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Early childhood care and education (ECCE), is an area of education theory and international development, related to Early childhood education, focusing on the development of care and education of children between zero and eight years old.,

It focuses on how studying attending to his or her social, emotional, cognitive and physical needs – in order to establish a solid and broad foundation for lifelong learning and well-being. ‘Care’ includes health, nutrition and hygiene in a warm, secure and nurturing environment; and ‘education’ includes stimulation, socialization, guidance, participation, learning and developmental activities. ECCE begins at birth and can be organized in a variety of non-formal, formal and informal modalities, such as parenting education, health-based mother and child intervention, care institutions, child-to-child programmes, home-based or centre-based childcare, kindergartens and pre-schools. Different terms to describe ECCE are used by different countries, institutions and stakeholders, such as early childhood development (ECD), early childhood education and care (ECEC), early childhood care and development (ECCD), with Early Childhood Care and Education as the UNESCO nomenclature.

It proposes that children’s care and educational needs are intertwined. Poor care, health, nutrition, and physical and emotional security can affect educational potentials in the form of mental retardation, impaired cognitive and behavioural capacities, motor development delay, depression, difficulties with concentration and attention. Inversely, early health and nutrition interventions, such as iron supplementation, deworming treatment and school feeding, have been shown to directly contribute to increased pre-school attendance. Studies have demonstrated better child outcomes through the combined intervention of cognitive stimulation and nutritional supplementation than through either cognitive stimulation or nutritional supplementation alone. UNESCO conclude that quality ECCE is one that integrates educational activities, nutrition, health care and social services.

History
ECCE has always been an integral part of human societies. Arrangements for fulfilling these societal roles have evolved over time and remain varied across cultures, often reflecting family and community structures as well as the social and economic roles of women and men. Historically, such arrangements have largely been informal, involving family, household and community members. The formalization of these arrangements emerged in the nineteenth century with the establishment of kindergartens for educational purposes and day nurseries for care in much of Europe and North America, Brazil, China, India, Jamaica and Mexico.

State-led expansion of ECCE services first emerged in the Russian Federation in the early twentieth century as part of the socialist project to foster equal participation of women and men in production and in public life, and to publicly provide education from the youngest possible age. This development extended to socialist or former socialist countries such as Cambodia, China and Viet Nam. France was another early starter having integrated pre-school into its education system as early as 1886 and expanded its provision in the 1950s. In real terms, the significant expansion of ECCE services began in the 1960s with the considerable growth in women’s participation in the labour market and extensive developments in child and family policies in Europe and the United States of America.

ECCE development in 1990s
The field developed in the 1990s partially due to the rapid and successive ratification of the 1989 United Nations Convention on the Rights of the Child (CRC). By its explicit mention of ‘the child’ – meaning every human being under the age of eighteen or majority – the CRC reinforced the 1960 UNESCO Convention and Recommendation against Discrimination in Education which should have covered young children in any case. With its moral force and near universal ratification, the CRC formally recognized children as holders of rights to survival and development, to be heard and to participate in decisions affecting them in accordance with their evolving capacities with their best interests and non-discrimination as overarching principles. While the CRC in Article 18 also recognizes the primary role of parents and legal guardians in the upbringing and development of children, it obliges States Parties to help them carry out these duties.

The second boost to the development of ECCE was the adoption of the World Declaration on Education for All (EFA) in March 1990 in Jomtien, Thailand. Reflecting General Comment 7, the Jomtien Declaration explicitly stated that ‘learning begins at birth’, and called for ‘early childhood care and initial education’ (Article 5). This novel recognition of ECCE as an integral part of basic education featured again in the major goals adopted at the 1990 UN World Summit for Children. Ten years later, in 2000, this expanded vision of basic education was rearmed in the Dakar Framework for Action on EFA, adopted at the World Education Forum as the first of the six EFA goals: ‘Expanding and improving comprehensive ECCE especially for the most vulnerable and disadvantaged children’. Regrettably, unlike other EFA goals, this was stated as a broad and aspirational goal without numerical targets or clear benchmarks.

