An Integrated Community-based Home Visitors Program improves Early Childhood Development in West Bank, the Occupied Palestinian Territory
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World Health Organization’s Nurturing Care Framework highlights five components of nurturing care for early childhood development (ECD): responsive caregiving, security and safety, opportunities for early learning, good health and adequate nutrition. The Palestinian Authority (PA)’s National Strategy for ECD and Intervention recognizes these needs and the service gaps in West Bank, especially at community level, where young children and their caregivers are at increased risks for toxic stress due to protracted military occupation, poverty, violence and restricted movement. There is a need to adapt existing approaches to reach mother-infant dyads at risk. Since 2010, World Vision (WV) have collaborated with the PA Ministry of Health (PA-MoH) to train female community health workers (CHWs) to deliver timed, behavioural change communication on health and nutrition for the First 1000 Days to pregnant (PWs) and postpartum women through scheduled home visits. This community-based approach is known as Timed and Targeted Counseling (ttC). Cognizant of the unmet needs for nurturing care, from 2017-19, WV tested “Enhanced ttC” (EttC) which integrated ttC with capacity building in early childhood stimulation (ECS) for caregivers and psychosocial support to mothers. WV subject matter experts provided additional training to female CHWs, who delivered EttC during scheduled home visits to PWs until their infants’ first birthday. These CHWs were also trained to facilitate group sessions at the local clinic or community venues to reinforce caregiver capacity in ECS.