political, technical and management fundamentals

Transcription

political, technical and management fundamentals
EARLY CHILDHOOD
COMPREHENSIVE CARE STRATEGY
POLITICAL, TECHNICAL
AND MANAGEMENT FUNDAMENTALS
Early Childhood Comprehensive Care Strategy
POLITICAL, TECHNICAL AND MANAGEMENT
FUNDAMENTALS
C oor dinat ion
of t he document
Constanza Liliana Alarcón Párraga
C ompil at ion
a nd produc t ion of t he f ina l t e x t
Marina Camargo Abello
Adriana Lucía Castro Rojas
E dit ing
Mariana Schmidt Quintero
Carolina Turriago Borrero
P roof
r e a ding
Lilia Carvajal Ahumada
D e sign
a nd l ayout
Misty Wells & Zea Asociados
P r int er
Panamericana Formas e Impresos S.A.
B ogotá D.C., C olombi a
2013
ISBN 152152
O f f ice
P r e sident - R epubl ic
President
of t he
of
C olombi a
Juan Manuel Santos Calderón
“D e C ero
S iempr e” St r at eg y S pok e swom a n
a
María Clemencia Rodríguez de Santos
H igh C ounsel ing for S peci a l P rogr a m s . O f f ice of t he P r e sident
High Presidential Advisor for Special Programs
María Cristina Trujillo de Muñoz
N at iona l P l a nning D epa rt ment
General Director
Tatiana Orozco
Social Develoment Director
Lina María Castaño Mesa
M ini st ry
H e a lt h a nd S oci a l P rot ec t ion
Minister
of
Alejandro Gaviria Uribe
Deputy Minister for Public Health and Service Providers
Fernando Ruiz Gómez
M ini st ry
of
N at iona l E duc at ion
Minister
María Fernanda Campo Saavedra
Deputy Minister for Pre-school, Basic and Middle School
Julio Salvador Alandete
M ini st ry of C ult ur e
Minister
Mariana Garcés Córdoba
Deputy Minister of Culture
María Claudia López Sorzano
D epa rt ment
for
S oci a l P rosper it y
Director
Gabriel Vallejo López
Deputy Director
Mariana Escobar Arango
C olombi a n Fa mily W el fa r e I nst it ut e
General Director (Acting)
Gabriel Vallejo López
Early Childhood Director
Natalia Velasco Castrillón
N at iona l A genc y
for
O v ercoming E x t r eme P ov ert y (ANSPE)
General Director
Beatriz Linares
Senior Management Advisor
Ingrid Rusinque Osorio
5
Early Childhood Comprehensive Care Strategy
Technical Team of the Intersectoral Commission
for Early Childhood Comprehensive Care
H igh C ounsel ing for S peci a l P rogr a m s . O f f ice of
Intersectoral Commission Coordinator
t he
P r e sident
Constanza Liliana Alarcón Párraga
N at iona l P l a nning D epa rt ment
Health Deputy Director
Anwar Rodríguez Chehade
Advisor to the Social Development Director’s Office
Juan Guillermo Alba Garzón
M ini st ry of H e a lt h a nd S oci a l P rot ec t ion
Advisor to the Minister’s Office
Ana María Peñuela Poveda
Lifetime Group Coordinator
Martha Imelda Linero
M ini st ry of N at iona l E duc at ion
Early Childhood Director
Ana Beatriz Cárdenas Restrepo
Early Childhood Quality Deputy Director
Claudia Milena Gómez Díaz
M ini st ry of C ult ur e
Arts Director
Guiomar Acevedo Gómez
Populations Director
Moisés Medrano Bohórquez
Early Childhood Advisor
Sandra Argel
S oci a l P rosper it y D epa rt ment
Advisor to the General Deputy Director
Angélica María González
Advisor
Miguel Mauricio Ortega
C olombi a n Fa mily W el fa r e I nst it ut e
Early Childhood Director
Natalia Velsasco Castrillón
Director of the National Family Welfare System
Yebrail Haddad
Technical Management Deputy Director for Early Childhood Care
Carlos del Castillo Cabrales
Operations Deputy Director for Early Childhood Care
Javier Medina
N at iona l A genc y for O v ercoming E x t r eme P ov ert y (ANSPE)
Institutional and Territorial Supply Manager
Juliana Sánchez Calderón
Advisor to the Early Childhood Dimension of the Institutional Offer
María Consuelo Castro
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Early Childhood Comprehensive Care Strategy
Technical Team of the Entities Contributing
to the Reference Studies
M ini st ry
of
N at iona l E duc at ion
Ana Aideé Pachón Durán • Angélica María González Acevedo
Carolina Pedroza Bernal • Doris Andrea Suárez Pérez
Hellen Maldonado Pinzón • Luz Ángela Caro Yazo
Nidia Esperanza Buitrago Rodríguez • Patricia Helena Torres Salazar
Pedro Antonio Barbosa Caicedo • Sara Elena Mestre Gutiérrez
M ini st ry
of
C ult ur e
Carolina Ospina • Claudia Mejía
Fabio Alberto López • Graciela Prieto
Juan Carlos Flechas • Juan Sebastián Suanca
Margarita Ariza • María Teresa Jaime
Pilar Bermúdez
C olombi a n Fa mily W el fa r e I nst it ut e
Early Childhood Director’s Office
Ana María Ortíz Hoyos • Diana Marcela Rodríguez Ríos
Gerson Orlando Bermont Galvis • Gladys Nubia Hernández
Gloria Carvalho Vélez • Luz del Carmen Montoya Rodríguez
Luz Marina Hoyos Vivas • Mary Luz Cárdenas Fonseca
María del Carmen Bernal Latorre • Milbany Vega Salinas
Yaneth Cecilia Romero Gamarra • Yohana Amaya Pinzón
Nutrition Directorate
Ana María Ángel Correa • Ángela Patricia Guarnizo Cárdenas
Cenyde Leal Rodríguez
Protection Directorate
Alexandra Margarita Herrera Puente • José Antonio Romero Villarreal
Family Directorate
Blanca Leticia Arteaga Díaz • Claudia Marcela Rangel Esparza
Martha Yaneth Giraldo Alfaro
D ir ec tor
of t he
N at iona l Fa mily W el fa r e Syst em
Constanza Liliana Gómez Romero
M ini st ry
of
H e a lt h
a nd
S oci a l P rot ec t ion
Adriana Estrada • Aldemar Parra
Amanda Valdés • Ana María León
Ana María Ortiz • Ana María Peñuela Poveda
Ana María Rodríguez • Ana Margaret Raba
Andrés Motta • Arturo Quintero Vergara
Blanca Stella Patiño • Carolina Chica Zapata
Carolina Delgado Torres • Catalina Borda Villegas
Claudia Helena Prieto • Constanza Castilla
Dayana Gómez • Diego Alejandro García
Diva Jeaneth Moreno • Elsy del Pilar González
Esperanza Lara • Fernando Ramírez Campos
Gina Marcela Alba Díaz • Gloria Isabel Puerta
Gloria Ochoa • Gonzalo Gutiérrez
Isabel Cristina Idárraga V. • Javier Ricardo Bohórquez
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Early Childhood Comprehensive Care Strategy
Jeannett Adriana Umaña • Jorge Eduardo Suárez
José F. Valderrama • José Luis Ortiz
Jovana Ocampo • Juan Carlos Correa
Juan Manuel Rodríguez • Juan Pablo Corredor
Lely Stella Guzmán • Leonardo Arregocés
oenza Beatriz Ospino • Lía Marcela Guiza
Luis Carlos Olarte • Luz Emilse Rincón
Luz Stella Méndez • Marcela Calle
Margarita García • María Elena González
Martha Álvarez • Martha Patricia Ospino
Martha Imelda Linero • Mery C. Bolívar
Myriam Lucía Ramírez • Patricia Delgado Rodríguez
Ruth Yelitza Rubio • Sandra Tovar
Sara J. Torres M. • Yennifer Viviana Cano
Yennifer Mariño
A dmini st r at i v e S port s , R ecr e at ion , P h ysic a l A c t i v it y
a nd E njoy ing F r ee Time D epa rt ment – C ol deport e s –
Diana Marleny Duque Giraldo
S peci a l
ack now l edgment s to
Beatriz Londoño Soto
Former Director of the ICBF, former Minister of Health and Social Protection,
International expert on early childhood development. Colombia
Diego Andrés Molano Aponte
Former Director of ICBF
Verónica Silva Villalobos
Social Protection Consultant in Latin America and the Caribbean - World Bank
I nt er nat iona l
ent it ie s prov iding f eedback for t he document
World Bank
Interamerican Development Bank
Organization of Iberoamerican States for Education,
Science and Culture
Organization of American States (OAS)
Panamerican Health Organization (PAHO)
8
Early Childhood Comprehensive Care Strategy
Specialists who wrote the reference studies
that underpinning the present document
Adriana Lucía Castro Rojas • Alberto Vélez
Ángela Patricia Nocua Cubides • Blanca Luz Hoyos Henao
Consuelo Angarita • Deidamia García Quintero
Doris Andrea Suárez Pérez • Eliana Ramírez
Elsa Castañeda Bernal • Ernesto Durán Strauch
Esperanza Osorio Correa • Fadua Kattah
Graciela María Fandiño Cubillos • Hellen Maldonado Pinzón
Leonor Isaza Merchán • Luz María Babativa
Javier Augusto Medina Parra • María Victoria Estrada
María Consuelo Martín Cardinal • Marina Camargo Abello
Marina Llanos • Martha Lorena Padrón Gómez
Nora Corredor Martínez • Nisme Yurani Pineda Báez
Paula Quintero • Sandra Marcela Durán Chiappe
Yolanda Reyes Villamizar
W it h
t he support of :
Camilo Ernesto Peña Porras • Jaime Rafael Vizcaíno Pulido
A nd
r ecommendat ions by :
Alejandro Acosta Ayerbe
Ascofade
Graciela María Fandiño Cubillos • Leonor Isaza Merchán
María Cristina Torrado Pacheco • María Inés Cuadros Ferrer
Marta Torrado Pacheco • Manuel Manrique Castro
Olga Alicia Carbonell Blanco
International Development Experts Providing
Feedback for the reference studies
Cassie Landers • Clyde Hertzman (R.I.P.)
Jane Squires • Juan Narbona
Helia Molina • Magdalena Janus
Mary Young • Norma Reategui • Paula Bedregal • Sally Brinkman
9
Early Childhood Comprehensive Care Strategy
Photography Credits
Adriana Lucía Castro, pages 68 and 158
Adriana Gómez (Ministry of Culture), page 80
Candelaria Martínez
(Agreement 442, 2012 for Early Childhood Comprehensive Care), pages 52, 102, 203d and 222
Carolina Turriago Borrero, pages 18, 39, 43, 47, 67, 93, 98, 109, 149, 189a and 197d
César Carrión (Press Office, Office of the President), pages 40, 44, 56, 134, 138 and 141
Diego Díaz (High Counseling for Special Programs. Office of the President), page 173
Luis Eduardo Díaz, page 238
Elizabeth Sánchez (Sueños Alegres Kindergarden, San Andrés), pages 105 and 121
ICBF Team, page 234
Ventana de Infancia Team, United Nations, pages 213c and 230
Presidency Team, page 83, 86, 106, 133 and 242
Ministry of Culture Team, page 182
Ministry of Health Team, pages 114, 122, 137, 177, 189b and 189d
Ingrid Marcela Moreno
(Agreement 442, 2012 for Early Childhood Comprehensive Care), pages 126 and 213a
Juan Gabriel Muñoz (ICBF Press Office), pages 17, 21, 35, 51, 72, 75, 76, 84, 90, 113,
142, 145, 153, 161, 162, 178, 183 and 221
Laura Mercedes Hoyos (Agreement 442, 2012 for Early Childhood
Comprehensive Care), pages 60, 110, 125, 164, 189c and 241
Liliana Ávila
(Agreement 442, 2012 for Early Childhood Comprehensive Care), pages 36, 130 and 197c,
Linda Flor Salazar (Agreement 442, 2012 for Early Childhood Comprehensive Care),
pages 63, 174, 203b, 213b and 229
Luisa Fernanda Juliá (High Counseling for Special Programs. Office of the President)
front cover and pages 22, 30, 59, 64, 79, 94, 97, 117, 118, 129, 137, 146, 154, 157, 166, 170,
181, 187c, 187d, 197b, 225, 226, 233 and 237
Mariana Schmidt
(Agreement 442, 2012 for Early Childhood Comprehensive Care), pages 55 and 213d
Paola Andrea Rueda
(Agreement 442, 2012 for Early Childhood Comprehensive Care), page 187a
Resguardo Inga de Aponte
(Agreement 442, 2012 for Early Childhood Comprehensive Care), page 187b
Sara Montoya (Reserva para la Infancia Foundation), page 101
Tatiana Ángel Muñoz (Reserva para la Infancia Foundation), pages 48, 71, 203a and 203c
10
Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Reference Studies Underpinning
this Document . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
First part
Context for the Early Childhood Comprehensive
Care Strategy in Colombia . . . . . . . . . . . . . . . . . . . . . . . . . 31
The Situation of Colombian Children
under the Age of Six . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
• Demographic Data . . . . . . . . . . . . . . . . . . . . . . . . . . 34
• Caregiving and Upbringing . . . . . . . . . . . . . . . . . . . 35
• Health, Food and Nutrition . . . . . . . . . . . . . . . . . . . 38
• Initial Education . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
• Recreation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
• Participating in and Exercising Citizenship . . . . . . . 45
Early childhood public policy in Colombia:
a path to continue building . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
• Early Childhood Care
Before the Constitution of 1991 . . . . . . . . . . . . . . . . 48
• Constitution of 1991 and Early Childhood . . . . . . . . 61
• Generating Conditions to Draw Up
an Early Childhood Public Policy . . . . . . . . . . . . . . . 62
Early Childhood Comprehensive
Care Strategy “De Cero a Siempre” . . . . . . . . . . . . . . . . . . . . . 75
• Country Developments Compiled
by the Strategy to Carry On . . . . . . . . . . . . . . . . . . . 76
• Challenges posed by the Strategy . . . . . . . . . . . . . . . 82
Second part
Technical Grounds for Early Childhood
Comprehensive Care Strategy . . . . . . . . . . . . . . . . . . . . . 87
Conceptual Grounds for
the Early Childhood Strategy . . . . . . . . . . . . . . . . . . . . . . . . . . 89
• Understanding Girls and Boys in Early Childhood
from a Rights-Based Approach . . . . . . . . . . . . . . . . . 89
• Early Childhood Development . . . . . . . . . . . . . . . . . 94
• The Family’s Role . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
• Environments where Children Develop . . . . . . . . . . 108
Comprehensive Care Fundamentals . . . . . . . . . . . . . . . . . . 117
• Comprehensive Protection,
an Action Framework for the Strategy . . . . . . . . . . . . 117
• Children’s Rights and their Realizations:
The Strategy’s Commitment . . . . . . . . . . . . . . . . . . . 121
• Early Childhood Comprehensive Care . . . . . . . . . . . 124
• Early Childhood Comprehensive Care
Structuring Factors . . . . . . . . . . . . . . . . . . . . . . . . . 126
Third part
Management of Comprehensive Care Strategy
for Early Childhood: Institutions, Comprehensive
Care Road-map, and Lines of Action . . . . . . . . . . . . . . 167
Comprehensive Management
Favoring Child Development . . . . . . . . . . . . . . . . . . . . . . . . . . 169
The Strategy of Comprehensive Early Childhood
Care: Relationship with Various State Agencies . . . . . 171
• The National Family Welfare System (SNBF) . . . . . . 171
• The Intersectoral Commission
for Comprehensive Early Childhood Care . . . . . . . . . 172
• National and regional bodies coordinated in favor
of comprehensive early childhood development . . . . 175
The Comprehensive Care Roadmap:
Guidance for Management in Territories . . . . . . . . . . . . . 178
• RIA classifying criteria . . . . . . . . . . . . . . . . . . . . . . . 179
• The RIA, a Collective Production . . . . . . . . . . . . . . . 184
• A Roadmap Tailored to each Territory . . . . . . . . . . . 220
• Comprehensive Care Plan: Road to action . . . . . . . . 223
Each girl and each boy in the Strategy . . . . . . . . . . . . . . . . 225
• Adjusting modalities and services,
and their transit into comprehensiveness . . . . . . . . . 227
Lines of Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228
• Territorial management . . . . . . . . . . . . . . . . . . . . . . 229
• Quality and coverage . . . . . . . . . . . . . . . . . . . . . . . . 232
• Monitoring and evaluation of public policy . . . . . . . . 239
• Social mobilization . . . . . . . . . . . . . . . . . . . . . . . . . 241
• Knowledge management . . . . . . . . . . . . . . . . . . . . . 242
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
Introduction
The Early Childhood Comprehensive Care Strategy positions pregnant women, girls and boys from birth until the age of six in the center
of action.1 Conceiving them as holders of rights, as unique and singular
beings, active in their own development, valid and holistic interlocutors, and recognizing the State, the family and society as their duty
bearers have set the pace of the Strategy.
The great challenge is being consistent with this posture from San
Andrés y Providencia Islands to the Amazonas, in the central government and in the governments of the most remote regions, as well as
in urban and rural areas. Colombia is committed to a long term ambitious project convening all the stakeholders involved in the development of children, throughout the whole country, in its full depth,
diversity and complexity.
This is an ethical imperative, a vital intention of the nation recognizing the journey undertaken by the country towards an early childhood
public policy, with different sectors of society collecting and discussing
ideas, contrasting postures and experiences to reach agreements. It is
strongly supported by scientific developments and conscientious studies of strategies carried out previously in Colombia, and also elsewhere,
setting the basis for the country to act coherently towards the holistic
development of early childhood, which is still under construction.
Looking at the historic transformations of this topic throughout
the existence of mankind, clearly the concern for early childhood is
very recent.
Quite possibly in some years we will not have to justify collective
actions on this matter. Maybe society will soon consider it obvious
that children must always be in first place and at the center of all
comprehensive care.
1
Early Childhood comprises the period between pregnancy and the age of five years, 11 months
and 30 days. Therefore throughout this document this period is called “from zero to five”
(understanding that it concludes at the end of the 5th year) or “From zero until the 6th birthday”.
15
Early Childhood Comprehensive Care Strategy
But those days have not arrived yet, and furthermore a large amount
of research on human development2 has shown that most of the brain
connections3 as basic language skills, motor skills and symbolic thinking and the basis for social interaction occur between pregnancy and
the age of six. This means that although development occurs over life,
the grounds are set during the first years increasing the complexity of
the capabilities, skills and potentials of each person.
If this is the case, it is only natural to expect the State and society to
make enormous efforts to ensure that these beings starting their lives
have the necessary conditions for an optimum development and to fully live from the moment they are conceived. As stated in the very first
lines, Colombia has committed to this, acknowledging the categorical
imperative of early childhood rights.
Since the nineteen sixties the country has undergone important
transformations on the conception of children and the care they should
be provided, and consequently in 1990 Colombia formalized its adhesion to the International Convention on the Rights of the Child. The
approval of the International Convention on the Rights of the Child by
the Congress of the Republic of Colombia (Law 12, 1991), its inclusion
in the Political Constitution of 1991 (Article 44) and passing of Law
1098, 2006 whereby the Childhood and Adolescence Code was enacted were other extremely important milestones. The challenge is that
comprehensive care to early childhood is a permanent and sustainable
responsibility of the State, essentially for ethical and political reasons.
In line with scientific and economic research4, the Colombian
State embraces the evidences on human development stating that a
16
2
See for example Margaret Norrie McCain and J. Fraser Mustard (2002). The Early Years Study.
Three Years Later and C. Nelson (2000) From Neurons to Neighborhoods.
3
Approximately 85%.
4
See for example J. Heckman and P. Carneiro (2003). Human Capital Policy. National Bureau
of Economic Research – Working Paper 9495; L. Schweinhart (2004). The High/Scope Perry
Preschool Study Through Age 40: Summary, Conclusions and Frequently Asked Questions.
The High/Scope Educational Research Foundation; A. Rolnick & R. Grunewald (2003). Early
Childhood Development: Economic Development with a High Public Return. The Region 17, 4,
Supplement; A. Rolnick & R. Grunewald (2006). A proposal for achieving high returns on Early
Childhood Development. Harvard Graduate School of Education, 10.
Introduction
good quality of life during childhood is reflected in adulthood and
therefore the consequences of investment in health, education and
social cohesion make it the most effective way of breaking the circle of poverty and considerably closing the gaps of inequality5. It is
common knowledge that for Colombia it is still a challenge to make
progress in inequality. Not just in ethical terms but also in strategic
ones, the country is aligned with numerous studies evidencing that
investing in early childhood is the most profitable investment society
can make since it has the longest return period and it also results in
less social investment in the long term.
5
Van der Gaag (2002). From Childhood Development to Human Development. In: M. Young (ed.),
From Early Childhood Development to Human Development. Investing in our Children’s Future.
Washington: World Bank.
17
Early Childhood Comprehensive Care Strategy
Seeking the Consolidation of a Public Policy
We turn like
the dolphins,
we kick, we
rest on the tips
of our toes at
the base of the
belly as if we
were stretching
upwards; we
move our
arms and our
legs. We make
these sudden
movements
and startle our
mothers.
In 2010 the Ministries of Finance, Education and Social Protection
and the Colombian Family Welfare Institute (ICBF acronym in Spanish) hired a study and the outcome was a diagnosis of the situation
on early childhood care in the country. It also examined international
relevant experiences, it explored public-private partnerships that could
be implemented to increase coverage and quality of early childhood
care, and it presented a set of proposals and recommendations to make
the institutions, regulations, standards and finances suitable to ensure
universal care coverage for early childhood vulnerable populations.
Since one of the recommendations of the study was to create an
articulating and coordinating body for comprehensive care, a technical
team was formed to agree on and consolidate a proposal and the action
plan for the coming years. The results were reflected and included as a
priority in the “2010 – 2014 National Development Plan: Prosperity for
All”6 wherein the government committed to design and implement a
strategy involving decisive actions of the government sectors, planning,
health, education, culture and wellbeing. Law 1450, 2011 enacting the
Development Plan set out goals and specific investments for early childhood based on supplementary legal and technical developments, considering that early childhood comprehensive care will be a permanent
and sustainable action of the State.
In response to the provisions of the Development Plan, the Early
Childhood Comprehensive Care Intersectoral Commission was created
(Decree 4875, 2011); and the Office of the President, the Ministries of
Health and Social Protection, National Education, Culture and the National Planning Department, the National Department for Social Prosperity and the Colombian Family Welfare Institute have a seat on this
commission. Its role is to coordinate and harmonize policies, plans,
programs and actions required to provide early childhood comprehen6
18
Colombia, Congress of Colombia (2011, June 16) Law 1450, 2011 whereby the 2010 – 2014
National Development Plan is enacted. Bogotá. Official Journal No. 48.102 Available at http://
www.secretariasenado.gov.co/senado/basedoc/ley/2011/ley_1450_2011.html
Introduction
sive care, being accountable for securing agreements between the different sectors involved.
The challenge of progressing towards an intersectoral goal needed
the Government to define a mechanism to enhance convening and governance capabilities in the Intersectoral Commission, without weakening the institutions but strengthening the competences of all the member sectors. Consequently the Decree provided that the Commission
would be chaired by a senior government official directly appointed by
the President of Colombia.
The efforts of the Commission are steered towards strengthening
the institutions, ensuring leadership in each of the sectors involved,
guaranteeing commitment of the directors and suitability of the technical team, and mobilizing resources and actions to ensure full development of the children through comprehensive care.
In connection with the objectives, the Commission’s actions are
geared towards i) defining a long term, sustainable and universal early
childhood comprehensive care policy with a population and territorial approach; ii) guaranteeing relevance, quality and articulation of
the programmatic and social actions inherent to early childhood comprehensive care since before the conception and until the transition
to formal education; and iii) developing a social mobilization process
inspiring the understanding of early childhood and the interactions
established with children in the different environments of life, with
references embracing their integrality and human dignity.
The Commission has a technical committee comprising everybody
responsible for directing early childhood programs and projects in each
of the member entities. This committee is accountable for producing
national and territorial programmatic elements and policies, and articulating and guiding the technical decisions taken in the Commission.
Also the Early Childhood Comprehensive Care Intersectoral Commission has a technical secretariat.
19
Early Childhood Comprehensive Care Strategy
Design of the Early Childhood Comprehensive
Care Strategy
One of the first tasks undertaken by the Commission was to design the Early Childhood Comprehensive Care Strategy implemented
as national and territorial planned actions, to promote and guarantee
child development of girls and boys since pregnancy and until they
turn six. Through unified and intersectoral work -from a rights-based
approach and with a differential approach- it articulates and promotes the development of plans, programs, projects and actions for
comprehensive care to be ensured for every child, according to their
age, context and condition. Knowledge management promoted by the
Commission, as well as the social mobilization inspired for debating
and giving feedback on the different achievements accomplished are
of extreme importance.
In order to design a public policy based on evidence, the Commission hired studies on the implementation of the strategy, its financial
sustainability, institutional capabilities, human talent supply and demand, child development, birth defects, among other matters. It also
convened Colombian experts on early childhood to draw up technical guidelines in preparation for this document and it encouraged
direct exploration with the community to identify early childhood
differential features. The products delivered by these experts served
as input for other materials to accompany the policy executors in
their different fields of action.
Regarding mobilization, the Commission encouraged territorial dialogs and implemented face to face and virtual mechanisms for the
citizen’s participation in providing feedback on the technical instruments and proposals developed to date. They have contributed to presenting a strategy to the country today with background, institutional
framework, conceptual grounds, techniques and management based
on the idea of building on the foundations, as regards to early childhood rights, under the State’s long term perspective and the potentials
of articulated intersectoral actions.
20
Introduction
As a result of the two year’s work framed by the agreement of various entities and sectors of the population, the Commission presents a
strategy based on understanding and empirical evidence, offering very
specific guidelines to organize the actions in the territories favoring
early childhood and with the characteristics pertaining to all the places
where there are children. One of the tools resulting from this study is
the Early Childhood Comprehensive Care Roadmap (RIA, acronym in
Spanish), which undoubtedly will tune all the country to ensure that
every child develops integrally.
What has been Implemented
Since the Strategy is committed to the present, efforts have also
been conducted towards its implementation. This has entailed a large
mobilization of public and private resources, as well as international
cooperation, all joining efforts in successfully supporting comprehensive care tasks like infrastructure, access to cultural goods and services
and qualification processes of education, health and culture agents
throughout the country.
21
Early Childhood Comprehensive Care Strategy
At the territorial level, through the National
Family Welfare System and with the decisive
support of international cooperation, the Strategy has deployed its technical cooperation for
the territorial governments to become acquainted with, take ownership of and implement the
instruments built to drive the execution of the
early childhood policy. In the framework of
the territorial dialogs, it has opened settings
for national and local intersectoral meetings to
jointly analyze technical support requirements
and to establish working agreements. Based on
specific requests and undergoing processes in
the territories, the Commission has provided
direct technical accompaniment, has sought
the support of experts on very specific matters
and has revised and presented recommendations to proposals and documents developed by the territorial entities.
Additionally it has favored exchanges and internships between officials of the territories and meetings of working experience promoters
with early childhood in different contexts and with different populations to enrich the technical perspective provided by having contact
with previously tested knowledge and experiences.
From a monitoring perspective, the Strategy has taken important
steps in three different fields. Under the Unique Children’s Information System (SUIN, acronym in Spanish) providing information on
the holding of children’s rights, it has introduced early childhood
indicators; also progress has been made in harmonizing systems and
procedures to record and track the care that the National Family Welfare System offers to children; and a tracking system for every single
child is being structured as one of the fundamental axis for the Strategy’s implementation.
The Strategy has put important efforts into the qualification of the
human talent offering care to the children during their early childhood,
22
Introduction
driving training processes in the territories under the comprehensive
care model, emphasizing on children’s rights, children’s development
and the differential approach, among other topics.
This Document
The fundamentals of the Strategy are set out below for them to be
revealed, understood, shared and put into practice by all the stakeholders sharing the responsibility of providing fulfilling, decent and happy
lives to Colombian children.
The document is structured in three parts: the first one: “Context
for the Early Childhood Comprehensive Care Strategy in Colombia”
stages a quick overview of early childhood, its progress and challenges,
and a summary of the main events marking the transformations in the
country on how to understand children, until reaching the postures
currently showing the way. This first part points out the main components that the Strategy reassesses to continue making progress, as well
as the challenges undertaken to effectively guarantee the rights of the
people whose lives are just beginning.
The second part of the document presents the “Technical Grounds
for the Early Childhood Comprehensive Care Strategy” organized in
two fields: conceptual foundations as regards to early childhood and
those of comprehensive care.
The third part presents the core components of management towards a comprehensive development of children under the age of six,
the relationship of the Strategy and the different State bodies, the lines
of action, and maybe one of the most promising developments of the
Strategy –The Early Childhood Comprehensive Care Roadmap- a useful tool to organize actions in the territories.
23
Early Childhood Comprehensive Care Strategy
The Strategy, Commitment to Early Childhood
The Early Childhood Comprehensive Care Intersectoral Commission invites all the country to seal a commitment with early childhood,
towards ensuring that children can develop and lead their lives just
as they wish, to advocate for their environments, to contribute to the
development of their communities from the moment they are born and
to continue doing so throughout their lives.
This means that knowledge, experience and background, as well as
technical, administrative and financial resources need to be available
for the process. The Commission fully understands that this will only
be possible if all the country participates based on trust relationships
between the parties, on collective and transparent cooperation attaining important results on innovation, quality, integrality and social inclusion.
The invitation is to generate mutual listening situations between the
different stakeholders in order to define and prioritize actions related to
early childhood comprehensive care, based on the requirements of the
territory and to establish a joint working agenda.
Only then can we say that the commitment for the full development
of early childhood has been sealed by the State, the family and society,
in each of the territories in the country.
24
Reference Studies Underpinning
this Document
In order to design the Early Childhood Comprehensive Care
Strategy fundamentals and the technical guidelines, the Early
Childhood Comprehensive Care Intersectoral Commission hired
studies and their outcome served as the reference for the preparation of this Document and other material used for its implementation. The Commission thanks the authors for their contributions,
as well as the agencies who participated either through cooperation
agreements or with direct funding.
• Situation of Children During Early Childhood
Á ngela Patricia Nocua Cubides
Cooperation Agreement 442, July 26, 20127, Early Childhood Comprehensive Care.
2013
• “Cero a Siempre” Tells You: The Current Situation of the Children
from Pregnancy up until their First Two Years of Life in Colombia
Jaime Vizcaíno
Cooperation Agreement 442, July 26, 2012, Early Childhood Comprehensive Care.
2013
• Technical Fundamentals of the Comprehensive Care Strategy
M arina C amargo A bello and A driana Lucía C astro Rojas
With the support of the Inter- American Development Bank
2012
7
This Agreement was executed between the Ministry of National Education, the Ministry of
Health and Social Protection, the Ministry of Culture, the Colombian Family Welfare Institute,
the Saldarriaga Concha Foundation, the Éxito Foundation, the United Nations Children’s Fund
(Unicef ), the Bancolombia Foundation and the Génesis Foundation.
25
Early Childhood Comprehensive Care Strategy
• Technical Guidelines for Promoters of Development Environments
Ernesto Durán Strauch
Coordinated by the Ministry of Health and Social Protection and supported by the Inter- American Development Bank
2012
• Technical Guidelines for the Comprehensive Protection in the
Exercise of Children´s Rights since Early Childhood
M artha Lorena Padrón Gómez
Coordinated by Colombian Family Welfare Institute
2012
• Analysis of the Most Significant Experiences Developed and
Guided Towards Strengthening the Family for Full Development
of Children and Adolescents
Leonor I saza Merchán, with the collaboration of C armen Midaglia and
Héctor Rodríguez
Coordinated by the Colombian Family Welfare Institute. Supported by
the Inter-American Children’s Institute (OAS).
2011
• Technical Guidelines on Education and Accompaniment for
Families with Children in Early Childhood
A ngela Patricia Nocua Cubides
Coordinated by the Colombian Family Welfare Institute. Supported by
the Inter-American Children’s Institute (OAS).
2012
• Technical Health Guidelines in Early Childhood
Blanca Luz Hoyos Henao
Coordinated by the Ministry of Health and Social Protection. Supported by the Inter- American Development Bank
2012
• Technical Food and Nutrition Guidelines for Early Childhood
Nora Corredor M artínez
Coordinated by the Ministry of Health and Social Protection. Supported by the Inter- American Development Bank
2012
26
Reference Studies
• Pedagogic Guidelines on National Initial Education
Graciela M aría Fandiño Cubillos, Yolanda R eyes, Sandra M arcela Durán
Chiappe and M aría Consuelo M artín C ardinal
Coordinated by the Ministry of Health and Social Protection. Supported by the Inter- American Development Bank
• Recreation Guidelines
E speranza Osorio Correa
Coordinated by the Administrative Sports, Recreation, Physical Activity and Enjoying Free Time Department –Coldeportes-.
2013
• Feeling and Doing, Growing and Creating: Guidelines for the
Participation in and Exercise of Citizen Rights in Early Childhood
Elsa C astañeda Bernal and M aría Victoria E strada
Coordinated by the Ministry of Culture and the Rafael Pombo Foundation
2012
• Manual on the Territorial Implementation of the Early Childhood
Comprehensive Care Strategy
Deidamia García Quintero and Javier Medina Parra
Supported by the World Bank
2012
• Recommendations for Incorporating the Differential Approach in
the “Cero a Siempre” Strategy
C arolina Turriago B., Clemencia Á ngel :, Liliana Ávila G., M arina Bernal
G., L aura Victoria Gómez C., L aura Mercedes Hoyos G., C andelaria
M artínez M., Ingrid M arcela Moreno P., Paola A ndrea Rueda C., Linda
Flor Salazar A., M ariana Schmidt Q and Orlando Scoppetta Díaz G.
Cooperation Agreement 442, July 26, 2012, Early Childhood Comprehensive Care.
2013
• “De Cero a Siempre”: Towards Systematizing the Construction
Process
Germán M ariño Solano
Cooperation Agreement 442, July 26, 2012, Early Childhood Comprehensive Care.
