Promoting Nurturing Care for Early Childhood Development Through India's Public Health System

Implementing the nurturing care framework (NCF) for early childhood development (ECD) is essentially multisectoral, requiring coordination amongst all sectors and harmoniously integrating it within the existing contact opportunities in the health sector. This paper discusses the relative strengths, persisting gaps, challenges, and the way forward to implement nurturing care for ECD through the public health system. The vast network of frontline health workers and health facilities; community, home, and center-based service delivery; health and wellness centers located close to the communities have the potential to promote nurturing care. Persisting gaps include limited capacities of health workers in the nurturing care domains, lack of community engagement for ECD, weak referral linkages, inability to reach the most vulnerable children, missed opportunities for early identification of children at risk, and early intervention for children developmental delays and difficulties. Moving forward, incorporating nurturing care components into essential services packages, enhancing competencies of health workers, engaging with parents, establishing a mechanism for tracking children at risk, and developmental surveillance by trained service providers can provide the much-needed impetus to ECD.