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Improving early childhood development in the context of the nurturing care framework in Kenya: A policy review and qualitative exploration of emerging issues with policy makers

Abboah-Offei, Mary; Amboka, Patrick; Nampijja, Margaret; Owino, George Evans; Okelo, Kenneth; Kitsao-Wekulo, Patricia; Chumo, Ivy; Muendo, Ruth; Oloo, Linda; Wanjau, Maryann; Mwaniki, Elizabeth; Mutisya, Maurice; Haycraft, Emma; Hughes, Robert; Griffiths, Paula; Elsey, Helen


Patrick Amboka

Margaret Nampijja

George Evans Owino

Kenneth Okelo

Patricia Kitsao-Wekulo

Ivy Chumo

Ruth Muendo

Linda Oloo

Maryann Wanjau

Elizabeth Mwaniki

Maurice Mutisya

Emma Haycraft

Robert Hughes

Paula Griffiths

Helen Elsey


Introduction: The Nurturing Care Framework (NCF) describes “nurturing care” as the ability of nations and communities to support caregivers and provide an environment that ensures children's good health and nutrition, protects them from threats, and provides opportunities for early learning through responsive and emotionally supportive interaction. We assessed the extent to which Kenyan government policies address the components of the NCF and explored policy/decision makers' views on policy gaps and emerging issues.

Methods: A search strategy was formulated to identify policy documents focusing on early childhood development (ECD), health and nutrition, responsive caregiving, opportunities for early learning and security and safety, which are key components of the NCF. We limited the search to policy documents published since 2010 when the Kenya constitution was promulgated and ECD functions devolved to county governments. Policy/decision-maker interviews were also conducted to clarify emerging gaps from policy data. Data was extracted, coded and analyzed based on the components of the NCF. Framework analysis was used for interview data with NCF being the main framework of analysis. The Jaccard's similarity coefficient was used to assess similarities between the themes being compared to further understand the challenges, successes and future plans of policy and implementation under each of the NCF domains.

Results: 127 policy documents were retrieved from government e-repository and county websites. Of these, n = 91 were assessed against the inclusion criteria, and n = 66 were included in final analysis. The 66 documents included 47 County Integrated Development Plans (CIDPs) and 19 national policy documents. Twenty policy/decision-maker interviews were conducted. Analysis of both policy and interview data reveal that, while areas of health and nutrition have been considered in policies and county level plans (coefficients >0.5), the domains of early learning, responsive caregiving and safety and security face significant policy and implementation gaps (coefficients ≤ 0.5), particularly for the 0–3 year age group. Inconsistencies were noted between county level implementation plans and national policies in areas such as support for children with disabilities and allocation of budget to early learning and nutrition domains.

Conclusion: Findings indicate a strong focus on nutrition and health with limited coverage of responsive caregiving and opportunities for early learning domains. Therefore, if nurturing care goals are to be achieved in Kenya, policies are needed to support current gaps identified with urgent need for policies of minimum standards that provide support for improvements across all Nurturing Care Framework domains.

Journal Article Type Article
Acceptance Date Sep 9, 2022
Online Publication Date Sep 27, 2022
Publication Date 2022
Deposit Date Oct 14, 2022
Publicly Available Date Oct 14, 2022
Journal Frontiers in Public Health
Publisher Frontiers Media
Peer Reviewed Peer Reviewed
Volume 10
Article Number 1016156
Keywords early childhood development, nurturing care framework, nurturing care, children under five, policy, Kenya
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