2012
27
Early Childhood Comprehensive Care Strategy
• Guidelines for Human Talent Qualification
Nisme Yurani Pineda Báez, Leonor I saza Merchán, Luz M aría Babativa,
Fadua K attah, M arina C amargo A bello, Cristina Á lvarez, Á ngela M aría
Hernández, C arolina Ordóñez and Paula Quintero. Team of the Fundación
Centro Internacional de Educación y Desarrollo Humano (CINDE)
Cooperation Agreement 442, July 26, 2012, Early Childhood Comprehensive Care.
2012
• Technical Guidance on Development Evaluation
A lberto Vélez, Claudia Talero, C amilo Galvis, M aría Cristina M ariño,
Eliana R amírez, Jospe A mar A mar, M arina Llanos, Consuelo A ngarita,
A lbero de C astro, Fabiola Mesa, M arina Begoña. Professionals from the
Colombian Child Neurology A ssociation, Colombian Pediatrics A ssociation
and Fundación Universidad del Norte, Barranquilla.
Cooperation Agreement 442, July 26, 2012, Early Childhood Comprehensive Care.
2012
28
This document highlights children’s voices
from different regions of the country.
Their opinions were gathered during the
consultation exercise about their growing
up experience, helping the team of the Early
Childhood Comprehensive Care Strategy
realize whom they are working for1.
1
The consultation was designed and developed by Jorge Camacho and Adriana Villa under
Cooperation Agreement 442, July 26, 2012, Early Childhood Comprehensive Care.
1
Context for the
Early Childhood
Comprehensive Care
Strategy in Colombia
Early Childhood Comprehensive Care Strategy
T
he Early Childhood Comprehensive Care Strategy of Colombia
is the result of a rigorous exercise that began by recognizing the
situation of girls of boys from the ages of zero to five, and to value
progress made by the country in early childhood comprehensive care.
Both contextual elements set out important and determining courses to
design the Strategy and below is a synthesized perspective of both.
The first part includes some succinct figures to help the reader
understand the current situation of the rights of the children under
the age of six in Colombia, with demographic data and crucial matters for a holistic development at this stage of life. We will make a
brief presentation of the background of early childhood public policy
since the beginning of the X X century to date, detailing conceptual
discussions on some affairs regarding holistic development, programmatic momentums and contributions from the sectors. Finally it presents the developments that the Early Childhood Comprehensive Care
Strategy has compiled from the country’s experience and it identifies
the main challenges.
32
Context for the Strategy
The Situation of Colombian Children
under the Age of Six
1
A clear picture of the situation of the rights of Colombian children
in early childhood is the ground for planning priorities and actions to
improve their daily living conditions.
The country has undergone efforts to determine clear and detailed
information on who the children are and how they live in their environments. This effort, originated at a national level, was developed by different sectors and local authorities gradually improving their identification
and registration methods in their own systems, in intersectoral proposals
and in the planning and accountability exercises provided by the Law.
Nevertheless there are coverage gaps, as well as in the breakdown of
information and in the currency of the information, especially for the
ages running between zero and six, and also for ethnic groups, people with disabilities, children affected by the armed conflict and other
types of violence. The country’s main challenge is to generate accurate
information for the correct decisions to be made to contribute to overcome the inequality problems acting as barriers to the progress of many
development indicators.
The Early Childhood Comprehensive Care Strategy understands it
is compelling to rely on an information system accounting for all the
children living in the country, their situation, where they live and their
living conditions in order to profile the care and reach out effectively to
each one meeting their needs. Precisely the third part of the document
will refer to this.
Taking into consideration the country’s limitations on information,
following is some demographic data available on children in their early
1
This section is based on the products prepared by Ángela Patricia Nocua Cubides and Jaime
Vizcaíno under Cooperation Agreement 442, July 26, 2012, Early Childhood Comprehensive
Care executed between the Ministry of National Education, the Ministry of Health and Social
Protection, the Ministry of Culture the Colombian Family Welfare Institute, Saldarriaga Concha
Foundation, Éxito Foundation, the United Nations Children’s Fund (Unicef ), Bancolombia
Foundation and Génesis Foundation.
33
Early Childhood Comprehensive Care Strategy
childhood and their families, and also some figures related to crucial
matters for an holistic development during early childhood like caregiving and upbringing conditions, health, nutrition, education, recreation,
participation and exercise of citizenship.
Demographic Data2
According to the forecast for 2013 based on the general census of
2005, in Colombia there are 5,150,797 girls and boys who are between
zero and five years old, accounting for 10.9% of the country’s total population. Out of them, 48.8% are girls, and 51.2% are boys; 75.9% live
in urban areas, while 24.1% live in rural areas.
In Colombia approximately 14.4% of the total children’s population between the ages of zero and five belong to an ethnic group. Afro
descendants represent 9.8% of the total, with 507,272 people; out of
which 3,679 are raizales; 663 are palenqueros and 502,930 and black
and Afro Colombians3. On the other hand, 236,966 boys and girls belong to an indigenous community, accounting for 4.6%. Gypsy communities are estimated at 449 people, accounting for 0.0082%. Lastly the
census identified a total of 96,273 children with disabilities between
the ages of zero and five, representing 1.87% of the total population of
the country in this age range.
The indicators for the ethnic groups and the rural area tend to be
below the national average, so the Strategy realizes the importance of
influencing the living conditions of the children from these groups.
Maybe the most dramatic figure which must necessarily catch our
attention is the one provided by the Large Integrated Household Survey
(Gran Encuesta Integrada de Hogares) of the National Statistics Agency
(DANE ) in 2010, evidencing that 60.03% of the girls and boys in their
early childhood live in poverty; and 23.36% in extreme poverty.
34
2
The demographic data corresponds to the population forecast prepared by DANE (National
Statistics Agency) for 2013, based on the census of 2005, except when specified otherwise.
3
The denominations correspond to the ones used in DANE
Context for the Strategy
Poverty places children in a situation where they are at risk of violation of their rights from
the rights-based approach. The World State of Childhood declared in 2005 that children living in
poverty endure deprival of material, spiritual and emotional resources required to survive, develop
and thrive. It prevents them from enjoying their rights, reaching their overall potential and participating as full members and under equal conditions in society1.
In addition to material deprival, poverty is associated to limitations or precarious access to
basic services, food and nutrition safety, exposure and vulnerability concerning social risks, discrimination and social exclusion, among other situations affecting the children’s physical, psychological and social conditions, beyond family income.
Poverty and inequality conditions multiply the barriers for the exercise of rights therefore
overcoming them is mandatory to progress towards their guarantee.
1
United Nations Children’s Fund (Unicef ) (2005). World State of Childhood. 2005. New
York, p. 18
Caregiving and Upbringing
Human condition directly depends on the construction of emotional bonds and socialization. The family is the desirable social group a
person is born into. It is the first group a person belongs to and it is a
reference, wherefrom children become part of society.
The fact that home is the first environment means that as of the
conception, they have a niche with relatives and caregivers awaiting
their arrival ready to receive them and accompany them while they
grow up and establish relationships with their environments under
different contexts.
When the
people in our
families, sisters
and brothers,
cousins, mom
and dad,
grandmothers
and
grandfathers
talk to us and
cuddle us, we
know they love
us.
It is therefore essential for the State and society to focus on supporting and preparing the families to enhance their emotional bonds
with their daughters and sons, and to provide enriched, protecting
and safe environments where they participate significantly. Additionally the State, society and family must expand their responsibility as
promoters and overseers of risk prevention and remove vulnerable
situations affecting the wellbeing and physical and psychological integrity of the youngest.
Considering the main role played by the families, it is important
to know that the National Demography and Health Survey (ENDS,
35
Early Childhood Comprehensive Care Strategy
acronym in Spanish) determined that out of 51,447 homes surveyed in
2010, 35% where formed by complete nuclear families; 12% by incomplete nuclear families due to the absence of the father or the mother;
14% by extended complete families (the couple lives with their children
and other relatives); 3% by extended incomplete families (the bread
winner without a spouse lives with his/her single children and other
relatives) and 4% by families comprising relatives and non-relatives.
Average household numbers have been dropping; from 4.1 people in
2005 to 3.8 people in 2010; and this is greater in the rural areas (3.9)
than in the urban areas (3.7).
Between 2005 and 2010, based on data provided by the National Demography and Health Survey, marital unions are occurring at
younger ages: at 20 in rural areas and at 22.3 in urban areas. Also the
percentages of women getting into relations before they are 15 (8.5%
and 3.6%) and 18 (32.6% and 19.4%) are greater, so the ratio of marital
unions in adolescents is increasing.
36
Context for the Strategy
Regarding the use of contraceptives, the survey indicates that it
starts later in rural areas compared to urban ones. Only two out of
five women (40.5%) start using them before they have their first child,
while in the urban area it is the case of 1 out of 2 women (50.5%).
According to the National Demography and Health Survey in 2010,
approximately 700,000 girls and boys are born every year in the country. Half those born in the last five years were planned and wanted
babies, and one out of four was reported as un-wanted.
Pregnancy in adolescents is one of the country’s great concerns as
well as of the Early Childhood Comprehensive Care Strategy, since
19% of the adolescents are mothers. In the rural area this figure reaches
26.7% while in the urban area it is 17.3%: There is a dormant context
behind this, since inequality and lack of opportunities have an effect
on poverty and social mobility.
Pregnancy at early ages is a risk to the protection of life and health
of the girls, boys and their mothers, before, during and after birth. Pregnancy in adolescence is associated to a greater probability of high blood
pressure (preeclampsia), placental abruption, maternal anemia, low birth
weight, premature births, newborn jaundice, respiratory distress syndrome, sepsis, congenital malformations and other situations possibly resulting in life-long consequences for the children’s health and wellbeing.
Regarding the commitment of the State, society and family to the
protection of early childhood rights, the country must become aware of
the current effects and future impacts on the lives of children and their
families when these rights are not guaranteed properly. Acknowledging
this situation must only result in a profound mobilization for the protection of those people whose lives are starting.
In accordance with the Unique Registration of Displaced People
(RUPD, acronym in Spanish), as a result of the exposure to the armed
conflict, in 2011 in Colombia there were 397,080 children under the
age of six victims of internal forced displacement4, representing 7.7% of
the country’s population in those ages.
4
The RUPD is undergoing a restructuring process and doesn’t have updated figures on the forced
displacement situation in the country.
37
Early Childhood Comprehensive Care Strategy
In connection with social violence the National Forensic Medicine and Sciences Institute (Forensis in Spanish) stated that in 2010,
2,796 cases of sexual violence against girls and boys under the age
of four were reported. Fifty girls and boys between the ages of zero
and four were homicide victims and three children between the ages
of zero and five died as a result of violent actions. Regarding deaths
resulting from external causes, Forensis has a record of 508 children
between the ages of zero and four in 2011 broken down as follows:
58% accidental deaths, 18% in road accidents, 9% homicides and
15% from undetermined causes. It is noticeable that between 2005
and 2011, a 10% reduction has been preserved 5.
Health, Food and Nutrition
Girl’s and boy’s physical, mental and social wellbeing results from
the interaction between biological, social, political, economic, environmental and cultural factors set out by the circumstances they are born
to, live and grow up in.
Children growing up and developing in excellent health conditions
have a greater opportunity of enjoying their existence and contributing
to the wellbeing of their communities.
Maternal and Child Health
Following are the figures on maternal and child health understanding
that they are linked. The National Demography and Health Survey (ENDS,
acronym in Spanish) of 2010 shows that one out of five pregnant women
does not go to a health center; and 97% of the women who did go, received
5
38
The National Forensic Medicine and Sciences Institute (in Spanish INMLCF/National Reference
Center Group on Violence (in Spanish GCRNV). 2005-2006: Information System for Analysis of
Violence and Accidents in Colombia (in Spanish SIAVAC)(Direct) and Consolidated Statistical
Information by Region (Indirect). 2007-2008 Database Information Network System of Missing
People and Corpses (in Spanish SIRDEC) (Direct) and Consolidated Statistical Information by
Region (Indirect). 2009-2010 Database Information Network System of Missing People and
Corpses (in Spanish SIRDEC) (Direct) and National Indirect Statistics System (SINEI)(Indirect),
quoted in Report to the Citizens. Opting for Peace and Social Prosperity 2005-2012.
Context for the Strategy
specialized medical care during the pregnancy (91.7% by physicians and
5.3% by nurses). Prenatal medical care increased by 3.5% compared to
2005, with favorable perspectives for this to become universal in 2015.
The vital statistics of the National Statistics Agency (DANE, acronym
in Spanish) for 2009 show that in 83.8% of the cases, births followed
four or more prenatal medical care controls, a percentage growing since
1998, from 65%. Between 1990 and 2010 this indicator increased 20%
especially among low income women. Nevertheless this result is still
far from the Millennium Development Goals
(MDG), where the goal for Colombia is at 90%
by 2015.
The challenge is greater in the department6
of Amazon, where the percentage is below 50%
and in the departments of Putumayo, La Guajira, Caquetá, Casanare, Cauca, Arauca, Meta,
Córdoba and Nariño where the percentage is
under 80%. The departments already at the goal
are San Andrés, Huila, Quindío and Caldas.
Institutional care during the delivery has
increased progressively in the country, from
93.1% in 1998 to 98.6% in 2010, exceeding
the 95% proposed by the MDG. Many departments have surpassed 99% care for this indicator, although some regions like the Amazon
or the departments of Arauca, Putumayo, Cauca and Chocó, where this
percentage is below 96%.
According to the estimates of DANE based on vital statistics, maternal mortality has dropped from 100.14 deceased for every 100,000
children born alive in 1998 to 71.64 in 2010, representing a 25% reduction of this indicator over the last decade. It is a matter of concern
as this indicator has not exhibited much progress since 2005, remain6
Colombia is unitary republic conformed by 32 departments, 1.123 municipalities and one
Capital District as a political and administrative units.
39
Early Childhood Comprehensive Care Strategy
ing close to 73 maternal deaths for every 100,000 births. The situation
in rural areas and in populated regions increases this concern since the
rates there are more than double the MDG for 2015.
In connection with children’s health, the most recent figures presented by the DANE evidence a sustained reduction since 2005, of
20.4 deceases for every 100,000 infants born alive to 18.4 in 2010,
representing a 10% reduction. At the department’s level, child mortality rates exhibit a downward trend, like the national average, and it is
lower in Valle, Bogotá, Norte de Santander and Caldas.
To express
what we like,
we laugh, clap,
jump, pull
faces, move
our hands,
scream, point
with our
finger or touch
what we like.
According to the Ministry of Health and Social Protection, 59.5%
of the child mortality cases are of perinatal origin, between the 28th
week of pregnancy and seven days after birth, so these causes must be
overcome to achieve a significant impact on this indicator.
According to the basic health indicators 2009-2010, respiratory
diseases specific to the perinatal period (23.3%), congenital malformations, deformities and chromosome abnormalities (20.3%), other diseases occurring during the perinatal stage (11.1%), newborn
bacterial sepsis (8.7%) and acute respiratory diseases (7.2%) are the
main causes of mortality in children under one year. It is important
to highlight that the mortality due to acute diarrhea disease (EDA,
acronym in Spanish) dropped by over 50% between 2005 and 2010,
from 12.16 deaths for every 100,000 children under the age of five in
2005 to 5.26 deaths in 2010.
On health assurance, data from the Ministry of Health and National
Protection indicate that in 2010, 3,697,151 girls and boys under the age
of six were registered with the National Social Security Health System;
1,579,421 in the contributive regime; 15,884 in the exception regime
and 2,101,846 in the subsidized regime. During 2011, 3,274,197 went
for growth and development medical checkups.
The National Demography and Health Survey for 2010 estimated
that 76% of the children under five were registered in health programs
and went to an average of 2.6 appointments per year. Likewise, 79.9%
of the girls and boys under the age of two had their complete vacci-
40
Context for the Strategy
nation program, comprising at least polio, DPT BCG and MMR at the
dosage required for this age.
Nutrition
This is another determining development factor. It refers to a process whereby the body assimilates and benefits from food nutrients.
The nutritional condition impacts survival and life quality and therefore it is the perfect indicator to assess children’s health.
There is a lot of scientific evidence (The Lancet, 2007) clearly stating the negative and long lasting impacts of inadequate nourishment
in girls and boys. Early malnutrition reduces learning skills, school
performance, economic productivity in adulthood and the ability to
take care of new generations. It traps people in a circle perpetuating
malnutrition, poverty and slow development. Ensuring conditions
for the children to receive appropriate food and nutrition helps prevent diseases and prepares the body and the mind to develop to its
full potential.
Data related to the nutrition condition of expectant women shows
that 16.2% were underweight for their weeks of pregnancy; the young
ones being the most affected (13-18 years old, 28.6% and 19-24 years
old, 20.8%). One out of two expectant women in the country were at
the correct weight for their weeks of pregnancy, and 34.6% had a certain
degree of excess weight (24.8% were overweight and 9.8% were obese).
About nursing as a privileged option for child development, breast
milk is the only food providing all the nutrients required for optimal
growth and development of children during their first months. It has
cells, immunologic factors, anti-infectious factors and hormones improving health and protecting infants from a large number of common diseases, and it stimulates their physical, cognitive and psychosocial development (ENSIN, 2010:213). No other type of food is the
only one required during a specific period of life, and so up until six
months of age, it should be the only food given to infants; later it is
necessary to provide the nutrients required with a variation of food.
41
Early Childhood Comprehensive Care Strategy
Breast milk is irreplaceable and impossible to replicate by chemical
procedures; it doesn’t require any monetary compensation and it is
easily available.
In breast feeding, 96% of the women started nursing their baby at
birth; 56.6% of the women reported having breast fed their child in the
first hour after birth; 19.7% started nursing the baby on the first day
while 30.8% did so in the following three days after giving birth.
Yet on the whole breast feeding has decreased in the country since
out of 97.1% of the women who at some point nursed their child in
2005, it shifted to 96.0% in 2010 an increase from 2.9% to 4.0% of
women who never did breast feed.
In addition to the diminishing of this habit, extended breast feeding hasn’t progressed either. Its total duration increased importantly
between 1995 and 2005, but it didn’t change for 2010. Currently it
is at 14.9 months, while international recommendations are at 24
months.
The ENSIN results (p. 228) show that introducing supplementary
food to breast milk in the country is precocious and the diet quality
is unsatisfactory compared to early childhood nutrition requirements,
especially between the ages of six to eight months.
The country is running risks on the nutrition of children under
one year old, since they are nursed for a shorter period than recommended, supplementary food is introduced prematurely and deficiently, and the food offered lacks the nutrients required to ensure
their optimum development.
In accordance with the ENSIN, 13.2% of the children under the
age of five suffer from chronic malnutrition (their height doesn’t match
their age) and 30.2% is at risk of suffering it. And 3.4% have global malnutrition (low weight for their age) resulting in the risk of it becoming
chronic if not treated timely. Although these conditions have dropped
to half in the last 20 years, they are still above the MDG set at 8% and
2.6% correspondingly.
42
Context for the Strategy
In spite of the reduction noted in the malnutrition rates in the country, it is necessary to continue working very hard to ensure food safety
and nutrition for the children from the beginning of their lives.
Initial Education
Colombia has seen many discussions and
experiences resulting in the State’s commitment -both nationally and internationally- to
an initial education acknowledging that learning begins from the very moment of birth; that
the family, the community and the institutions
are their agents and they are accountable, and
also that the environment is determining
( Jomtien, 1990)7. Without intending to restrict education to the settings and programs
provided for this purpose, following are some
figures of the country.
According to the National Demography
and Health Survey, over one third (38%) of the
children under the age of six were enrolled in
an initial education program; 8% went and dropped out and 54% have
never been. Out of the later, half (53%) don’t go because they are cared
for at home. When the mothers go out, a quarter of the children go with
them; 39% are taken care of by the grandparents; 11% by the spouse;
5% by the eldest girl in the family; 10% by other relatives and the rest
by neighbors, friends or household help; and 4% goes to school, the
ICBF or another institution.
In 2011, under early childhood comprehensive care, the national
government provided initial education to 402,183 children, prioritizing
7
World Declaration on Education for All “Satisfying Basic Learning Needs” ( Jomtien, Thailand,
March 1990), p. 10.
43
Early Childhood Comprehensive Care Strategy
displaced and vulnerable population, and in SISBÉN8 levels I, II and
III. In June 2013, the initial education operation was passed from the
Ministry of National Education to the ICBF.
Recreation
Recreation is closely related to the education conception described
in the paragraphs above. Providing opportunities to explore and interact with the environment, to enjoy playing, physical activity, recreation,
art, literature and dialog between children and adults contribute to
creative, thoughtful and caring human beings.
The National Demography and Health Survey (2010, 265) presents
some figures on the recreation right in the country. It identifies the
main activities carried out by caregivers with children at home, play
(89%), followed by going out for walks (78%), sing songs or tell stories
(74% each) and lastly, story reading (38%). There is a worrisome correlation between mothers in rural areas and lower education levels with
less play and reading percentages.
8
44
SISBÉN is the information system designed by the national government to identify potential
beneficiaries families of social programs.
Context for the Strategy
Also (p. 265) the survey shows that among the caregivers reading to
the children, 28% have books at home, 3% gets them from the library,
2% from a play center and another 2% from the community center. And
82% of the children play with purchased toys, 31% with objects found
outside the homes, 17% with household things and 5% with homemade toys. Also in 6% of the cases, the mother indicated that the boy
or girl doesn’t play, and this is mainly for children under the age of one,
for children whose mothers are under 20, with no education and with
the lowest wealth index.
Undoubtedly for the country it is still a challenge to build settings to
promote recreation as well as information showing different recreation
activities and their benefits for the children’s development.
Participating in and Exercising Citizenship
Feeling a free and self-determined person and being aware of oneself
is the result of the experience that the relations children may have personally, and with others in their environments and multiple contexts.
Identity allows for singularity and also to value diversity and to feel part
of a family, a community and a nation.
Fully living human condition entails expressing yourself through gestures, words and all the signs of language and communication. Interlocution places participation in a context of dialog, recognizing that from
the beginning of their lives, the children have the ability to understand
and contribute important elements to the purpose of their interest, and
in acknowledging also that there are other people with the same capabilities who could be their peers or adults. This implies that adults play
the interlocution role in a democratic manner and recognize children as
active parts in the decisions affecting their lives and the community.
Colombia is a State under the rule of law, and the Constitution
embraces its multiethnic and multicultural condition and promotes
the enjoyment of “the same rights, liberties and opportunities without any discrimination for gender, race, national or family origin,
45
Early Childhood Comprehensive Care Strategy
language, religion, political or philosophical views” (Political Constitution, tit. I art. 13). These conditions pose significant challenges
for those responsible for the comprehensive care of girls and boys. If
the State and its institutions, in each of their decisions and in each of
their actions, recognize that Colombia is an extremely diverse country, this would result in care allowing for the genuine participation
and willingness to answer to the needs of every girl and boy at the
right moment and in perfect proportions.
The birth certificate is the main instrument for the State to formalize
citizenship, as it identifies children at birth and it grants them citizenship. It gives them legal birth and they can hold the access key to the
State assets and services.
According to the National Registry of the Civil Status, between 2005
and 2012, 5,195,727 people between the ages of zero to five were registered and 524,228 from zero to one year old. The National Demography
and Health Survey states that the percentage of children born over the
last five years in the country and not registered reached 4%, and it is
higher in the rural areas (5%).
After reviewing the information clearly the human development indicators in Colombia progress steadily, but rigidity associated to poverty and inequality is present. However this may be overcome by working
intently with early childhood in all the sectors and at all government
levels, having a positive impact on the whole society.
Consequently the Early Childhood Comprehensive Care Strategy
is placing its bets on an ambitious long term process requiring commitment from all the stakeholders involved in the development of
girls and boys.
46
Context for the Strategy
Early childhood public policy
in Colombia: a path
to continue building
At the end of the nineteen nineties, the country underwent a process to build an early childhood public policy as a result of significant
social mobilization processes, international and national regulation
changes and lessons learnt from the experiences of different sectors of
the State in pursuing the country’s development. Its purpose is to fully
guarantee the rights of children under the age of six.
As customary in processes of this nature, the construction of this
policy has been facilitated by political circumstances, the contexts, the
discourses and daily habits of whom participated in this cause, marked
by their ways of thinking, perceiving and relating to children.
Being aware of the historic background of early childhood in society makes it possible to act meaningfully and relevantly towards new
policy horizons from a rights-based approach. Hence the Early Childhood Comprehensive Care Strategy has considered it is important to
understand the evolution of the country over the XX century and to
date regarding its vision on children and consequently on how they
understand, assist and steer actions towards this population.
We like to go
out every day:
go to the park,
take a walk;
see, hear and
feel what is
out there, pick
plants and
touch the soil.
This section will provide the readers with a general overview of
the background and conditions enabling the construction of a public
policy on early childhood comprehensive care and the grounds to
build the Strategy.
Firstly we will address the changes experienced by early childhood
comprehensive care during the XX century up until 1991, when the
country’s Constitution was amended; undoubtedly a milestone in setting
out a policy for children. The following paragraphs present the main contributions of the Constitution in this matter, followed by various events
and transformations giving birth to the early childhood comprehensive
care in the country. This historic synthesis concludes by presenting the
47
Early Childhood Comprehensive Care Strategy
events formalizing the policy’s framework describing the Early Childhood Comprehensive Care Strategy we are addressing in this document.
Early Childhood Care Before the Constitution
of 1991
Since this was a long period (from the beginning of the century
until 1991), the actions on early childhood comprehensive care will be
presented in three blocks: i) from the beginning of the century until
1968; ii) from 1969 to 1974 when the ICBF was created and rolled out;
and iii) from 1975 to 1988 when early childhood care was deployed in
the country.
From the Beginning of the Century until 1968
48
Context for the Strategy
Upon reading the literature on childhood in Colombia, especially
studies carried out on the history of children’s education, until very
recently –the beginning of the X X century- care provided to children
was responsibility of hospices and shelters relying on religious communities taking in children under the age of seven who were orphans,
abandoned or poor, to give them food, provide hygiene, care, protection and a bit of education.
Yet under the European influence on child pedagogy (Active School)
the country experienced a transformation, and education played a leading role in early childhood comprehensive care when the first private
kinder gardens were opened and working pedagogies were developed
and guided specifically to this population.
From the legislative perspective, children’s education was defined
for the first time under Decree 2101, 1939 as “received by a child between the ages of five and seven, and its main purpose is to create
necessary life habits jointly with a coherent development of the personality”. (Cerda, 1996: 12).
Over 20 years had to go by before the government took over kinder
gardens. Decree 1276, 1962 created six national working class kinder
gardens under the Ministry of National Education hoping to give integral care to the children and to project the school’s education action towards the community through family education activities and to serve
as guides for the private initiatives in pre-school education.
After their impact, the national government decided to increase the
number of schools to 22.
One year later pre-school or kinder garden education fell under primary education for guidance and supervision purposes, and pre-school
education was considered advisable but not mandatory. (Article 9, Decree 1710, 1963).
Health wise, it is of essence to refer to the Children’s Code or to the
Organic Law for Children’s Defense (Law 83, 1946) enacted together
with the creation of the Colombian Social Security Institute and the
49
Early Childhood Comprehensive Care Strategy
Ministry of Hygiene to protect children from malnutrition, abuse and
abandonment. Inspired in the hygienist model of the United States of
America, it is founded on a health conception based on disease, and
resulting from environmental conditions affecting the individual and
requiring treatment from a hygienic interpretation.
Lastly we must refer to the creation in 1947 of the National Nutrition Institute. Their studies provided the country with the table on the
composition of Colombian food, which served as the basis to characterize the diets and eating habits of Colombian citizens.
During the first half of the XX century, there was an emerging interest of a public policy to recognize the smaller children, even though
with a view of exceptionality, and with insufficient clarity on holistic
development and care.
Creation and Roll Out of the ICBF 1969 – 1974
The Colombian Family Welfare Institute (ICBF) was created in
1968, by Act 75. The Children’s Division of the Ministry of Justice
and the National Health Institute were incorporated thereto. It became the first expression of a political will to protect those considered “children under irregular conditions” to ensure family stability
and wellbeing.
The historic moment when the ICBF was created allowed for the
reflections on women, the vindicating movements of their rights, their
active and key role in society (the right to vote, work, access to education, to the labor market and to public matters, the expansion of their
role beyond the intimate boundaries of the homes) when considering
the families, to shift towards the smallest children, and towards women needing to provide the care required to their children.
Also nutrition accomplishments gave increasing visibility to children as a population segment requiring State actions to guarantee their
care and protection.
Additionally movements of social groups, the academy and eco50
Context for the Strategy
nomics, history and sociology contributed renovated views on childhood and influenced the changing conceptions emerging and circulating in society.
Competences undertaken by the Ministry of National Education
(MEN, acronym in Spanish) and the ICBF at the time opened a parallel story in early childhood care: The Ministry in accordance with the
organization of the education system tended to pre-school education
and focused its efforts on building pedagogic and curricular proposals
contributing to the children’s holistic development.
Meanwhile the ICBF focused its attention on children under seven
and their families, in creating Community Centers for Children (CCI,
acronym in Spanish) for children under two, and the Pre-School Comprehensive Care Centers (CAIP in Spanish), for children under seven
(Law 27, 1974). With a holistic care conception, the objective was to
protect the working mother and her family helping her taking care of
51
Early Childhood Comprehensive Care Strategy
her children while she worked. the companies contributed 2% of their
payroll (additional fiscal contributions) to the ICBF.
Additionally the children’s daycare centers, under the direct responsibility of the ICBF’s trade union, made contributions to quality, educating the people taking care of the children, to pedagogy and education of the youngest.
Expansion of Early Childhood Care 1975-1988
I like to
play the
bass drum
and dance.
A very important discussion animated by social or community
movements took place between 1975 and 1988; as well as important
legal developments and programs on health and education making this
period relevant.
Education
Early childhood education in the country was guided and managed
during this period by the Colombian Family Welfare Institute and the
Ministry of National Education. By means of Decree 088, in 1976 the
Ministry structured the education system and reorganized the Ministry
by decentralizing and nationalizing primary and secondary education.
Pre-school was envisioned as the first level of formal education, although it was not mandatory. Its objectives were to “promote and foster
physical, affective and spiritual development of the children, their social integration, their thoughtful perception and preparation for school
activities, in coordination with the parents and the community” (Art.
6, Decree 088, 1976). This new administrative structure resulted in
joint efforts between the Ministry of National Education and the ICBF:
in the first case the Ministry prepared the curriculum with the cooperation of the ICBF; and in the second case the cooperation of the Ministry of National Education with ICBF programs.
The creation of study plans for all the levels, areas and modalities of
the education system were set up eight years later, in 1984, by Decree
1002. Article 2 of the decree stated that the objective of pre-school ed-
52
Context for the Strategy
ucation was “An integral and coherent development of biologic, sensor
and motor, cognitive and social-affective matters, and particularly communication, autonomy and creativity to foster an adequate preparation
for their enrolment in basic education”. After discussions, controversies
and agreements, the Pre-School Curriculum (children between the ages of
four and six) was published presenting four forms of work –community,
free play, didactic unit and in group- as well as basic and daily activities.
Towards the end of the eighties, the Ministry of Education was
committed to non-conventional programs developed in the country
to improve the life quality of the children under seven, and two more
were added with the conventional pre-school program: Pre-School
Qualification and Articulation between pre-school and the first basic
primary grade.
To ensure consistence and significance to the care of children in the
CCI and the CAIP, the ICBF created a curriculum with contributions
from the French model and the theories in force on early stimulation
for development. While the construction of the curriculum for the institutional modalities of care evidenced the importance of child development, the ICBF carried out awareness processes.
In order to overcome the limitations identified in the CCI and the
CAIP when delegating the responsibilities of the families on socialization and taking care of the children to these programs, the ICBF
opened the doors for the communities to participate. Based on documented participation on child care, it was supplemented by education
and community care.
This resulted in changes to the CAIP program of the ICBF, and since
1979 they became the Children’s Daycare Centers giving priority to the
participation of the families. The same year, Law 07, amending Law 27,
1974 was enacted, whereby to date the resources only allocated to the
children of working mothers were also funneled to children of families
in great need.
In 1985, the ICBF with the support of Unicef, published the Work
Guide in Units for the Protection and Care to Children, compiling and
53
Early Childhood Comprehensive Care Strategy
rewriting texts and experiences achieved in the CAIP project in different parts of the country (the city of Bucaramanga and the Pacific
Coast), capturing them in pedagogic guides for employees, directors,
members of the community boards and parents to promote the maximum development of the potentials of children under the age of seven
in the care and protection process provided in the CAIP.
The community welfare homes were created the following year, a
comprehensive human development strategy focused on early childhood comprehensive care. They were preceded by the children’s daycare strategy (former CAIP), and the recognition and drive of new less
formal ways of promoting early childhood development in different
parts of the country. Child development was the objective of the community welfare homes, with a pedagogic substrate and education intent favoring children’s interaction with their social, cultural and community environments, and an adequate organization for community
self-management and family empowerment.
As a result of the community welfare homes, it was a priority to build
a pedagogic model bringing together the experiences and lessons learnt
from the institutional models of the ICBF and also projecting care to
children from a community approach. Clearly child development was
closely related to the socialization environments of the children and
their daily interactions were recognized for their education potential.
In 1988 the ICBF accepted the challenge of creating one hundred
thousand homes to provide care to one and a half million highly vulnerable children. The “community welfare homes” started to be operated
and managed by the mothers and the community who started to organize child care and receive financial support and permanent pedagogic
education from the ICBF. Enactment of Law 89, 1988 contributed by
growing the budget of the ICBF increasing the contributions made by
public and private companies from 2% to 3% solely for the community
welfare homes.
Early childhood education in the nineteen eighties was marked by
an opening towards conventional and non-conventional modalities,
54
Context for the Strategy
justified in three facts: progressive separation of the welfare State and
the need to resort to community work strategies; emphasis on the participation and empowerment of the communities from the emancipating and critical theoretic perspectives of the nineteen seventies; and
strengthening early childhood education oriented towards a holistic
development, and intended for future enrolment into school.
