Background: Early childhood development (ECD) is of paramount importance in child health care, as its implication is deep, immense, and far-reaching. Having largely controlled the global issues of preventable childhood morbidity and mortality, the focus is now on ECD, to enable all young children to achieve their full developmental potential. With 43% of children still at risk to do so, the majority from South-East Asia and Africa, it calls for immediate action. The deliverables for nurturing care (NC) are simple and affordable but require a robust delivery system with multi-stakeholder involvement to reach every caregiver, the ultimate implementing agent. Developing an effective ECD-NC delivery system is a perplexing primary healthcare issue, novel for each country and community.

Objectives: To devise an appropriate, cost-effective, and sustainable program to promote ECD-NC in remote, rural India through trained field-level workers (FLW).

Method: We selected a rural community with estimated 8000 children within 0-6 years. The baseline survey revealed a lack of a stimulatory home environment, poor learning opportunities, and inadequate responsive parental care as major hindrances to ECD, strongly influenced by poor maternal education and awareness. A team of 8 local girls was trained on ECD and NC delivery techniques, who conducted intensive and sustained awareness generation programs in a participatory mode with mothers, in the form of weekly mother-child group meetings. Simultaneously 800 mothers were participating and 560 continued regularly till the end of the 5-month session.

Results: The participatory intervention program brought in a significant change in the knowledge, skill, and attitude of parents as well as children

Conclusion: Promotion of maternal education and empowerment of primary caregivers at the grass-root level will promote ECD. Awareness generation among parents by trained FLWs through regular sustained home-based group activities is a simple, cost-effective way to reach large populations simultaneously and bring in a tangible change.

Prof Nandita Chattopadhyay did her graduation and post-graduate studies from Calcutta University, following which she trained in Developmental Pediatrics at various Institutes in India and abroad. She has been practicing as a Developmental Pediatrician for the last 24 years and is the Director of Un mesh Child Development Centre, Kolkata. She has been a faculty member in different medical colleges since 1997, presently holding the chair of Head of Pediatrics at MGM Medical College.

Prof Chattopadhyay is also actively engaged in various research projects on child health and child development in rural India, mostly in collaboration with UNICEF. Her special interest is in Early Childhood Development. She has more than 30 published papers and 8 books on pediatrics and childcare (as sole author or chapter contributor) to her credit. She serves as an editorial board member for various medical journals.

She has been honored with Fellowship from the Indian Academy of Pediatrics, National Neonatology Forum, and FAIMER Fellowship in Medical Education.