Community-based groups are organized around particular aspects of early childhood development (ECD), such as literacy, parent education, and early childhood activities. In the Colombian national program, community households call upon women to devote a portion of their home to organized child care for minimal material reward. The Indian Child Development Service subsidizes the payment of organizers; and Kenyan parents construct basic preschool facilities, provide school lunches, and subsidize a teacher. In such cases the government plays a subordinate role, while the burden of program maintenance is carried by the community. These programs share the characteristics that children and adults learn side by side; adult learning ranges from women's literacy, to health, organizational issues, or small-scale economic development; a strong cultural component emphasizes mother tongue language learning, indigenous child-rearing practices, and local working models; physical structures are in homes; capacity-building for the adults is central which will be transferred to other spheres of community life. In the remote coastal villages of Colombia, an organization called Promesa works with mothers on designing their preschool children's educational activities. Promesa began to confront other priority needs in the villages, especially in environmental health and malaria control. A 1990 assessment related that participants' pride, self-confidence, and ability to solve problems regarding the healthy development of their children increased; groups learned to make use of the physical, human, and institutional resources from their environments; and participants' children remained in school and performed better. Conclusions from a decade of loose experimentation suggest that through communication community women can be organized to provide basic early education and early childhood activities can help rural children over the cultural barrier of school.
Peasant Children Centers (CICA), or Huahuanapao Huasi, were created in 1978 through the Marginal Rural Development Fund at the Central Bank of Ecuador to care for Ecuador's young, marginalized rural children. Focusing upon both communities and children aged 3-6 years, these centers use informal education and communication techniques to promote overall child development within the community. Games and interactive activities are employed to promote the confidence, creativity, and health of children. Specifically, centers stimulate children's psychomotor development and sensitivity to the world, support their creative and problem-solving abilities through cultural and artistic expression, and improve their diet and nutrition within the resources of the community. 92 CICAs exist in 9 provinces serving 4500 children. Approximately 37,000 children have thus far benefited over the course of the program. Administratively the program is organized through a national work team, community coordinators, and community promoters, with most staff recruited from local communities. These centers have been well-accepted by communities, are in great demand, highly successful, and cost little. Economic austerity in Ecuador, however, threatens program survival. Early childhood care makes lasting improvements to individuals' lives and should continue to be supported.
Older children commonly care for their younger siblings while parents work to provide for the household. Through play, dance, and talk, children tend to interact with each other more intensely than do adults. In so doing, messages and awareness are exchanged more effectively. Child-to-Child is an active, child-centered learning approach which aims to capitalize on this phenomenon by training older siblings to be effective communicators. This approach has been formally practiced in over 70 countries since 1979. Child-to-Child encourages children to learn the meaning and importance of health messages on their own. Children will then be most likely to retain and communicate information throughout the family, to neighbors, and to the general community. No blueprint exists, however, on which program planners may base the design of new programs. Programs should instead be adapted by those living within the community and culture to fit local needs and circumstances. Nonetheless, the Aga Khan Foundation supported the study of 7 highly different Child-to-Child projects over 3 years in India to obtain some sense of which program elements are successful and potentially useful in other settings. The study revealed that all of the programs helped increase the health knowledge of children and teachers. Little information was obtained on the extent to which information was diffused by children within the community. Overall, the study produced the following results: planners should consider using Child-to-Child projects in schools; teacher training should be made a priority; administrative support should be provided; entire staffs should be made to feel involved in the decision making process; obstacles to changing teaching methods should not be underestimated; teaching materials should be locally made; projects should be integrated into official curricula; program topics should be relevant to local realities; respected authorities should be called upon to reinforce the validity of health messages; and incentives should be provided to teachers who use the approach.
In Thailand, videotapes on food supplementation, food preparation, the value of breast feeding, infant needs, nutrition, and child development were evaluated for their impact on attitude and behavior change. Videotapes were interactive and lasted 25-30 minutes; there were 8-10 interactions/tape. The audience was drawn from 12 villages in northeastern Thailand and consisted of 478 men, 930 women, and 3225 children. Interviews were conducted among village mothers with children 2 years old prior to the initial viewing and 2, 10, and 14 months after the initial viewing. In the pre-test, 1.7% of women were aware of infant sight at 1 week after birth and only 14.7% at 1 month. This level of awareness was very low compared to Bangkok slum women of whom 20% were aware of infant sight at 1 week and 35% at 1 month. These expectations change after viewing the tapes. Interaction with children increased from 33% at pre-test to 85% at 2 and 6 months after media exposure; there was a decline to 50% at 14 months. The most successful change in behavior was toward infant feeding. Mothers learned to engage and continue to feed infants who turned away or thrust out tongues during feeding; prior behavior was to stop feeding. Reference is made to another study by the Institute of Nutrition Research which compared the effectiveness of health education using video, video and a radio spot, just radio, and nothing. The results indicated that rural mothers were better informed after video or video and radio and provided better nutrition for their children aged 0-4 years. In the assessment of child nutrition and maternal knowledge and attitudes toward child rearing, media exposure-related behavior change was found in mother-child interaction, existing play materials, and type of cradle chosen. Urban parents may not be as affected. The learning strategies of the videotapes are identified.
Successful communication projects show that effective development communication depends on good context, good messages, good channel use, and good audience knowledge. Knowledgeable communication professionals know when and where not to carry out a communication program and when a communication program may be successful based on the context. A communication campaign in Jordan promoting breast feeding within 6 hours of delivery was not successful in private hospitals because they did not promote early initiation of breast feeding. Good communication programs use formative research to develop messages that solve problems of which audiences are aware and build on or respond to current behaviors. In the Philippines, messages about child's age for measles vaccination resulted in improved vaccination coverage rather than those emphasizing the dangers of measles. Precampaign research helps identify what communication channels are the most effective and reach the greatest audience. In Swaziland, face to face communication was 1.5 times more effective than the mass media, but 3 times as many people has access to a radio. So the radio was more effective. Communication programs must know their audience well and be able to track it to determine the successes as well as the failures of the campaign. Even though some professionals have adequate technical knowledge to affect development communication well, the successes of early communication projects do not seem to endure. Sometimes the immediate health benefits justify the communication campaign. Further, limited political will, the fact that the campaign does not match the health educators' routine, and limited skilled health educators are obstacles to institutionalization. The key to sustained communication capacity is patience to stay for the long term. Other needs are a consistent call on budgets and staff, some satisfaction with what has already been accomplished, and translating the successful strategies used in the short term to successful strategies in the long term.