Health
Primary healthcare is a concept arriving to the country through
international declarations like Alma-Ata approved by the International Conference on Primary Healthcare in 1978 and summoned by the
55
Early Childhood Comprehensive Care Strategy
World Health Organization (WHO). The national health system was organized through
primary, secondary and tertiary care.
Regarding early childhood, the leadership
of the sector is visible in nutrition, pregnancy,
pregnancy in adolescents, nursing and maternity. As presented below, programs like Surviving (Sobrevivir in Spanish) and the report of
satisfactory indicators on health as a result of
sanitary control and the expansion of the vaccination programs are especially outstanding.
Articulation Efforts between the
Ministry of Education – the ICBF and
the Ministry of Health
One of these efforts was carried out in 1988 with non-conventional
programs, guided towards providing better conditions for the development of children who were not covered by the formal education system. This contributed to enhance care perspectives beyond the formal
education system and to conceive development more comprehensively.
These include:
• Sobrevivir (National Plan for Survival and Child Development)
for urban children from zero to six in the poorest sectors. It was
carried out between 1984 and 1992 to promote better health and
nutrition conditions for the development of children, to reduce
mortality and morbidity due to controllable causes and to provide
care to pregnant and fertile women. High school graduates from
state and non-state schools participated under the social service
program (Health Guards); through family visits they helped
identify the risks of diseases of death of children under five or
pregnant women. These health guards provided information to
prevent or address health issues once they appeared, and offered
guidance on health services available from the State, including
vaccination programs.
56
Context for the Strategy
• Family Education Program for Child Development (Pefadi). It started
in 1985 offering family education for intellectual and emotional
development of children from zero to seven in the rural areas,
environmental sanitation and undoubtedly improving the actions
of responsible adults in caring for the children. It was supported by
high school students doing social work and it was also intended for
students from skill training schools as part of their practices.
This articulation endeavor was also present in Decree 088, 1976,
and expressed in the nineteen eighties with the support of the Ministry
of National Education to the pedagogic component in the community
homes of the ICBF, with pre-school teachers and illustrating community mothers on education pedagogy for children.
Early Childhood Care in the Times of the
Convention on the Rights of the Child, 1989 – 1990
The Declaration of the Convention on the Rights of the Child executed in 1989 took place at a very active time when a lot of summits
and meetings of Ministers of Education were held and they drove many
early childhood activities. Also during this period, various community
activities were conducted, the Community Pedagogic Education Project
(PPEC, acronym in Spanish) and the community homes (FAMI, acronym in Spanish) promoted by the ICBF that brought in all the experience
gained from lessons learnt and promoted innovating and alternative conceptions and customs when working with early childhood. Following are
the most important matters related to these three fields.
Convention on the Rights of the Child
Adopted and up for execution and ratification by the United Nations
General Assembly in Resolution 44/25, November 20, 1989, it became
enforceable on September 2, 1990 in accordance with Article 49. Its
staging is of paramount importance for early childhood throughout the
world in giving visibility to the children, as well as the conceptions
circulated, some of which are listed below:
57
Early Childhood Comprehensive Care Strategy
• Child means all human beings under the age of 18 (Article 1).
• Every person has all the rights and liberties listed in the Human
Rights Universal Declaration, with no distinction of race, color,
gender, language, religion, political opinion or of any other
nature, of national or social origin, economic position, birth or
any other condition (Preamble).
• Children are entitled to special care and care (Preamble).
• The family is considered “the fundamental group of society and
the natural environment for all the members, and especially the
children, to grow up and be well”. Consequently they “must
receive necessary protection and care to fully undertake their
responsibilities in the community”. (Preamble).
• Children are entitled to: 1) a name, a nationality, and whenever
possible, to know their parents and be taken care of by them, from
the moment they are born (Article 7); 2) to express themselves,
with freedom of thought, conscience and religion, of association
and to meet (Articles 13, 14 and 15); 3) to be brought up, to develop,
to receive education under equal conditions and considering their
highest interest (Articles 18 and 28); 4) to protection “against any
type of damage or physical or mental abuse, neglect or negligent
treatment, ill treatment or exploitation” (Article 19); 5) to special
protection and care from the State when they may be deprived
from their home temporarily or permanently (Article 20); 6)
enjoyment at the most highest level of health (Article 24); 7) to an
adequate life level for their physical, mental, spiritual, principles
and social development (Article 27); 8) to rest and relax, to play
and recreation activities as appropriate for their ages and to freely
participate in the cultural life and in art (Article 31).
• Respect of the rights stated in the current Convention by the
Member States to ensure their application for each child subject
to their jurisdiction, with no distinction of any nature, regardless
of race, color, gender, language, religion, political opinion or of
58
Context for the Strategy
any other nature, of national, ethnic or social origin, economic
position, physical impediments, birth or any other condition of
the child, the parents or their legal representatives (Article 2).
By Law 12, 1991, Colombia adopted the agreements executed in
the Convention on the Rights of the Child, expressing its will to work
for the children of the country. This occurred at a time when the Minor’s Code had been recently approved (1989); and in the light of the
rights-based approach set forth in the provisions of the Convention,
the code was set aside.
International Summits and Meetings
The World Declaration on Education for All “Meeting Basic Learning
Needs” (Jomtien, Thailand, March 1990) is an important precedent for
the policy since the Government committed to work within the actions
and recommendations framework resulting from the agreements among
different countries. Article 5 of the Declaration explicitly refers to national education in the following words:
I like grownups, teachers,
mom and dad,
grand-parents
and aunts to
teach me how
things work, to
draw and to go
head over heels.
Learning begins at birth. It requires early care and initial education since
childhood. This can be achieved by mechanisms addressed to the family,
the community or the institutions, as appropriate.
Creation of Relevant Programs to Promote
Early Childhood Care
Firstly the Community Pedagogic Education Project (PPEC, acronym in Spanish) was of great importance and it went back to
1990; followed by the creation of the Family, Women and Childhood
Scheme with the community welfare homes FAMI, under Agreement
021, 1989.
The PPEC drives actions emphasizing on:
• Focus on child development and community development –family
and community organization- as axes for human development
and children’s education
59
Early Childhood Comprehensive Care Strategy
• Emphasize on interaction as the child development motor (with
him/herself, with others and with the environment)
• Underscore building citizenship since early childhood
• Acknowledge local and regional experiences on early childhood
care bringing insight to the project
• Promote collaborative and cooperation work among the people
interacting with the children: parents and community
• Organize education activities pedagogically in six moments:
welcome, let’s explore, let’s create, let’s play, let’s eat and we go
home.
• Track the actions of educators, parents and community
(scorecard).
60
Context for the Strategy
• Value child development with the Qualitative Development
Valuation Scale
Meanwhile the community welfare homes FAMI of the ICBF are
defined as:
A set of actions carried out by the State and the community intended to
promote psychosocial and physical development and principles of children
under seven in extreme poverty, by stimulating and supporting their socialization process, improving their nutrition and life conditions (ICBF 2009).
The objective is to strengthen the parent’s responsibility in upbringing and taking care of their children, with their solidary work as well
as the community’s.
This scheme promotes an active participation of the organized community and strengthens the family’s capacity so together they can undertake the task of looking after the children and their socialization
during the first years of life. It focuses on encouraging healthy lifestyles,
access to basic health services and generating moments to strengthen
emotional bonds. Additionally it offers care to expectant women and
nursing children pursuing care of the babies during pregnancy and
fostering nursing. It also provides a nutritional supplement and health
checkups for the mother and children under the age of two. The objectives of this program progressively expand to encompass the country’s
developments and needs.
Constitution of 1991 and Early Childhood
The Constitution of 1991 brought the country’s commitment to early
childhood to the constitutional level, when children between the ages
of zero and five became extremely visible from a rights-based approach.
This new Constitution inaugurated a fruitful period of changes contributing to setting out child policy. Article 44 is of great importance as it
establishes the importance of the fundamental rights of children and
the role of the family, the State and society for their fulfillment and to
ensure the holistic development of children:
61
Early Childhood Comprehensive Care Strategy
Children’s fundamental rights: life, physical integrity, health, social security, balanced diet, name and nationality, to have a family and not be separated from it, care and love, education and culture, recreation and free
expression of their opinion…
Family, society and the State have the obligation of assisting and protecting
the children to ensure their coherent and comprehensive development and
the full exercise of their rights (Political Constitution, Chap II, Art. 44).
Likewise the constitutional principles acknowledge diversity. According to Article 7, “the State recognizes and protects ethnical and
cultural diversity of Colombia”. This mandate implies placing individual, social, economic, political, religious and cultural diversity discussions in the center of early childhood matters.
In addition to a legal event, the Constitution of 1991 is considered a
cultural matter as it introduces important changes to the perspectives
about girls and boys, setting aside their being considered as children,
objects or miniature adults. Also as Article 67 states that at least one
pre-school level is mandatory for all the children, it promotes reflection
upon and care to early childhood.
Generating Conditions to Draw Up
an Early Childhood Public Policy
Changes to the legislation, social mobilization and the lessons learnt
from projects and experiences developed in the country set the foundations to outline the children’s policy. Following are some of the most
significant achievements as of 1991.
The Education Sector: From Focusing on PreSchool to Initial Education
The Constitution of 1991 gave way to Law 115, 1994 (General Education Law) and to the establishment of Pre-School education. According to Article 15: “Pre-school education corresponds to the one offered
to children for their development in biological, cognitive, psychomotor,
62
Context for the Strategy
social-affective and spiritual fields through pedagogic and recreation
socialization experiences”.
On this basis, girls and boys over the age of five pass from daycare centers, community welfare homes and kinder gardens to public
schools, and early childhood education begins to experience important
developments. Provisions like the ones below and set forth in Law 115,
contribute to this end:
• Article 6, Decree 1860, 1994: Provides that pre-school education
is intended for children under the age of six, before starting basic
education, and it comprises three levels; the two first ones are
prior to mandatory schooling and the third one is compulsory.
• The same Article states that the Nation and the territorial
governments need to specifically support this education, and
the MEN has to organize and regulate a service providing
education elements and instruments and create coordination
actions among those participating in this education process.
• Resolution 2343, 1996: Sets forth the curricular achievement
indicators for the three pre-school levels, considering the
63
Early Childhood Comprehensive Care Strategy
dimensions of human development (body, communication,
cognitive, ethical, attitudes and values, aesthetic) and these
differ from the indicators for the other levels in the education
system presented by mandatory and fundamental areas. It also
provides the pre-school pedagogic guidelines.
• Decree 2247, 1997: Provides the rules for offering pre-school
services for public and private schools, specifying that:
We like to be
bigger. Before
we moved
around in the
crib and we
fell in the play
pen. Now we do
many things.
–– Pre-school has three levels, pre-kinder, kinder and
transition, for three, four and five year old children,
correspondingly.
–– Grade 0 corresponds to transition and it is mandatory.
–– Integrality, participation and play are the principles for preschool education
–– Curricular processes are carried out with the execution
of play-pedagogic activities taking the integration of the
human development dimensions into account.
Pre-school education was offered throughout the country, but following a separate path of the discussion taking place on the meaning
of being a boy and a girl, their rights and initial education. Over the
following ten years, the discussion of education for children between
zero and six was held in other sectors of society and it was only until
2007 that the education sector addressed early childhood matters once
again, not from a pre-school approach but from a holistic care view, as
a result of Law 1098, 2006.
In the first decade of this century, initial education or early childhood education was addressed more profoundly. During the first years
of the XXI century, it was debated and promoted and commitments to
early childhood were made as a public policy matter. At an education
level, there were great discussions about opening the education sector
for younger children, and international commitments were made in the
summits, at the Minister’s meetings and in multilateral agreements.
64
Context for the Strategy
At a regional level, and in preparation for the Dakar Forum in Santo
Domingo, the countries in Latin America, the Caribbean and North
America made evaluations on the achievement of the objectives and
goals set out ten years earlier at the “World Conference Education for
All” ( Jomtien, 1990). At this meeting, the countries renovated their
commitments for the following 15 years still acknowledging that in
spite of the achievements of the decade, the challenges were still present and they included: “Increase social investment in early childhood,
increase access to child development programs and improve coverage
of initial education”.
During the World Forum on Education in Dakar, in April 2000,
“Education for All:
Keeping our Collective Agreements”, Jomtien’s statements were ratified in that the first objective was to “develop and improve early childhood protection and education in all matters, emphasizing on the most
vulnerable children in the worst conditions”.
Meanwhile the Summit of the Ministers of Education under the
leadership of Colombia (between 2006 and 2007) in Cartagena de Indias, education for the youngest children was part of the agenda, and
the resulting hemispheric agreements were essential.
During the same period, with the creation of the Early Childhood Office in the MEN –under the Vice-Ministry of Pre-School, Basic and Middle Education- early childhood comprehensive education was motivated
to define the education policy and to ensure its appropriate implementation. The objectives illustrate the partnership with the ICBF and the territory authorities for “quality comprehensive care, always seeking respect
for diversity and the features of the families and the communities”.
To renovate the decennial 2006-2016 plan, the Ministry summoned
a large mobilization process in the country, with forums, work groups
and conferences, in a social pact for the right to education, committing all the agents accountable for it (State, society, family), where early
childhood was demanded persistently and with the greatest participation. Interestingly the objective of this plan related to child develop65
Early Childhood Comprehensive Care Strategy
ment and initial education was to: Guarantee universal comprehensive
care for children from pregnancy until they reach the age of six, under
a rights-based approach and for a full exercise of citizenship.
To differentiate early childhood education, initial education is emphasized:
As a permanent and continuous process of quality, relevant and timely interactions and social relations, enabling children to potentiate their capacities and learn skills for their full development as human beings and holders
of rights. As such, they require care and appropriate accompaniment from
the adult promoting their growth and development in healthy and safe socialization environments (MEN, 2009:8).
And so towards the middle of the first decade in the XXI century, it
included early childhood care in its policies and actions and it routed
the discussion and orientation, differentiating it from pre-school.
The ICBF, Towards its Redefinition
Regarding the changes to the construction of early childhood policies, during the first decade of the XXI century the ICBF reviewed and
restated its action plans, resulting in an important production with
careful, critical and rigorous understandings and discussions on early
childhood, on children as right holders, the development dimensions,
the importance of social-affective development, nutrition, play, the role
of pedagogy and training community mothers.
This was achieved by placing the PPEC in a different setting and
learning from experiences such as the Pedagogic Expedition.
In connection with the Community Education Pedagogic Project, new
stakeholders and new forms of management and performance appeared
in 1994. The State as contractor and organizations, whether public or
not, as operators, replaced the ICBF’s technical teams and changed the
direction of their work focusing more on supervision than on support.
Although towards the end of the nineties the PPEC was weakened
and it became invisible in the country as a public policy, it still remains
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Context for the Strategy
current in the regions preserving its intent and dynamics in accordance
with the specific features each one gave it, and nurturing from the support of the ICBF and from other emerging processes under the policies
laid out by the government in office.
This has also been complemented by strategies like: the “Fiesta de
la Lectura”, Colombia grows in complying with human duties since
early childhood, Household Vegetable Gardens, Pro-Social Behaviors
and Best environmental practices for community welfare homes and
daycare centers. It also became a sort of guideline to steer care and
education for children in early childhood.
Experiences like the Early Childhood Pedagogic Expedition under
the leadership of the ICBF showed important achievements and set out
action routes and policy mobilization for early childhood in defining
technical guidance, for example on comprehensive care from a rightsbased approach.
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Early Childhood Comprehensive Care Strategy
Early Childhood Health, Food and Nutrition
In line with the Constitution of 1991, the laws and the CONPES (National Council on Economic and Social Policy) related to health, food and
nutrition, the health sector has focused on seeing that early childhood
has the highest possible health level, as provided in their rights.
To this end, a comprehensive view, taking
into account all health related matters: food
and nutrition, protection and initial education
to provide children with the support required
for their survival, growth, development and
learning process has to be taken.
These developments occurred in the Primary Healthcare (APS, acronym in Spanish),
the core of the country’s health system and
governed by the constitutional principles of
universality, solidarity and efficiency, and by
the principles of equality, quality, prevention,
differential approach and social participation.
This is essential sanitary care, accessible to all
the individuals and families of the community through acceptable forms for them, with
their full participation and at a reasonable price for the community
and the country.
The APS is an assurance system where the guarantee of the protection for every person with no type of discrimination prevails, during all
the moments of life. It offers special financing for the poorest and most
vulnerable population; it generates conditions to protect and improve
people’s health and it evolves around the user’s wellbeing and satisfaction. The APS is a comprehensive part of the community’s general
socio-economic development; its main objective is to reach the highest
health level possible and at the same time maximize equity and solidarity (PAHO, WHO, 2007).
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Context for the Strategy
On children’s health –considered a national priority- the Ministry of
Health and Social Protection considered that care during early childhood is essential for a healthy life; they placed their political bets on
this and also the Ministry made a social commitment with the country.
The national government made arrangements to fund and earmark resources so children in their early childhood would receive preferential
and differential attention, under equal conditions, including expectant
and breastfeeding women.
The children’s entrance door to the health system is the assurance
through health promotion entities (EPS, acronym in Spanish), accountable for guaranteeing access to all the health services. The system offers
multiple promotion strategies with other sectors, on disease prevention,
services and attention, included in the Benefits Plan, intending to improve the health and life quality of children during their early childhood.
Mobilizing Civil Society Towards
an Early Childhood Policy
An important articulation effort took place at the end of the XX century between the national authorities and the Capital District favoring
early childhood. This lasted four years and resulted in the amendment
of the Minor’s Code by Law 1098, 2006 (Childhood and Adolescence
Code) and it also set out the Early Childhood Policy.
It started by forming an Alliance for Colombian Children with the
involvement of Fundación Restrepo Barco, CINDE, Save the Children,
Plan International, Fundación Éxito and Unicef to position children’s
matters in public policies. These joint efforts sought to change the
political frame for early childhood since paradoxically, while Colombia executed the International Convention on the Rights of the Child,
simultaneously
it was enacting the Minor’s Code, far from having a rights-based
approach. The alliance helped materialize contributions to be incorporated in the Childhood and Adolescence Code replacing the
Minor’s Code. At the beginning of the X XI century, although ear69
Early Childhood Comprehensive Care Strategy
ly childhood was not on the country’s agenda, an agreement was
executed between the Social Welfare Administrative Department of
the Capital District (DABS, acronym in Spanish), the ICBF, CINDE,
Save the Children and Unicef. In 2003 this agreement prepared the
international forum “Early Childhood, the Challenge of the Decade”.
It involved over 2,000 people from various territorial authorities and
local mayors and it was the first social mobilization for children from
zero to six. This process collected experiences from the ICBF and
DABS and simultaneously it generated the need for the evaluation of
early childhood care in Bogotá, in an attempt to answer the question
on the weight of the differences of the different types of initial education for children. In turn it triggered an important change to the care
schemes available at daycare centers.
The “Program to Support the Formulation of Early Childhood
Policy in Colombia” was created in 2005 to define an institutional
framework and a local, regional and national management system to
help guarantee early childhood rights, increase coverage, improve the
program’s quality and pursue strategies to empower families and the
community. With this objective in mind and by forming seven commissions or work groups, hopefully the content of an early childhood
policy would be agreed to.
While this took place, the Second International Mobilization Forum, “Early Childhood Mobilization” was held in 2005, coordinated by
the ICBF with work groups on early childhood, with the participation
of NGOs, the academia, foundations and the State.
The mobilization process of the forums and the work groups was
systematized in a document serving as the basis for the preparation of
CONPES 109, on early childhood public policy.
The early childhood agreement was extended to other entities in
2006 and 2009; its action became extremely strong in Bogotá. At the
time there was nothing similar country wise, and it was an experience
evidencing the scope and results of partnership actions.
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Context for the Strategy
Childhood and Adolescence Code
Law 1098 enacted in 2006 shifted the paradigm of the Colombian legislation in force,
from the Minor’s Code where children were
considered weak and incapable, to the Childhood and Adolescence Code where they are
acknowledged as right holders; and the statements of the Convention on the Rights of the
Child are recognized and materialized. The
current Code specifies that the rights cannot
be postponed since what is not done in time,
cannot be restored in the future.
This impossibility of postponement prevents matters related to early childhood from
becoming a government program, and on the
contrary they are necessarily converted into
public policy intentions.
Article 204 of the Childhood and Adolescence Code, explicitly states
that the president, governors and mayors are accountable for childhood
and adolescence public policy; this responsibility cannot be delegated; if
breached it is considered as misconduct and consequently it will result
in dismissal, punishment and inability to hold public posts for 15 years,
and it also implies public accountability.
The Childhood and Adolescence Code is coherent with the international guidelines and it is a legitimating instrument for the rights-based
approach they postulate. Article 29, referring to the right to full early
childhood development, defines the characteristics of this period and
states that children’s rights to healthcare and nutrition, the complete vaccination scheme, initial education and protection against physical dangers cannot be postponed.
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Early Childhood Comprehensive Care Strategy
Strategy of the Municipalities and Departments
for Childhood, Adolescence and Youth
Facts and Rights
The Facts and Rights Strategy (Hechos y Derechos in Spanish) was
created to offer tools and technical accompaniment to the governors in
setting out, managing and in the evaluation of public policies related to
children and adolescents in compliance with the obligations imposed
on them by the regulations, and to perform preventive supervision and
management control.
It works towards strengthening territorial capacities, forming an effective alliance between different kinds of entities (official, Public Ministry, international cooperation, non-governmental organizations) and
it has advocated for the inclusion of childhood and adolescent matters
in the territorial planning agendas and instruments.
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Context for the Strategy
CONPES 109, 2007, a Regulation Formalizing
Public Policy
The “Early Childhood National Public Policy, Colombia for Early Childhood” was approved by CONPES 109, 2007, resulting from
the progress achieved and the participation of health, education and
wellbeing sectors.
It promotes comprehensive development of children from pregnancy until the age of six, to answer to their needs and specific features,
and to contribute to ensuring fairness and social inclusion.
This document from the National Council on Economic and Social
Policy formalized an effort to build an early childhood public policy, as
the starting step for developing a long term process. It presents the diagnosis of the rights of the children in the country and the priorities on
their attention. The CONPES could also look deeply into a clear definition of the institutional responsibilities of its execution, to encourage
the construction of local policies and to develop permanent evaluation
processes on what has been determined as policy.
Fulfilling early childhood rights is considered to involve the families and society; and this falls on the State in that it is directly
accountable for guaranteeing material, legal and institutional conditions to promote, guarantee and protect them as a whole, for they
prevail over the rights of others. The State must have mechanisms
to promote accessibility, availability, permanence and social acceptability criteria.
Three investment lines for the CONPES were established in the
country’s budget. Due to the diversity of the supply of the ICBF at the
time, focusing on modalities of care9 it considered resorting to social
kinder gardens for positioning purposes10.
9
The ICBF has guidelines for each of its modalities of care.
10 Although social kinder gardens go back to 1999, when they were conceived as mega kinder
gardens to be located, under an urban reorganization rationale, next to a mega school and a mega
park, the ICBF started talking about them between 2005 and 2006.
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Early Childhood Comprehensive Care Strategy
Even though six years later the goals and resources provided in the
CONPES may be considered outdated, the technical contents and their
proposal remain relevant.
Law 1295, 2009
Law 1295, 2009 results from the fundamental agreements between
civil society and the State on the principles, objectives, goals and strategies on education and comprehensive protection of the children during
early childhood, and in regards to the rights stipulated in the Political
Constitution and the laws ensuring their
Rights. It presents the State’s commitment to improvethe life quality
of expectant women and children under the age of six in the sectors
rated 1, 2 and 3 of the SISBÉN. Five strategies were proposed for its
implementation:
• Access for children under the age of six to education care, within
the comprehensive care framework since pregnancy.
• Construction of early childhood comprehensive care centers.
• Illustrate education agents accountable for initial education and
early childhood comprehensive care with competences and
inclusion approaches.
• Strengthen the territories on the implementation of the initial
education policy, under a comprehensive early childhood care
perspective.
• Certification and quality assurance system in providing initial
education.
In summary, the Early Childhood Public Policy is the result of experience gained by the country thanks to the effort of many stakeholders
from the State and society, laying the foundations to develop the policy
on early childhood currently executed by the country through the Early
Childhood Comprehensive Care Strategy.
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Context for the Strategy
Early Childhood Comprehensive
Care Strategy “De Cero a Siempre”
The preceding summary of the country’s progress on early childhood presents an overview of the knowledge acquired and the debates
being held in Colombia, recognizing a legacy that should be put towards guaranteeing children’s comprehensive development.
The Strategy synthetized the main elements required to continue
progressing down the path (as explained in the Introduction, to build
on the foundations). It also presented the vital challenges Colombia
needs to address to answer to the ethic mandate of caring for and
offering the appropriate conditions so children under the age of six in
our country develop in full. Only then will it be possible to maintain
that the Early Childhood Comprehensive Care Strategy is committed
to Colombian early childhood.
Following is a description of the progress made in this field in the
country, encompassed in the Strategy to continue progressing, and also
the challenges being tackled.
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Early Childhood Comprehensive Care Strategy
Country Developments Compiled
by the Strategy to Carry On
This section comprises some elements presented above, grouped to
present future paths and lines of work. In some cases the debates held
are made explicit and they must be held to ensure the holistic development of early childhood.
Education Development Steered
by the MEN and the ICBF
The Strategy recognized education as a right and the relevant debate
on educability of children from zero to six, and the meaning of an
educable individual from a rights-based approach and coherently with
initial education.
It also considers the actions taken jointly by the Ministry of National
Education and the ICBF, which may not be of cross-functional nature,
but they do aim to a future construction in this sense since they allow
for the distribution of roles, to share budgets and to answer to the competences each sector is accountable for.
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Context for the Strategy
Development of the Early Childhood
Comprehensive Care Plan (PAIPI)
This program intended to provide care to 400,000 children between 2006 and 2010, under three dimensions: an institutional one
in urban areas for children from six months old to five years of age; a
community one addressed to children cared for in community welfare
homes supplementing the care with an education component, and a
family one, for children under two, and expectant and nursing families
in rural areas.
The experience evidences two important lessons: the first one related to the integrality required from cross-functional efforts involving
the MEN, the ICBF and also the health, culture and recreation sectors.
The second evidences the need of decentralizing care to the territories.
One of the debates in this program underscores how an increase
of early childhood care will be more relevant for the country: Through
pre-school by hiring teachers? By means of non-formal education with
community mothers and education agents? Via an initial education articulating experiences from both sectors and building a path to improve the quality of initial education? The country will need to address
this dilemma under the current Strategy.
Developments in the Health Sector
This sector is prosperous in early childhood policy, with a comprehensive care approach, including mother-child health, healthy habits,
food safety and safe environments.11
On the other hand, the health sector has developed primary healthcare conditions involving characterizing the population, tracking and
monitoring the health processes and results, inspection and supervision, tracking and monitoring and information systems of great value.
11 The Strategy for a Comprehensive Care for Prevailing Diseases in Childhood –AIEPI and the
Strategy of Women and Child Friendly Institutions stand out.
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Early Childhood Comprehensive Care Strategy
It is extremely helpful to track each family and the supply and demand
articulation scheme to reach out to every family through complete and
reliable monitoring, even if there are updating limitations. Focusing on
the poorer families and on ethnical inclusion are two very important
fields of progress, and it is necessary to continue working on them.
The above poses a large challenge to the Strategy: transforming the
idea that comprehensive care relates exclusively to access to services,
and focusing it directly towards advocating for human, social and material conditions, with a direct impact on their development possibilities.
Finally the definition of primary healthcare presented in Law 1438,
2011 amending the General Social Security System considers that intersectoral coordination contributes to overcome the health services fragmentation, it helps transition to comprehensive and integrated healthcare and it also proposes integrated health services networks (RISS,
acronym in Spanish) to operate and materialize core matters on primary healthcare such as coverage, universal access, the first contact, integrated and continuous healthcare and appropriate care, among others.
Basic health teams were created to strengthen primary healthcare
services and as a functional, organizational and system based alternative to strengthen and facilitate access to health services, and their
action axe revolves around extramural work and care at home.
Development on Progressive and Comprehensive
Access to Health, Nutrition and Education
To fulfill the obligations set forth after enactment of Law 1295, 2009
regulating comprehensive care for children during their early childhood, the ministries of Finance, National Education, Health and Social
Protection and the Colombian Family Welfare Institute, coordinated
by the National Planning Department, prepared a proposal on comprehensive care to ensure progressive and comprehensive access to health,
nutrition and education for expectant women, and children under six
in SISBÉN levels I, II and III as provided by the law.
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Context for the Strategy
Early Childhood Policy Accomplishments
in the Territories
Experiences in the cities of Bogotá and Medellín on initial education, quality education and early childhood Comprehensive Care reveal
important achievements that need to be revisited.
Lessons extracted from these experiences, together with the lessons from the socialization and preparation process of the Strategy
in the territories evidence multiple and diverse headways, developments, stories and practices that need to be taken into account in its
implementation.
Early Childhood International Accomplishments
To incorporate these achievements, the
Strategy intended to become acquainted with
and share international experiences, and by
reading them through the expectations and
national reality they could contribute analysis elements and strengthen the design of the
strategy for the country.
Canada contributed thoughts towards understanding that an early childhood national
policy enables human development growth
process in the country.
Cuba’s influence was determining in defining the PAIPI at the time, supporting the initial
education conception on family, and deepening the reflection on family and community
participation in education processes and in child care.
The Child Protection System “Chile Crece Contigo” showed the
Strategy that health is the entrance door to comprehensive care; it provided indications on the child by child tracking system and empha79
Early Childhood Comprehensive Care Strategy
sized on the importance of strengthening the territories, not only on
the attention capacity but also in reporting and tracking.
Mexico’s experience brought the Strategy up to the standard, design
and implementation of different social services oriented towards integrality and quality care, and Brazil shed light on alliances and involvement of civil society.
Progress on health supported by the Pan American Health Organization (PAHO) has inspired schemes and strategies on what the
Comprehensive Care Roadmap currently is, and the child by child
tracking system.
Colombia has learnt from the experiences mentioned and has set
up its own design, consistent with how people are, understanding
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Context for the Strategy
and living reality, achieving accomplishments that can be made available to other countries.
Conceptual Accomplishments on Early
Childhood, Child Development,
Comprehensive Care and Management
Although these concepts will be described in detail in the second
part of this document, it is of utter importance to mention them here
when underpinning the core matters that the Strategy collected from
the country’s history on this matter. Therefore the Strategy recognizes:
• Every child’s differences, in accordance with the life moment of
their development.
• Neuroscience contributions on implications for children born in
vulnerable conditions, without the conditions and guaranties to
ensure their full development.
• Economic studies highlighting the importance of investing in
early childhood since these investments yield high return rates
and they are cost-effective for the country.
• Acknowledgement of children as holders of rights and the
center of action.
• Diversity as a social value resulting from culture, ethnical
belonging, context, conditions, specific dimensions or permanent
or temporary situations of the children.
• The need and importance to realize the comprehensive attention
to early childhood and become the engine of child development.
• The need to go from a model focused on offering services, divided
into sectors and actions not articulated, to a comprehensive
cross-sectorial model, which takes into account girls and boys as
holders of rights
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Early Childhood Comprehensive Care Strategy
• The cross sectorial action knowing that comprehensive care
cannot be developed by a single sector and that intersectoral
work opens up possibilities to several of them, and at the same
time strengthen its specificity.
All these aspects point finally, to give life to a strategy that builds on
the already constructed and advances on key issues to respond to the
challenge of ensuring comprehensive care to children from pregnancy
until reaching the age of six.
Challenges posed by the Strategy
The Strategy poses major challenges among which are the following:
Formulation of a Sustainable and Long-Term
Early Childhood Public Policy
This means to transcend from the sectorial public policies to a population where early childhood children become the center of their management, comprehensive development, and the comprehensive care
which is the means to achieve it.
The design, implementation and evaluation of this public policy requires of all sectors and their coordinated action. Therefore it is essential to:
• Recognize the role of each stakeholder involved and put into
action their knowledge, institutional structure, actions, resources,
capabilities and openness to change.
• Recognize and value the role, competencies and resources from
the Government, the civil society organizations and the family.
• Promote the construction of a supportive management in which
resources, responsibilities and processes interact with each other
and with the opportunity required to ensure that children fully
enjoy their rights.
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Context for the Strategy
Provide Comprehensive Care
to Early Childhood Children
The challenge of the Strategy is to reach children as comprehensive beings and not as a sum
of services that are diffused as assistance center.
Comprehensive care, recognized as the
means through which the stakeholders responsible for guaranteeing the right to full development of children in early childhood materialized in a comprehensive protection, involves
meaningful, coherent, and consistent steps
towards the structuring factors that shape it
and organize it ensuring that actions of those
involved converge around each girl and boy, in
a relevant, timely, flexible, differential, continuous, complementary way and with quality.
Including the Differential Approach
in Early Childhood Care
For the Early Childhood Comprehensive Care Strategy is a challenge to
advance in the visibility and recognition of heterogeneity, non-linearity of
child development and their specificities in their life cycle. Also, it is a challenge to take into account the diversity of children and families because of
their culture, ethnicity, context, conditions, particular dimensions or transitional effects. Only as such it will be possible for every Colombian girl
and boy to be subject of approximation, support and relevant assistance.
Promote Integrated Management
that Recognizes the Knowledge, Practices
and Developments of the Territories
The Early Childhood Comprehensive Care Strategy requires management to reach the territories, to recognize its diversity and con83
Early Childhood Comprehensive Care Strategy
texts, exchanging knowledge to enrich the proposal and to generate
consistent, relevant and empathic answers. The territories – its villagers and public servers have tailored proposals, relevant to their particular conditions, which are worth to be valued by the institutions and
used in all its richness.
To recognize communities as legitimate partners with knowledge to
contribute is a challenge for the construction of roads that will guarantee the realization of children’s rights from a differential approach.
A public policy of this kind commits different decision-making levels and technical schemes compatible with the specificities and capacities of human potential and of the institutions existing in the territories, as well as a joint construction of work and horizontal cooperation
that allows mutual learning, exchange of knowledge and experiences.
