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HLTC23H3 Study Guide - Africare, European Route E20, Arrow Lakes

Health Studies
Course Code
Jason Ramsay

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HLTB02 Reading Notes 2011
January 10 and 17/2011
Irwin, L.G., Siddiqi, A., & Hertzman, C. (2007). Early child development: A powerful equalizer. World
Health Organization Commission on the Social Determinants of Health. P 1-25
early childhood as the period from prenatal development to eight years of age
early child development (ECD) sets a critical foundation for a childs entire life because it influences
basic learning, school success, economic participation, social citizenry, and health
ECD is due to social determinants of health and the governments must invest in it, acting equally to
help families nurture their kids in proper environments globally
Poor ECD leads to higher risk of many health implications and diseases as adults
ECD includes: physical, social/emotional and language/cognitive domains
The more stimulating the early environment (social interaction), the more positive connections are
formed in the brain and the better the child thrives in all aspects of his or her life, in terms of physical
development, emotional and social development, and the ability to express themselves and acquire
Family friendly” policies guarantee adequate income for all, maternity benefits, financial support for the
ultra-poor, and allow parents and caregivers to effectively balance their time spent at home and work.
ECD is a predictor of adult gender inequity in all domains
The environmental conditions to which children are exposed including the quality of relationships and
language environment in the earliest years literally sculpt the developing brain.
Socioeconomic inequities in developmental outcomes result from inequities in the degree to which the
experiences and environmental conditions for children are nurturant. Thus, all recommendations for
action stem from one overarching goal: to improve the nurturant qualities of the experiences children
have in the environments where they grow up, live, and learn.
transactional model = child is a social actor who shapes and is in turn shaped by his or her
environment = principal driving force of child development is relationships
Family environment most important for ECD, social factors in a family include parenting skills,
education and health while economic factors include wealth, occupational status and dwelling condit.
Residential community (where a family lives / pop.) along with relational communities (the people,
adults and children, who help form a childs social identity) also play a role in ECD
National environment affects multiple determinants of ECD through wealth creation, public
spending, child- and family-friendly policies, social protection, and protection of basic rights
A major feature of the global environment in relation to childrens well-being is the element of power in
economic, social, and political terms.
Civil society groups are instrumental in organizing strategies at the local level to provide families and
children with effective delivery of ECD services, to improve the safety, cohesion, and efficacy of
residential environments, and to increase the capacity of local and relational communities to better the
lives of children
the agenda to improve child survival and health is indivisible from the agenda to improve ECD
Governments should meet the Millennium Development Goals (MDG) for poverty reduction, education
and health
Societies with the most successful policies and programmes for ECD spend approximately 1.5%–2.0%
of gdp per year on it
Equity based approach = provide nurturant environment for all children
Gradient-effect = This step-wise relationship between socioeconomic conditions and ecd ( higher SES,
better ECD)

