Early Childhood Care & Development: Health Care & Learning

Every child has the right to optimal cognitive, social and emotional development. Notably, early childhood is more than a preparatory stage assisting the child’s transition to formal schooling; it has been recognized as the critical period for comprehensive development taking into account the child’s social, emotional, cognitive and physical needs, so as to establish a solid and broad foundation for lifelong learning and wellbeing. If the child is not given adequate support and stimulation to aid this development, he or she is at risk of being prejudiced in reaching their full potential. It is therefore crucial for a society, and a nation, to invest in this period of a person’s life – particularly for a country like India, where over 40% of the population is below the age of 20, and 13% below the age of 6.* Thus, Early Childhood Care and Education (ECCE) refers to an integrated approach combining nutrition, health and education for the holistic development of a child below the age of 6-8 years.

The Indian Child Abuse Neglect & Child Labour (ICANCL) group, Institute of Home Economics, Delhi University and BUDS as partner organization organized a one-day expert group consultation to bring together a convergence of stakeholders working on the issue of ECCE. The participants included doctors, including representatives of governmental ministries and Non-Government Organisations (NGOs) as well as academics and students.

Recommendations to the Government

  • Comprehensive ECCE is possible if it includes the medical, health, developmental needs, education and early stimulation of the young child during infancy and preschool years. The approach has to be holistic.
  • As for health, the facts are well known and it is distressing that those who cannot afford treatment, shy away from spending money on primary health care. This has to be addressed on an urgent basis.
  • The government is trying to reduce out-of-pocket expense on health care, and while this is necessary, it is necessary to make a push for the right to health for all children to be made a part of the government’s obligations.
  • Budget for children is also being reduced. This is very worrisome as studies are indicating that for every Rs.1 spent on ECCE, there is a return of Rs. 25. Investigating in early years is the foundation of any strong nation.
  • Much information is available and this must be translated into practice. The Anganwadi centres must be transformed into genuine one-stop centres providing comprehensive health care and learning for children. Also, the centres have to be made inclusive across socioeconomic strata as well as with respect to disabilities and other disadvantages.
  • Strengthen the ECCE profession by working on the curriculum, training of early educators, access to quality preschools, and childhood free from violence and abuse.
  • The government must come out with a policy to regulate play schools centres that provide ECCE.
  • There is an opportunity at the Delhi level to look at a Delhi-centric mapping, assessment and outreach and this is practically feasible. We can look at gap areas and concerns that need to be addressed.
  • There is a felt need for training across the board – from Anganwadi and ASHA workers to government doctors as well as those in policy-making positions, so as to ensure that they understand the parameters of good ECCE.

Recommendations to the Medical Community

  • Paediatricians tend to worry more about physical health rather than overall early stimulation and this is missing from the paediatrics curriculum, and this needs to be addressed. To start, the IAP can form an advisory group to encourage paediatricians to provide anticipatory guidance to parents
  • IAP can also have an advocacy document on right to health and learning for early childhood.
  • The IAP must also take the initiative to identify some innovators from other sectors and make first connections so as to foster convergence.

Recommendations to the Civil Society

  • More components of ECCE must be included in academic discourse.
  • There is a case to be made for the need to look for convergence across issues, or instance to find connections between government policy which may even inadvertently lead to the exclusion of certain categories of persons, and tie these in with broad-based advocacy on ECCE.


All India Institute of Medical Sciences, November 18, 2016

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*Census of India 2011, www.censusindia.gov.in