Promote the National Family Welfare System
The sustainability and governance of the Strategy require a location
to construct public policy, nation-territory balance, articulation of sec84
Context for the Strategy
tors and cross-sectoral linkages, as well as criteria and unified action
lines, participation and citizen mobilization. To achieve it the Strategy
is challenged to count with institutional framework and governance
as the policy achieving recognition of territorial realities and a greater
balance of territory-nation, for which it is necessary to sign up and
strengthen institutions, namely: the National Family
Welfare System, the social policy council boards and the Intersectoral Commission for Comprehensive Early Childhood Care.
*******
The brief presentation of the context that gave origin to the Early Childhood Comprehensive Care Strategy of Colombia provides a
clear idea of the current conditions in which children under six are in
Colombia, about their sectoral and intersectoral learning experiences,
and the courses the State must consider to obtain comprehensive care
with quality and pertinence. The State poses objectives, priority action lines and instruments for managing the Strategy, which in an articulated way between entities with direct competence regarding that
population and other sectors that have an impact on the generation
of welfare conditions, will allow it to make of the comprehensive care
the way to express prosperity for early childhood. This information
will be developed in detail in part three. The next part will focus on
the technical basis of the Early Childhood Comprehensive Care Strategy both in regards to the conceptual foundations of early childhood
as well as of comprehensive care.
85
2
Technical Grounds
for Early Childhood
Comprehensive Care
Strategy
Early Childhood Comprehensive Care Strategy
T
he Early Childhood Comprehensive Care Strategy results from
the study, and deliberation of the role of the State and society
in guaranteeing comprehensive development of those beginning life. Thus, the country now has a clear focus for its actions in
two broad areas: early childhood and comprehensive care within the
rights protection framework.
This second part describes the technical or conceptual bases to
support the Strategy, in line with the country’s development introduced in the first part. With that in mind we hope the readers thoroughly understand the meaning of the Strategy’s components presented in the third part.
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Technical Grounds for the Strategy
Conceptual Grounds for the Early
Childhood Strategy
1
Following are the main concepts guiding the Early Childhood Comprehensive Care Strategy, including understanding children from zero
to five, their comprehensive development, the family role and their
environment. Each concept specifies the position assumed and gives
meaning to the Strategy and its development.
Understanding Girls and Boys in Early
Childhood from a Rights-Based Approach
The Strategy is built on the conviction that the children are citizens
holders of rights; they are social and singular beings and immensely diverse. This understanding has specific implications regarding the comprehensive attention given to them and characterizes the Strategy; those
responsible for their comprehensive development must ensure that this
early childhood perspective marks every decision and behavior.
Children, Citizens Holders of Rights
By acknowledging that children are holders of rights due to their
human nature, the Convention on the Rights of the Child set a milestone that triggered important changes on how childhood was seen
and in the ways society relates and interacts with children from their
early years.
Perhaps one of the most important changes was to stop seeing them
as small adults, as incomplete beings waiting for the adults’ actions to
develop themselves, and therefore deemed invisible because they do
not exist other than to the extent that adults act on them.
1
This section was built on the reference document Technical Fundamentals of Comprehensive
Early Childhood Care written by Marina Camargo Abello and Adriana Lucia Castro Rojas, by
request of the Intersectoral Commission for Comprehensive Early Childhood Care (2012)
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Early Childhood Comprehensive Care Strategy
To be a holder of rights since early childhood is to declare that the
nature of a social being is inherent to mankind at the onset of life.
Thanks to such nature and their capacities, children participate in society and develop by interacting with others.
To understand children as beings who participate in social life by
interacting with people surrounding them and who grow up pursuing
greater autonomy means they need adults, guaranteeing their development to assure quality conditions relevant to the vital moment they are
in, and in agreement with the children’s characteristics and capabilities.
As holders of rights exercising citizenship, children need to be considered valid speakers, able to express and build the meaning of their
lives, their existence, with particular ways of relating to peers, adults,
families and development environments. They are capable of making
decisions about topics that affect them as well as of expressing their
feelings according to the moments of life they are going through.
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Technical Grounds for the Strategy
These citizens have the right to grow and develop in participatory
environments, guaranteeing optimum conditions to potentiate their capabilities and achieve their wellbeing.
Children, Social Beings
From the moment of birth, girls and boys become part of a family
immersed in a given social and cultural context, and enter an existing
society. As stakeholders, they interact with society through adults and
the institutions representing it. Children use their capabilities to solve
the main needs of their existence and to begin a growth process for their
integration into social life as protagonists of their own development.
This means that children are born with the ability to learn, participate and actively explore the physical and social world, and to develop
their autonomy progressively. From birth they have physical, psychological and social skills supporting the ongoing interaction principles
they establish with themselves, with others and with their environment, all of which are mutually interdependent.
Children, Unique Beings
As holders of rights children are unique, singular and unrepeatable.
From birth they undergo a process of individualization and differentiation that develops their particular characteristics, their own rhythms
and styles, their preferences, their different capacities, qualities and
potentials. All children journey through life developing in accordance
with their characteristics, their own care process, their interactions
with peers and adults, and the opportunities that the environment and
context have offered.
Children, Beings in Diversity
Processes related to the beginning of life, specifics of social life, and
cultural variability, help understand how the personality of children
from zero to five manifest.
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Early Childhood Comprehensive Care Strategy
Children mature at different paces and therefore they don’t all learn
to walk and talk at the same time. While some totter others run, some
use words to communicate and others don’t. Some live in rural areas, others in big cities, and their families are made up differently, and
likewise the role of the adults surrounding them differ. Additionally,
during early childhood children are exposed to cultural, ethnic and
religious values transmitted from generation to generation, within their
groups, communities and relations.
Recognizing the differences, not only takes into account the diverse culture in the country, but also considers age, gender, the specificities of each
individual and the conditions in which children and their families live.
• From the individual point of view, early childhood covers different
moments in child development, showing learning processes and
achievements impossible to homogenize, given the ways in which
each individual participates in his/her development according to
children’s own characteristics and gender.
• On a social scale, the characteristics of the family, the district, the
city, the rural context, the living conditions of the population,
determine how entering to society affects the processes of
growing, developing and belonging.
• From the cultural point of view how communities live, think, act
and feel, allow to talk about territory, ethnicity, beliefs, values,
customs, languages, and artistic expressions, among others. In
Colombia these differences are present in indigenous groups,
Afro-descendants, black, raizal, palenqueros and gypsies, and
therefore the country needs to assess, preserve and strengthen
the heritage of this diversity from early childhood, essential to
take a differential approach2.
2 In accordance with human rights ethics, “The differential approach involves the recognition of
personal and community characteristics of those who have historically suffered social exclusion
either by their participation or way of life, because of ethnicity, gender, life cycle, disability,
displacement due to armed conflict or natural disasters, violence, etc., as well as the differential
response that these individuals and groups must receive from State institutions and society in
general. In: “Differential approach guideline for the effective enjoyment of rights of displaced and
people with disabilities in Colombia”. Ministry of Social Protection, UNHCR, 2011: 27-29.
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Technical Grounds for the Strategy
The same is true from the gender equality approach, avoiding dominance of one gender over the other and recognizing singularities on
ways to grow, mature and develop.
Diversity is a challenge and an opportunity for children, for those
who contribute to their development and for policymakers and public
policy advisors.
These aspects recognize, value, and respect human dignity as of
birth, and acknowledge that their rights depend on ensuring affective,
social and material conditions, which are optimal and indispensable for
their realization.
The State, family and society share this responsibility. Within the
framework of comprehensive protection they need to create real and
concrete opportunities to materialize them and make them true.
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Early Childhood Comprehensive Care Strategy
Early Childhood Development3
Understanding children as
holders of rights (social beings,
cultural, unique and diverse,
active and able to build their
subjectivity, as participants and
citizens) is realizing that early childhood development has
important implications, and requires meaningful experiences
ensuring that all the boys and
girls in early childhood in the
country have necessary and sufficient conditions for their full and
optimum development.
Development of the Human Being
Ideas about human being development have changed throughout
history, and very significantly since the end of the 20th century, thanks
to the dissemination and scientific research findings, and by acknowledging children as holders of rights.
According to the current conceptions of child development, as of
birth children have the ability to relate actively with whom they share
life and welcome them, as well as to learn and solve problems of their
immediate environment and identify opportunities needed for their
development. Also the society they are born into presents them with
changing and differentiated demands resulting from historical, cultural
and social specific moments.
Human being development is a process of transformations and
changes that allow innovative and orderly behaviors, generated over
3 This section was developed thanks to the contributions of Olga Alicia Carbonell, Leonor Isaza
Merchán and Mariela Orozco, who actively participated in the discussions on developments
proposed by the Early Childhood Comprehensive Care Strategy.
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time and due to the activity of children, their capacity to organize
themselves, their experiences and the resulting information.
This process is continuous. It starts in the womb and only concludes
when life ends, and includes biological and psychological aspects, but
also social, historical and cultural ones. Through out life individuals
permanently grow, learn, mature and structure their individual and
social personality. Their functions and processes become increasingly
more autonomous and complex.
In short this process:
• Is experienced by an active human being who becomes the center
and primary holder of rights.
• Is shaped by the dynamic and continuous interaction between
biology (Genetics) and the experience of the individual interacting
in social and cultural environments,.
• Extends the capabilities of reflection and internalizes experiences,
contributing to the decision making process with greater
autonomy.
• Is comprehensive, active, participatory and it is promoted through
rich and loving interactions with other human beings and the
environment.
• Is constructed in special environments where life unfolds,
becoming a diverse and differential development that can’t be
standardized4.
• Increases life options for all the people in a country or region in
various fields (education, labor, material, recreational, cultural,
social and political among others.)
4 Three aspects characterize the current conception of development. First, the cognitive,
linguistic, social and emotional development of children is not a linear process. Conversely, it
is characterized by irregular advances and setbacks. Second, the development does not have a
definite and clear beginning, i.e., does not start from scratch. And third, development does not
seem to have a final moment, in other words, it never ends (MEN, 2009:) 18).
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• Involves creating conditions for progressively changing the life
quality of all human beings enabling their overall wellbeing.
• Tends towards sustainable human development, satisfaction of
human needs and promotion of economic growth with social
equity providing opportunities for people to improve their
quality of life.
• Starts with conception and birth and ends with old age and
death.
Comprehensive Development of Children
from 0 to 6
A complex process of permanent change characterizes early childhood development similar to what happens during the rest of the life.
This change does not happen in a linear, sequential, cumulative, always ascending, homogeneous, prescriptive and identical way for all
boys and girls; it is expressed in the specificities of each one, in an
equally wide variety of contexts and conditions.
Thus, development moves between the singularities of each girl or
boy, however their different rhythms and styles bear some relation with
the characteristics of their peers’ processes, and with the features offered by the environments they live in: home, health and educational
environment and public space.
The recognition of the importance of early childhood has increased, as
noted in the introduction, thanks to the numerous research on human development that show how, although this occurs throughout the life cycle,
it is during the early years where the foundations for further development
of the individual are placed, where their capabilities skills and potential
become very complex. Recent studies have shown the influence of good
care and assistance of children from pregnancy by the primary caregivers
adults (both relatives and initial teachers), because it impacts a greater
number of cerebral connections, the development of basic language skills,
mobility, symbolic thought, ways to learn, to relate, to communicate, to
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play and to transform their environment. Similarly, their social interactions bases are highly developed before they start their formal education.
These decisive years for all human beings are built using a process
that has an irregular performance - complex, dynamic and discontinuous, with changes and setbacks-, without a beginning or an end defined,
that for every girl or boy is specific and differentiated as time passes. Even
in a same period we can find varied developments of the same boy or girl.
These variations occur in all cultures and in no way are signs of backwardness, rather show that from birth, children have capabilities specific
to each one and may appear differently throughout their life.
As children are unique, unrepeatable and considered in a holistic
sense, its development is understood as a comprehensive process, impossible to break in areas or dimensions. All psychological and social
processes are interrelated and influence each other in the active construction of the individual and its reality where each one is its own
main character and architect. The active interaction of children with
those who surround them and what surrounds them and the orientation of development to the organization or structuring of increasingly
varied and complex abilities, leads them to progressively construct their
autonomy. It is so that initially the development is achieved through
interaction with others, and subsequently, it can be achieved also without their support through their own means.
We like people
to give us
toys, dolls and
candies.
While development occurs throughout the life cycle, it is demonstrated that there are particularly sensitive moments, windows of opportunities to act on behalf of health, nutrition, growth, development
and welfare of children, which should be considered when identifying
actions to undertake comprehensive care.
Play, Art, Literature and Environment
Exploration during Child Development
Play, art, literature and environment exploration are early childhood
activities, as those help children to build and represent their reality, as
well as to interact with the world, with their peers and with adults.
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Play
Play reflects culture and society representing constructions and developments of environments and contexts. Children play representing
what they see and when they play what they live they redefine their
reality. Therefore, play is a means of interpreting the adult’s world and
culture, initiating children in the society life.
In play there is great pleasure to represent what they have gone through
in their own view, and to have the control to modify such reality. Children
represent the culture they grow in and thrive. Through play children get
acquainted with their reality.
Literature
Children are particularly sensitive to the
sounds and meanings of words. They need to
play with them, be nurtured, wrapped, lulled
and figured out with words and symbols carrying emotion and affection. That is why literature
is also one of the guiding activities of childhood.
People closer to smaller children regularly note that playing with words – breaking
them apart, signing them, pronouncing them,
repeating them, exploring them - is a way of
appropriating language. Perhaps that is the reason why they say that children resemble poets
in the way they “release” and marvel at words,
connecting them with their life experience.
Generally literature in early childhood encompasses not only written
literary works, but also oral tradition and picture books, showing the
art of playing and representing experiences through verbal and pictorial
symbols.
The need to give sense inherent to human condition encourages
from the earliest childhood to work with words, to inhabit possible
worlds, and to operate with invisible contents.
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The wealth of oral repertoire represented by the lulling, rounds,
songs, personal stories, plays on words, stories and legends, make part
of the cultural heritage which together with children’s traditional and
contemporary literature, are a varied and polyphonic wealth where
children discover other ways of structuring language linked to their
emotional life.
Art
To watch the rounds and oral tradition games allows to see how literature, music, drama, choreography and movement are combined. From
this point of view, the artistic experiences - plastic arts, literature, music,
dramatic and corporal expression - can not be seen as separated compartments in early childhood, but as forms of inhabiting the world at
these ages, and as languages which the children use to express themselves in many ways, to know the world and to decode themselves.
Within the life cycle it is in early childhood when human beings
are more eager and more willing to those forms of interacting with
the world. The fact of “discovering it for the first time”, to feel and
question every thing, to merge understanding with emotion and with
what passes through the senses makes the artistic experience a guiding
activity of childhood.
Exploring the Environment
Children are born into a constructed world. A physical, biological,
social, and cultural world they need to adapt to and that needs them
to transform itself. In this world they find elements and possibilities to
interact with their own specificities and capacities.
Senses - taste, touch, see, smell, hear - play a fundamental role in
instrumental exploration because they come closer to the environment in different ways. To explore empowers children to question,
solve problems, interact, use their body, investigate, meet, rehearse,
persevere, and gain independence. This experience gives them a sense
of what is happening in the world and what it means to be part of it.
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Play, literature, art and exploration of the environment are often interdependent activities. Thus for example, when a child plays or explores, she/he can do it by manipulating plastic materials such as paint
or clay, coming closer to an artistic experience. Sometimes play is combined with literary and musical expression.
Adults Mediation for Achieving
Comprehensive Development
While adults are the mediators of cultural tools and together with
some peers help children carry out activities that are beyond their capabilities (scaffolding), as researcher Jerome Bruner has pointed out,
it is required to have quality interactions providing them with secure
attachment links and trust relations with people who show them they
can count on them both in moments of exploration and curiosity, as
well as in stressful or difficult situations. .
Studies have shown that a sensitive care relationship creates a link
for secure attachment between those who established it. To be able to
interact with a caretaker who is present not only physically, but emotionally and psychologically available for care, physical, emotional and
affective contact, accompaniment of interests, channeling of emotions
and building of meaningful relationships, allow children to feel loved,
recognized and valued; i.e., it allows them to build their emotional
security and as they develop their ability to symbolize and represent
the environment they live in, create a representation of themselves as
valuable, capable and deservers of affection.
Thus, children are able to see the caregiver as a reliable person,
someone to count on when in need and that will lead them to feel
themselves in a predictable world where their actions are effective. Also
to experience and grow up in a family and social atmosphere with care
relationships characterized by empathy, affection and satisfactorily negotiating goals regarding conflict, helping adult caregivers and children
to build a representation of others and of the social world with confidence and security.
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Primary caregiver - basis of children security - helps them organize
their behavior, explore and learn from their environment, makes them
feel protected in stressful situations, and teaches them to regulate their
emotions and affections.
Consequently, children do not access alone the meanings of culture. Meanings are built from their relationships with each other. This
implies that all institutions and persons in charged of their assistance
and education recognize that they are responsible for providing them
with opportunities to build them, considering them as valid speakers,
and consequently favoring scenarios where they can express themselves and be heard. Therefore we insist that the main function of early
childhood education is to encourage child development - rather than
transmitting knowledge, care for or entertain - through meaningful experiences, which mobilize their capabilities and facilitate the exploration and understanding of the world and the moment they are living.
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Towards a Sustainable Human Development
The purpose of sustainable human development is to increase the
population levels of well being. For that economic growth is needed
through increasing production and productivity, with an imperative:
conservation of natural resources. In other words, sustainable human
development meets the needs of a country and strengthens the development of present generations without damaging or compromising that of
future generations.
Therefore it depends on the individual and
collective responsibility of all human beings to
preserve the environment and to have a well-balanced relationship with the surroundings, core
elements of sustainable development. For example, the threat to ethnic, cultural, biological and
geographical diversity of the country requires
that people and communities democratically
decide and build what is produced and how to
produce it, together with their right to survival
and the realization of themselves in agreement
with their own life projects.
To make development sustainable it requires
cross-sectorial multiple ways progressively ensuring all people the benefit of drinking water,
sanitation, suitable housing, energy systems,
health care, safety, food sovereignty and biological diversity protection.
Specifically, that all of the above is guaranteed to early childhood children for the fulfillment of their rights. Education plays a fundamental role promoting human being relations with its environment in
a more harmonious way.
A childhood comprehensive care policy should include the construction of scenarios and processes of participation of children and adults for
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the creation of alternatives to take care of their environment, ecosystem
conservation, good consumption practices and environmentally friendly
forms of relationship with nature. If the natural and cultural diversity of
the environment is protected, it becomes more secure and protective for
all people living there.
The Family’s Role
It is in society where early childhood is made possible. In it and in
its institutions materialize the actual conditions of children existence
determined by historical, political, social, economic and cultural contexts that are transformed with the passing of time and mainly by the
action of the social stakeholders involved.
Children enter society under specific conditions through the family. At the same time, environments frame children’s development
through processes of interaction; influence their lives, the acquiring
of significant experiences and conversely children also transform the
environments through the ways they adopt them, represent and act
upon them. This mutual transformation creates important differences
in child development.
Family Concept Approach
The family is a social institution, a social system, a basic cell of society, a social group, and a social unit. Family belongs to society, exists
and develops under its influence and, reciprocally, affects it.
The social character implies it to be formed by individuals who are
not isolated; the relationship of permanence, solidarity, affection and
bond between its members to carry out specific functions, makes it
different from any other group of society.
From an anthropological point of view, the family has a universal
character. Indeed, it is referenced throughout the history of the world
in a good part of societies. What makes it different is the culture that
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comes to life, through beliefs, values, rules, rituals, traditions and ways
of life, allowing to recognize different types or forms over time and
according to societies (matriarchal, patriarchal, large, nuclear, among
others), as well as various forms of kinship relations and relationships
with other social groups (classes, clans and tribes). Some key aspects
to understand the family are found in the cultural attributes identifying it and giving meaning to a society and its members. The family as
a specific element of society can be considered a primary group whose
members relate to each other according to roles and functions, creating
specific dynamics, as well as changes and transformations that make
up moments in their development cycle.
Considered as a general aspect of society, the family is seen as
an institution responsible for the socialization of its individuals, and
for transmitting the culture, to reproduce, recreate and maintain the
society over time.
From a psychological point of view the family is a space for training and development of the individual and collective personality of its
members. It is good to recall that the family exerts a decisive influence
during their first years, given the ability its members have to provide
meaningful experiences for constructing the children’s identity through
its dynamic interrelations.
The family is a complex network of permanent and stable relations
based on affective bonds and functions and roles of its members. It
provides them with experiences that contribute to their development
and individual and social identity as well as the construction of ways of
seeing the world and entering to it by acquiring elements of the culture
in which it is registered.
Now, the meaning of these experiences is different for everyone. The
way and intensity with which the family members relate to each other
and with the environment and the contexts it belongs to varies and
affects each member differently. The family promotes the construction
of personal and social identity and when it is conceived in the difference
and generates important experiences for its members, related to the
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ability to recognize others, arrange, solve conflicts, recognize that existence is incomprehensible without the other.
Thus, the family provides an identity reference. Norms, values, cultural elements, among others, contain meanings to be internalized
making part of what every human being is and those environment and
contexts to which it belongs. Thus, the family becomes a mediator of
processes of inclusion of its members in society, and generates the required line so they can carry out their personal projects, and collaborates in the construction of the projects of others and of society itself.
In short, it can be said that a good comprehensive development for
children is possible through family socialization, providing them with
rewarding experiences to develop their capacity to feel unique, safe, willing to recognize each other and with suitable resources to live in society.
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Family Characteristics
The family has a set of attributes, making reference to its condition
of collective holder of rights, to its dynamic system, and to the set of
functions and roles that its members follow.
The Family as a Collective Group
We like to
jump on the
bellies of large
people, ride on
their backs or
balance us on
their legs; hide,
show our face
and make bu!
and get them
very much
scared. We also
like to play with
toys, but less.
The collective condition makes it possible to recognize the family
as a unit with self-determination, with characteristics, capabilities, and
own vital moments. Also to appreciate its different forms and organization as an expression of diversity, and to value the advantages of each
of them to exercise its functions of affection, support, solidarity and
survival of its members.
Families Live in Permanent Transformation
The family is characterized by its openness to the environment
with its own development activity. Both elements make it an entity
in permanent transformation impacting its environment. Both changes caused by internal and external factors manifest in different ways
and having different intensities depending on the moment they occur;
some are more critical than others, deserve different positions and lead
to reconfigurations in the family to overcome the crises caused. The
family confronts all this in different ways according to their resources.
The family is transformed with the arrival or departure of its members;
with changes in their functions and roles, with the way of conforming,
with the improvement or loss of income, with the consequences of favorable or adverse conditions. When these changes are made in a proactive
manner, they enrich the family life and relations between its members.
Families have Different Compositions
The Early Childhood Comprehensive Care Strategy recognizes the
diversity in the composition of families in Colombia: there are nuclear
families - composed of father, mother and children - and there are single
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Technical Grounds for the Strategy
parent families where there is only one of the parents, called families
with female or male headship; there are also extensive families, those
consisting in addition to parents and children, of grandparents, uncles
or cousins. There are polygenetic, or reconstituted families composed
of children who come from previous biological families of the spouses,
and there are also families formed by same-gender couples.
Family Members Play Various Roles
Indeed. Family members play different and complementary roles:
father, daughter, grandmother, uncle, which in turn are combined with
the roles they play in society: student, worker, leader. Roles create commitments and responsibilities to individuals with themselves and with
others, causing feelings of complacency or dissatisfaction, impacting
directly on domestic relations.
Some roles within the family are clearly identified because they
match the conceptions and expectations of society regarding the family. However, there are changes like the ones having to do with gender,
where aspects such as tasks distribution at home, responsibility for
economic provision, or the type of relations established with the children, have greater diversity.
Similar is the case of children conception; it has an impact on how
to relate to them, on rearing practices at home, on how to promote their
comprehensive development.
Family Functions
The family has three functions: sexual and reproductive, survival or
pursuit of economic or material welfare, and socialization. Regarding
the first one it stands out that even though the family is still one of
the main sources to ensure the biological reproduction, there are other
mechanisms such as assisted reproduction, which at present means
that this characteristic is no longer exclusive to family structure. Similarly, it is necessary to highlight that sexuality also transcends the
reproductive function.
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The survival and material and economic welfare function ensures
the physical survival of its members and allow them to satisfy their biological needs. However, meeting these needs is not enough for human
development. Living together requires - affective, social, communicative life - to provide binding experiences.
Therefore the third function acquires meaning: socialization of children in order to foster their development as individuals and as social
individuals. This function enables the creation of affective links from
relationships that generate attachment and provide affective and emotional security allowing them to be accepted and recognized as valuable and worthy of being loved.
The family is responsible for transmitting culture to children, to introduce them to its different expressions, social relations and language
codes, and their various standards, guidelines and values.
Not to forget that the family is the first social group they belong to
and serves as reference, the closest and most intimate one that children
have at birth and from which they depart to start living and develop in
other various social groups. Thus the importance that family has for the
Strategy and to be considered as subject of comprehensive care.
Environments where Children Develop5
The environments (Entornos in Spanish)6 , are physical, social, and
cultural spaces inhabited by human beings, in which there is intense
and continuous interaction between them and the context that surrounds them (biological and physical space, ecosystem, community,
culture, and society in general).
5
This section was developed based on elements provided by the reference study for the “ Technical
Guidelines of Environments Promoting Development “ developed by Ernesto Durán Strauch,
Intersectoral Commission for Early Childhood Comprehensive Care with the coordination of the
Ministry of Health and Social Protection and the support of the Inter American Development
Bank (2012).
6 In Spanish there is a difference between the words “ambiente” (environment), and “entorno”,
while in English the same word is used. In education, environment has a particular connotation
that is not used by the Strategy. Therefore it is essential to take into account the meaning that the
Strategy gives to the environments as a broader concept that is fully explained in this chapter.
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It is characterized for having precise and visible contours, people
with defined roles and an organizational structure. Its wealth lies in
the ability to promote the development of children, to promote the
construction of its subjective and daily life and to link them with the
social, historical, cultural, political and economic life of the society
they belong. This is why for the Strategy environments are vital and as
we will see in the third part are important organizers of comprehensive
care to early childhood.
The Strategy recognizes that environments are different as it is the
territorial wealth of the country in terms of physical, social, and cultural conditions in departments, municipalities, the municipal seat, and
rural areas. All affect, in one-way or another the development of early
childhood. It is important to emphasize that those who favor development are those who promote and guarantee the comprehensive protection of children’s rights, to:
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• p
romote and care for their physical, emotional and social
integrity;
• generate confidence and trust in children;
• be sensitive to their interests, concerns and capabilities;
• enhance their development;
• facilitate the inclusion of children from different cultures, ethnic
groups and children with disabilities, and
• p
romote social equity, peace and harmony between people and
the environment.
The children’s life within different environments is influenced by
a set of factors affecting directly their welfare and development. These
conditions are recognized as different types of determinants: biological, social, political, economic, environmental, and cultural. Its power to impact on children’s lives since pregnancy and during their first
years demands actions to protect them under favorable conditions or
modify them otherwise.
To grow surrounded by affection, attention, assistance, respect
and recognition, enables children to feel loved, accepted and valued,
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Technical Grounds for the Strategy
to have high self-esteem, to better develop their autonomy and identity, to better face the difficulties, to be able to live with others and to
establish relations of coexistence, and to have more tools to participate in society.
Adverse determinants are the basis of inequalities and inequities,
injustice, exclusion, discrimination, violence and poverty. Overcoming
it involves not only the development of processes allowing individuals,
families and communities to exercise more control over them and full
compliance with individual and family responsibilities; commitment of
political and social order is also required to implement political, economic, environmental, social and cultural transformations ensuring environments that guarantee dignified living conditions to all Colombians.
The environments where children’s daily lives take place during
their early childhood have been expanded to the extent that society
has become more complex. Similarly has happened to institutions, the
roles of social stakeholders that constitute them and attributes required
of them. Thus, for example, increase of women participation in the
labor, political and social world has made it necessary to have different spaces to accommodate children and look for qualified care, to be
timely and relevant.
In order to organize comprehensive care to early childhood, the
Strategy has highlighted four environments needed to ensure those human, material and social conditions that make development possible
and full exercise of rights according to the life cycle they are in:
• Home
• Health environment
• Educational environment
• Public space
Although these are not the only environments where the children’s
lives take place, the Early Childhood Comprehensive Care Strategy
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takes them into account so that the country guarantees its quality,
including the development promotion through simultaneous and concurrent assistance to girls and boys.
The Home Environment
The home is the closest environment to the children thanks to the
crucial role the family plays, (and even the community in the peasants’
case, indigenous groups and some, African descent and black people,
raizales, palenqueros and gypsies where family has a leading role in
the upbringing). Home, in its wider sense, represents acceptance and
affection; it is a space where they spend most of their time from early childhood providing them with basic social and cultural references
with which they start moving through society.
Starting from pregnancy, the home begins to be transformed. New
roles, relationships and dynamics are looking to give form to life of the
new member. Expectations, affections and emotions that accompany
pregnancy produces close ties of the new being with adults surrounding him/her. Thus the importance that pregnant women have adequate
and safe support provided by those who accompany them.
Different spaces at home also undergo transformations in trying
to admit children. New elements, new dispositions, new glances on
the conditions of security that the small ones require, concur along
with the relational elements trying to provide a favorable development environment..
From birth and beyond care and upbringing are actions owned by
those who accompany children at home. Significant adults in the life
of the new family member - not only the mother as it has been the traditional role-, take part in those chores and provides accompaniment.
If adults involved are sensitive to interests, feelings, and capabilities,
and as a result respond in a timely and adequate way to its manifestations, i.e. if they build meaningful relationships, these actions will help
make the home a beneficial environment for children.
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Technical Grounds for the Strategy
Since the home is a gathering place, it is an environment where
conflicts are present. To this extent, mechanisms must also be present
to achieve their resolution by avoiding the use of physical, emotional
or moral violence. Screaming, threatening, insulting, mocking, hitting,
humiliating, among others, bring adverse consequences for children:
resentment, pain, fear, sadness, hopelessness, confusion, insecurity,
and revenge desires.
Finally, the home has to be a safe environment. So its spaces, elements
and surroundings have to be modified to prevent accidents, emergencies
or disasters and help defend life in case of a hazardous event.
Health Environment
At the start of the life cycle, this setting
also understood in a broader sense, occupies
a fundamental place because it is the first institution that welcomes children. It accompanies the process of preconception, pregnancy,
birth and onwards, with the fundamental aim
of preserving the existence of children in conditions of full dignity.
Quality and warmth are qualities that
must stand out in those who accompany
children in the health environment in order
to be beneficial for them. Then suitable and
competent health personnel is required, who
are also interested in people, ready to listen,
to communicate with simplicity, committed
and supportive of life, able to interact with
each pregnant women, each girl, each boy and their families, and
ready to have empathic and genuine relations, sensible, respectful
and amiable personal treatment, that goes beyond assistance. It is
urgent that actions in this environment be the example of a humanized health.
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The health environment also plays a very
important role in the promotion of good treatment and in the prevention and protection
against domestic violence and any other form
of violence against women, boys and girls,
as well as in the prevention and protection
against abuse and exploitation.
A health institution protective of girls and
boys welcomes them with priority, it has no
access barriers, is capable of interacting with
its contexts, to respect the differences, to recognize and assume human diversity as a value and make of it an opportunity for a comprehensive development. It also has suitable
spaces to accommodate safe and comfortably
pregnant women, children and their families.
These environments recognized and made
possible are the way to be in the world during
early childhood.
The Educational Environment
This environment deliberately encourages pedagogical actions
allowing children to experience and go deeper in their condition of
holders of rights, participative citizens, transformers of themselves and
of reality, creators of culture and knowledge. These relations between
peers, teachers, and other agents, play a crucial role. This is a privileged
environment to explore in depth the experience of living together, to
meet and to respect each other, to gradually internalize and steadily
construct basic rules of coexistence.
By guaranteeing human, material and spatial conditions, pertinent,
timely and of quality mediated by pedagogical intention, the educational environment is one of the first scenarios where they encounter
diversity in an ongoing process of cultural and social relations that offer
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Technical Grounds for the Strategy
them confidence and security. So the educational environment is the
place to express emotions and ideas through different languages, to
explore the physical, social and cultural world, to pose questions and
possibly to gamble hypothesis, all those elements that contribute to
strengthen their identity and autonomy.
However, all these possibilities will contribute to comprehensive development if marked by intrinsic education care practices characterized
by interaction, exchange and affection. As said, the educational environment requires an intentional work by, especially by experienced teachers,
educational agents, and trained officers to do so, who should lead to
challenging situations promoting interactions and activities that enrich
the spontaneous and natural contact of children with themselves, with
the environment, with adults and with their peers. All this in the context of welcoming environments, safe and protective, ensuring favorable
conditions of location, infrastructure, security, accessibility and comfort.
The educational environment needs to combine actions related to
health, food and nutrition, with care and upbringing by families and
caregivers, with recreation, protection and participation of children
in early childhood. Only then can comprehensive care be guaranteed
in this environment and thus contribute to construct of a more equitable country.
This certainly implies the promotion of learning processes aimed at
all stakeholders (parents, mothers, caregivers, educators and community in general) to qualify their performance in the promotion of comprehensive development of children. It is possible to emphasize that the
educational environment carries out a fundamental work in education
and accompaniment of families in their experience to welcome, take
care and up bring their daughters and sons.
The Public Space Environment
This environment is composed of free access open spaces (plazas,
parks, roads) and places in infrastructures to which the community gives
political, historical, cultural or sacred value (libraries, playgrounds, hous115
Early Childhood Comprehensive Care Strategy
es of culture, museums, theatres, temples, Malocas, participation scenarios). The first are sites of intense social activity, the second preserve the
inherent common good values, keep the collective memory, and protect
the venerable. Both express the collective will of social assets.
This environment has a vital role in children’s identity, citizenship
and democratic education, as it constitutes a vital and humanizing
space to integrate their condition as living, social and cultural beings.