ECCE Development in the 21st century
ECCE was further reinforced by the Millennium Development Goals (MDGs), albeit only partially. Adopted at the UN Millennium Summit in 2000, two of the MDGs had direct relevance to early childhood development: (i) improving maternal health, with the targets of reducing the maternal mortality rates by three-quarters and providing universal access to reproductive health (MDG4), and (ii) reducing the under-five mortality rate by two-thirds between 1990 and 2015 (MDG5). Thus, the child and maternal health aspects of ECCE became part and parcel of a global ‘effort to meet the needs of the world’s poorest’ while childcare and early education aspects were left out.

In recent decades, ECCE has further received attention from diverse stakeholders including research communities, civil society and intergovernmental organizations which furthered understanding of its holistic and multisectoral nature. Research continues to document the multifaceted development benefits of ECCE for health, education, social and emotional well-being, social equity and cohesion, the economy, employment and earnings.

Economic benefits of early childhood care and education
There is evidence that public investment in early childhood care and education can produce economic returns equal to roughly 10 times its costs. The sources of these gains are (1) child care that enables mothers to work and (2) education and other supports for child development that increase subsequent school success, labour force productivity, prosocial behaviour, and health. The benefits from enhanced child development are the largest part of the economic return, but both are important considerations in policy and programme design.The economic consequences include reductions in public and private expenditures associated with school failure, crime, and health problems as well as increases in earnings.

Impact of emergency and conflict experiences
In sum, emergency and conflict may impact on children’s development in the following manner:


 * Physical: exacerbation of medical problems, headaches, fatigue, unexplained physical complaints.
 * Cognitive: trouble concentrating, preoccupation with the traumatic event, recurring dreams or nightmares, questioning spiritual beliefs, inability to process the event.
 * Emotional: depression or sadness, irritability, anger, resentfulness, despair, hopelessness, feelings of guilt, phobias, health concerns, anxiety or fearfulness.
 * Social: increased conflicts with family and friends, sleep problems, crying, changes in appetite, social withdrawal, talking repeatedly about the traumatic event, refusal to go to school, repetitive play.

Impact on pregnancy
Research shows that environmental factors and experiences can alter the genetic make-up of a developing child. Exposure to prolonged stress, environmental toxins or nutritional deficits chemically alter genes in the foetus or young child and may shape the individual’s development temporarily or permanently. Violence and maternal depression may also impair child development and mental health. When trauma occurs at critical times of development for the foetus or young child, the impact on specialized cells for organs such as the brain, heart, or kidney can result in underdevelopment with lifetime implications for physical and mental health. For instance, a study on Iraq showed the rate of heart defects at birth in Fallujah to be 13 times the rate found in Europe. And for birth defects involving the nervous system the rate was calculated to be 33 times that found in Europe for the same number of births. Prolonged stress during pregnancy or early childhood can be particularly toxic and, in the absence of protective relationships, may also result in permanent genetic changes in developing brain cells. Evidence has shown that toxins and stress from the mother cross the placenta into the umbilical cord, leading to premature and low birth weight babies. Likewise, conflict trauma can affect pregnant women and the subsequent emotional health of their children. In addition, babies of severely stressed and worried mothers are at higher risk to be born small or prematurely.

Impact on child development
Children’s reactions to emergencies fluctuate depending on age, temperament, genetics, pre-existing problems, coping skills and cognitive competencies, and the dose of the emergency. Although most children are said to recover over time, if emergency reactions are left untreated, they can have a significant adverse impact on children’s social, emotional, behavioural and physical development.

