Comparative and International Education Society

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• Comparative and International Education Society

Supporting healthy development and learning
capacity of 0 3 year old children in
emergencies and crisisApplications for
community based child care in AIDS affected
communities of Malawi March 18, 2008
March 18, 2008
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In emergencies and crisis 3 extraordinary threats

• Stress
• Feeding and Nutrition
• Safety

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Stress in emergencies can be toxic and have long
term consequences

• TOXIC STRESS
• Extreme events
• Prolonged activation
• Repetition

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Managing childrens stress responses in
emergencies

• Interventions can reduce the probability of long
  term negative impacts
• Presence of supportive adults who can help
  children cope and recover
• How to best ensure this?
• Prioritize breastfeeding for as long and as
  intensively as possible
• Prioritize young childrens proximity to those
  with whom they have loving caring relationships
• Inform parents and other caregivers of
• The impacts of stress on childrens development
• The roles they play in childrens management of
  stress
• Train parents and other caregivers in stress
  management

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Breastfeeding, active feeding

• Breastfeeding
• stress reduction
• food security
• Active feeding
• stunting, food competition, need for training
• stress, relationships
• stimulation
• Micronutrients, parasites
• iodine, vitamin A, iron
• deworming
• Immunizations and IMCI assumed

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Feeding and Nutrition

• Long term impacts of mal or undernutrition
• Lifelong impairment and disability
• Combination of malnutrition and psychosocial
  challenges can be devastating
• vicious cycle, but
• Also opportunity

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Safety and Protection

• Fires
• Guns
• Violence
• Landmines
• Protection can offer Opportunity
• boundaries, routines improve safety
• reassure children, lower stress
• routinize food and feeding

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Application to Community Based Child Care in
Malawi

• AIDS Crisis Parallels with Emergencies
• Severe, prolonged
• Disruptive of relationships and routines
• May challenge food security

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Special considerations for Centers and 0 3 year
olds

• Ensure physical safety for youngest children
• Foster predictable routines
• Protect and promote breastfeeding with special
  attention to exclusivity and other features that
  minimize HIV transmission
• Promote active feeding and provide nutrition
  education
• Show as well as tell what to do with young
  children
• Include caregivers and reinforce bonds
• Include older siblings if they are caregivers
  (being mindful not to take them out of school)