A public space that provides early childhood development has fundamental social and cultural elements for building sense of belonging, is
a source of relational experiences to establish ties with others, allows
contact with a historic past, contributes to the development of creativity, aesthetic sense, and enjoyment of art and cultural property.
The public space contributes significantly in the socialization of children because there they see the organization and how society works,
interact with people of different ages and characteristics, appropriate
cultural heritage, build their identity, and learn from the world.
The design of the public space that welcomes children and promotes its development makes them visible, recognizes them, listens to
them and takes them into account. It promotes and ensures good treatment, social inclusion and non-discrimination. It establishes solidarity,
respect, acceptance and valuation of differences, and prevents all forms
of violence against them.
The diversity of environments and stimuli that public space provides
demand to take into account different aspects in its maintenance, accident prevention, preparation and action in case of emergency and disaster
and to guarantee mobility and information for people with disabilities.
Due to public spaces characteristics and its teachings, it is important to
encourage environment protection and ecosystems conservation.
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Comprehensive Care Fundamentals
7
The first part of the Strategy was dedicated to present advancements
and reflections of the country regarding understanding childhood,
comprehensive development, the role of the family, its context, and environments promoting development. Upon entering this second part,
these concepts are linked with action through a setting in the doctrine
of comprehensive protection, emerging from international regulations
framework and is the guiding reference of the State management to
make comprehensive care for early childhood true.
Comprehensive Protection, an Action
Framework for the Strategy
The Comprehensive Protection doctrine collects philosophical and
ethical ideas, and political and regulatory developments to consider
how to conceive, assume, recognize and guarantee the children’s rights
from a rights-based approach.
When our
mothers are
happy and
calm, we are too.
When they are
sad or angry we
stay very quiet.
The United Nations doctrine on comprehensive protection, involves the
total universe of the child-juvenile population. This doctrine includes all
individual and collective rights of future generations, i.e. all rights for all
children. This situation makes every child and every adolescent a holder
of rights to be enforced. For us adults, recognition of this condition results
in the need for the rules of the democratic State to work for childhood8.
This doctrine was picked up by the Convention on the Rights of the
Child and is part of the regulatory and political internal adjustment process of Colombia. It has been incorporated as a central tenet of the Code
7. This section is developed from elements provided by the reference study for the “Technical
Guidelines for the Comprehensive Protection of Children’s Rights since Early Childhood”,
prepared by Martha Lorena Padrón, Intersectoral Commission for Early Childhood Comprehensive
Care coordinated by ICBF (2012).
8 Emilio Garcia Méndez (1984). Rights to Childhood and Adolescence in Latin America: From
irregular situation to comprehensive protection. Santa Fe de Bogota: Forum Pacis, p. 11.
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Early Childhood Comprehensive Care Strategy
of Childhood and Adolescence9; it is a reference that guides the design
and implementation of the Early Childhood Comprehensive Care Strategy.
The Code of Children and Adolescents (Article 7) contains the comprehensive protection in four imperatives regarding the children’s rights:
• recognition of ownership,
• warranty and fulfillment of their rights,
• prevention of threat or violation, and
• full restoration when they have been violated.
In turn, the Code complements saying that regarding management:
Comprehensive protection is embodied in the set of policies, plans, programs and actions at national, departmental, district and municipal levels
9. Law 1098 of 2006
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with the corresponding allocation of financial, physical and human resources (Art. 7, Code of Childhood and Adolescence).
Similarly, the code defines that the responsibility of actions conducive to ensuring the exercise of the rights of children is shared between
different State stakeholders, the family and society, and that these must
happen concurrently.
Summarizing we could say that comprehensive protection leads to
a transformative role of conceptions about children, their place within society and adults roles. It also raises the manner and type of actions through which the guarantors of rights (State, family and society)
should perform responsibilities regarding comprehensive development
resulting in comprehensive care to early childhood, guaranteeing the
development of children from the rights-based approach.
The comprehensive protection principles of Law 1098 of 2006 are:
• Higher Interest. “Forcing everyone to ensure comprehensive and
simultaneous satisfaction” of children’s rights (Article 8, Law
1098 of 2006). It implies that the measures to be taken to fully
protect a girl or a boy should be based on the legislation that gives
effectiveness and enforceability for their rights (Cillero, 1999).
• Prevalence. Locates the children’s rights in supremacy over the
rights of other persons, because are classified as fundamental and
of higher level. Thus, in any act, decision or administrative, judicial
or of any kind to be taken in relation to the children, will dominate
their rights, especially if there is conflict between these and those
of any other person (Article 9, Law 1098 of 2006).
• Co-responsibility. Refers to the concurrence of actions by the
State, the family and society in accordance with their specific
competences, for the promotion and guarantee of the fulfillment
of rights as well as prevention of non-compliance situations, threat
or violation and its restoration. Actions must be concomitant,
coordinated and articulated (Article 10, Law 1098 of 2006).
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Early Childhood Comprehensive Care Strategy
• Enforceability. It empowers anyone to demand from the competent
authority compliance and restoration of children’s rights,
establishes the unavoidable responsibility of the State to respond
with appropriate actions at all levels and through each of its agents,
guaranteeing achievement, protection and restoration of children’s
rights (Article 11, Law 1098 of 1996).
• Equity. Guide actions to achieve justice towards children, taking
into account that everyone should enjoy equal opportunities and
conditions for the exercise of rights, regardless of their social status,
race, gender or age.
• Social Inclusion. Actions to ensure that all girls and boys can enjoy
those conditions that ensure their full protection.
• Solidarity. All stakeholders must cooperate to create conditions
that favor the development of chidren10.
• Complementarity. Recognizes the specificity of each stakeholder
and the relationship of interdependence that their actions hold
in favor of the public interest regarding others actions. The
relationship based on this principle strengthens the creation of
a collective awareness of what is public, expanding the cultural
consensus among human groups, social and culturally diverse,
and strengthens the management capacity of local politics in favor
of early childhood.
• Subsidiarity. Ensures compliance and restoration of children’s
rights when the titleholders cannot do so, through regulation or
allocation of competencies to certain authorities or stakeholders
by the State.
10 In accordance with the jurisprudence of the Constitutional Court, it can be said that there
are three statements of the solidarity principle: (i) as a pattern of behavior; (ii) as a criterion
for interpretation in the analysis of acts or omissions of individuals who violate or threaten
fundamental rights, and (iii) as limit to own rights. (Cf. Technical guidelines for the general
framework and guidelines for public policies and territorial plans regarding childhood and
adolescence. ICBF, May 7, 2007).
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It is worth highlighting that according to the Code of Childhood
and Adolescence, these principles are not optional. They are mandatory to those responsible for guaranteeing the rights of children; in
such a way that their actions and decisions correspond to what is most
appropriate for comprehensive protection. As it will be discussed later
the comprehensive care to early childhood Strategy has been designed
entirely in coherence with this doctrine.
Children’s Rights and their Realizations:
The Strategy’s Commitment
The comprehensive protection central element is to guarantee the
child’s rights. Its raison d’être. In addition the law delves into its features and defines rights as:
• Universal, that is, applicable to all mankind, in all time and
places, without distinction of age, gender, race, culture, ideas,
social or political status.
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Early Childhood Comprehensive Care Strategy
• Indivisible, because it cannot be shatter, separated into parts, or
distributed or shared among several people.
• Interdependent, as they relate among themselves not in a
hierarchical or subordination way that implies that one is more
important or that may become effective at the expense of others.
• Irreversible, because rights are lasting and irrevocable. Once
recognized, they acquire the status of inherent human dignity
and are not lost in the course of time.
• Progressive, considering that they become complex and expands
as the human being develops and that new social conditions will
be determining the validity of other rights.
• Demandable, given that compliance must be guaranteed,
effectively carried out and in case of violation, restored.
• Unrenounceable, because is not possible to decline them, transfer
or separate them from the person.
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Technical Grounds for the Strategy
As a breakthrough of the country regarding the children’s rights in
early childhood, the Intersectoral Commission has raised a horizon
of meaning to the Strategy that focuses on the concept of Realizations (Realizaciones in Spanish). This refers to conditions and states
that materialize in the life children, making possible their comprehensive development.
The realizations raised in singular for each girl and boy and in present tense, imply that:
1. Has a parent or primary caregivers who welcome it and put
into practice parenting guidelines that promote their integral
development.
2. Live and enjoy the highest attainable standard of health.
3. Enjoys and maintains an adequate nutritional status.
4. Grows in environments that promote their development.
5. Build its identity in a context of diversity.
6. Expresses feelings, ideas and opinions in their everyday
environments and these are taken into account.
7. Grows in environments that promote their rights and act upon
exposure to situations of risk or violation.
Thus, each realization show evidence that children’s rights are exercised. At the same time call for all stakeholders involved in the promotion of integral development to make rights a reality; to be present in
everyday environment, to permeate their contexts and interactions and
to express them in their lives.
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Early Childhood Comprehensive Care Strategy
Early Childhood Comprehensive Care
When referring to comprehensive care, the Strategy raises the
challenge of collectively defining their structuring factors (estructurantes in Spanish), to be meaningful, coherent, and consistent. Also
organized between levels of government, sectors and institutions to
ensure that actions reach children in a concurrent, complementary,
harmonic, relevant and timely way.
What is it about?
Comprehensive care, recognized as the means for the stakeholders
responsible for guaranteeing children’s rights to full development in
early childhood, to materialize in an articulated way the comprehensive
protection. To make this so, actions must be cross-sectorial and take
place at national and territorial level.
In turn it includes social, political, programmatic and budgetary
fields, and they are intentional, planned, continuous, relational and
effective. These actions attributes allows an interest to ensure that
in each environment children live in there are human, social and
material conditions ensuring promotion and enhancement of their
development. In effect:
• To say that comprehensive care is intentional, highlights that its
actions are directed to conscious and valued purposes showing
how to interact significantly and in a timely manner with the
child and with their environments, in order to contribute to their
overall development.
• When saying that it is relational it is understood as a result
of a process of social interaction that occurs in environments
with particular conditions and contexts, where the stakeholders
involved are recognized and influence each other.
• Its effectiveness is given by its orientation to concrete results in the
children’s life. In this sense comprehensive care reaches its intentions.
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Technical Grounds for the Strategy
Comprehensive care has the following additional attributes ensuring that the quality is intrinsic to its nature:
• Relevant: It responds to interests,
characteristics and potentialities of the
children at the time of their life cycle, and
the characteristics of their environments.
• Timely: Means that it occurs at the right
moment and in the place that corresponds.
It is effective in the right time.
• Flexible: It ensures that it is open to adapt
to persons, contexts and environments
characteristics.
• Differential: Values children as beings
that are built and live in different
ways. It is sensitive to their particular
characteristics because of the diversity
of situations, conditions and contexts, and intentionally acts on
the environments to transform situations of discrimination.
• Continuous: Occurs on a regular basis and thus guarantees the time
that children require for their individual development process.
• Complementary: Their actions contribute to attention
comprehensiveness as a result of joint interaction and articulation
between the stakeholders responsible for the comprehensive
protection of children in early childhood.
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Early Childhood Comprehensive Care Strategy
Early Childhood Comprehensive Care
Structuring Factors
The National agreement 11 reached regarding what comprehensive
care encompasses and that it should be guaranteed to all children to
ensure their comprehensive development is focused on five Structuring
Factors namely:
• Care and upbringing
• Health, food and nutrition
We grow when
we can play
with adults
and especially
if they tickle
us. That is the
remedy against
all sadness.
• Initial education
• Recreation
• Citizenship and participation
Consequent to the qualities of comprehensive care established,
these structuring factors materialize thanks to the concurrence of
stakeholders responsible for the comprehensive protection of children,
taking into account their specificities and daily lives experiences.
This section contains technical guidelines cross-sectoral and territorially 12 agreed that provide all stakeholders involved, conceptual
and operational criteria to implement each structure and favor the
realizations of children in a context of completeness. Allow stakeholders involved to reflect on the work; that the sense and intent of
11 This agreement is the result of the Intersectoral Commission for Comprehensive Early Childhood
Care that included the process of social mobilization for territorial feedback, and experts from
the Comprehensive Care Road-map (Ruta Integral de Atenciones) in 2011 and documents
based on technical guidelines in 2012 attended by nearly three thousand people of recognized
suitability in relation to Early Childhood Comprehensive Care, belonging to public entities,
private organizations of the civil or community society present in the country and who share the
responsibility to ensure the children’s development
12 To carry out the collective construction of these guidelines the Intersectoral Commission for
Comprehensive Early Childhood Care looked at three moments: First the preparation of reference
studies on each of the structuring factors of comprehensive care, second to develop a process
of social mobilization that would allow its territorial feedback and with experts and third to
produce the guidelines. The social mobilization process involved 17 territories representing the
various regions of the country.
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Technical Grounds for the Strategy
comprehensive care are shared and materialized in practice, regardless of who or which entity developed them, and that they contribute to the national purpose of ensuring full development of children
during early childhood.
Following are the framework guidelines developed for each structuring factor. It should be noted that the Strategy has a number of tools
(guides, manuals, protocols, etc.) that technically orient each structure
own actions.
Care and Upbringing
This structuring factor seeks to promote and strengthen the links
between children with their family and with the persons responsible
for their assistance through by creating rich, safe, protective, inclusive,
participatory and democratic environments.
The development of the structuring factor technical line has two
large fields of action. The first related with training and support to
families by its leading role in this aspect, and the second relating to
the restoration of rights, on the understanding that care is also related
to aspects of prevention and protection to safeguard the integrity of
children.
Training and Accompanying Families13
The fact that home is the first environment where children interact
and that the family and nearby community are social determinants and
stakeholders par excellence of this environment, it is necessary that
within the Early Childhood Comprehensive Care Strategy to contem-
13 This section is developed from elements provided by document “ Analysis of the Most Significant
Experiences Developed and Guided Towards Strengthening the Family for Full Development of
Children and Adolescents”, developed by Leonor Isaza Merchán together with Carmen Midaglia
[Uruguay] and Héctor Rodríguez [Mexico]) (2011) and the reference study for the “Technical
Guidelines on Education and Accompaniment for Families of Children in Early Childhood”
by Ángela Patricia Nocua Cubides (2012), both produced for the Intersectoral Commission for
Comprehensive Early Childhood Care coordinated by the Colombian Institute of Family Welfare,
as a result of technical cooperation between the Inter American Children and Adolescents
Institute, and the Government of Colombia.
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Early Childhood Comprehensive Care Strategy
plate actions to support and prepare families to have all the elements
required to strengthen emotional ties with its members in early childhood, and to contribute in the configuration of homes as rich, safe and
participating environments14.
This means having a solidly structured component of work with
them, prompting permanent education and accompaniment processes
to strengthen the leading role in the development of children.
• Training consists of a series of actions with educational intent
aimed at facilitating families’ reflection on their dynamics,
openness to alternatives and the construction and enrichment of
new practices and patterns of relationship.
• Accompaniment on the other hand, is a process intended to be next
to the families in their development processes. Both training and
accompaniment can be carried out with personalized methods
per household or using mechanisms to group several families,
and in any case must be guided by a few guiding principles
(Isaza, 2011).
Taking into account the various forms of family organization as
well as the cultural and social contexts of the country, the overall
purpose of the training and accompaniment is the building, transformation or strengthening of family dynamics that are oriented toward affectionate, warm, caring, friendly, equitable and participatory
interaction patterns among different members of the family particularly children from early childhood, giving priority to enrich the
following processes:
• Expressions of affection, solidarity and configuration of playful and
pleasant moments, promoting a sense of belonging in the families
and the inclusion of children as an important part of them.
14 Studies of neuroscience, development psychology and related disciplines, coincide in declaring
the convenience of favoring the children’s care during the first five years and emphasize the
importance of qualifying the assistance they receive in the family environment, as a factor that
guarantees the sustainability of adequate comprehensive care.
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Technical Grounds for the Strategy
• Democratic power relations between genders and generations,
that facilitates conflict resolution and support in open and
constructive communication styles.
• Involvement of children in decisions affecting them as individuals
or as family members.
• Family environments promoting physical and social security for
children, their health and nutrition and the development of their
capabilities and potential.
• Empowerment of families to access services that guarantee the
rights of its members and also their rights as a social group.
• The construction and strengthening of family or community
support networks in which families actively participate to
strengthen relations and projects in favor of children.
Following are some criteria to take into account when designing training and accompaniment programs15:
15 Idem
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Early Childhood Comprehensive Care Strategy
• To recognize families as collective holders of rights and not
only as guarantors of the rights of children in early childhood.
The condition of collective family subject, makes it possible to
conceive it as a unit, with its own characteristics, capabilities and
vital moments, which must be met at the time of accompanying
it while exercising its responsibility of developing its early
childhood members. This implies:
–– To appreciate its distinct conformations and
organization as an expression of diversity,
and evaluate its advantages to exercise their
functions of affection, support, solidarity
and survival of its members.
–– To involve them as individuals with selfdetermination in the structuring and
development of accompaniment and
education processes considering its
knowledge and practices.
–– To be sensitive towards the relationship
developed between the vital moment of the
family and its members in early childhood.
• To consider the resources families have to act in search of the
welfare of its members. In addition to their skills and abilities,
family groups develop strengths resulting from facing domestic
and external pressures16 they are exposed to when searching
for a good achievement of their purposes. The first have a
great emotional burden for their members and are difficult to
perceive. The latter originate in other social systems and expose
it to confront limitations. Skills, abilities and strengths are the
16 Among domestic pressures are tensions inherent in relationships, the performance of roles,
the vital moments of its members. External pressures are the armed conflict, the conditions
of poverty and exclusion, and natural disasters among others. To these, we can add a long
tradition of patriarchal models or violence affecting families, as well as pressure from the media
for keeping life status impose even higher pressure to adults, or just the confrontation of internal
family changes like the birth of children.
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Technical Grounds for the Strategy
best capital to leverage processes oriented to qualify family
dynamics, in a context of dialogue and exchange of knowledge
between families, communities, educational agents and other
social stakeholders.
• To have a gender equality approach that guide the relations
between men and women without predominance of either
one. This equitable approach wants that care and upbringing
responsibility be shared by men and women, leading to
strengthening everyone’s capabilities. Gender equity involves the
pursuit of agreements regarding male and female roles. It assumes
the valuation of gender difference to be able to complement.
To make visible and include the cultural diversity of the regions,
ethnic groups or areas of settlement as well as the different capacities of children, and families. In addition, in a multi-ethnic
and multicultural country like Colombia, education and accompaniment to families must take into account ethnic, cultural,
regional diversities and (urban, rural) settlement area to develop differential processes that take into account beliefs, representations on the family and ways to relate as well as the early
childhood conceptions.
It is important to consider families with children with disabilities, to have a particular way of fortifying them and their family,
to have access to assistance according to their age, specificity and
context, and to recognize their human value and the possibilities
of capacity development.
• To accept that changes or transformations of family systems are
complex and require long-term systematic processes. This means
that education activities should be continuous and suitable so
families can make required changes in a sustainable way. In this
sense, it is necessary to promote the accompaniment processes to
supplement the education scope and guide the families according
to their specific characteristics.
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Early Childhood Comprehensive Care Strategy
As part of the Strategy design, the country has a set of working
guidelines directing the attention of this structuring factor concerning education and accompaniment of families, expressing , the priority
processes that must be enriched, outlining elements to be taken into
account in the design of programs and methodologies most appropriate
to work with families.
Reestablishment of Rights17
According to Article 50 of the Code of Childhood and Adolescence (Law 1098 of 2006), the restoration of the children’s rights
make reference to “the restoration of their dignity and integrity” as
individuals and the ability to effectively exercise the rights those violated to them 18.
In this sense the Colombian Institute of Family Welfare established
technical guidelines to regulate the routes, management and attention
model for the restoration of rights19, in situations that may affect them
by non-compliance, threat or violation of these.
• Non-observance consists of failure to comply, omission or denial of
access to a service, or of duties and unavoidable responsibilities of
those who are responsible for ensuring the full exercise of rights
of Colombian or foreigner children in the country or nationals
living abroad.
• Threat refers to the situation of imminent danger or risk for
children to exercise their rights.
17 This section is developed from elements provided by the reference study “Technical Guidelines
for the Comprehensive Protection in the Exercise of Children’s Rights since Early Childhood”,
prepared by Martha Lorena Padrón, Intersectoral Commission for Comprehensive Early
Childhood Care coordinated by ICBF (2012).
18 According with ICBF guidelines. Resolution 2785 of July 10, 2009 “Technical guidelines for the
administrative process of re-establishment of rights is added, approved by resolution 911 of May
7, 2007 added by resolution 4104 of September 29, 2008.”
19 Resolution 5929 of December 27, 2010, “Technical Administrative Road-map and Actions
Guidelines, and Assistance Models for Restoring Rights of Children, Adolescents and of Age with
disabilities, threatened, not observed and violated rights “, modified by the Resolution 707 of
February 28, 2011, and added by Resolution 2850 of 2012.
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Technical Grounds for the Strategy
• Violation denotes any situation of damage, harm or injury that
prevents children from exercising their full rights.
The children may be in an unprotected situation to exercise their
rights when their basic needs are neglected long enough to cause them
serious damage to their welfare and development, either by the behavior of family members, by the conditions in which it is, or by difficulties
or circumstances external to this (Cantabria 2011).
An unprotected situation occurs when three conditions are combined:
1. A person or service responsible for ensuring the satisfaction of
one or more basic needs of a child does not meet its responsibility
(because it cannot or don’t want to). Or certain external conditions
are given that prevent that person or service from satisfying them.
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Early Childhood Comprehensive Care Strategy
2. There is no external agent capable of counteracting this situation
and to satisfy the needs, or actions of these agents is not enough.
3. As a result of this situation, the child has suffered or is likely
to suffer significant health damage, welfare or development
(Cantabria, 2011).
The violation of rights is associated to all those environments where
children’s life happens. The home, the institutions where they are cared
for and comprehensively assessed, public space, etc. The State, the family and society must act immediately, generating alerts to support the
restoration of children’s rights and the implementation of measures by
competent authorities.
To identify violation situations, threat or non-observance, the institutional or community stakeholders may rely on physical, behavioral
and family signals seen in them and in their families. There are indicators that according to the particular area in which they act are more
or less visible. The health personnel, for example, has greater facility
to detect physical signs that go unnoticed to other people; In addi134
Technical Grounds for the Strategy
tion, teachers and other educational workers have privileged access to
children’s development and everyday behavior characteristics , their
families or caregivers.
The restoration of rights includes actions and comprehensive efforts
to restore them fully and effectively, and if needed with the implementation of measures by the competent authorities in the interests of providing assistance, care and immediate protection to children.
The restoration actions demand from the State, to act in a coordinated, concurrent, and articulated way with the family, institutions
and the community, to create alternative solutions. Given the impact
of situations of violation on children’s development, the country’s effort
is that all the instances and people who must take part to restore their
rights act in a sensible and empathic way with those who have undergone such situation. It is also essential to enrich the environments
and shelters through which children must move over the course of the
restoration of their rights so that they are an example of dignity and
warmth.
Health, Food and Nutrition20
This structuring factor seeks to preserve the existence of children
with full dignity promoting their welfare, preventing of conditions that
alter it, treating diseases with quality and warmth, and rehabilitating
their emotional and functional stability for an autonomous and active
existence.
Health, food and nutrition are fundamental rights, which are closely
related and are part of the social determinants of child development.
• Health is defined as the physical, mental and social welfare of
people, enabling them to lead productive, social and economic
20 This section is developed from elements provided by the reference study “Technical Health
Guidelines in Early Childhood”, and the “Technical Food and Nutrition Guidelines for Early
Childhood”, developed by Blanca Luz Hoyos Henao and Nora Corredor Martinez respectively, for
the Intersectoral Commission for Comprehensive Early Childhood Care with the coordination of
the Ministry of Health and Social Protection (2012).
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Early Childhood Comprehensive Care Strategy
lives (WHO, 1946, 1977). This concept goes beyond the absence
of disease and involves conditions that favor the development
of capabilities to fully exercise their freedom in decent living
conditions. When it comes to children in early childhood, this
welfare depends significantly on adults who surround them.
• Nourishment is a biopsychosocial and cultural process, related
to the consumption of food that helps human beings get the
nutrients they need to fulfill their vital functions and achieve a
full life. Food is essential to stay alive and healthy, and is object
of ritual and symbolic interpretation, and economic, social,
political and cultural manipulation (Pelto and Pelto, s. f., in
Romero, 1993).
Nourishment is the first event in children lives that attracts
the attention of mothers, parents, caregivers and those who are
around the child. It is a social event, and also a factor involved
in the construction of identity and sense of belonging to a family
and a community.
During the first thousand days, from pregnancy and up to two,
nourishment plays a crucial role since the formation of billions
of nerve cells occurs during this period and 85% of the communication network between them is established, allowing the
transmission and reception of information between brain, body
and environment.
• Nutrition, refers to a fundamental process for the development
of children, where the body assimilates and takes advantage of
nutrients coming from food. Nutritional status affects the survival
and quality of life, therefore is one of the best indicators to assess
the children’s health condition.
Health conditions, as well as those of nutrition, are the result of
interaction of biological, social, political, economic, environmental and
cultural decisive factors that shape the circumstances in which the
child is born, grows and lives.
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Technical Grounds for the Strategy
Based on this framework and based on decisive factors as a perspective of analysis and organization, the Strategy identifies the following as
actions related to health, nourishment and nutrition:
• Promotion and Protection of Welfare seeking to empower children
from early childhood and their families in the exercise of their right to
health, and the promotion of equitable conditions guaranteed from
preconception, so human beings begin their lives under conditions
that enable them to achieve a comprehensive development
regardless of their social, cultural or economic circumstances.
• Prevention, which purpose is to reduce the likelihood of
conditions affecting the well being of children through its early
detection and intervention.
• Treatment and Care of health changes oriented to impact with
quality, warmth and comprehensiveness the effect on the welfare
of children and their families in accordance with their own needs,
in pursuit of self-improvement.
• Rehabilitation seeks to promote and restore emotional and functional
stability of pregnant women, children and their families, needed to
ensure the continuity of its process of development and construction
of an autonomous existence at the highest possible level of wellness.
We like to
celebrate
our birthday
because we now
we grow up that
day. We also
like to go to the
swimming pool,
look ourselves
in the mirror
and see that we
are growing.
In short, health, nourishment and nutrition assistance, in the
framework of comprehensive care, comprises a series of political actions, intentional, and effective, that generate conditions and promote
individual, family and social capacities to protect the comprehensive
development of children. It develops its potential and specificities and
context, anticipating health risks, addressing shortcomings in development and providing assistance with quality and warmth to those who
are affected in their nutritional and health condition.
Through the promotion and protection of welfare, prevention, treatment and assistance of alterations of health and rehabilitation, it should
reassure pregnant women, and children:
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Early Childhood Comprehensive Care Strategy
• A healthy atmosphere - which means protective and promotional
environments of development, favoring and promoting quality of life
of present and future generations, through the positive transformation
of social, sanitary and environmental decisive factors.
• A family, social and community coexistence free from violence,
with strong links with caregivers, as well as social and cultural
capacity of the latter to assist in all settings where their lives happen.
• The right to a healthy diet, appropriate, timely, secure, and
consistent with the territorial and cultural specificities.
• Social, economic, political and cultural conditions that allow
women and men exercise free, autonomous and informed sexuality
as a human right.
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Technical Grounds for the Strategy
• Healthy lifestyles, modes, and conditions as well as access
to comprehensive care during situations, conditions, and
contagious21 and non-contagious22 diseases.
• Individual and collective protection against emergency risks
or disasters, seeking to reduce damage affecting human and
environmental health thus contributing to safety, welfare and
quality of life.
In view of this health, nourishment and nutrition structuring factor,
comprehensive care to early childhood:
• Tends to guarantee the rights to health, nourishment and nutrition
of all women in fertile age, pregnant women and children from
0 to 5, in different environments, to ensure comprehensive
development in early childhood.
• Looks to preserve the existence of children in conditions of full
dignity, through the promotion of their welfare and development,
prevention and early detection of conditions that alter it, treatment
and assistance of disease with quality and warmth, and the
rehabilitation and promotion of its emotional and functional
stability to have an active life according to their cultural specificities
and autonomous existence and territorial identity.
• Aims to impact the biological, social, political, economic,
environmental and cultural determinants affecting health
conditions, nourishment and nutrition of women in fertile age,
pregnant and children from zero to five.
• Recognizes the responsibility of social stakeholders as a
condition to manage the social decisive factors of health,
nourishment and nutrition.
21 Emerging, re-emerging and neglected diseases; transmitted by air and by direct contact; immune
preventable, and transmitted by vectors (etv) and zoonoses.
22 Non-contagious diseases (NCD) refer among others to the cardiocerebrovascular, cancer,
diabetes, respiratory diseases of lower tract, chronic renal disease, and disorders affecting oral,
visual, hearing and communication health.
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Early Childhood Comprehensive Care Strategy
• Recognizes primary assistance in health23 as a fundamental part of
comprehensive care to early childhood.
• It is consistent with the Strategy of Integrated Management of
Childhood Illness (AIEPI, acronym in Spanish), with the initiative
of Institutions friends of women and children (IAMI, acronym in
Spanish), and Safe Maternity and Healthy Environments, among
others. It behaves like orientation of actions in harmony with the
public health ten-year plan in the territorial scope, and recognizes
that children’s guarantee of health, nourishment and nutrition
involves the participation of all stakeholders and sectors.
In turn from the perspective of health, food and nutrition structuring factor the Strategy provides precise information on the conditions
that every woman should have in fertile age, pregnant women, and
children. Next are some of the most significant topics for each population group clarifying that the Strategy has very precise guidelines
and protocols.
Women’s Health and Nutrition
• Health and nutrition condition
• Physical and emotional condition
• Eating habits and proper nutrition
• Reduction or temporary increase in vitamins and minerals.
Consumption of folic acid to reduce neural tube defects
23 “Primary assistance uses methods, technologies and scientifically informed, socially accepted
practices that contribute to equity, solidarity, and cost-effectiveness of health services” (Art.
12, Law 1438 of 2011). “The Primary Health Care Strategy consists of three integrated and
interdependent components: health services, the cross-sectorial /trans-sectorial action for
health, and social, community and citizen participation;” and shall be governed by the
principles of universality, multiculturalism, equality and differential approach, comprehensive
and comprehensive care, cross-sectorial action for health, community social participation and
decision-making and joint citizenship, quality, sustainability, efficiency, transparency, escalation
and irreversibility”(msps in agreement with the Centre for the Development and Evaluation of
Policies and Technologies in Public Health (Cedetes), Universidad del Valle 2012).
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Technical Grounds for the Strategy
• Prior to pregnancy stop consumption of substances harmful to
health
• Control of diseases or risk factors (diabetes, heart diseases,
hepatitis B, rubella, chicken pox, HIV - AIDS, etc.)
Pregnant Women’s Health, Food and Nutrition
• Health and nutrition condition
• Physical and emotional condition
• Personal hygiene
• Refrain from the use of psychoactive
substances
• Antenatal periodic control before twelve
weeks pregnancy, full and comprehensive
coverage and warmth
• Inclusion in nutritional
programs if required.
recovery
• Consumption of micronutrients (ferrous
sulfate, folic acid and calcium) from the
beginning of pregnancy
• Full vaccination scheme during pregnancy
• Access without barriers to antenatal care and health services in
general (dentistry, psychology, nutrition, laboratory)
• Early detection of conditions affecting the pregnant woman’s
health and the newborn
• Prevention of mother to child transmission of infections diseases,
including STDs (syphilis, HIV)
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Early Childhood Comprehensive Care Strategy
• Active participation of the pregnant woman’s family in caring
for the woman and the baby to be born, guaranteeing their
protection and security
• Accompaniment of the couple or a significant person during
childbirth process
• Humanized priority assistance and access to skilled birth
assistance
• Respect, privacy and avoidance of physical, verbal and
psychological aggression of women during childbirth
• Clamping of umbilical cord when it stops beating, contact skinto-skin and initiation of breastfeeding in the first hour after birth
• Counseling about healthy lifestyles, alarm signs and symptoms
of breastfeeding, sexuality, and violence based on gender,
preparation for childbirth, and oral health
• Counseling about woman health self-care, her baby,
breastfeeding and family planning: importance of birth spacing
of at least 24 months
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Technical Grounds for the Strategy
• Comprehensive assessment of women before hospital discharge
• Home visits after birth, in the following month
Newborn’s Health and Nutrition
• Health and nutrition condition
• Exclusive mother breastfeeding
• Neonatal screening in the first seven days
• Assessment of the development
• Vaccination full scheme according to age
• Iron supplement, vitamins A, D, E, K, and calcium for the infant
with low weight at birth or with risk factors24
• Prevention and early detection, diagnosis and treatment in
children with risk of blindness by prematurity and low weight
• Monitoring oxygen management
• Outpatient and hospital treatment of premature children and
with low weight at birth25
• Counseling to parents and caregivers about danger signs, basic
care of the newborn baby and the appropriate civil registry
• Comprehensive assessment of neonate before hospital discharge
• Home visits during the first month of life
24 Resolution 412 of 2000.
25 The Kangaroo program has demonstrated its ability to significantly reduce morbidity and
mortality in a particularly vulnerable group of newborns. The body heat of the mother, exclusive
breastfeeding and the Kangaroo (nestled between the breasts of mother), position are the basic
principles of the methodology; However, above all, it is the loving and close relationship between
mother and child that allows to improve the survival of children. The main characters are mother,
father, baby and family and not doctors or hospital.
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Early Childhood Comprehensive Care Strategy
Children’s Health, Food and Nutrition
• Health and nutrition condition
• Physical and emotional condition
• Exclusive breastfeeding up to six months and complementary
feeding up to two years
• Adequate and balanced diet
• Use of vitamins and minerals (vitamin A, iron, zinc)
• Vaccination full scheme according to age
• Child development follow-up
• Counseling to parents mothers, caregivers, and children about
danger warning signs, accident prevention and key practices.
Initial Education26
As an unpostponable right of early childhood, initial education is
a structuring factor of comprehensive care aimed to intentionally promote comprehensive development of children from birth to six, recognizing their characteristics and specificities of the contexts in which
they live and favoring interactions generated in environments enriched
through educational and practical experiences of assistance.