Age 6 and younger
In conflict-affected countries, the average mortality rate for children under 5 is more than double the rate in other countries. On the average, twelve children out of a hundred die before their fth birthday, compared with six out of a hundred. Common reactions among this age group are severe separation distress, crying, clinging, immobility and/or aimless motion, whimpering, screaming, sleeping and eating disorders, nightmares, fearfulness, regressive behaviours such as thumb-sucking, bed-wetting, loss of bowel/bladder control, inability to dress or eat without assistance, and fear of darkness, crowds and being left alone.

During an investigation of the relationship between exposure to day raids and shelling and behavioural and emotional problems among Palestinian children, aged 3–6, in the Gaza Strip, children demonstrated sleeping problems, poor concentration, attention-seeking behaviour, dependency, temper tantrums and increased fear. Mothers of Palestinian kindergarten children reported severely impaired psychosocial and emotional functioning in their children. Thabet et al. examined the behavioural and emotional problems of 309 Palestinian pre-schoolers, and found that direct and indirect exposure to war trauma increased the risk of poor mental health. Zahr et al., in a study on the effect of war on Lebanese pre-school children, found more problems in children aged 3–6 years exposed to heavy shelling over a 2-year period than in a control group living without this threat. According to Yaktine, 40 mothers of different socio-economic backgrounds during the civil war in Beirut reported that their pre-school children became more anxious and fearful about bombardments and explosions. After Scud missile attacks, displaced Israeli pre-school children demonstrated aggression, hyperactivity and oppositional behaviour and stress. This was compared with non-displaced children and, despite a continuous decrease in symptom severity, risk factors identified shortly after the Gulf War continued to exert their influence on children five years after the traumatic exposure.

Ages 6 to 11
Common symptoms in this age bracket include disturbing thoughts and images, nightmares, eating and sleeping disorders, noncompliance, irritability, extreme withdrawal, outbursts of anger and fighting, disruptive behaviour, inability to pay attention, irrational fears, regressive behaviour, depression and anxiety, feeling of guilt and emotional numbing, excessive clinging, headaches, nausea and visual or hearing problems. Traumatic events experienced before the age of 11 are three times more likely to result in serious emotional and behavioural difficulties than those experienced later in life. According to the Palestinian Counseling Centre, Save the Children, even six months after the demolition of their homes, young Palestinian children suffered from withdrawal, somatic complaints, depression/anxiety, unexplained pain, breathing problems, attention difficulties and violent behaviour. They were afraid to go to school, had problems relating to other children and greater attachment to caregivers. As a result, parents reported deterioration in educational achievement and ability to study. Al-Amine and Liabre revealed that 27.7 per cent of Lebanese children aged between 6 and 12 suffered from symptoms of PTSD, as well as from problems sleeping, agitation, difficulties in concentrating and excessive awareness of events related to the 2006 Lebanese-Israeli war. Many children in Sudan and northern Uganda who were forced to witness family members being tortured and murdered exhibited stunting, PTSD and other trauma-related disorders.

Disabilities
Children with disabilities are disproportionately affected by emergencies, and many become disabled during disasters. Children with disabilities may suffer due to loss of their assistive devices, loss of access to medicines or rehabilitative services and, in some cases, loss of their caregiver. In addition, disabled children tend to be more vulnerable to abuse and violence. UNICEF research indicates that violence against children with disabilities occurs at annual rates at least 1.7 times greater than their able-bodied peers. Young children with disabilities living in conflict are more vulnerable and the consequent physical, psychological or emotional problems are higher. They are also more likely to develop emotional and mental health problems during emergencies because of lack of mobility, treatment, and medication or through starvation. The Inter-Agency Standing Committee (IASC) recognizes that children with pre-existing disabilities are more vulnerable to mistreatment, discrimination, abuse and destitution. Children with mobility, visual and hearing disabilities or intellectual impairments may feel particularly vulnerable if an emergency leads to the relocation of school and the learning of new daily routines. During emergencies, long unsafe distances to school, the lack of buildings with adequate facilities and equipment and teachers with minimum qualifications, are likely to be overwhelming challenges for young children with disabilities to be enrolled in day care and early education.