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The purpose of this document is to synthesize knowledge to inform the CSDH about opportunities to
improve action on a global scale in the area of ECD
The Total Environment Assessment Model of Early Child Development (TEAM-ECD) has been
developed for the CSDH as a means of framing the types of environments (and therefore experiences)
that are integral to healthy ECD, and linking these to the biological processes with which they interact to
shape childrens outcomes.
The Individual Child
ECD has strong links to other social determinants of health, particularly Urban Settings, Gender,
Globalization and Health Systems
The Total Environment Assessment Model of Early Child Development (TEAM-ECD) has been
developed as a means of framing the types of environments children are exposed to
Early life brain development and environment are crucial for a baby, attachment, nutrition (from utero
and breastfeeding) and biological embeddedness (interaction of genes and environment) also play a
Early years, sensitive areas” of brain start to develop, particularly the central nervous system
Brofenbrenner = developing brain and enviro. Is the driving force of development
Malnutrition = one of the worst detriments in a childs life and development
150 million children under the age of 5 in developing world suffer from malnourishment
Education of women/mothers will benefit the child, improving survival rates and school attendance
Malnutrition = complex mix of all factors/determinants of health (education, ECD, food security etc)
which begin in utero, affect physical and mental health
Support from community for malnutritious families equally important
Role of child play = key in ECD, universal to all cultures, its processes influence synaptic formation and
are linked to secure attachment with caregivers and relationships with other children
Stimulation (mothers and children playing with home-made toys with a focus on guided learning and
exploration) has an effect on perceptual motor development outcomes among stunted children
The Family
Primary influence on child dev.
Fundamental group and the natural enviro.
Salient features of family environment: social (eg. education) and economic (wealth) resources
Secure relationships and attachment to trusted caregiver, with consistent caring and affection = IMP
Exploration in environment = self confidence in child, master and control environment
Negative biological and environment factors for attachment: low birth weight, malnutrition, poverty,
violence, maternal depression, low support from families
Gradient effect of family resources/ SES on ECD = critical factor
Family health conditions have a strong impact on ECD: chronic problem, partner violence, maternal
depression, extreme poverty, family stress all lead to impaired child-parent relationships
Prevalence of HIV greatly effect CD, contact it from mother, become orphans
Fathers role very important, must be equal responsibility b/w mother and father
Lack of control of women - gender inequality , lead women to get less wealth and food, be denied health
services and proper education
Gender equity at the family level contributes in reducing poverty
Girls kept at home to care for siblings = no education
Family dwellings need to be clean and healthy (no pollution, harsh temperatures, overcrowding) to
nurture healthy ECD
Families need to have support in accessing resources that enable them to make choices in th best
interest of their children , such as parenting skills, proper and affordable childcare, education, health
Despite lack of resources, resilience (capacity of a child to thrive, despite adversity) creates nurturant
environments and social relationships

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Improving resilience = access to services, sufficient income, social protection policies
Residential and Relational Community
Residential community = where the child and family live, include SES, physical and service enviro.
High SES better school readiness, and school achievement
Creating economically mixed neighbourhoods = key
Physical characteristics : the integration of proper water, crowding, housing and space = allow play to
occur and increase proper ECD
Service characteristics: institutions and facilities for learning and recreation, childcare, medical facilities
Increase number of children living in slums and shanty-towns
Relational community = based on social ties among networks of people with a shared identity
primary source of social inclusion & exclusion, sense of self worth, self-esteem and gender socialization
increase reciprocated exchange (of info, services, support), social control and mutual support provide
nurturant environments for children
Traditions, values, norms and practices of child rearing are passed down and learned
ECD Programmes and Services
Gov’t need to implement quality ECD programmes and services & meet Millennium Development goals
ECD is an issue for all societies, not just the resource-poor
OECD policies that had a positive influence on outcomes for children included increasing childrens
access to reasonable quality early childhood care and education
Countries where resources were limited (and policy data is also sparse) priorities must be set such that
the most vulnerable are targeted, while universal coverage should remain the longer term goal
In order to meet Mill.Dev.. goals, gov’ts should expand high quality, cost-effective ECD programmes
Tiger Economies” of Southeast Asia from resource poor, low L.E to the opposite was accomplished
through early investment in children
ECD programmes address one or more of these issues: breastfeeding, childcare, early child education,
nutrition, and other forms of family support
3 aspects of quality in ECD programmes and services: STRUCTURE, PROCESS & NURTURANCE
Structure = appropriate staff training, expertise, group size, safety characteristics
Process = staff stability, continuity, and relationships b/w services providers, caregivers & children
Nurturance = enviro.. where exploration is encouraged, mentoring in basic skills, development of new
skills, protection from inappropriate discipline, language is responsive, gender equality
The Early Childhood Development Virtual Uni = innovative approach to the leadership and capacity
building requirements of countries seeking to address the human development needs of children
Health care systems -contribute to ECD and survival rate, first system of contact for children & moms
Kangaroo Care unique hands on intervention, carried and developed in hospitals, to increase skin-to-
skin contact and stimulation for low birth-weight babies
Regional and National
Both environments are key in determining the extent of services and resources that are available to
communities and families
Womens autonomy = more opportunities
Key policies on child poverty: 1) income transfers (cash and tax benefits), 2) employment policies, 3)
parental leave and other policies to support maternal employment, 4) early childhood education and
care services, and 5) prevention and other interventions related to teen pregnancy and births
***Look at Figure 2: Early Development Instrument (EDI) Vulnerability Map
Monitoring variation in childrens developmental outcomes at the regional level provides insights
regarding nurturant macro-environmental conditions
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