Initial education is valid in itself because the pedagogical work there
discussed starts with interests, concerns, capacities and knowledge of
children. This initial education does not search as ultimate preparation for primary school, but offering them challenging experiences that
drive their development; they play, explore their environment, express
themselves through art and enjoy literature.
144
26 This section is developed from elements provided by the reference study for Pedagogic Guidelines
on National Initial Education, prepared by Graciela Fandiño, Yolanda Reyes, Sandra Durán and
María Consuelo Martín, for the Intersectoral Commission for Comprehensive Early Childhood
Care with the coordination of the Ministry of National Education and the support of the InterAmerican Development Bank (2012).
Technical Grounds for the Strategy
Now, play, art, literature, and exploration of the environment as
guiding activities of early childhood, point the way to create a “culture
of initial education”. The foregoing means that far from being tools or
teaching strategies, “used as a means to achieve other learning experiences”, they enable learning. The approach, which Garvey makes about
play helps to explain this idea, saying that: “The child does not play
to learn but learn when playing”, the same could be said regarding
art, literature, and environment exploration. Painting and drawing, for
example, appear in the context of initial education as activities that
children use to express themselves, to build symbolic worlds, to make
appropriation of real-world objects, among others, and not as a strategy
to develop their fine motor skills, which does not exclude that mastering brushes or crayons contribute to this.
The following are some guidelines listed which provide elements for
pedagogical work in the framework of initial education.
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Early Childhood Comprehensive Care Strategy
Play in Initial Education
Conceived as a cultural phenomenon and a social practice play
opens a new path on the moments of initial education that is recognized and understood beyond the instrumental.
Play becomes children’s natural form of language; they can express
to others their intentions, desires, emotions, feelings. When playing,
children can propose new rules to the game and they learn to wait for
their turn and to share with others.
Fish and
yucca…
Yummy
Play mobilizes structuring thinking factors allowing children to
wonder about the use of objects and propose different ways to use
them or transform them. These interactions help them to develop observation and investigation skills, to be surprised, to give objects and
environments a new meaning, to solve daily life situations.
Children from zero to five play with their body, play traditional
games, play to explore, play roles, play to build. Adults can accompany
these playful activities through observation allowing the teacher, and
educational agent, to know the children, to identify the right time to
interact, to propose or to keep a distance. Also through interaction,
that means to assume a role within the game that echoes with games
proposed by them and enhances them with new ideas that contribute
to building the playful universe.
Literature in Initial Education
Understood as the art of working with words from the particular
and subjective experience of children and of exploring other meanings
that transcend the conventional use of language, literature is part of the
fundamental artistic expressions in early childhood given the approach
to verbal language.
Literature in initial education means to unconditionally support the
desire of children to express themselves, to communicate, to be fascinated with fantastic worlds described by adults, of moving or lull to
the rhythm of songs and lullabies, of playing with spoken and written
words and of telling their own stories.
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Technical Grounds for the Strategy
Books shape the existential questions and inspire and enrich the
desire to learn. To respect children’s choices, give them importance
and talk spontaneously about what was the reading about without
forcing them to answer questions addressed by adults, is a source
of knowledge about who these early readers are and arouses deep
conversations about life that people need to know to get to know
themselves and others, to name their own emotions, to imagine with
empathy and sensitivity those of others, to think critically and to
connect with mankind.
Although the literary experience is fundamental to approach written
language, it is important to clarify that in initial education (and in general in all aspects of life), to read has the broad sense of vital decipherment, of exploration of symbolic worlds and interpretative possibilities,
which means that reading cannot be associated or restricted to teach
lyrics out of context, to write endlessly or teach prematurely.
Also, learn to communicate in writing is not simply to transpose
oral language to a few signs on paper or other media, but to learn to
think otherwise and, as a result, literature in initial education offers
fertile ground to progressively be familiar with that other language: the
written language.
For children, the teacher, educational agents, and family members,
are the model for appropriating the complexities of their native tongue:
its tones, their linkages and rhymes they sing and read, give rise to
multiple interpretations and provide them with an ear training, which
helps them feel and think about the functioning of their language
through the possibility of changing, recompose and play with words
(Reyes, 2007).
The same happens with the story or read stories that reveal how
is time organized in a story, how are events structured and how
there is a different way other than language, beyond the one daily
spoken: a rich, poetic and symbolic language that is the ancestor of
the written language.
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Early Childhood Comprehensive Care Strategy
Art in Initial Education
In initial education to “make art” means to make sound, to dance,
to sing, to paint and to express emotions and thoughts with the body.
It is an activity enjoyed by girls and boys devoting much time.
More than teaching art, initial education creates an environment of
freedom and gratitude suitable for artistic expression, without filling
the time with directed activities because art requires a special time:
the time taken by children to start a painting until they say, I’m done.
It is then to boost its forms of expression, accompany them while
interest lasts, engaging in expressive and creative process, and to assess
those moments when each recognizes and learn about itself.
That doesn’t mean to stop accompanying with sensitivity and availability all what children express through their paintings and body, but
being there, listening to what they say, sing, scribble, or represent, respecting their times and their compositional sense.
Artistic proposals in initial education are oriented in two directions:
firstly, to nourish and enrich sensitivity, perception and enjoyment,
making works of art - plastic, visual, musical and dramatic available that expand the repertoire. Therefore a function of initial education is
linking children with cultural experiences, which propose a dialogue
with what has been invented by others in different times and latitudes,
to enrich its ways of listening, looking, and feeling.
Furthermore, art is aimed at fostering experimentation, expression
and creativity, through the construction of spaces where it is possible
to “make art”.
Music, plastic arts and dramatic or body expression are the multiple
languages children use to express themselves to connect, first of all with
their body and senses, to talk in many ways, to understand and rework
its reality and to begin that endless task of representing and sharing their
experiences. In addition these are spaces for meeting, exploring and recognizing what makes them unique, to link them with each other, and
above all, are channels to experience joy, happiness, laughter and humor.
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Technical Grounds for the Strategy
Exploring the Environment in Initial Education
Exploring the environment in initial education is focused from the
life learning perspective. It is a process that invites to know physical
objects, natural and man made, to unveil the natural phenomena, to
understand rituals or practices of a community. Indeed, exploring the
environment in initial education supposes to begin to understand that
the social and the natural are in permanent interaction.
It is through the senses that children interact with objects discovering
its properties: they touch them, smell them, taste them, and give them
different uses. Experimenting with them they go from manipulation to
experiential knowledge, from abstraction to construction of knowledge.
Guided by the desire to know and understand how the world works
they raised concerns, hypotheses and explanations, expressed through
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Early Childhood Comprehensive Care Strategy
actions, language and graphic presentations. All these ideas are tested
through experimentation, observation, direct contact with the object
of their attention, but also in conversation with others, where they contrast ideas and enrich their idea about life. Thus exploring the environment promotes the construction of consciousness and knowledge,
constitutes an ongoing process of creation. Every time they discover
the laws of nature and logic in which social and cultural world moves,
“is as if it were for the first time” (Hohmann and Weikart, Epstein,
2010, p.) (16).
In contexts of interaction with objects, environment, adults and
peers, there are possibilities for children to build the sense of the
world, which is imperative to accompany to develop their curiosity
and initiative in the framework of initial education. Hence the importance that the teacher, and educational agent foster experiences of
observation, organization of reality, encouraging that desire to quest,
to be able to check and compare their actions with others, allowing
them to participate in the construction of the physical, social and
cultural world they are part of.
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Technical Grounds for the Strategy
When asking for exploration in initial education is necessary to refer to the first approaches of the pedagogical movement Active School
whose emphasis is on “life entering school and school going to life”
approach inviting to review the place of near and distant in educational
work. The near would have to do with what children live, what is ordinary, what does not imply to address certain issues in a homogenizing
way. In terms of access to the distant, children are exposed to communication media, therefore, events like the Olympics and the World Cup,
or earthquakes or floods, lead us to think of places and people who
are in distant locations but which in turn are very “close” and awaken
a great attraction to be known. Certainly, initial education is also contacting children with the cultural heritage created by humanity.
The Purpose of Pedagogical Work
In order for initial education actions to contribute to children’s comprehensive development it needs teachers, and educational agents to
organize and plan the environment, select materials and design educational experiences. They are participant observers that accompany, ask
questions enriching children’s actions, and create security conditions
where they can act calmly.
The pedagogical work in initial education is flexible, not homogenizing, by responding to a deliberate planning and by enabling
performance and participation of children and thus recognizing the
uniqueness of each.
The way education environments are arranged and decorated is crucial to preserve cultures as an identity seal encouraging children to
identify themselves with their history, their customs, beliefs and habits.
These approaches invite to reflect and enrich the initial education
proposals so play, art, literature and environment exploration be part
of the pedagogical practices of teachers, and educational workers. It is
essential to recognize that these proposals will always be re-contextualized, redeveloped and enriched according to interests, needs and
expectations of children, their families and communities. Finally, it is
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Early Childhood Comprehensive Care Strategy
necessary to be aware that the relevant and with quality initial education contributes to close the country’s gaps and effectively promotes
equity in development opportunities for children and early childhood.
Recreation27
This structuring factor seeks to promote children’s autonomy and
self-determination through the promotion of meaningful experiences
that privilege and promote enjoyment, leisure, free creative expression
and desire to be in relationship with the world.
Early childhood recreation focuses on development of playfulness,
so through free will and creativity children can build an enjoyment
relationship with their environment.
To make of recreation a structuring factor of comprehensive care to
early childhood opens up possibilities in the construction of enriched
environments that generate concrete options for free and independent
participation, oriented to their comprehensive development.
Leisure responds to the human need to have spare time free of obligations in which to set up autonomous and specific experiences of
enjoyment, relaxation and fun.
As a result, leisure is satisfied in everyday life when children
challenge barriers and limitations imposed by their reality, to be and
to freely choose what they want to do besides their inherent obligations
in certain activities. In this sense, it is a possibility to experience using
freedom in an autonomous way, to build new understanding of the
world and of them.
It is necessary to understand that genuine exercise of freedom and
self-determination involved in leisure is part of contexts and environment’s
decisive factors.
27 This section is developed from elements provided by the reference study “Recreation Guidelines”
prepared by Esperanza Osorio Correa, of Funlibre, for the Intersectoral Commission for
Comprehensive Early Childhood Care with the coordination of the Administrative Department
of Sports, Recreation, Physical Activity and the use of free time. Coldeportes (2013).
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Technical Grounds for the Strategy
The law recognizes recreation as a necessity and as a human right.
• As necessity it is:
–– Basic: The United Nations General
Assembly declared in 1980 that for
humans “after nutrition, health,
education, housing, work and
social security, recreation should
be considered a basic, fundamental
need for its development”.
–– Fundamental: The Conference
of the United Nations on
Human Settlements, Habitat
and Environment unanimously
declared
that,
“…recreation
is a fundamental necessity of
contemporary man…”.
–– Unsatisfied: Law 136 of 1994
which dictates standards aimed at
modernizing the organization and
functioning of the municipalities,
establishes in Article 3 that these
should address, among other things,
the unmet need for recreation, with
special emphasis on children.
• As a right it is individual and inalienable: Article 24 of the
Universal Declaration of Human Rights States: “Every person has
the right to rest, to enjoy free time, to a reasonable limitation of
working hours and to periodic paid holidays”.
–– Article 15 of the American Declaration of the Rights and
Duties of Man states that: “Everyone has the right to
rest, to honest recreation and the opportunity to usefully
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Early Childhood Comprehensive Care Strategy
employ the free time, for the benefit of its spiritual, cultural
and physical improvement”.
–– The International Convention on the Rights of the Child
issued by the United Nations and whose agreements were
ratified by Colombia, expressed in its preamble, and later
in Article 31:
States parties recognize the right of the child to rest and leisure,
to engage in playful and recreational activities appropriate to their
age and to participate freely in cultural life and the arts.
States parties will respect and promote the right of the children
to participate fully in cultural and artistic life and will lead to
appropriate opportunities, in conditions of equality, participate
in cultural, artistic, recreational and leisure.
–– Article 44 of the Constitution expresses: “The fundamental
rights of children are: the life [...] education and culture,
recreation and free expression of opinion”.
In turn from a social point of view, Article 4 of Law 181 of 1995,
by means of which sport, recreation and use of leisure time are encouraged, expresses:
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Technical Grounds for the Strategy
Social right. Sports, recreation and the use of leisure time, are fundamental to education and a basic factor in the education of the person. Its
promotion, development, and practice are a comprehensive part of the
public education service...
To be recognized as a fundamental necessity and a human right,
regardless of gender, age, race, creed, or conditions they are in, all
children must have the possibility to enjoy recreation. Because they
are holders of rights, recreation cannot be subordinated to other
conditions, on the contrary, it urges and mobilizes other rights, enables the expression and recreation of human beings, and helps to
integrate efforts and cross-sectorial actions by virtue of its benefits
in development.
Now, as a socially constructed phenomenon, the meanings and
senses that adults and society give to recreation, influence the subjectivities that children in early childhood set in their lives in relation to
being, thinking and doing in leisure time.
From this perspective to provide a place for recreation in the lives of
the children and their families means to give them the opportunity to
be part of environments where they have the possibility of being. Seen
in this way recreation transcends the functional aspect in children’s life.
On the other hand, even though recreation benefits child’s development, it must ensure - beyond the specific pedagogic intentions – to
maintain the vital purpose of freedom and autonomy.
Leisure, recreation and play are phenomena crossed by a non instrumental purpose, mediated by a purpose or motivation of enjoyment
and creative expression, and can be structured or not, i.e. its manifestations may derive naturally from exploratory and discovery activities,
or be permeated by cultural experiences.
To talk about leisure and recreation necessarily refers to a society
approach that assumes conditions of freedom and autonomy so that
children achieve the life they want, and complicates the human being
concept that puts above the transcendence and spiritual and affective
development, the training for work, productivity and efficiency, bridg155
Early Childhood Comprehensive Care Strategy
ing its historical construction of present under a vision of future centered in human talent for competitiveness.
As stated by McLean, Hurd and Rogers (2008), although it is considered that recreation and play can overlap, they are not the same.
Play is an expression of human beings marked by exploration and
fiction, taking place from birth throughout its life. It is the leading
activity of childhood allowing children to represent, understand and
transform reality. From this perspective, even though play is present
in recreation, this involves activities such as travel, reading, going to
museums, and other cultural and intellectual activities that go beyond
play itself.
Recreation as a structuring factor of comprehensive care for children
in early childhood is then to create spaces where they can “be”, through
visions and relationships. From this perspective the playful activity appears as fundamental given that the aim is to stimulate the ability of
children to establish a relationship with the world, with knowledge and
relationships, through enjoyment allowing them to be structured as
critical individuals, able to become excited and to get uncomfortable.
In this way, recreation as a space for real participation allows children to learn about freedom; It invites them to make simulated or real
decisions through the creation of parallel realities, but also related to
their daily life.
As an alternative space for the expression of languages and ways
of seeing the world, which contradicts what has been given by society
and question it, recreation opens many possibilities using art, play and
creativity through creation, imagination, and even a replica of practices
and standards of the real world.
Insofar as the subjective construction of time for children in early
childhood is not modulated from pedagogical work but routines of their
environments, then recreation is possible and has greater resonance to
their daily lives if it is presented as a proposal for education and during
their leisure time to have impact on families and caregivers.
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Technical Grounds for the Strategy
Rojeck, Shaw and Veal (2006) pose that to take children’s perceptions about quality of time helps to better know the ways they value
their families leisure time, and for them to assume the ways they want
to spend their leisure time. Leisure pedagogy seek that people, learn to
build their leisure contexts through experiencing leisure.
According to Puig and Trilla (1996) the principles of leisure pedagogy are:
• Respect for autonomy and freedom of choice.
• Harmonize fun, creation and learning in times of leisure,
individually as well as collectively.
• Value leisure time and respect observation vs. activism. Children
have the right to do nothing. Idleness resulting from not doing any
activity opens the possibility for observation to start becoming
part of a vital necessity and be a source of learning.
• Stimulate the value of the everyday life.
• Develop the extraordinary, offering the opportunity to carry out
activities that get out of daily routine.
We grow up if
our mothers
and fathers
share lots of
time with us,
if they don’t
leave us alone.
When they are
home and watch
us play and do
mockeries, we
know we are
important for
them.
• Release time for rewarding and instructive leisure time.
• Participate in trainings given by different institutions organizing
activities for leisure time.
• Combine individual and collective leisure to enable satisfactory
engaging with oneself and with others.
• Identify harmful leisure and raise awareness about its
consequences.
Education for recreation, meant as an education for freedom and
autonomy, raises the need for spaces where children can assess to what
extent this contributes to their own welfare, to achieve their personal
and social life projects. (Osorio, 2009).
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Early Childhood Comprehensive Care Strategy
The construction of an approach based on the principle of equity
and equality, the recognition of difference, would be the task of what
Henderson called “fair leisure”, which relates to the notion that leisure
and recreation contribute to social justice helping others to make appropriate and ethical choices.
Recreation for children takes into account in their designs and space
their social and cultural realities, their knowledge, their visions of the
world; makes possible their participation in the construction of their
own styles for recreation and to create experiences that reaffirm them
individually and collectively.
A proposal for recreation focused on early childhood education requires involving adults in that building since it implies to:
• Give a new meaning and sense to leisure and to self-referenced and
referenced recreation, with a human being vision that surpasses
the stand of economic productivity as axis of development.
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Technical Grounds for the Strategy
• Identify and overcome barriers (perceptual,
geographical, physical), hindering leisure.
economic,
• Favor creative and exploration opportunities for children,
enabling them to develop talents, abilities and interests related
to arts, play and knowledge, that serve as a basis for establishing
autonomous interests, preferences, attitudes and habits.
Citizenship and Participation28
This early childhood comprehensive care structuring factor promotes a personal and collective identity in diversity, making children
wanting to participate in their environments, as an exercise of freedom
and inclusion in accordance with life cycles, recognizing its multiple
forms of expression and various manifestations of what it means to
be heard, perceived, taken into account and take an active part in decisions about their own lives and of the groups and communities to
which they belong.
As mentioned, children become citizen at birth, i.e. are valid and legitimate speakers, knowing that participation is built in action inherent
to citizenship.
Early childhood participation requires environments for socialization and daily interaction that respect the uniqueness and diversity of
children and promote dialogues according to their skills and individualities, taking into consideration their territory, ethnicity, and gender in
order to ensure the vital experience of belonging to a group, a community, a family, and of being unique and singular.
The relationship between the public and the private, the collective
and the individual, is defined by the heritage values of people and places, which become community property. Thus, when a family shares
28 This section is developed from elements provided by the reference study Technical Guidelines for
Participation and Citizenship of Citizen Rights in Early Childhood” prepared by Elsa Castañeda
and María Victoria Estrada for the Intersectoral Commission on Early Childhood, with the
coordination of the Ministry of Culture (2012).
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Early Childhood Comprehensive Care Strategy
its knowledge on participation with the children during the rearing
period, the individual and the collective are linked by means of this
heritage value.
Equally as important is participation in the community’s cultural
life to forge an individual, collective and cultural identity 29 during early
childhood. Thus, group membership and mutual acceptance are necessary exercises in democratic participation that contribute to the enjoyment of full citizenship (Castañeda and Cáceres, 2012).
Children’s participation during early childhood is determined by
their life cycle period, and by the skills of adults in reading the expressions and meanings they communicate. The deeper the level of
participation, the greater its influence on what happens to them, on
the strengthening of a democratic culture, and on their opportunities
for personal development.
Participatory processes must be continuous and enable children to
develop confidence, recognize and build their own communication
channels, and perform with autonomy in the community.
He that respects himself does not require that others like him or that
they accept him, or that he agree with others in order to feel fine, rather
he has no difficulty in being loved or loving the other. He that respects
himself is independent and autonomous without being in opposition;
respect for himself does not lie in being different from the other, but in
the acceptance of his own legitimacy (Maturana and Sima, l998: 29).
In addition to reflecting on the relationships we build with children,
we require a teaching that allows participation in the act of knowing, that
takes into account the individual, the group, the collective and the diverse.
Exercising citizenship and participation is linked to child development, becomes complex, and requires opportunity. Some guidelines for
care actions are identified below:
29 “Cultural identity is a sense of ‘belonging to the same community’ experienced by a group of
people. It incorporates the feelings that each individual has of belonging to a group or culture or
being subject to its influence” (Nsamenang, 2008: 16)
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Technical Grounds for the Strategy
• Protection, rearing and care of children: the starting point
for participation
From the beginning of their lives humans communicate their interests. Repetitive sounds such as gurgling, crying,
babbling and gestures, smiles, frowns
and body movements such as stretching, yawning, and reaching with arms
and legs invite people to join the child,
to mobilize in response.
In this everyday interaction, the adult
plays an important role in children’s participation. Being sensitive, responsive
and respectful allows children to experience being recognized, valued, and considered, and to develop skills for participating with more and more autonomy in
community life. Thanks to that sensitive
relationship they will gradually develop certain actions by themselves, make decisions about their movements, their hobbies,
their likes, their games, and their company.
• Communication: a key element of participation
Communication is the stage for sharing the meanings that children transmit as carriers of information, history and culture.
Consequently, in children’s participation, it is not enough to
meet their needs. We must learn to communicate with them, to
listen, to read the meanings of their expressions, to take them
into account, to speak, inform, and explain to them.
Children are communicators who use a variety of languages skillfully, according to their abilities, to express their unique opinions
and experiences. Similarly, the words, gestures and other expressions of the adult who is narrating, singing, informing, explain161
Early Childhood Comprehensive Care Strategy
ing and consulting become powerful forms of communication
with children from the time they are in the womb.
In the explanation given to them about everyday life--with
siblings, grandparents, neighbors, even with themselves, with
their development, rules, routines, boundaries--lies one of the
first levels of participation: information, which together with
lullabies, songs, children’s tales, stories of oral tradition, and
literature, have an effect on their emotions, psyche, and imagination. “This body of words, sounds, voices, and rhythms delivered by adults to children in early childhood becomes a reservoir for life” (Robledo, 2010: 49).
• Cultural life as an expression of participation
The provisions in Article 30 of the Code of Childhood and Adolescence30 entitle children to the tangible and intangible cul30 “Children, girls and adolescents have the right to rest, play and other recreational activities
appropriate to their life cycles (SIC) and to participate in cultural life and the arts. Similarly, they
have the right to be recognized, respected and supported in the knowledge and experience of the
culture to which they belong “(Article 30, Law 1098 of 2006).
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Technical Grounds for the Strategy
tural31 goods that are part of their of their family, community,
people, city, and country heritage, and of humanity.
Children’s access during early childhood to cultural centers, museums, palpable and impalpable heritage items, libraries, Malocas
and sacred places enables their appropriation of the public, and
thus encourages participation.
• Children’s identity: a key issue in heritage management
In policies, heritage plays a pivotal role in building a local, regional and national identity, which characterizes a specific group of
individuals that differs from others in their ways of viewing the
world. Unique goods and values are transmitted from generation
to generation through storytelling: everyday life, habits, death,
life, music, dance, arts, etc. Such adoptions occur in childhood
during the first level of learning: the family order, where all members transmit their worldview.
The beginning of cultural heritage is to protect, display, and safeguard customs as testimony for present and future generations.
The integration of natural, urban, ancestral knowledge, socio-cultural, economic and political landscapes is a critical factor in the
school-child-family interaction. Heritage relates to children from
the time of their gestation and when they are cared for according
to the cultural practices of their environment; the first transfer of
heritage occurs during the mother’s preparation for childbirth.
The transmission of local knowledge varies according to context
and practice. It should be natural and allow children to recognize
and embrace their environment.
31 Intangible assets are those intangible manifestations, expressions, knowledge and practices that
give a community and a group of people a sense of identity, belonging and historical continuity.
These events are transmitted from generation to generation (cf. Law 1185 of 2008). Lullabies,
songs, oral narratives, poems, tongue-twisters, riddles, traditional games, proverbs, incantations
and spells are part of cultural property.
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Early Childhood Comprehensive Care Strategy
*******
This second part of the document has disclosed the technical bases,
which sustain the Strategy, both related to early childhood and referring to comprehensive attention to children just beginning their lives.
The following were considered structuring factors of care: protection
and upbringing, health, food and nutrition, early education, recreation,
and exercise of citizenship and participation. The third part of this
document will present the enhanced role of these structural factors in
the Comprehensive Care Roadmap, a crucial tool in the Strategy to be
presented with other management elements.
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Technical Grounds for the Strategy
165
3
Management
of Comprehensive
Care Strategy
for Early Childhood:
Institutions,
Comprehensive Care
Road-map, and Lines
of Action
Early Childhood Comprehensive Care Strategy
A
ll that has been discussed here would be of no use to pregnant
women, girls and boys in early childhood if not made a reality
in the present time, in each of the territories of the country and
in each of the environments where they find themselves. This led the
Intersectoral Commission for Comprehensive Early Childhood Care to
an institutional architecture that would materialize the Strategy’s proposal, and to summon the various sectors of society to define skills, set
avenues of action and design specific instruments.
Readers will find here the results of this joint effort, among which
is the Comprehensive Care Road-map (RIA, Spanish acronym), a powerful tool that guides the territories in ordering and reviewing their
performance, and setting clear paths to achievement.
The technical line and the RIA are deepened and put into operation
through tools (guides, manuals, guidelines, protocols, etc.) built by
the different sectors, nationally and locally, according to their competencies. These tools facilitate services, programs, or other forms of care
and attention by developing specific actions for pregnant women and
children, consistent with territorial conditions.
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Management of the Strategy
Comprehensive Management Favoring
Child Development
Comprehensive Strategy management is the intersectoral, concurrent
and coordinated manner in which the state sectors (education, health, culture, welfare, planning, etc.) and other stakeholders in society (families,
community, civil society, academia, private sector, NGOs, etc.), act in coordination, nationally and locally, to achieve comprehensive care for pregnant women and children based on their needs and requirements.
Understanding this approach is vital, since management is where
the Strategy’s full importance comes alive. A comprehensive Strategy
must run consistently in two directions: as a condition inherent in children’s development and rights, understanding specifically how their
rights manifest at this moment in their life cycle; and as the attribute
resulting from its structuring factors, which make concurrency an imperative under the Comprehensive Care Roadmap.
A comprehensive management consistent with the spirit of the Strategy calls for authorities and entities to break the sectoral paradigm, and
move towards a unified construction of the technical line that needs
coordination and synergy. This requires a major effort by the institutions and sectors, as well as real humbleness to understand that no
entity, sector or stakeholder can respond by itself to the challenge of
ensuring a comprehensive development during early childhood.
The fundamental challenge of the Strategy is to place pregnant women
and children at the center of action, transcending the conventional sum
of atomized and sectored measures. Each stakeholder should execute it
from their specific expertise, but in a way that is complementary with the
expertise of others, as a result of collective and concerted construction.
A consensus by stakeholders on the policy in each territory, its intent regarding early childhood, and management of its RIA help define the scope,
commitments and responsibilities of each stakeholder and sector, national
and local, and add value to the parts that would be managed separately.
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Early Childhood Comprehensive Care Strategy
Comprehensive management requires that each stakeholder recognize its role in the development of children and provide its knowledge,
institutional structure, policy actions, resources and capabilities. It also
requires a willingness to change their orientation, planning, conditions,
coordination or tracking of comprehensive care.
Thus, sectoral coordination becomes one of
the Strategy’s main attributes for comprehensive management. This is joint management
with a common ethical, political and technical
framework, where resources, responsibilities
and processes are coordinated to ensure that
girls and boys enjoy their rights fully.
An example of this type of management is
the Intersectoral Commission for Comprehensive Early Childhood Care, which itself has
operated successfully at the national level, and
is a reference point for coordination of early
childhood public policy in the territories.
The Commission’s experience has shown
that it is possible to work across sectors
and that through this work a collegial management proposal can be
achieved in the country today.
Another attribute of a comprehensive management of children’s
rights is territorial coordination. Early childhood public policy requires
alignment, concurrency and technical cooperation between the national, departmental and municipal levels. This cooperation should
comprise planning processes, strengthening of capacities, specialized
institutional architecture, technical and financial resources, and policy
monitoring, among others.
Additionally, the authorities, technical teams and social sectors
should commit at all levels (national, departmental and municipal),
to evidence-based decision-making, social mobilization, high quality
standards of care, and monitor progress in early childhood care. The
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Management of the Strategy
commitment should be complemented with work on other sectors such
as water, basic sanitation, road networks, transportation, and access to
food and housing.
This requires management that synchronizes actions at the national,
departmental and municipal levels, and coordinates the responsibilities
of State sectors and other stakeholders involved with early childhood.
The Strategy of Comprehensive Early
Childhood Care: Relationship
with Various State Agencies
The Strategy for Comprehensive Early Childhood Care falls under
the framework of the National Family Welfare System (SNBF). Its objectives are universality, quality and territoriality, as well as becoming a
sustainable state policy that lays the foundations on which the country
can continue the program for the next ten years or longer.
A detailed look at the Strategy’s institutional framework follows, beginning with the SNBF. Then, the legal basis and functions of the Intersectoral Commission for Comprehensive Early Childhood Care are
reviewed. Finally, we examine its presence in the territories and the
role of various authorities in comprehensive protection.
The National Family Welfare System (SNBF)
The SNBF (Spanish acronym) is the set of agents, coordination bodies, and relationships that comply with the comprehensive protection
of children and adolescents and strengthening of families at the levels
of nation, province, district, municipality, and safeguard areas or indigenous territories. Its objectives are1:
1 Decree 936 of May 9, 2013.
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Early Childhood Comprehensive Care Strategy
• Achieving comprehensive protection of early childhood,
childhood and adolescence and promoting family strengthening
through coordinated and timely responses from the State, under
the principle of shared responsibility with family and society.
• Promoting the development, implementation, monitoring
and evaluation of policies for early childhood, childhood and
adolescence, and strengthening of families, at the national and
territorial levels, with a differential focus.
• Making early childhood, childhood and adolescence and family
strengthening a social, political, technical and financial priority
at the national and territorial levels.
• Improving participation and social mobilization for the
comprehensive protection of early infancy, childhood, adolescence
and strengthening of family, at national and regional levels.
• Assessing and monitoring the implementation of children’s and
adolescents’ rights.
The SNBF coordinates early childhood, childhood and adolescence
policy with other public policies to achieve interconnection and interdependence of rights during the entire life cycle.
The Intersectoral Commission for
Comprehensive Early Childhood Care
Under the SNBF, the country achieved institutional and technical specialization progress, related to early childhood. Then, Decree
4875 of 2011 from the Administrative Department of the Office of
the President created the Intersectoral Commission for Comprehensive Early Childhood Care, composed of the Ministry of Health and
Social Protection, the Ministry of National Education, the Ministry of
Culture, the National Planning Department (DNP), the Department
for Social Prosperity (DPS) and the Colombian Family Welfare Insti172
Management of the Strategy
tute (ICBF), under the coordination of the High Council for Special
Programs of the Office of the President.
According to this decree, the Commission aims to “coordinate and
harmonize the policies, plans, programs and actions necessary to implement comprehensive early childhood care, and be the forum for dialogue between the different stakeholders involved” (Art. 2).
The general functions of the Commission are (i) the direction of
national policy regarding comprehensive early childhood care, (ii) coordinating implementation of the Strategy, (iii) definition of guidelines
and mechanisms for institutional and financial sustainability, and (iv)
coordination of public, private, cooperative and civil society stakeholders around common goals for early childhood.
In order to advance in the creation of an intersectoral, sustainable,
viable and universally visionary working scheme, the mandates of each
sector it comprises were clearly defined, as follows:
I like
to play
soccer
• Ministry of Health and Social Protection: Defines policies, plans,
programs and projects for maternal and child health, disease
prevention and public health surveillance. It also provides
guidelines for primary care health services for the family group,
defines quality standards, regulates the delivery of services, and
performs inspection, supervision and control of the General
Social Security System for Health through local authorities. It
emphasizes its action under the First Thousand Days of Life
Scheme (pregnancy and first two years of life)
• Ministry of Education: Defines policies, plans, programs and
projects for initial education as a fundamental right of children
in early childhood, as part of comprehensive care. It also issues
guidelines on the qualification of human talent in all areas within
the framework of comprehensive early childhood care. Structures
and commissions the child by child tracking system and Quality
Management System for early education modalities through
guidelines and quality standards.
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Early Childhood Comprehensive Care Strategy
• Ministry of Culture: Defines policies, plans, programs and projects
to preserve, promote and recognize the cultural rights of children
and their families as part of the Strategy, based on diversity of
population, territorial ethnicity, linguistic and social life in the
country, which requires a differential action without harm.
Provides guidelines for the promotion of language and artistic
expression, early childhood literature and reading in, and child
participation and citizenship. Develops processes for quality care
in public places such as libraries, cultural centers and museums.
• Department for Social Prosperity: Supports territorialization
processes, joint actions with government programs aimed at
eradicating extreme poverty, and the management of victims,
among others.
• Colombian Institute of Family Welfare: The Role of the ICBF (Spanish
acronym) within the framework of the Strategy is defined by its
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Management of the Strategy
institutional nature. The SNBF promotes early childhood policy
in the context of territorial management, ensuring its specificities
and technical line as defined by the Strategy. It aligns all its areas,
units, programs and services with the political, technical and
management framework of the Strategy. It also coordinates and
implements early childhood education with a comprehensive
care approach, and provides technical assistance and support
to providers of services. Similarly, it defines guidelines for
comprehensive protection, guarantee, and prevention of
breaches and restoration of the rights of children with the joint
responsibility of society and the family, and contributes training
and orientation guidelines for families.
• National Planning Department: Gives technical support to the
formulation, implementation and evaluation of the Strategy in its
financial, territorial and policy components.
• Office of the President: Chairs the Intersectoral Commission for
Comprehensive Early Childhood Care, serves as its technical
secretariat and coordinates the design, implementation,
monitoring and evaluation of actions envisaged in the action plan
of the early childhood policy.
