Shifting the discourse from survive to thrive: a qualitative exploration of beliefs, actions and priorities for early childhood development in Uganda

Abstract

Investment in early childhood produces healthier and more productive adults, benefiting families, communities and countries. Carers need support in providing nurturing care, but there is little information on what is required to achieve acceptable, affordable and effective early childhood development (ECD) in resource-constrained environments. Uganda has identified human capital development as a key priority. In Uganda, an estimated 75–80 per cent of 3–6-year-olds have no toys and are not engaged in learning. Uganda has established a national Secretariat to support ECD and there is political will to define a multi-sectoral programme with low resource requirements. This study aimed to understand the characteristics of an acceptable, scalable and effective ECD intervention in Uganda. This study finds the discourse around ECD has not yet moved from ‘survive’ to ‘thrive,’ with nutrition and child health programming such as immunisation widely conflated with ECD. Intelligence is seen as innate, with carers believing they have little influence over cognitive development. Language and beliefs around child stimulation will need to be carefully constructed, given the significant and persistent negative impact of poverty and malnutrition on both child survival and the potential for child stimulation in this context.