Gender differences
Some research shows that girls exhibit higher levels of distress than boys in relation to stressful situations and are considered at higher risk in situations of war and terror. Other research has found that girls express more worry, anxiety and depressive disorders, and PTSD symptoms while boys show more behavioural problems in the aftermath of a disaster. However, pre-school girls exposed to earthquakes in Sultandagi (Turkey) displayed more problematic behaviours than boys in the same educational category. Additionally, Wiest, Mocellin, and Motsisi contend that young children, especially girls, may be vulnerable to sexual abuse and exploitation. Garbarino and Kostelny reported that Palestinian boys suffered more than girls from psychological problems when exposed to chronic conflict. In another study, Palestinian boys were more susceptible to effects of violence during early childhood and girls during adolescence. In general it appears that boys take longer to recover, displaying more aggressive, antisocial and violent behaviour while girls may be more distressed but are more verbally expressive about their emotions.

Educational consequences
In all conflict-affected countries, 21.5 million children of primary school age are out of school. Over the past decade, the problem of out-of- school children has been increasingly concentrated in conflict-affected countries, where the proportion increased from 29% in 2000 to 35% in 2014; in Northern Africa and Western Asia, it increased from 63% to 91%.

Quality education alleviates the psychosocial impact of conflict and disasters by giving a sense of normalcy, stability, structure and hope for the future. However, emergency and conflict situations often undermine the quality of educational services. They result in shortages of materials, resources and personnel, thereby depriving young children of the opportunity to receive quality early education. In most conflicts, education infrastructure is usually a target. Pre-schools and schools are often destroyed or closed due to hazardous conditions depriving young children of the opportunity to learn and socialize in a safe place that provides a sense of routine.

Young children living under emergencies are less likely to be in primary school and more likely to drop out. Primary school completion in poorer conflict-affected countries is 65 per cent while it is 86 per cent in other poor countries. According to the 2000 UNICEF MICS report, information from Iraq, for example, confirms the lack of Early Childhood Development programmes within the formal educational system. Only 3.7 per cent of children aged from 36 to 59 months were enrolled in nurseries or kindergartens. Low enrollment rates in early education programmes decrease the opportunity for young children to find a safe space where they flourish and release the stress and tension resulting from the emergency. In countries with ongoing emergencies, researchers have found a full range of symptoms that may be co-morbid with trauma, including attention deficit hyperactivity disorder, poor academic performance, behavioural problems, bullying and abuse, oppositional defiant disorder, conduct disorder, phobic disorder and negative relationships (Terr, 1991; Streeck-Fischer and van der Kolk, 2000).

A study using the Young Lives data in Ethiopia found that young children whose mothers had died were 20 per cent less likely to enroll in school, 21 per cent less likely to be able to write, and 27 per cent less likely to be able to read. Dybdahl found that 5- to 6-year-old war-traumatized Bosnian children showed lower levels of cognitive competence. Pre-school and school age Palestinian children exposed to severe losses, wounding and home destruction suffered impaired cognitive capacity for attention and concentration. Severe trauma has been found to be associated with in exible and narrowed attention and problem-solving strategies. Since both physical and mental health are linked to language and cognitive development, it is reasonable to assume that violent conflict has a negative effect on these areas of development.