National and regional bodies
coordinated in favor of comprehensive
early childhood development
As noted herein, Law 1098 of 2006 established the obligation of
national, departmental and municipal authorities to design, implement
and evaluate public policies aimed at all children and adolescents. In
the field of early childhood, the Act requires giving full scope to the
provisions of Article 29, which defines the right to comprehensive development. Under the mandate of the SNBF, there must be in each jurisdiction a coordinating body for early childhood, in which everything
relevant to comprehensive care is discussed and built across sectors.
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Early Childhood Comprehensive Care Strategy
Its viability will depend on the national, departmental, district and
municipal development plans, as well as the life plans of the indigenous
peoples, explicitly incorporating strategies and programs for comprehensive early childhood care, supported by the necessary economic
resources. Also, the nation, departments, districts and municipalities
need the institutional will for dialogue and intersectoral building between territorial levels, around criteria for the common purpose of
comprehensive protection in early childhood.
Both at the national and the territorial levels, public policy objectives on early childhood require functional coordination by the National Family Welfare System in each jurisdiction. This task is fulfilled
by the national, provincial, district and municipal Councils on Social
Policy, and by special ethnic groups jurisdictions that comprise public,
private, and third sector agents for decision-making, operation, technical development and participation, and the national and international
cooperation that is part of said third sector.2
In general, these bodies are responsible for establishing annual action plans to meet SNBF objectives. Strengthening of institutional capacities and territorial autonomy in early childhood topics are sought
at the local level, developed by the Intersectoral Commission for Comprehensive Early Childhood Care.
In the SNBF, the National Strategy for Comprehensive Early Childhood Care responds to the guidelines defined by the councils on social
policy. The SNBF entities responsible for developing and harmonizing
public policies for early childhood, childhood and adolescence, and
particularly early childhood, are:
• Nationally
–– The National Council of Social Policy, which is the highest
decision-making and guidance body in the SNBF.
–– The IntersectoralCommission for Early Childhood which
2 Decree 936 of May 9, 2013, Article 6.
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Management of the Strategy
guides and defines intersectoral public policy actions for
early childhood at the national and regional levels .
• At the departmental level:
–– The Departmental Council on
Social Policy, the highest authority
for decision and guidance of social
policies, including those for early
childhood.
–– Technical Development Bureaus for
comprehensive early childhood
care.
–– Regional Operational Structures
in other administrative systems
with expertise or interest in early
childhood conditions3 and in
technical development.
Each department must define which bodies and strategies will promote participation, and link them into the SNBF institutional scheme.
• In districts and municipalities:
–– The municipal or district councils for social policy will be the
highest entities within the SNBF. Their aim is to coordinate
and monitor implementation of plans, programs and
projects developed by each entity in social policy matters,
with a comprehensive management model.
–– Population and Thematic Bureaus, as well as district or
municipal operational structures in other administrative systems
will offer technical support to address early childhood
3 Decree 936 of May 9, 2013, Article 8.
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Early Childhood Comprehensive Care Strategy
conditions4. The Council must ensure that there is at least
one technical committee focused on specific management of
comprehensive protection for children in early childhood. It
shall also promote participation and social mobilization by
children in this age group, to guarantee their rights.
We like
water:
being in the
bath, being
placed in
the shower,
when they
take us to the
river and let
us play with
the hose.
The Comprehensive Care Roadmap:
Guidance for Management
in Territories
We have looked at the situation of pregnant women and children in
early childhood, the country’s background in public policy for this population group, the concepts of early childhood, child development, and
family environments, the reasons for focusing on comprehensive care,
its main structuring factors and characteristics, and the placement of
the Strategy within the country’s institutions. The key question now is
how to materialize comprehensive care for them in the territories.
This section describes a tool developed by the technical team of
the Intersectoral Commission for Comprehensive Early Childhood
Care that answers the above question. The Intersectoral Commission
received feedback on it from various teams and stakeholders across the
country as well as some international experts. It is the Comprehensive
Care Roadmap (RIA, Spanish acronym), which guides local authorities
and other stakeholders responsible for implementing the Strategy for
Comprehensive Early Childhood Care, regarding actions to ensure the
full development of each and every girl and boy. Thus, the RIA will
be the instrument par excellence that allows integration of operational
ideas into a comprehensive, concrete form.
This is a tool to organize comprehensive care consistently with the
situation and characteristics of children in each territory and their
4 Decree 936 of May 9, 2013, Article 8.
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Management of the Strategy
respective contexts, and is applicable at any moment in the public
policy cycle.
As a tool for intersectoral management, the Comprehensive Care
Roadmap calls on all stakeholders in the National Family Welfare System
with competencies and presence in the territory. It is not an exclusive
tool for the mayor or governor. Within the framework of the SNBF, it is
available to the coordinating body managing comprehensive early childhood care policy, according to the particular dynamics of each territory.
The Intersectoral Commission for Comprehensive Early Childhood
Care in full brought together the intended and effective care actions
so that each child’s environment has the human, social and material
conditions for his or her growth.
The care actions in the Comprehensive Care Roadmap emerged
when the Intersectoral Commission for Comprehensive Early Childhood Care established, taking into account the rights of children, these
structuring factors for comprehensive care: attention and upbringing,
health, food and nutrition, early education, recreation, and exercise of
citizenship and participation (see pages 141-187). Readers will not find
within the Roadmap which specific care actions correspond to which
structuring factors, as some may respond to two or more and thus give
rise to confusion. The important thing is to know what is necessary to
ensure care from preconception until the child is six years old.
RIA classifying criteria
Time frames or age groups
Because the care actions that should be given to men and women of
childbearing age, pregnant women, and children for the comprehensive
development of the latter vary according to age, the Intersectoral Commission for Comprehensive Early Childhood Care agreed to organize
the care actions as follows:
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Early Childhood Comprehensive Care Strategy
• Preconception
• Gestation
• Birth to one month
• First month to three years
• Three to six years
These time frames are the first classifying criteria for the Comprehensive Care Roadmap shown on the following pages. Readers can identify:
Recipients of care
For each age group or time frame, different care actions are provided, which vary according to the type of recipient, namely:
1. Men, women, families and caregivers.
2. Girls or boys in early childhood.
Environments where care is provided
Once care recipients are located in the time frame or age group being attended to, the list of necessary actions appears, with the environments in which these will materialize as the last classifying criterion.
Recall how the Commission envisions the main environments in
which the lives of girls and boys elapse:
• The home environment: Is the space of welcome and affection in
which most early childhood occurs, which provides them with
basic social and cultural references they use to begin moving
in society.
• The health environment: This is the first institutional expression
that welcomes children. It supports the process of preconception,
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Management of the Strategy
pregnancy, birth and thereafter, to preserve their existence and
autonomy in conditions of full dignity.
• The educational environment: Promotes educational activities
for children to experience themselves as owners of rights,
participatory citizens, transformers of reality, and creators
of culture and knowledge. It deepens the experience of living
together, understanding and respecting other people, internalizing
and gradually building basic rules of coexistence.
• Public space environment: Consists of open accessible spaces
(squares, beaches, parks, roads) to which the community attributes
political, historical, cultural or sacred value (libraries, play
centers, cultural centers, museums, theaters, temples, malocas,
participative scenarios). Plays a key role in the construction
181
Early Childhood Comprehensive Care Strategy
of identity and in the exercise of citizenship and democratic
education, allowing children to experience themselves as living,
social and cultural beings.
For more details readers can refer to pages 122-131, where a more
extended description of these environments is found.
Specialized and differential attention
As we grow,
our moms will
know what we
like and what
we don’t like,
by the way we
move in their
bellies.
One of the most valuable aspects of the roadmap is its focus on
specificity. Setting every boy and girl at the center of each care action makes their individual characteristics relevant. Thus, in addition
to universal care by age group, differential attention, specialized care,
and respectful and appropriate approaches, accompaniments and attentions are required from caregivers.
Differential attention arises from recognizing diversity in characteristics, conditions, or situations of individuals and their interaction with
the environment, not only from conditions of vulnerability.
Thus, culture, ethnicity, disability, specific experiences or dimensions, and permanent or temporary effects in the lives of children and
their families become relevant in the RIA, as well as territorial context
(rural area, urban, jungle, access paths, the zone affected by armed
conflict, etc.). They invite caregivers to approach, accompany and attend recipients sensitively and in an appropriate manner.
The Strategy takes diversity into account, respecting and contributing to the reinforcement of the population’s own characteristics and
helping surmount situations that infringe upon rights.
Differential attention actions are therefore the concrete embodiment
of universal attention, considering the children as unique and singular
human beings.
This is not different care, but a supportive, sensitive and appropriate
approach by caregivers. Thus, specific differential care actions do not
appear in the RIA. These will be part of a complementary recommen-
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Management of the Strategy
dations guide that specifies how universal care should be developed
according to population categories and types of approaches, support
and care depending on what each child or family requires, and joint
work with different population groups.
Specialized care actions are those designed to respond to specific situations of infringement or risk. The RIA provides a list of situations
that trigger specialized care for each age group, so each territory can
identify the specific actions to develop in safeguarding the rights of
pregnant women and children in early childhood. These include detection, benchmarking, monitoring, treatment, rehabilitation and restoration of rights.
From now on both the use and the scope of the RIA will not be linear or flat. The individual care focus will allow the RIA to contextualize
care, contribute to the quality of interventions, and every girl and boy
to receive the care they need for their comprehensive development.
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Early Childhood Comprehensive Care Strategy
The RIA, a Collective Production
The RIA was developed by the technical team of the Intersectoral
Commission for Comprehensive Early Childhood Care and received
feedback from many teams and individuals across the country, as well
as some international experts. It is a collective construction by the nation made available to departments and municipalities to guide management of early childhood programs.
The roadmap serves as a reference for local authorities and other
stakeholders responsible for the Strategy implementation on the actions
included in the comprehensive care structuring factors, their attributes,
and their relations, to ensure the full development of every child. Thus
the RIA allows concepts to become interrelated and embodied, giving
life to the comprehensive nature of the Strategy.
It is a tool to organize comprehensive care management in a manner
consistent with the situation and characteristics of children in each
territory, and is applicable at any time in the public policy cycle.
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Management of the Strategy
Ruta Integral
de Atenciones
–RIA–
Comprehensive
Care Road-map
–RIA–
185
Care actions destined to
each woman and man
in fertile age
Guide and support each woman and man in:
 The exercise of their sexual and reproductive rights.
 The shared parental responsibility acquired when making the decision
to become a mother or a father.
 Recognition of each girl and each boy as a holder of rights.
 Conditions that favor or alter the comprehensive development of each child,
from the time of preconception.
 Understanding the importance for each boy and each girl of establishing
solid affectionate bonds and quality relationships between
adults and with them.
 Development of leisure and recreational activities as self-care practices
and healthy lifestyle habits.
 Recognizing the right of the new member of the family to have a name
and a civil birth registration, and belonging to a culture in which to participate.
Valuing the emotional, social, physical and nutritional health of each woman
and each man in fertile age, and preparing them for pregnancy and, if required,
carrying out specific intervention actions in each case. Always provide folic acid
as a supplement.
Promote healthy habits in each man and woman in fertile age.
Valuing the oral health of each woman who has decided to have a child,
and giving her timely and comprehensive care if required.
1 The care actions specified here correspond to the educational environment, and are specific to middle and secondary schooling.
186
Health
Environment
Educational
Environment 1
Public
Space
Preconception
Home
187
Care actions destined
for each pregnant woman
Valuing the gestation process in woman.
Monitoring development of the fetus.
Valuing mental health of the woman.
Providing supplements with micronutrients and monitoring adherence to them.
Immunizing the expectant mother according to the vaccination scheme in force.
Valuing the oral health of each pregnant woman and giving her timely and comprehensive care if needed.
Promoting physical activity and recreation for pregnant woman, as well as the participation of all members
of the family group in these activities.
Motivating each pregnant woman to enjoy parks, paths, seawalls, ecological spaces, rivers,
and other open air spaces that facilitate enjoyment of physical activity and recreation in accordance
with her customs and those of her partner, family and community.
Care actions destined
for each man who will become a father.
Guide the father in:
 The experience of being a father and the transformation it will bring upon him and his relationship
with other persons in his home and close community.
 The importance of assuming the role of a father.
188
Health
Environment
Educational
Environment 1
Public
Space
Pregnancy
Home
1 In the event the pregnant woman is in school.
Home
Health
Environment
Educational
Environment 2
Public
Space
2 In the event the father is in school.
189
Care actions destined
for each pregnant woman and her partner
or significant other.
Guide and support each woman and her partner or significant other in:
 The exercise of sexual and reproductive rights.
 Recognizing their daughter or son as a holder of rights.
 The shared parental responsibility acquired when making the decision to become a mother or a father.
 The conditions that favor or alter the comprehensive development of the girl or boy from the time of preconception.
 The experience of being parents and the transformation it will bring for themselves, their union as a couple,
and their relationships with the other persons who are part of their home and close community.
 The gestation period step by step, considering the physical changes, nutrition, signs of alarm, breastfeeding,
labor during childbirth, relations as a couple, family planning, etc.
 The active participation of the father or other significant person the woman decides, at the time of childbirth,
if the conditions of the mother and the child allow it.
1 These care actions are provided in the environment
Care actions destined
for each mother, father and family
of a child,
from the time of conception until childbirth
Guide and support each mother, father, and family in:
 The acceptance, understanding and coping with the physical and emotional changes in the woman due to pregnancy.
 Preparing the woman during pregnancy for breastfeeding and care of the baby.
 The process of pregnancy and childbirth.
 The establishment of a bond between the mother, the father and the son or daughter through skin to skin contact
and the active participation of the father or significant other for the woman, at the time of childbirth.
 Nutritional and food conditions during pregnancy and postpartum.
 Exclusive breastfeeding during the first six months, and thereafter in a combined form with complementary
nutrition until two years of age; the participation of the spouse and the family in generating a favorable
environment for this practice, and the possible situations that may arise.
 Recognizing the right of the new member of the family to have a name and a civil birth registration,
and to be integrated to a culture in which to participate.
190
Health
Environment
Educational
Environment 1
Public
Space
Pregnancy
Home
in the event the mother, father or significant other is in school.
Home
Health
Environment
Educational
Environment 2
2 In the event the mother or father is in school.
Public
Space
Continued on page 192
191
Care actions destined
for each mother, father and family
of a girl or boy,
from conception until childbirth
Continued from page 191
Guide and support each mother, father, family and caregiver in:
 Valuing the multiple forms of expression of the girl or boy and the diverse expressions of what it means
to be heard, perceived, and considered, and taking an active part in the decisions about his or her own life,
and those of the groups and communities to which the child belongs.
 Promotion, recognition, dialogue, exchange and enjoyment of the various expressions and cultural assets
of the country, and those belonging to the region where the child lives, and which become
his or her heritage.
 Rescue and protection of the child’s family memory and heritage, formed among generations
and which can be transmitted to the girl or boy.
 Approach to arts, literature, cinema and science.
 Assistance and participation in activities appropriate to cultural and knowledge management centers
(libraries, museums, culture houses, entertainment centers and parks, among others).
Situations that trigger
specialized care actions
from conception until childbirth.
Pregnant woman:
• Adolescent
• Girl under 14 years old
• Has not received medical attention
or attended prenatal controls
• Incomplete vaccination record
• Lack of nutritional security
• Situation as a beggar or street dweller
• Has sexually transmissible disease
• Consumes alcohol or psychoactive substances
• At risk or suspected of mental disease,
including maternal depression
• With illnesses such as cancer, HIV/AIDS,
unusual, chronic, or high cost diseases, etc.
• Evidence of domestic violence during pregnancy
192
Pregnant woman or father,
with disability
Pregnant woman’s family victim of:
• Trafficking of persons
• Armed conflict
• Forced displacement
Family of pregnant woman where there are:
• Examples of harmful childrearing or that violate
the rights of the boy or girl.
• Disavowal of paternity
• Suspicion of violence during pregnancy, physical,
emotional or psychological mistreatment, neglect,
abandonment, sexual abuse, etc.
Health
Environment
Educational
Environment
Public
Space
Pregnancy
Home
Recall that if the above conditions were to be
present the territories must guarantee
the availability of human, administrative,
financial and technological resources,
among others, to offer the care actions
that these require.
Continued on page 194
193
Situations that trigger
specialized care actions
from pregnancy until childbirth
Continued from page 193
If one of the following situations arises...
The specialized care actions are…
Girl younger than 14
is pregnant
Adolescent
is pregnant
• Providing differential care to the girl and her family.
• Guaranteeing permanence of the girl in the educational system.
• Informing the competent authorities
of the pregnant girl’s situation.
• Following an administrative process for reestablishment of rights
(see sidebar).
• Tracking and application of special care actions
in the social protection system.
• Provide differential care for the adolescent, her partner
or significant other and the family.
• Guaranteeing permanence of the girl in the educational system.
• Informing the competent authorities of the pregnant girl’s situation.
• Tracking and application of special care actions in the social
protection system.
Actions implied in
an administrative procedure
for reestablishment
of rights.
When becoming aware of risk or vulnerability situations
that merit specialized care actions it is important
to remember that the State, society and the family
are guarantors of the rights of children, and it is the duty
of these stakeholders to inform authorities so that
administrative processes can be implemented
to reestablish rights.
It is important to mention that the center
of the administrative process is the boy or girl
in early childhood, and that this process must be
at the service off his or her rights, considering
the delicate time of life that is early childhood.
194
During and after the emergency or disaster:
• Making the pregnant women visible within
the census of affected people or victims.
• Establishing packages of humanitarian assistance
in the emergency differentiated and adapted
to the pregnant women.
• In healthcare, prioritize the pregnant women
after classification or triage (establish the priority
of attention according to the severity of injuries
and their probability of surviving them).
• Guarantee the protection of pregnant women
and help them remain close to their families.
• Prioritize the pregnant families in reconstruction
and rehabilitation processes.
Pregnancy
Expecting families who are
in an emergency or disaster situation
The administrative process for reestablishment
of rights is composed of the following steps:
1. Initiating the process.
2. Verifying rights.
3. Requesting evidence.
4. Development of care process according
to the specialized care roadmap.
5. Transfer of evidence.
6. Adjudication.
7. Relevant monitoring.
195
Care actions destined
for each mother, father, family
and caregiver
from the moment of birth
until the first month of life.
Guide and support each mother, father, family and caregiver in:
 Care required by the mother postpartum.
 Care required by the girl or boy according to age characteristics.
 Strengthening of the bond with the child.
 Permanent contact between the baby and the mother, and the importance of allowing accompaniment
by the father.
 Establishment of a bond between the girl or boy and whomever fills the father figure.
 Exclusive breastfeeding during the first six months and thereafter in a combined manner
until two years of age with complementary nutrition; participation of the couple and the family
in generating an environment that favors this practice, and the possible situations that might arise.
 Conditions for safe sleep for the newborn.
 Care and recognition in the girl or boy of his or her own body.
 Recognizing the right of the new member of the family to have a name and a civil birth registration,
and belonging to a culture in which to participate.
 Valuing of the multiple forms of expression that the girl or boy may have and the various expressions
of what it means to be heard, perceived, and considered, and taking an active part in the decisions
about his or her own life and those of the groups or communities to which the child belongs.
 Growth of the girl or boy in harmonious and respectful environments.
 Identification of opportunities in the home to promote
sensorial exploration.
 Identification of everyday activities that foster comprehensive development in the girl or boy such
as experiences of play, art, literature and exploration of environment.
 Generating experiences favorable to the development of the child, including practices appropriate
to the cultural context where he or she lives.
 Importance of applying vaccinations to the boy or girl in accordance with the vaccination scheme
for Colombia.
 Importance of performing the neonatal screening tests and analyzing their results.
 The practice of physical and recreational activities that stimulate the senses, physical growth
and the interaction between different members of the household and the girl or boy.
 The promotion, recognition, dialogue, exchange and enjoyment of the various manifestations
and cultural assets of the country and those belonging to the region where the child lives,
and which become his or her heritage.
 Rescue and protection of the family memory and heritage formed among generations,
and that may be transmitted to the girl or boy.
196
Health
Environment
Educational
Environment
Public
Space
Birth to first month
Home
197
Care actions destined
for each girl or boy
from the time of birth
until the first month of life.
Performing a thorough physical evaluation of the newborn on his first day of life and a control on the third day.
Valuing the childhood development of each girl and each boy before the end of the first month.
Performing cutting of the umbilical cord when it stops beating, prophylactic measures and neonatal screening tests,
analyzing their results and indicating treatment, when required.
Performing skin to skin contact between the newborn and the mother.
Initiating breastfeeding within the first hour of the baby’s birth.
Housing the mother-child pair jointly, and allowing accompaniment by the father, or the person chosen
by the woman, before egress from childbirth care.
Performing neonatal screening tests and analyzing the results.
Vaccinating each girl or boy as corresponds to their age.
Processing the civil birth registration of each child during the first month of life, and making it exigible, if he or she doesn’t have one.
Situations that trigger
specialized care actions
for the girl or boy during childbirth
until the first month of life.
Situation of the child
at the moment of birth
• Premature baby
• Intrauterine growth retardation – IGR –
or low birth weight
• Instrumental delivery with complications
• Low Apgar test score
• Congenital defects
• Respiratory difficulty syndrome
• Infectious or other type diseases
• Disability
• Metabolic adaptation disorder
• Rh and blood type incompatibility
• Abnormal TORCH test (toxoplasmosis, rubella,
cytomegalovirus, herpes simplex, HIV and syphilis)
• Neonatal sepsis
198
•
Prevention of vertical transmission of syphilis,
HIV/AIDS and other diseases (such as retinopathy)
Situation of the girl or boy during
the first month of life
• Not registered for the growth or development appointment,
or has not attended it.
• Alterations in growth or development.
• Does not have a civil birth registration.
Situation of the family of a girl or boy
at the time of birth or during
the first month of life
• Nutritional insecurity
• Examples of harmful childrearing or practices
that violate the rights of the boy or girl
• Disavowal of paternity
•
Health
Environment
Educational
Environment
Public
Space
Suspicion of some expression of violence toward
early childhood: child abuse, physical abuse, emotional
or psychological mistreatment, abandonment
or neglect, sexual abuse, shaken infant syndrome,
Munchhausen syndrome, parental alienation syndrome,
suicidal ideation, gestational violence.
Birth to first month
Home
Family is a victim of:
• Trafficking of persons
• Armed conflict
• Forced displacement
Recall that if the situations mentioned above
were to arise, the territories must guarantee the
availability of the human, administrative,
financial and technological resources, among
others, to offer the care these require.
199
Situations that trigger
specialized care actions
for the girl or boy from birth
and during the first month of life
What to do if families
are identified who are
in an emergency
or disaster situation
During and after the emergency or disaster:
• Make the early childhood population visible
within the census of affected persons or victims.
• Establish packages of humanitarian care for emergencies,
differentiated and adapted to the population of children
from 0 to 6 years old.
• In healthcare, prioritize the early childhood population
after classification or triage.
Actions implied in an
administrative process
for reestablishment
of rights
When becoming aware of situations of vulnerability or risk
which merit specialized care actions, it is important
to remember that the state, family and society
are guarantors of the rights of childhood, and it is the duty
of these stakeholders to inform the authorities of such
situations so the administrative processes destined
to restitution of rights are implemented.
It is important to mention that at the center
of this administrative process is the boy or girl in early
childhood, and that this process must be at the service
of his or her rights, considering the especially delicate time
of life that is early childhood.
200
• Guarantee that each girl or boy remains with his
or her mother and other relatives, unless these
are in critical physical or emotional condition.
• Prioritize the early childhood population
in the reconstruction and rehabilitation processes.
The administrative process for reestablishing
rights is composed of the following steps:
1. Initiating the process.
2. Verifying rights.
3. Requesting evidence.
4. Development of care process according
to the specialized care roadmap.
Birth to first month
(Establish priority of care actions according to severity
of injuries and probability of surviving them).
5. Transfer of evidence.
6. Adjudication.
7. Relevant monitoring.
201
Care actions destined
for each mother, father, family and caregiver
of a girl or boy
from the first month of life to three years of age
Guide and support each mother, father, family and caregiver in:
 Care required by the girl or boy according to his or her age characteristics.
 Experiences of care and upbringing that are harmonious, respectful, and favorable to the development
of children and that recognize the features of their sociocultural context.
 Strengthening of the bond with each girl or boy.
 Establishment of a bond between the girl or boy and whomever fills the paternal role.
 Promote and make use of encounters with family, community and other boys and girls in the same age group
and of other ages to strengthen bonds and qualify the establishment of relationships between the child
and people of various ages and in different spaces.
 Exclusive breastfeeding during the first six months, and thereafter in a combined manner up to two years of age;
participation of the spouse and family in generating an environment favorable to this practice, and the possible
situations that could arise.
 The introduction of complementary nutrition beginning with the sixth month, the opportunities of the boy or girl
to continue breastfeeding until two years of age while including other foods that complement his nutrition,
and the establishment of healthy habits for nutrition considering the cultural tradition of the family and the place
where they live.
 Development of experiences that allow children to begin autonomous activities
relating to feeding.
 Establishment of healthy habits related to nutrition, corporal hygiene and sleep.
 Care of and recognition by the girl or the boy of their own bodies.
 Expression of emotions and manifesting affection by the girl or boy, especially
through physical contact.
 Importance of positively valuing the achievement of the girl or boy and inspiring him or her
to new discoveries.
 Growth of the girl or boy in harmonious and respectful environments.
 Precautions in the handling of toxic substances, ladders, appliances, electrical plugs, heights, and water basins,
among others.
 Identification of daily activities that promote comprehensive development
in the child, such as experiences with games, art, literature, and exploration of the environment.
 Generation of experiences favorable to the development of the girl or boy, including practices appropriate
to the cultural context where they live.
 Generation of experiences in which girls and boys have an opportunity to explore and construct
with various materials from nature, and from their social and cultural medium.
 Knowledge of the modalities for first education.
 Transition and adaptation processes for the girl or boy to the institution for initial education.
202
Health
Environment
Educational
Environment
First month to three years
Home
Public
Space
Continued on page 204
203
Care actions destined
for each mother, father, family and caregiver
of a girl or boy
from the first month of life to three years of age
Continued from page 203
Guide and support each mother, father, family and caregiver in:
 The importance of applying vaccinations to the girl or boy according to the vaccination scheme
for Colombia.
 Importance of taking the child to all appointments for tracking growth and development
and to the orientation sessions provided by the health service.
 Practice of physical and recreational activities that stimulate the senses, physical growth,
and the interaction between various members of the household and the girl or boy.
 Construction of a democratic and participatory environment for the child in the family.
 Establishment of coexistence rules that take into consideration the opinion of the child.
 Promotion, recognition, dialogue, exchange and enjoyment of the various manifestations
and cultural assets of the country, and those where the girl or boy lives that become
his or her heritage.
 Rescue and protection of the family memory and heritage formed among generations
and that may be transmitted to the girl or boy.
 Approach to arts, literature, cinema and science.
 Assistance and participation in the activities pertaining to cultural and knowledge management centers
(libraries, museums, culture houses, entertainment centers and parks, among others).
Linking the family to educational and pedagogical processes that are developed with the child.
Communicate permanently with the family regarding the girl or boy’s achievements in the developmental process.
204
Health
Environment
Educational
Environment
Public
Space
First month to three years
Home
205
Care actions destined
for each girl or boy
from the first month of life until
three years of age
Carrying out sessions for evaluation of growth and development of each girl or boy that support the mother,
the father, the family and the caregivers in monitoring his or her wellbeing.
Periodically monitoring the comprehensive development each child involving the mother, the father,
and the caregivers, so they may recognize the processes features of their son or daughter at these ages.
Performing deworming and monitoring nutrition, supplementing with micronutrients and complementary
foods according to their nutritional requirements.
Timely evaluation for dentistry, optometry and audiometry.
Observing, monitoring and registering in a qualitative manner the development of each child.
Vaccinating each girl of boy according to their age and the vaccination scheme in force for Colombia.
Promoting healthy habits related to nutrition, corporal hygiene, physical activity and sleep.
Promoting the recognition of signs, symptoms or situations that express alteration in the health and wellbeing
of the child.
Generating experiences that support recognition and construction of sexuality in each girl or boy.
Promoting the strengthening of solid affectionate bonds between each child and the adult persons
who are significant to them.
Promote encounters for strengthening the socialization processes for boys,
girls and adults in different spaces.
Promote the evaluation of the multiple forms of expression of each girl or boy and the various expression
of what it means to be heard, perceived, and considered and to take part actively in the decisions regarding
his or her own life and those of the groups and communities to which he or she belongs.
Strengthen the implementation of pedagogical strategies and experiences in the public space that correspond
to the characteristics and interests of each child to empower their development.
Promote activities that stimulate play, exploration of the environment, art, and literature.
Generate intentional environments and pedagogical experiences in which boys and girls play, explore the natural,
social, and cultural environments, express themselves through various artistic manifestations,
and approach literature, considering their interests and their developmental features.
Construct pedagogical experiences and provide enriched environment that consider the interests
of each child and that even arise from their initiatives or proposals.
Carry out construction and exploration experiences with different materials from nature and their social
and cultural environments.
Promote spaces for spontaneous play in which each girl or boy can make decisions,
solve everyday problems, and freely establish various interactions with the environment
and the people surrounding him or her.
206
Health
Environment
Educational
Environment
First month to three years
Home
Public
Space
Continued on page 208
207
Care actions destined
for each girl or boy
from the first month of life until
three years of age
Continued from page 207
Generate environments that strengthen autonomy and decision-making.
Evaluate positively the achievements of each girl and each boy, and motivate them toward new explorations.
Promote the use of open spaces (parks, bike routes, forest, beaches, among others) so that each boy
and girl participates in physical and recreational activities.
Generate experiences which promote corporal expression, movement, and participation
by children in play activities.
Generate spaces in which each child can approach, participate and enjoy different cultural, literary
and artistic expressions.
Promote dialogue and exchange between each girl, each boy, and the persons attending
to them regarding cultural expressions and assets pertaining to the region and the country
that become the heritage of each child.
Support each girl or each boy in the process of adapting to initial education.
Process the civil birth registration of each child during the first month of life, and make it demandable
from there on, if they do not have it.
Situations that trigger
specialized care actions
for the girl or boy from the first month of life
until the age of three
Situation of the child:
• Not registered for the growth and development
appointment, or has not attended it.
• Food insecurity
• Alterations in growth and development
• Does not have civil birth registration
• Incomplete vaccination protocol
Family is a victim of:
• Armed conflict
• Forced displacement
208
Situation for the family of a girl or boy
•
•
•
Examples of harmful rearing or violation
of the rights of the child.
Disavowal of paternity
Suspicion of some expression of violence
toward early childhood, such as child abuse,
physical abuse, emotional or psychological
mistreatment, abandonment or neglect,
sexual abuse, shaken baby syndrome,
Munchhausen syndrome, parental alienation
syndrome, suicidal ideation, gestational violence,
childhood exploitation, etc.
Health
Environment
Educational
Environment
Public
Space
Family with one or several members who:
• Have psychosocial difficulties
• Abuse consumption of psychoactive substances
• Have a disability
• Present one or various special diseases
such as cancer, HIV/AIDS, rare, chronic
or high cost diseases, etc.
First month to three years
Home
Recall that if any of the situations
mentioned above were to arise, the territories
must guarantee the availability of the human,
administrative, financial and technological
resources, among others, to offer
the care that these require.
Continued on page 210
209
Situations that trigger
specialized care actions
for the girl or boy form the first month of life
until three years of age
Continued from page 209
What to do if families
are identified who are
in a situation of emergency
or disaster
During and after the emergency or disaster:
• Make the early childhood population visible
within the census of affected persons or victims.
• Establish packages of humanitarian care
for emergencies, differentiated and adapted
to the population of children from 0 to 6 years old.
• In healthcare, prioritize the early childhood
population after classification or triage.
Actions implied in an
administrative process
for reestablishment
of rights
When becoming aware of situations of vulnerability
or risk which merit specialized care actions, it is
important to remember that the state, family and society
are guarantors of the rights of childhood, and it is
the duty of these stakeholders to inform the authorities
of such situations so the administrative processed destined
to restitution of rights are implemented.
It is important to mention that at the center of this
administrative process is the boy or girl in early
childhood, and that this process must be at the service
of his or her rights, considering the especially delicate
time of life that is early childhood.
210
• Guarantee that each girl or boy remains with his
or her mother and other relatives, unless these
are in critical physical or emotional condition.
• Prioritize the early childhood population
in the reconstruction and rehabilitation processes.
The administrative process for reestablishing
rights is composed of the following steps:
1. Initiating the process.
2. Verifying rights.
3. Requesting evidence.
4. Development of care process according
to the specialized care roadmap.
5. Transfer of evidence.
6. Adjudication.
7. Relevant monitoring.
First month to three years
(Establish priority of care actions according
to severity of injuries and probability
of surviving them).
211
Care actions destined
for each mother, father, family and caregiver
of a girl or boy
from three to six years of age
Guide and support each mother, father, family and caregiver in:
 Prevention and treatment of conditions in the home environment that do not favor development,
and promotion of protection practices.
 Care required by the girl or boy according to age characteristics.
 Experience in care and upbringing that are harmonious, respectful, and favorable to development
of children and that recognize the features of their sociocultural context.
 Strengthening of bonds with the child.
 Promote and make use of meetings with family, community, and with boys and girls of the same age
and other ages to strengthen bonds and qualify the establishment of relationships between the girl or boy
with people from various ages and in different spaces.
 Development of experiences that allow children to initiate autonomous activities
regarding feeding.
 Establishing healthy habits related to nutrition, corporal hygiene and sleep.
 Care and recognition by each girl or boy of his or her own body.
 Expression of emotions and affection by the girl or boy, especially through physical contact.
 Importance of evaluating positively the achievement of the girl or boy and motivating them toward new explorations.
 Growth and development of the girl or boy in harmonious and respectful environments.
 Taking precautions in the handling of toxic substances, ladders, appliances, electrical plugs, heights,
and water basins, among others.
 Identification of everyday actions pertinent to the home environment that promote comprehensive
development of the girl or boy such as experiences in play, art, literature and exploration of the environment.
 Generation of experiences favorable to the development of the girl of the boy that include practices
appropriate to the cultural context where they live.
