improved concentration, physical and emotional independence, alert mind, fit body and a desire to learn.
Young children with different abilities should also be reached by ECCE. Children with disabilities should be a part of the AWC’s attending the preschool programme. Inclusion of children with disabilities at such an early age would lay the foundation for lifelong inclusion, develop social and communication skills in children and develop acceptance of diversity. With minor adaptations, it is possible for children with disabilities to be a part of the preschool programme of AWC. Legally also, it is unlawful to deny admission to any child on the basis of a disability.
Early Childhood Education: Basic Activity Ideas
For development of the physique: running, jumping, skipping, climbing, throwing—catching ball, skipping, dancing, jumping on the spot, swimming, etc.
Small muscle coordination: scribbling, colouring, tracing, sketching, pasting, sorting of pebbles/beads, buttoning, paper folding, playing with clay and plasticine, etc.
For language and communication: listening to stories, free conversation, making up stories, role play, riddles, free play.
For cognitive development: recognising colours, shapes, counting, learning about things in ones surroundings, information about vegetables, fruits, animals, people who constitute society (family, teacher, tailor, farmer, cobbler, police, shop keeper, etc.)
Social-emotional: playing group games, interacting with peer mates, role play, waiting for turn, sharing play things/food, learning rules of fair play, learning not to hit friends, saying please/sorry, learning to manage independently while away to preschool, etc.
3.3 Status of Early Childhood Care and Education Services in India
There are 1.18 million anganwadi centres in the country catering to 346 lakh preschool children (Sheeranjan and Awathi 2010).
Integrated Child Development Services (ICDS) has 1.18 million AWCs. But these centres have no provision of crèches for the 0–3 age group, nor are daycare facilities included for 0–6 years old children of working mothers. ICDS leaves the care of under 3’s largely with the family.
Census 2001 declares that there are 120 million working mothers, 90 % of whom work in the unorganised sector. As per current estimates, 60 million children under 3 are in need of crèches. Crèches are needed at work places to facilitate continued breast feeding, complementary feeding, to provide a safe environment and to cater to the psychosocial and learning needs of under 3’s.
The Rajiv Gandhi Crèche Scheme has sanctioned 22,038 crèches for children of working mothers as against a requirement of 800,000. This programme covers only 0.55 million children in the age group 0–5 years.
District Primary Education Programme (DPEP) has opened 10,000 ECE centres in non-ICDS areas.
Sarv Shiksha Abhiyan: 73,860 ECCE centres and 254,179 schools have pre-primary wing (Sheeranjan and Awathi 2010).
It is estimated that the private sector provides preschool education services to more children than the ICDS. The quality of services provided by privately run preschools needs to be regulated as there is a wide variability in services provided by them. NGO services for ECCE are reaching to a varying number from 3 to 20 million (National Council of Educational Research and Training 2006).
3.4 ECCE as Per Costitution and the Legal Framework
As per the Constitution of India, Article 45 ‘The State shall endeavour to provide ECCE for all children until they complete the age of 6 years’.
Though the Right to Education Act, 2009 is for children of age 6–14 years, Section 11 pertains to ECCE ‘With a view to prepare children above the age of 3 years for elementary education and to provide ECCE for all children until they complete the age of 6 years, the appropriate government may take necessary arrangement for providing free pre-primary education for such children’.
The National Early Childhood Care and Education (ECCE) Policy, 2013 reaffirms the commitment of the Government of India to provide integrated services for holistic development of all children, along the continuum, from the prenatal period to 6 years of age. The Policy lays down the way forward for a comprehensive approach towards ensuring a sound foundation, with focus on early learning for every Indian child.
3.5 Linking Early Childhood Care with Child Protection
Unarguably, early childhood constitutes the most vulnerable stage of life. Deprivation and neglect in this stage can lead to development retardation. ECCE has mostly been linked to ‘right to development’. But when we examine closely, ECCE contributes clearly to child protection. Proper care in early years reduces neglect. A child who in the absence of parents (due to jobs or otherwise incapacity to care), is in the safe environments of a ECCE programme, is protected from abuse of many forms which could arise due to violence by known persons, neighbours or strangers. With joint families breaking and families migrating to bigger cities for livelihood, both parents working, this is posing a threat to children. Child abuse by relatives and neighbours is on the rise. Home is at times, not the safest haven. The relationship of ECCE with child protection cannot be ignored.