Promoting Nurturing Care for Early Childhood Development Through India’s Public Health System
Promoting Nurturing Care for Early Childhood Development Through India’s Public Health System
复制标题
通过印度的公共卫生系统促进儿童早期发展的培育护理
作者：
Deepti Agrawal;P. Chaudhary;Pawan Pathak
实施幼儿发展养育框架(NCF)基本上是多部门的，需要所有部门之间的协调，并将其和谐地纳入卫生部门现有的接触机会。本文讨论了通过公共卫生系统实施ECD养育性护理的相对优势、持续存在的差距、挑战和前进方向。由一线卫生工作者和卫生设施组成的庞大网络；以社区、家庭和中心为基础的服务提供；靠近社区的健康和健康中心，都有可能促进养育护理。持续存在的差距包括卫生工作者在养育护理领域的能力有限、社区对幼儿发展缺乏参与、转诊联系薄弱、无法接触到最脆弱的儿童、错过了及早识别处于危险中的儿童的机会以及对儿童发育迟缓和困难的早期干预。展望未来，将养育保健部分纳入基本服务包、提高卫生工作者的能力、与父母接触、建立跟踪处于危险中的儿童的机制以及由训练有素的服务提供者进行发育监测，可以为幼儿发展提供亟需的动力。
Implementing the nurturing care framework (NCF) for early childhood development (ECD) is essentially multisectoral, requiring coordination amongst all sectors and harmoniously integrating it within the existing contact opportunities in the health sector. This paper discusses the relative strengths, persisting gaps, challenges, and the way forward to implement nurturing care for ECD through the public health system. The vast network of frontline health workers and health facilities; community, home, and center-based service delivery; health and wellness centers located close to the communities have the potential to promote nurturing care. Persisting gaps include limited capacities of health workers in the nurturing care domains, lack of community engagement for ECD, weak referral linkages, inability to reach the most vulnerable children, missed opportunities for early identification of children at risk, and early intervention for children developmental delays and difficulties. Moving forward, incorporating nurturing care components into essential services packages, enhancing competencies of health workers, engaging with parents, establishing a mechanism for tracking children at risk, and developmental surveillance by trained service providers can provide the much-needed impetus to ECD.