 Generating experiences in which children have the opportunity to explore and build with various materials
from nature, and from their social and cultural environment.
 Knowledge of the modalities of first education.
 Processes of transition and adaptation of the girl or boy to the initial educational institution.
 Importance of recognizing signs of alarm and adequate care at home when they become sick.
 Importance of applying vaccinations in accordance with the vaccination scheme for Colombia.
 Importance of taking the child to all appointments for measuring growth and development,
and to the guidance sessions offered by the health service.
 Importance of providing the child with micronutrient supplements, and deworming them.
 Practice of physical and recreational activities that stimulate the senses, physical growth and interactions
between various members of the household and the girl or boy.
 Construction of a democratic and participative environment for the girl or boy in the family.
Health
Environment
Educational
Environment
Three to six years of age
Home
Public
Space
213
Continued on page 214
Care actions destined
for each mother, father, family and caregiver
of a girl or boy
from three to six years of age
Continued from page 213
Guide and support each mother, father, family and caregiver in:
 Establishing rules for coexistence that take into account the opinion of the girl or boy.
 Promotion, recognition, dialogue, exchange and enjoyment of the various expressions and cultural assets
of the country and those pertinent to the region where the child lives, and which become his or her heritage.
 Rescue and protection of the family memory and heritage formed among generations and that can be
transmitted to the girl or boy.
 Assistance and participation in the activities appropriate to cultural and knowledge management centers
(libraries, museums, culture houses, entertainment centers and parks, among others).
Linking the family to educational and pedagogical processes developed with the girl or boy.
Communicate permanently to the family the achievements in the developmental process of the child.
Care actions destined
for each girl or boy
from three to six years of age
Carrying out evaluation sessions for the growth and development of each girl or boy that support the mother,
the father, the family and the caregivers in monitoring his or her wellbeing.
Carrying out deworming and nutritional monitoring, supplementing with micronutrients and food complements
according to their nutritional needs.
Perform nutritional monitoring and complementing food according
to nutritional requirements.
Timely evaluation of dentistry, optometry and audiometry.
Observe, monitor and record qualitatively the development processes of each girl or boy.
Vaccinate each child according to his or her age.
Promote healthy habits related to nutrition, corporal hygiene, physical activity and sleep.
Generate experiences that contribute to recognition and construction of sexuality in each girl or boy.
Promote strengthening of solid affection bonds between each child and the adult persons
who are significant to him or her.
Promote encounters to strengthen the socialization processes
between girls, boys and adults
in different spaces.
214
Health
Environment
Educational
Environment
Public
Space
Home
Health
Environment
Educational
Environment
Public
Space
Three to six years of age
Home
Continued on page 216
215
Care actions destined
for each girl or boy
from three to six years of age
Continued from page 215
Promote the evaluation of the multiple forms of expression of each child and the various expression
of what it means to be heard, perceived, and considered and to take part actively in the decisions regarding
his or her own life and those of the groups and communities to which he or she belongs.
Strengthen the implementation of pedagogical strategies and experiences in the public space
that correspond to the characteristics and interests of each girl or boy to empower their development.
Promote activities that stimulate play, exploration of the environment, art, and literature.
Generate intentional environments and pedagogical experiences in which the children play, explore
the natural, social, and cultural environments, express themselves through various artistic manifestations,
and approach literature, considering their interests and their developmental features.
Construct pedagogical experiences and provide enriched environment that consider the interests
of each child and that even arise from their initiatives or proposals.
Carry out, with each girl and each boy, construction and exploration experiences with different materials
from nature and their social and cultural environments.
Promote spaces for spontaneous play in which each girl or boy can make decisions,
solve everyday problems, and freely establish interactions with the environment
and the people surrounding him or her.
Generate environments that strengthen autonomy and decision-making.
Evaluate positively the achievements of each girl and each boy, and motivate them toward new explorations.
Promote the use of open spaces (parks, bike routes, forest, beaches, among others)
so that each child participates in physical and recreational activities.
Generate experiences, which promote corporal expression, movement, and participation
by boys and girls in play activities.
Generate spaces in which each child can approach, participate and enjoy different cultural,
literary and artistic expressions.
Promote dialogue and exchange between each girl, each boy, and the persons attending
to them regarding cultural expressions and assets pertaining to the region and the country
that become the heritage of each child.
Support each girl or each boy in the process of adapting to initial education.
Process the civil birth registration of each child during the first month of life, and make it exigible
from there on, if they do not have it.
216
Health
Environment
Educational
Environment
Public
Space
Three to six years of age
Home
217
Situations that trigger
specialized care actions
from the age of three until the age of six
Situation of the girl or boy:
• Not registered for the growth and development
appointment, or has not attended it.
• Food insecurity
• Alterations in growth and development
• Does not have civil birth registration
• Incomplete vaccination protocol
•
Situation for the family of a girl or boy
Family with one or several members who:
• Have psychosocial difficulties
• Abuse consumption of psychoactive
substances
• Have a disability
•
•
Examples of harmful rearing or violation
of the rights of the child.
Disavowal of paternity
What to do if families
are identified who are
in a situation of emergency
or disaster
Suspicion of some expression of violence
toward early childhood, such as child abuse,
physical abuse, emotional or psychological
mistreatment, abandonment or neglect,
sexual abuse, shaken baby syndrome,
Munchhausen syndrome, parental alienation
syndrome, suicidal ideation, gestational violence,
childhood exploitation, etc.
During and after the emergency or disaster:
• Make the early childhood population visible within
the census of affected persons or victims.
• Establish packages of humanitarian care
for emergencies, differentiated and adapted
to the population of children from 0 to 6 years old.
• In healthcare, prioritize the early childhood
population after classification or triage.
Actions implied in an
administrative process
for reestablishment
of rights
When becoming aware of situations of vulnerability or risk
which merit specialized care actions, it is important
to remember that the state, family and society are
guarantors of the rights of childhood, and it is the duty
of these stakeholders to inform the authorities of such
situations so the administrative processed destined
to restitution of rights are implemented.
It is important to mention that at the center of this
administrative process is the boy or girl in early childhood,
and that this process must be at the service of his
or her rights, considering the especially delicate time
of life that is early childhood.
218
Present one or various special diseases
such as cancer, HIV/AIDS, rare, chronic
or high cost diseases, etc.
Family is a victim of:
• Armed conflict
• Forced displacement
Recall that if any of the situations mentioned
above were to arise, the territories
must guarantee the availability of the human,
administrative, financial and technological
resources, among others, to offer
the care actions that these require.
(Establish priority of care actions according to severity
of injuries and probability of surviving them).
• Guarantee that each girl or boy remains with
his or her mother and other relatives, unless these
are in critical physical or emotional condition.
• Prioritize the early childhood population
in the reconstruction and rehabilitation processes.
The administrative process for reestablishing rights
is composed of the following steps:
1. Initiating the process.
2. Verifying rights.
3. Requesting evidence.
4. Development of care process according
to the specialized care roadmap.
Three to six years of age
•
5. Transfer of evidence.
6. Adjudication.
7. Relevant monitoring.
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Early Childhood Comprehensive Care Strategy
A Roadmap Tailored to each Territory
The Comprehensive Care Road-map comes alive in territorial practice. Each local authority can use it as te guiding reference for designing, ordering, and giving relevance, timeliness and consistency to comprehensive care, ensuring its actions are coordinated and delivered
harmoniously to children in their everyday environments according to
age, context and condition. A Comprehensive Care Roadmap design
tailored to their territory will fulfill this purpose.
The local authority must begin by reviewing the diagnosis of the
early childhood rights situation under the development plan, which
may be periodically updated.
While the RIA comprises care actions necessary to achieve comprehensive care, and these should be used to project action plans in the territory, it will require prioritizing care according to the specific situation
of children and pregnant women, the state of indicators, the emphasis of
the development plan and the available resources. Also, the existing care
must be analyzed in order to adjust it, create new actions, transform what
must be changed, and coordinate it around the RIA with quality criteria.
Only then is it possible to advance the logic proposed by the Strategy.
It is therefore proper to advance questions such as:
1. How does the territory interpret the comprehensive care roadmap
as an organizing and structuring axis for early childhood care? The
answer leads the territorial team to interact with the RIA and
begin to understand its local and intersectoral logic.
2. What care actions require priority in the territory according to the
current situation of children? The answer requires a vision by
which to organize the territory in matters of comprehensive early
childhood care.
3. Which care actions are provided effectively in the territory and which
are not? The reply requires establishing the gap between what
exists and what still needs to be secured.
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Management of the Strategy
4. From the eight indicators by which the national government proposes
to start tracking care child by child (see sidebar 1), what actions
should the local government develop to start the process? The answer
involves defining intersectoral and territorial coordination for
monitoring each child.
5. How does the care reach the everyday environments of the children?
This question will not only allow determining whether all
environments are being reached, but will provide clues about
the state of cooperation between institutions and stakeholders in
these environments. It also invites the local authority to check if
it is promoting and strengthening shared responsibilities in the
family and society.
6. Which actions should be developed for such care to reach every
child in the territory? The answer requires making each child
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Early Childhood Comprehensive Care Strategy
visible with their own name and identification, guaranteeing
their access to a certain set of features required for their
comprehensive development. It will help highlight coverage and
gaps within the care. It can also help identify care appropriate
for children in one part of the territory (e.g. urban areas) but
not relevant to others (such as dispersed rural or indigenous
reserves or collective territories).
I like
games and
traditional
rounds in
our native
tongue. I
like my
house.
7. What actions should we take to ensure coverage of unmet care and
to sustain or improve what is already offered? The answer leads
authorities to the interagency coordination needed to ensure care
actions and to specify the priorities of their own Comprehensive
Care Roadmap. The result should be captured in a comprehensive
care plan for early childhood, which in turn translates into
programs, projects and complementary offerings. It must also set
out programs, services and campaigns for the priorities in the RIA.
While it is likely that the priorities in the RIA match those in the
development plan, the answers to the questions outlined above will
lead the territories to revise their goals and budgets.
Clearly, it will not be possible to achieve all the challenges outlined
in the RIA care plans. Therefore, priorities should be set that become
gradually more complex until they are all achieved.
The Strategy has suggested initiating nominal monitoring as part of
comprehensive care from the beginning of the RIA. Each Colombian
boy and girl should initially receive care actions comprising the following indicators:
The Strategy’s proposal is that territories ensure care that at a minimum shows the prioritized indicators starting in 2014. This will surely
require a management leap in the right to comprehensive early childhood development and human development in the country.
If the territories feel the need for other care actions, they must be
given a central place in the comprehensive care plans.
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Management of the Strategy
Indicators by which the National Level Proposes
Initiating Child by Child Monitoring
The child:
1. Has current health insurance in the General Social Security System.
2. Has a completed vaccination schedule for his or her age.
3. Attends appointments for early detection of alterations in growth and
development.
4. Has nutritional assessment and monitoring.
5. Attends a service unit in the modality of initial education within the
framework of comprehensive care, whose human talent is certified by
qualification processes.
6. Has access to collections of books or specialized cultural content in
the modalities of early childhood education within the context of
comprehensive care.
7. Has a civil birth registration.
8. The family participates in training processes.
Comprehensive Care Plan: Road to action
First and foremost, territorial authorities meeting in councils of
social policy and related technical committees or commissions on
early childhood must have information to help them make decisions
and take action.
Each territory’s implementation can be formatted in an intersectoral
comprehensive care plan that best suits it, as long as it sets out priorities with precise targets for the structuring factors and the environments, specifying responsible officials, interagency coordination, and
necessary resources for the short and medium term.
Regarding the Comprehensive Care Roadmap, the plan specifies
care actions within the structuring factors and defines relationships
between different stakeholders, so the intervention can move beyond
the sectoral to enable comprehensive care. It promotes organized action by the stakeholders in terms of early childhood development.
This instrument:
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Early Childhood Comprehensive Care Strategy
1. Establishes operational objectives for comprehensive development
of children in early childhood residing in the territory.
2. Defines the structure of comprehensive care in a specific
territory based on its particular reading of the Comprehensive
Care Roadmap.
3. Defines universal, specialized and differential care actions.
4. Proposes intersectoral relations and dynamics to achieve
objectives and comprehensive care.
5. Proposes required transformation actions and strengthening of
territorial institutions.
6. Specifies intersectoral, sectoral and institutional responsibilities
and the budget for their funding.
7. Defines mechanisms to enhance knowledge of the children’s
situation and for the monitoring and evaluation process.
Other questions to ask during formulation of the plan to specialize
aspects of coordination, monitoring and participation include:
• Do competent institutions in the territory act in a coordinated
manner when providing care and services to pregnant women,
children in early childhood and their families?
• Which tools are available to record the delivery of care
actions to pregnant women, girls and boys in the context of
comprehensive care?
• Which areas of training are contemplated for the different persons
responsible for implementing this policy strategy?
In addition to convening public entities, the Comprehensive Care
Plan should invite social agreements on early childhood development
through mobilization and shared responsibility of families.
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Management of the Strategy
Using the Roadmap as a screening of territorial reality will result in
a contextualized Comprehensive Care Plan that responds to the conditions, situations and environments in which children will develop.
Each girl and each boy in the Strategy
As mentioned, the Comprehensive Care Plan also identifies girls
and boys in the territory who receive care and those who do not. A
child receiving any care action provided for development is a reason
for any SNBF entity to identify the child and make him or her visible within available registration and institutional monitoring systems.
The territory can then track its early childhood policy and review
what care actions a child has access to, and ensure all other care actions begin to be available.
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Early Childhood Comprehensive Care Strategy
Once a girl or a boy has been registered through an SNBF entity, the
system must arrange for care to expand and become more comprehensive across the structuring factors. This will increase the possibilities
for comprehensive development of each individual, decrease lags, and
contribute to equity.
Consequently, the Comprehensive Care Roadmap requires nominal management of care in which every individual is registered by
name, surname, ID number and location, and each care action they
receive is monitored.
Process-focused management, which normally operates under the
logic of care quotas, is thus transformed into results-based management, which tracks changes in the lives of children.
Under the Strategy, monitoring tools will be promoted at the territorial level for every girl and boy, to guarantee the care required for
their development. Monitoring will be sustained and will link information from various public, private and community stakeholders to verify
children’s access to programs, services, and other care offers under the
Comprehensive Care Roadmap.
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Management of the Strategy
Child by child monitoring will also generate alerts for timely implementation of care actions. Preventive and timely care is very important at this point in the life cycle, for example in vaccination. A
software tool is being developed to collect required information and
periodically update it.
The Strategy for Comprehensive Early Childhood Care contributes
to the indicators in the Single Information System for Children (SUIN,
Spanish acronym), jointly agreed by the entities that comprise the
SNBF, which targets three main purposes:
• Assess the life situation of boys, girls and adolescents.
• Verify the level of compliance with national and international
commitments in guaranteeing the rights of children.
• Compare the status of compliance with these rights from the
population, differential and territorial approaches.
The Strategy is an integral part of this monitoring system, oriented
to the evaluating public policy by assessing the conditions and quality
of life of children and adolescents.
Adjusting modalities and services,
and their transit into comprehensiveness
Comprehensive care removes sectoral practices and promotes coordinated dynamics and synergies, and these transfer to modalities for
early childhood care. Some modalities must move gradually towards
comprehensiveness with the help of various sectors, such as early childhood education already initiated by the national Government. Another
group of modalities will have to be reviewed critically by territorial entities and the SNBF so they can become flexible and adapt to individual
contexts and conditions, always while ensuring quality of care.
Recognizing we are a country with a vast cultural and ethnic diversity poses the challenges of being flexible, being able to see the multiple
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Early Childhood Comprehensive Care Strategy
realities of children, understanding and interpreting them in light of
some basic agreements we have built as a society for early childhood
care, and providing the answer every Colombian girl or boy needs in a
timely manner. This applies to food programs, teaching strategies, care
in native or sign languages, traditional knowledge and practices, and
guidelines for construction, adaptation and furnishing of infrastructures for early childhood education.
Lines of Action
The transition between the design and implementation of the Strategy has a number of strategic areas which the Intersectoral Commission
for Comprehensive Early Childhood Care and all SNBF entities must
work on to achieve the consolidation and sustainability of early childhood public policy. These areas should be based on a body of law that
establishes a mandate for the country and on the continuation and
escalation of territorial resources for early childhood issues.
Therefore the following lines of action and their contents are projected:
• Territorial management, which involves specialization of the
institutional architecture and strengthening of capabilities for
local public servants, as well as the promotion of decentralization
and regional autonomy.
• Quality of care actions aimed at the humanization and flexibility
of care according to population and context, qualification of
human talent, and the adjustment and review of the quality of
services supplied.
• Monitoring and evaluation of policy, understood as a permanent
review of instruments and actions to make adjustments necessary
for achieving comprehensive care.
• Social mobilization as the challenge of creating cultural change and
influencing social imaginary, where children actually come first.
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Management of the Strategy
• Knowledge management as the current construction of meanings,
covering the needs of all, that refer to different languages and
that are based on scientific knowledge, community knowledge
and new technologies.
Each line of action will be discussed in depth below.
Territorial management
Strengthening institutions and the capabilities
of local stakeholders
It is clear for the Strategy that a full guarantee of the rights and subsequent development of children is not possible without the support
and commitment of the territorial levels of government. Therefore it intends to continue working with local governments in establishing institutional and financial conditions to sustain long-term actions required
for enforcing the rights of children during their early years.
We like
to dance,
that others
watch us
dance and
dance with
us
While progress has been made in influencing development plans so
that departments, municipalities and districts have the administrative,
budgetary, financial and management mechanisms necessary to ensure
comprehensive care for early childhood, and in coordinating and co-financing them with the nation for a sustainable expansion of coverage
and quality 5, the Commission is aware this is an ongoing advocacy and
support task. It must be progressively implemented through comprehensive care plans that are duly formulated, implemented and evaluated.
Therefore this line of action provides advice and support to the departmental, district and municipal teams, and to institutions present
in the territories, to qualify their management for contextualization,
development and monitoring of the Strategy.
5 This is within the scope of the obligations conferred by Act 1098 of 2006 under Section 204, on
the National Planning Department, the Ministry of Health and Social Protection, the Ministry of
National Education and the Colombian Family Welfare Institute, and Article 137 of Law 1450 of
2011 on the Intersectoral Commission for Comprehensive Early Childhood Care
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Early Childhood Comprehensive Care Strategy
Various mechanisms are available to the territories, for example:
• Technical cooperation, which facilitates dialogue between
the national and the territorial levels and promotes a joint
construction of the policy in which all cooperate and all gain.
• Regional dialogues, which are intersectoral meetings between
the national and local levels to jointly analyze the needs
and scope of technical cooperation and establish working
arrangements.
• Direct technical support on specific issues according to current
needs and processes in each territory.
• Review and recommendations on documents, proposals or
schemes developed by local authorities to seek support from
technical teams of national entities.
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Management of the Strategy
• Internships, to enhance the technical view through exchange
with other areas and the ability to share knowledge and proven
experiences.
• Support from experts on specific topics to provide guidance in
all moments of the early childhood public policy cycle in the
department, district or county.
Promoting decentralization
and territorial autonomy
The Intersectoral Commission for Comprehensive Early Childhood
Care recognizes that implementing the full guarantee of rights for
women of childbearing age, pregnant women, infants, and children requires designing and adapting comprehensive care processes according
to population, territories and contexts.
Although the structuring factors of comprehensive care are organized for all areas of the country, however unexplored they might be,
it is a challenge for the Commission to provide clear guidance to local
entities for implementing the flexible programs, services and other offers of care contained in these factors.
Decentralization and territorial autonomy require understanding
the different responsibilities of provincial and municipal orders, and
higher levels of coordination among decentralized national entities
(regional and zonal).
Departmental administrations are a major ally of the Strategy for
assistance and technical cooperation to municipalities. They help adapt
the Strategy’s technical line to territorial reality. They also support
strengthening of planning, implementation and monitoring capacities,
and qualification of human resources in the municipalities.
In turn, municipalities are the designers and implementers of their
own comprehensive care plan, and of other early childhood care programs and projects. The Intersectoral Commission for Comprehensive
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Early Childhood Comprehensive Care Strategy
Early Childhood Care, the departments and the municipalities must
work to strengthen municipal planning and execution capacity, since
that is where care will materialize for children and their families, and
where the Comprehensive Care Roadmap is put into operation.
The national level must recognize degrees of autonomy for the comprehensive care agencies in the territories, so they can creatively solve
situations in favor of the rights of children.
This implies that the Strategy must believe in and learn from those
who work every day with early childhood at various levels, in their abilities, their knowledge, and their experiences, and also in the resources
and supports of the environments that favor appropriate, friendly and
warm surroundings for the development of children.
At all levels, national, departmental and municipal, it implies recognizing communities as legitimate interlocutors, with a wealth of knowledge regarding the care of children and the local human talent characteristic of populations and cultures.
Quality and coverage
Humanization of Care
Providing quality humane care that addresses social, cultural and
territorial attributes and considers different living conditions of children and their families, helps create empathic environments that respond to the needs of children in their development process.
Hence the Strategy proposes working on several levels valuing everyday individual experiences that allow human beings to connect with
each other beyond the discursive, to engage in actions as deeply human
as to care for a pregnant woman, or a child.
At an administrative level, this involves ensuring the delivery of care
in an appropriate and dignified manner, both to urban communities
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Management of the Strategy
and those living in rural areas of difficult access, while maintaining
permanent contact between those providing care and the reality each
Colombian child lives.
Replies relevant for all girls and boys
The universe of pregnant families, infants and children in early
childhood in a country like Colombia has many nuances, either by the
contexts where they live, their culture, their ethnicity, their disabilities,
particular dimensions or by transient affections. What is clear is that
according to the Strategy they should all receive closeness, accompaniment and relevant attention from caregivers to achieve comprehensive
development in early childhood. Work will continue on individuality
as a social value that opens the door to learning and complementarity,
and contributes to the growth of society.
This
is me.
Thus the Strategy will continue organizing its efforts to meet the
requirements of each boy or girl while respecting and contributing
to the strengthening of their individuality. It will promote reflection
and gradual actions so that care begins to encompass, for instance,
the language of ethnic groups and communities with disabilities, to
consider individual traits in the procedures and standard formats of
care actions, to enrich environments, to identify and strengthen their
own strategies and teaching resources, and to enrich food programs
with local food. This will involve local stakeholders in developing human talent, and will help the Strategy reach every corner of Colombia
where there is a child.
Part of the work of the territories is to contribute to the debate
and understanding of those specific characteristics of each town,
each community, and each group, to ensure the relevance of the
proposed strategy.
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Early Childhood Comprehensive Care Strategy
Qualification and training of human talent6
People with varied experiences, knowledge,
expertise and training converge in the comprehensive care for early childhood. These people
have different types of education: informal, formal (technical, professional, specialized), linked
to qualification exercises or empirical knowledge. Some interact in a more permanent and
daily basis with children, as in the case of teachers and preschool teachers; others do it sporadically, such as doctors and nurses; and others
indirectly, like architects when designing care
spaces. This wide variety of profiles and types of
interactions opens up a range of conditions and
nuances for developing that care.
The Strategy understands by qualification of human talent, all processes of informal education or guidance that allow strengthening the labor practices of those who care for children under six years old, in different contexts and sectors, so that comprehensive development is achieved
for children through improvement in the quality of comprehensive care.
Qualification differs from training because the latter is formal education leading to a degree or certification at various levels: vocational
secondary education, career education and human development, technical and technological education, higher education and postgraduate
education (specialization, masters, doctoral and postdoctoral).
Qualification of human talent is conceived as a structured process in which people update and expand their knowledge, redefine
and mobilize their beliefs, imaginary, ideas and knowhow, and enhance or strengthen their skills and daily practices in order to improve in a given field of action.
6 This section was built from the information provided by the reference document for the “Outline
of qualifications of human talent,” prepared by the Cinde Team commissioned by the Intersectoral
Commission on Early Childhood Care, with the coordination of the Ministry of Education (2012)
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Management of the Strategy
The Strategy promotes long-term processes for qualification of agents
involved in the comprehensive care of children in early childhood, to
increase coverage and quality of activities that enhance development of
children under six years old in different environments.
Qualification aims to modify or strengthen practices, for which it
is also necessary to work on the concepts and knowledge underlying
them. This implies recognizing the lore, perspectives, beliefs and experiences of the various stakeholders linked to comprehensive early
childhood care, to interact with them in ways that address new and
relevant theoretical and practical acquisitions, which impact favorably
in the promotion of child development.
There are two types of recipients in processes qualifying human
talent: beneficiaries and those responsible for offering the qualification process.
Direct beneficiaries of qualification processes include people in
charge of comprehensive care for early childhood, i.e., education and
health agents and others providing care in institutional and non-institutional environments. These comprise physicians, pediatricians,
teachers, therapists, professionals in social, educational and health
sciences, as well as community mothers and educational and cultural
operators in the territories, who want to increase their knowledge and
improve their practices to contribute to comprehensive development.
Institutions responsible for providing qualification processes are
those working with early childhood and higher education and vocational institutions, because they do the work of forging human talent at
various levels and in different areas.
Specifically, recipients of human talent qualification encompass the
following groups:
• Planners, designers and decision makers in public policy for early
childhood: These are the people responsible for the design and
planning of policies related to early childhood. In this group are
the authorities representing the Government.
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Early Childhood Comprehensive Care Strategy
• Technical Teams from institutions and entities: Are all those
belonging to organizations and institutions responsible for
implementing policies established for early childhood and related
areas. Qualification involves the design and implementation teams
for plans and programs in comprehensive early childhood care,
technical teams in charge of early childhood in institutions, and
public officials whose function is technical support, monitoring,
and evaluation and supervision.
• Direct care teams or teams operating programs and services: People
who interact daily or sporadically with children and their families,
providing a specific service in the context of comprehensive care.
• Teams from entities supporting implementation of early childhood
policies: Recipients in this group are NGOs, community
groups, grassroots stakeholders, services supervisors and social
communicators. As for grassroots stakeholders, especially in
geographical contexts of difficult access and populations having
their own language (native or sign), qualification facilitates
understanding, effective communication and delivery of services
to children in these communities. This qualification should
develop an intercultural dialogue that respects the worldviews
of their culture.
As part of comprehensive care for early childhood, there are a multitude of topics that can be addressed within the processes of qualification.
Quality of service offerings
According to Article 137 of Law 1450 of 2011, the Intersectoral Committee on Early Childhood is responsible for “The integrated development of an information, quality assurance, and monitoring and control
system.” Therefore, the commitment to quality has been an imperative in
all guidelines of the Intersectoral Commission regarding children’s care.
The Quality System is a set of rules, processes and interrelated procedures, administered in an orderly manner. They are closely related to
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Management of the Strategy
continuous improvement, seeking to satisfy the country’s quality needs
and expectations in comprehensive early childhood care.
The Strategy’s focus is establishing a culture of continuous improvement in management, to achieve comprehensive care through conditions of quality; raising awareness of the importance of quality; designing and implementing tools for the provision of comprehensive care
and increasing its ownership by those jointly responsible for it; and
the inspection, monitoring and territorial enforcement of quality conditions, as well as the operating systems for such purposes.
A detailed review of national regulatory frameworks is therefore necessary. Regulatory and technical developments in quality, inspection, monitoring and control are also needed in each sector. These will capitalize
the plurality of knowledge built by the sectors for the process, facilitating
common criteria and guidelines for quality in comprehensive care.
A first step of the Strategy was to identify some modalities of care,
such as public libraries and early childhood education, and to begin reviewing quality and delivery standards to ensure suitable conditions in
the services. Still, this issue is one of the most complex for the Strategy
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Early Childhood Comprehensive Care Strategy
due to the challenge of arranging intersectoral quality criteria in the
territories in terms of care actions in the RIA.
Coverage of the service offering
I like it when
grownups,
teachers and
mom, dad,
grandparents
and aunts
teach me how
things work, to
draw, to turn
cartwheels.
One of the biggest challenges facing the country is achieving universal comprehensive care. This universality has two fundamental
and complementary objectives. The first, from the perspective of early
childhood development, is achieved when all the structuring factors of
comprehensive care actions concur in the same child, when disjointed
or atomized services are surpassed and deliberate and effective care is
achieved, ensuring the child’s development.
The second, belonging to management, involves directing the entire intersectoral effort, adapting the offering, and having available the
knowledge and the human, technical, financial and administrative resources to serve the needs of every child for optimal development in
their own territory.
Thus, universality is not only concerned with the extension of programs or the number of individuals covered by a service, but with the
scope of institutional action enhancing their development, with a clear
approach, support and differential attention.
The Strategy, aware of the institutional changes this involves, has set
targets for the short, medium and long term. In the short term total coverage is expected for birth registration and health-related care for every
child, including insurance, vaccination, prenatal visits and appointments
for monitoring growth and development. In the midrange term care expands progressively to early childhood education and access to cultural
goods. Finally, local authorities universalize the other priority care actions for children in their territory, according to their specific situation.
The Government has invited all local authorities and entities involved with early childhood to consider the following as initial goals of
universal care:
1. Current health insurance in the General Social Security System.
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Management of the Strategy
2. Completed vaccination schedule for his or her age.
3. Attending appointments for early detection of alterations in
growth and development.
4. Nutritional assessment and monitoring.
5. Attending a service unit in the modality of initial education
within the framework of comprehensive care, whose human
talent is certified by qualification processes.
6. Access to collections of books or specialized cultural content in
the modalities of early childhood education within the context of
comprehensive care.
7. Civil birth registration.
8. Participation by the child’s family in training processes.
These goals are consistent with the indicators on which the national
level proposes to begin child by child monitoring, and which appear in
sidebar 2 of the section “A roadmap tailored to each territory.”
In addition to these goals, municipalities and departments will develop the Comprehensive Care Roadmap required by children in their
territories, so that their accomplishments will benefit every child.
Monitoring and evaluation of public policy
A purpose of the Strategy is to monitor different aspects of comprehensive care from systematic information records to ensure this care is
delivered with quality and relevance.
This means monitoring the following issues:
• The process of children’s development. The Strategy has defined
evaluation lines on child development, both for populations
and individuals.
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Early Childhood Comprehensive Care Strategy
The major surveys developed by the country on a population
scale have systematically included specialized modules on
early childhood coherent with the Strategy. Development of
longitudinal tracking studies is also projected for specific population groups.
At the individual level the Strategy reviews and identifies child
development assessment tools, allowing detection and early identification of alerts for appropriate follow-up in the development
of each child.
• Monitoring the policy’s impact. These types of assessments inform
policy makers on a number of decisions, from the interruption
of inefficient programs, and the expansion of interventions that
work, to adjustments to a program or a choice between several
programs. They identify policy actions which by their strategic
investment and importance for child development require
accurate, reliable and quality information.
• Assessment of the pertinence and quality of the offering. The Strategy
has generated a major transformation in programs, modalities
and patterns of care. One line of work in this area is identifying
baselines in terms of quality of the institutional offer and tracking
improvement of the defined conditions and quality criteria.
Different aspects of the Strategy require assessment during longer periods to improve understanding of comprehensive care
processes and of the outcomes that endure in children and their
families over time. It is important to develop short and medium
term assessments for processes, results and impacts.
Monitoring and evaluation will identify progress, strengths and
limitations of early childhood care programs and of the policy
itself, and will provide inputs for improved decision-making.
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Management of the Strategy
Social mobilization
It is a great challenge for the Strategy to involve society in the task
of comprehensive early childhood protection. Social mobilization is a
principal line of action to promote cultural transformations and a social
imaginary in which childhood comes first, and for results appropriate
to management of the public policy cycle for early childhood.
While the Strategy has built basic social agreements, these need to
be widely known, analyzed, appropriated and enriched by those whose
actions have an impact on children, especially territorial public servants.
One of the first challenges would be encouraging a large national mobilization around these agreements and creating opportunities for their
discussion and study. Moreover, authorities and institutions in the SNBF
must understand the central priority and logic of the Strategy. That
means, of course, meeting the challenge of strengthening regional work.
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Early Childhood Comprehensive Care Strategy
While it is clear that the Strategy has positioned early childhood as
a prioritized population group, this group still tends to be invisible.
The challenge is to keep showing the country, through communication campaigns and other strategies, the existence of children at this
stage of life, emphasizing their diversity and strengthening the message
to grant them priority without distinction of culture, ethnicity, religion,
social level, the contexts in which they live, physical or mental condition,
experiences or particular dimensions, or their transitional affections.
Likewise, campaigning to disclose the care they require at each stage of
their development, such as the care for women during pregnancy, immunization, and breastfeeding, adequate registration, and early education.
Proposals are also needed for public space friendly to early childhood
safety and accessibility issues, with appropriate areas for breastfeeding,
diaper changing and toilet for the smaller ones, among other issues.
Knowledge management
This line of action generates evidence and reflections on the meaning and sense of comprehensive care in the lives of children and its
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Management of the Strategy
implications for their growth. It also goes deeper into several key issues
deserving rigorous investigation, to obtain insights
into actions that have increasing relevance and quality in early
childhood care. It guides new constructions of current meaning covering the needs of children who attend to different languages, based on
developments in the social and natural sciences and new technologies.
It also includes feedback and adjustment processes for comprehensive
early childhood care through the systematization of experiences.
It is of vital importance for the Strategy, academia and centers of advanced studies to work together with shared and complementary horizons, providing a thoughtful and specialized look at this field in light of
the latest developments in the world. This is expected to continue with
the support of multiple sectors.
*******
This third and final part of the document has included the main
guidelines for management of the Strategy of Comprehensive Early
Childhood Care. The qualities of such management within the logic of
the Strategy were presented; references were made to the institutional
framework in which the Strategy is supported and its territorial references; the Comprehensive Care Roadmap was introduced as the quintessential tool to guide the territories in reviewing and organizing their
actions into clear paths; and the main lines of action in the Strategy
that will support comprehensive early childhood care were disclosed.
The Intersectoral Commission for Comprehensive Early Childhood
Care invites organizations and individuals that deal with children under six years of age, both those who participated in the design of the
Strategy and those who barely know about it, to take part in it, to
assume it as a path to achieving comprehensive protection for those
just starting life and who require help from adults and institutions to
survive and develop to their full potential.
243
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