Supporting young children during emergency and conflict situations
Early childhood care and education (ECCE) is a multisectoral field that holistically addresses children’s multiple needs. During emergencies ECCE supportive services may address a range of issues including prenatal care, immunization, nutrition, education, psychosocial support and community engagement. Coordinated services of health and nutrition, water sanitation and hygiene, early learning, mental health and protection are considered essential in supporting young children living under emergencies and conflicts. Many programmes and strategies, whether in the formal or non-formal education sector, have proved to be very supportive to the well-being and recovery of young children living in areas of conflict. Child Friendly Spaces (CFS) programmes have been found valuable in creating a sense of normality and providing coping skills and resilience to children affected by emergencies. Child Friendly Spaces help children develop social skills and competencies such as sharing and cooperation through interaction with other children. They also offer opportunities to learn about risks in their environment and build life skills, such as literacy and non-violent conflict resolution, and provide a useful means of mobilizing communities around children’s needs. In an effort to strengthen community systems of child protection, Christian Children's Fund (CCF) established three centres for internally displaced young children in Unyama (Uganda) camp that provided a safe, adult-supervised place for young children between 3 and 6 years of age. War Child established six ‘safe spaces’ in schools in northern Lebanon for displaced Syrian children where counsellors used art and music therapy to help young children express their emotions in a healthy way. Several studies show that children who have participated in quality education programmes within schools tend to have better knowledge of hazards, reduced levels of fear and more realistic risk perceptions than their peers. In such contexts, psychosocial intervention programmes for young children and their families are considered to be vital. Interventions such as storytelling, singing, jumping rope, role-play activities, team sports and writing and drawing exercises helped to reduce psychological distress associated with exposure to conflict-related violence in Sierra Leone for children aged 8 to 18. Studies in Eritrea and Sierra Leone revealed that children’s psychosocial well-being was improved by well-designed educational interventions. In Afghanistan, young children and adolescents gained a sense of stability and security after their involvement in constructive activities (e.g. art, narrative, sports) which took place in neutral safe places within their communities.

International agreements
The first World Conference on Early Childhood Care and Education took place in Moscow from 27 to 29 September 2010, jointly organized by UNESCO and the city of Moscow. The overarching goals of the conference are to:According to UNESCO a preschool curriculum is one that delivers educational content through daily activities, and furthers a child's physical, cognitive and social development. Generally, preschool curricula are only recognized by governments if they are based on academic research and reviewed by peers.

Preschool for Child Rights have pioneered into preschool curricular areas and is contributing into child rights through their preschool curriculum.

Curricula in early childhood care and education
Curricula in early childhood care and education (ECCE) is the driving force behind any ECCE programme. It is ‘an integral part of the engine that, together with the energy and motivation of staff, provides the momentum that makes programmes live’. It follows therefore that the quality of a programme is greatly influenced by the quality of its curriculum. In early childhood, these may be programmes for children or parents, including health and nutrition interventions and prenatal programmes, as well as centre-based programmes for children.

Barriers and challenges
Children’s learning potential and outcomes are negatively affected by exposure to violence, abuse and child labour. Thus, protecting young children from violence and exploitation is part of broad educational concerns. Due to difficulties and sensitivities around the issue of measuring and monitoring child protection violations and gaps in defining, collecting and analysing appropriate indicators, data coverage in this area is scant. However, proxy indicators can be used to assess the situation. For example, ratification of relevant international conventions indicates countries’ commitment to child protection. By April 2014, 194 countries had ratified the CRC3; and 179 had ratified the 1999 International Labour Organization’s Convention (No. 182) concerning the elimination of the worst forms of child labour. But, many of these ratifications are yet to be given full effect through actual implementation of concrete measures. Globally, 150 million children aged 5–14 are estimated to be engaged in child labour. In conflict-affected poor countries, children are twice as likely to die before their fifth birthday compared to those in other poor countries. In industrialized countries, 4 per cent of children are physically abused each year and 10 per cent are neglected or psychologically abused.

In both developed and developing countries, children of the poor and the disadvantaged remain the least served. This exclusion persists against the evidence that the added value of early childhood care and education services are higher for them than for their more affluent counterparts, even when such services are of modest quality. While the problem is more intractable in developing countries, the developed world still does not equitably provide quality early childhood care and education services for all its children. In many European countries, children, mostly from low-income and immigrant families, do not have access to good quality early childhood care and education.