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Advancing Early Childhood Development in Cambodia

The USAID Cambodia Integrated Early Childhood Development Activity is helping young children in Cambodia to thrive

Cambodia has made great strides in reducing poverty, infant mortality, and disease over the past 20 years. However, Cambodian families continue to face significant and compounding barriers that increase their vulnerability and jeopardize the ability of children to reach their full potential. Family support services, such as screening for disabilities and developmental delays in children, remain nascent and are hindered by insufficient integration, coordination, and expertise to target those most in need.

More than a third of Cambodian children under 5 years old are behind in their language, cognitive, physical, or social-emotional development. The COVID-19 pandemic exacerbated this problem and pushed more families into poverty and food insecurity. The complexity of this situation requires a holistic approach in order to advance early childhood development (ECD) in the country.

The USAID Cambodia Integrated Early Childhood Development (IECD) Activity

The USAID Cambodia Integrated Early Childhood Development (IECD) Activity focuses on building the skills, enabling environment, and supportive services needed for Cambodian caregivers, health center staff, and communities to provide optimal care for young children’s physical, cognitive, and social development.

The Activity supports children in the Kampong Thom and Preah Vihear Provinces and targets the deepest intervention to families with the most vulnerability and need. A randomized controlled trial studying the impact of this intervention on child development outcomes will provide valuable insights, learning, and best practices for future integrated programs such as this.

Graphic shows the components of nuturing care: good health, adequate nutrition, responsive caregiving, security and safety, and opportunities for early learning.
Graphic shows the components of nuturing care: good health, adequate nutrition, responsive caregiving, security and safety, and opportunities for early learning.

Encouraging healthy early childhood development and helping families thrive

The IECD Activity’s approach is built around the World Health Organization’s Nurturing Care Framework, which highlights five elements of support that young children need to thrive. As part of this holistic approach to early child development, the Activity focuses on building the capacity of Cambodia’s health workers to deliver streamlined, integrated services for families, and ensure access is convenient, especially for vulnerable caregivers. It also addresses gender inequity by involving more men in the caring and workload for young children.

USAID IECD prioritizes and integrates the following objectives to improve outcomes for Cambodian children and support them in reaching their full potential.

  • Improve the physical, cognitive, and social development of young children. Interventions include providing education, counseling, and support for caregivers of young children, as well as strengthening the providers, policies, and environment for quality ECD services in Cambodia. The Activity has trained nearly 200 child development leaders and village health support group workers in its first two years, with the goal of reaching 800 by 2025.
  • Decrease stunting among children under 5 years of age. Interventions include increasing families’ ability to grow more nutritious foods, generate more income from agriculture, and use both to provide nutritious foods for women and children.
  • Provide appropriate care and support for children with developmental delays and disabilities. Interventions include increasing Cambodia’s capacity for screening and detecting delays and disability in young children, improving specialized care and support services, and strengthening social inclusion for these children.

USAID IECD is also assessing needs and solutions to ensure a safe water supply and sanitation services in target areas and will work with local stakeholders to build on existing efforts in this sector, which are critical to early childhood health and development.

To achieve these early childhood development objectives, USAID IECD is ultimately promoting system-level change in Cambodia by supporting ECD planning and implementation by national and local governments, moving from coordination across sectors to full integration, and using data to target resources where they are most needed.

In doing so, the Activity is promoting equity by investing in families that need the most support, meanwhile also supporting other families and children in need. For example, home visits and special therapies are targeted to vulnerable families with the most acute needs, while vulnerable communities with at-risk families are reached through parent groups, disability screenings, and model farms that show families how to grow nutritious foods.

Building evidence for an integrated ECD programming

The USAID IECD Activity is at the forefront of integrated early childhood development efforts for USAID and RTI International. It is helping Cambodia create an environment where all aspects of child development are addressed in a coordinated manner. Multiple ministries are involved, as are multiple funding streams, sectors, and experts across USAID and RTI.

To examine the impacts of IECD on caregiver behaviors and child outcomes, RTI is conducting a longitudinal cluster randomized controlled trial. The study follows 1,790 caregivers in Kampong Thom and Preah Vihear Provinces and their young children over 4 years, documenting changes in the caregivers’ attitudes, behaviors, and practices and measuring their children’s development status.

The findings of this research will expand the knowledge and evidence on interventions that target caregivers in seeking to improve child development, as well as on integrated ECD programming working through government systems and services.