Integrating Responsive Care and Early Learning with Nutrition Counseling Inspires Mothers in Ghana

By: Kelsey Torres, Technical Specialist, USAID Advancing Nutrition

Through my work in social and behavior change, as a Technical Specialist for USAID Advancing Nutrition, I recognize that understanding behaviors is at the heart of nutrition programming. We know that how families support a child with loving care, play, and stimulation is just as important as feeding for improved childhood outcomes. Exploring why and how families can adopt these responsive care and early learning (RCEL) behaviors is critical.

I was eager for the opportunity to manage a pilot activity related to RCEL in order to better understand the nexus of early childhood development and nutrition. The pilot includes a cascade training for health care providers and community-level counselors, along with research on the feasibility, acceptability, and effectiveness of the draft RCEL Addendum counseling package and its integration with existing child health and nutrition packages. I joined our Ghana team for the first tier of the training to support preparation and facilitation, document experiences and learnings, and plan for adaptations as we cascade the training and make adjustments to strengthen the package. We aimed to equip facilitators, mostly nutrition or health officers and public health nurses, from four districts in northern Ghana who will be responsible for training health care providers in the next phase.

From the very beginning, there was a buzz of excitement among the participants. The content appeared to be relatable and familiar, but also new and interesting. On the third day, during opening reflections, a public health nurse described her experience, as a mother, practicing what she had learned the previous day—how to give her child daily age-appropriate opportunities to learn through play.

She told us that day after day, her young daughter always seemed to get fussy and restless after daycare, but this day was different. She was energized. And happy! The day before, the mother had sat down on the floor with her child when they got home. She crumpled up a piece of paper and gently tossed it across the room to her child who was sitting in front of her. Her child tossed the ball back with a big smile on her face. And so it went, back and forth. Her child was excited to continue with this fun new play activity she had learned the day before. The mother was relieved her child was not in tears like so many other days! And best of all, she enjoyed bonding with her child knowing that the play would help her child’s development.

Like so many other caregivers, the mother was happy to be able to provide the loving, responsive, and playful care her child needed. The package recognizes that many factors, such as family support and access to play items, can influence caregiver behavior beyond knowing optimal behaviors to practice. The mother who shared her story made do with a safe and simple homemade object—and her child loved it.

Embracing opportunities to learn through play is one of six high-priority caregiving behaviors essential for improving early childhood development (ECD) outcomes among children aged 0‒2 years. The RCEL Addendum training centers on these six behaviors:

• responsive caregiving
• responsive feeding
• providing opportunities for learning, especially through communication and play
• monitoring children’s development, and referring as needed
• identifying and caring for children with feeding difficulties
• supporting caregiver mental health and well-being.

Successful integration of the RCEL counseling content with nutrition content has tremendous potential to amplify both nutrition and ECD outcomes at the individual and population level. The RCEL Addendum also provides specific guidance on how to support children with disabilities and ensure they receive the RCEL that all children need. Anyone can explore the RCEL package, which can be adapted to any country’s context. I invite you to review the draft package and share your reflections on integrating responsive care and early learning with nutrition. In a few months, we will launch the final package for broader use. Follow us to stay updated on this exciting work!