How can integrated, multi-sectoral ECD programming support positive changes in caregiver behaviour that result in improved development outcomes for children aged pre-natal to 3 years old?

Group Submission Type: Pre-conference Workshop

Proposal

Purpose of workshop: Exploring behaviour change theory, participants will be able to better integrate behaviour change approaches in integrated multisectoral programming (linking directly to the NCF) for caregivers with children aged pre-natal to age 3.

Early experiences have a profound impact on children’s development. The experiences children have in their foundational years (prenatal-3y.o) have a lasting effect on learning, health, behaviour and ultimately, adult social relationships, wellbeing and earnings. In low- and middle-income countries, extreme poverty means an estimated 250 million (or 43%) under-5s are at risk of suboptimal development and stunted growth.

Until recently, ECD has been neglected by international donors and governments, and despite the evidence base, gaps in knowledge, a lack of interest from decision markers, and ministerial department siloes have resulted in fragmented practices and policy, which address child health, nutrition, education and protection separately and fail to respond to children’s needs as a whole.

In 2018 at the Global Health Assembly, the Nurturing Care Framework (NCF) was launched, providing a transformative roadmap that focuses on an integrated, multi-sectoral approach covering all 5 components of ECD (health, nutrition, responsive caregiving, security and safety, and early learning).

But, improvements in child development outcomes can only be achieved when caregivers change their behaviour. In many programmes interventions ‘control’ the training provided to caregivers, but can only ‘influence’ caregivers to change their behaviour, this reliance on caregivers as change agents highlights the critical importance of incorporating behaviour change methodologies in parenting programmes.

Social learning theory explains how people learn new behaviours, values and attitudes. Social learning requires observing the desired action, remembering the behaviour observed, the ability to replicate the behaviour, and a motivation to act in the same way. The WHO takes this further and identifies specific determinants like self-efficacy, perceived risk and consequences, emotions, social norms, knowledge and intention. Hence, although knowledge of optimal behaviour is important, behaviour change does not result from generating improved knowledge alone. Instead, an approach that identifies prevalent determinants and norms to a specific context and addresses these with a bespoke and comprehensive approach that measures impact is needed. This can be through using the ABCDE approach to behavioural change:
• Assess what is known about the target behaviours and environment
• Build a comprehensive social behaviour change (SBC) strategy based on research assessment findings
• Create a SBC strategy which describes the approaches to be used and identifies how these will be measured for impact.
• Deliver the interventions, making adaptations when needed, documenting and sharing successes, challenges, lessons and recommendations.
• Evaluate for effectiveness and impact.

The proposed workshop will apply this ABCDE approach to integrated multi-sectoral ECD programming.

Learning Objectives for the workshop:
1. Understand what integrated multisectoral programming is and the importance of behavioural change in caregivers
2. Using formative research, assess drivers and barriers to behaviour change including key determinants
3. Build and create SBC strategy that links to an integrated multisectoral model and considers an iterative approach
4. Consider the service delivery platform for delivery of SBC strategy
5. Discuss MEAL frameworks to measure and evaluate behaviour change of caregivers

Sub Unit

• General Pool

Workshop Organizers

• Chrystal Holt, Save the Children UK

• Holly-Jane Howell, Save the Children