Big Idea: To promote and support a mass campaign aimed at the wide-scale implementation of Integrated Early Childhood Development (IECD) nationally.

Over 1.3 million children are born in South Africa every year. While it has become trite to state that healthy societies are founded upon the health and well-being of children, this fact has continued to be borne out in local and international experience. There is no question that investments in early childhood, on a range of levels, produce multiple positive outcomes for individuals, families, neighbourhoods and countries. It is to these specific issues that this group addressed itself.

This working group addressed itself to questions of how organisations, communities and individuals may contribute to safety in South Africa through working with parents/caregivers and young children. The focus was on the period from pregnancy to the age of seven, and on what interventions should be promoted or extended to improve the health, well-being and life chances for mothers and their young children.

International research has shown that inputs in early childhood show far greater successes in achieving positive outcomes than inputs made later in the life-cycle of children. Internationally, programmes such as preschool enrichment programmes, home visitation programmes and parenting support programmes have all been demonstrated to be effective in not only reducing the risk factors for offending and victimisation, but also in promoting a range of other positive outcomes including improved school performance, and improved engagement with the job market (for both caregivers and children).

Maternal and Child Health
The physical and emotional health and well-being of mothers is a significant factor in the survival and development of children. The group focused on questions of how mothers (particularly young mothers) may receive support to strengthen their own physical and mental health and life chances, as well as how the physical and mental health of young children under the age of seven may be assured. Specific issues of interest in this regard were how young women and mothers may be supported through the actions of government, civil society organisations, communities and individuals to promote planned pregnancies, bonding and maternal health during pregnancy, and adequate preparation for motherhood, as well as how the survival, health, well-being and positive development of babies and young children could be assured.

Facts relating to Maternal and Child Health
At least 20% of the burden of disease in children below the age of five is related to poor maternal health and nutrition, as well as quality of care at delivery and during the new born period. The concept of maternal health encompasses family planning, preconception, prenatal and postnatal care. Goals of preconception care can include providing education, health promotion, screening and interventions for women of reproductive age to reduce risk factors that might affect future pregnancies.

Prenatal care is the comprehensive care that women should receive and provide for themselves throughout their pregnancy. Women who have the knowledge to begin with prenatal care early in their pregnancies have better birth outcomes than women who receive little or no care during their pregnancies. Postnatal care issues include recovery from childbirth, concerns about newborn care, nutrition, breastfeeding and family planning.  

Parenting and Strengthening of Families
The group recognised the significant role that may be played by those responsible for raising children. The role that parents, caregivers and families play in providing children with nurturing, attachment, appropriate socialisation, and a positive self-image received attention in group discussions. The group focused discussions on how those responsible for parenting (which may include grandparents, other children, and those unrelated to children) could be supported, through programme interventions, to deliver on these critical responsibilities. Specific attention was focused on the role of fathers in raising children and how men could be supported and encouraged to engage more effectively in the parenting role.

Facts relating to Parenting and Strengthening of Families
The government has recognised the importance of social services aimed at supporting parenting and families and through the Children's Amendment Act has made commitments to improving the provision and funding of these services. Services such as child and family counseling, parenting skills development, support groups for parents of children with disabilities, diversion of children from the Criminal Justice System and home-based care are included in the ambit of the Act's provisions.

Early Childhood Development (ECD) and Care for Young Children
The group explored a range of options relating to early childhood intervention programmes and focused on what actions needed to be taken by government, civil society organisations, communities and individuals to improve access to and the quality of these interventions. It also explored other questions relating to how the care, supervision and nurturing of young children may be promoted both within and outside the home setting.

Facts about access and quality of ECD:
Several government departments are involved in ECD; the Department of Education (DoE), Health (DoH) and Department of Social Development (DSD), with the latter two being mostly concerned with children up to the age of five years, and the DoE with the full period of birth to nine years. Access is however insufficient to improve early childhood outcomes. Furthermore, the quality of services is essential. Poor quality services may even increase risks for children. The DoE Ordinary Annual Survey and Snap Shots Surveys provide data on the number of learners per grade by race, gender and province in public and independent schools at different points in the year:

• Overall enrolment in ECD facilities nationally is 12%, with substantial provincial variations from nearly 20% in the Western Cape, to as low as 7% in Limpopo and North West.
• 30% of African children and 11% of coloured children enrolled in ECD are in rural sites. Rural and informal settlements sites tend to be less well resourced and this means that large numbers of African children are in poorer-quality sites.
• A large proportion of the poorest educational programmes are found in home-based sites in KwaZulu-Natal (23% of sites) and Mpumalanga (21% of sites). Significantly, support to home-based sites in KwaZulu-Natal (30%) and Eastern Cape (26%) is lowest.
• The audit also indicates that a large proportion of school based sites in the poorest provinces have the poorest infrastructure - Limpopo (32%); the Eastern Cape (20%) and KwaZulu-Natal (16%).