O2066: Building Capacity of Pediatricians as Early Childhood Development Advocacy Champions in Tanzania

Background: Advancing early childhood development (ECD) is essential to shaping life-course trajectories and educational, emotional, and economic outcomes. Pediatricians and pediatric societies, are positioned well to advance this agenda by ensuring national and sub-national health care systems are supportive of ECD and nurturing care. However, in many low- and middle-income countries pediatric societies are not engaged by stakeholders and funders. The Paediatric Association of Tanzania (PAT) and American Academy of Pediatrics (AAP) collaborated to leverage the clinical expertise and leadership of pediatricians to advance ECD services in Tanzania

Methods: A multiphase approach to support PAT in leading ECD advocacy initiatives was implemented from January 2020 to March 2022, based on an AAP model previously used to promote pediatric societies’ immunization advocacy. Phase 1 consisted of recruiting and training 15 pediatricians to become ECD champions on the science of ECD, developmental screening and service delivery, and the national ECD landscape. The champions were surveyed on baseline ECD knowledge, attitude, and practices before the training. After training, champions convened to define PAT’s ECD advocacy priorities, choosing to focus on creating ECD-enabling environments in selected healthcare facilities. Phase 2 involved implementing activities to advance the ECD advocacy priority identified in Phase 1. Activities included developing a national 2-day ECD training for health managers, general clinicians, and nurses and establishing ECD corners supplied with locally sourced toys and caregiver counseling materials. Phase 3 focused on promoting sustainability while expanding to 10 new facilities. ECD committees with supervisory and budgetary responsibility were established to oversee action plans at each facility. Additionally, a framework was developed via SWOT analysis and trend-mapping tools to further promote ECD within the pediatric society

Results: PAT established a cohort of 15 ECD champions that resulted in increased pediatrician involvement in training, mentorship, and advocacy at all levels. The champions trained 98 health managers and 318 health care providers from 19 health facilities to establish and sustain ECD services including ECD corners at pediatric outpatient clinic and inpatient wards. Each of the facilities have established ECD committees as part of work improvement team to sustain established services. Additionally, PAT became a full member of the Tanzania Early Childhood Development Network as a strategic partner to contribute in the implementation of National ECD Multisectoral Program. The framework for ongoing support includes continuing to scale establishment of enabling environments in health facilities, introducing a standardized developmental screening tool in pediatric care, and addressing insufficient services and stigma for children with developmental difference

Conclusion: Pediatric societies play an important role the advancement of ECD in Tanzania. Leveraging pediatricians’ expertise allows for innovative partnerships and evidence-based training and advocacy, ultimately improving ECD services that could be successfully replicated in other settings.