Situational Analysis of Early Childhood Care and Development Services in Ghana

• In Event: Promoting Nurturing Care to Improve Early Childhood Development through Health and Nutrition Services

Proposal

Background: Ghana has made strong political commitments to improve children’s development, including a multi-sectoral Early Childhood Care and Development (ECCD) Policy launched in 2004. Nevertheless, 45 percent of children in Ghana are at risk of not meeting their developmental potential. USAID Advancing Nutrition conducted a mixed methods study in 2021 to identify opportunities for promoting optimal development in early childhood, especially between conception and three years of age, through the health and social welfare sectors.

Methods: The mixed-methods study spanned three regions (Upper East, Eastern, and North East), with one district per region sampled based on maternal and child health indictors to include a mix of high and low performing districts. The assessment aimed to understand the status of current support for ECCD through these sectors and workforce competencies, and to identify opportunities to strengthen services through focus groups and interviews with caregivers, health workers, social welfare workers, and district government stakeholders. In addition, we conducted observations at health and social welfare points of service. The study included participants from various levels of the district health system, from the community to hospitals. Last, health and social welfare workers completed a quantitative competency assessment of their knowledge, skills, and practices related to ECCD.

Results: In total, we completed 70 key informant interviews, 26 observations, and 316 competency assessments from July to September 2021. This study indicated a positive landscape for strengthening support for ECD through the health and social welfare sectors. Features of that landscape include (1) the existence of relevant national tools, and (2) the willingness of health and social welfare workers and district-level stakeholders to do more to support children’s development. This includes strengthening services for all children through improved counseling and child-friendly spaces, and specifically for children with disabilities and supporting caregivers’ mental health. Further support is needed to fill gaps in knowledge and skills through workforce development strategies, as on average both health workers and social workers answered less than half (44 percent) the questions correctly on the knowledge assessment. Last, the government can improve accountability for ECCD through the integration of ECCD indicators in national information systems.

Conclusion: There are existing efforts to support ECD in both the health and social welfare sectors that can be strengthened to provide a more holistic approach to supporting caregivers and their young children. It is important to consider sustainability, including data monitoring approaches, as well as much- needed systemic investments in the workforce.

Author

• Kelsey Torres, USAID Advancing Nutrition