RTCCD has been working in the areas of maternal, and reproductive health since 1998. However, the organization started to focus on early child development (ECD) in 2014 after the WHO/UNICEF launched the guideline “Care for Child Development”. RTCCD’s vision in ECD is to unlock potential development of young children in Vietnam from the early age of children’s life. RTCCD missions are to be the lead local agency in providing parenting education of ECD and providing practice-based guidelines to health workers in examination and counseling of ECD to parents.
INNOVATIONS AND COMMUNITY ENGAGEMENT
The RTCCD’s notable innovation in ECD is the EJOL program – short for the Early Journey of Life [1]. It is an educational program for parents in Vietnam that focuses on the first 1,000 days of a child’s life (phase 1 [2]: 2014-2015; phase 2 [3]: 2018-2020; and phase 3: 2021-2022). The first 1,000 days of a child’s life is critical to their development and giving parents the opportunity to learn the appropriate skills to do so will assist them in this important phase of their children’s life. The general mission of the EJOL program is to help and support child development, along with women’s health. The EJOL program consists of perinatal information, practice-based learning activities, and social support, and focuses on nine different risk topics composed in five separate modules for child development in Vietnam. To make the program accessible to all parents, there is an in-person mode, online mode, and a hybrid mode. The EJOL program recognizes that areas of lower socioeconomic status in Vietnam don’t have access to childcare training learning models. The EJOL has been rolled out to 109 communities in Ha Nam province (in-person mode and hybrid mode) and to 10 factories in Ha Noi city and Ha Nam province [4] (online mode https://ejol.vn [5]). Even during the COVID-19, EJOL actively provided online materials to parents and promote parent-child and grandparent-child interactions [6].
| This program is in collaboration with RTCCD and Monash University in Australia. It has also received support from the Vietnam’s Ministry of Health and the Vietnam General Confederation of Labour. The EJOL’s impact was assessed by a cluster randomized controlled trial (2018-2020) which found EJOL has improved child development indicators (cognitive, language, motor) and promoted parent behavior changes. The findings were published in the Lancet Child and Adolescent Health [7]in March 2023. Analysis of the e-course learning progress also indicated that parents improved their knowledge after taking e-courses. |  [8] |
RTCCD is going to provide a positive parenting component to parents, integrated with the EJOL, under the project funded by the Resilience Fund for Women in Global Value Chains (2023 – 2024). The innovation is for industrial zone workers in four provinces (existing provinces Hanoi city and Ha Nam province and two new provinces Hai Duong and Tuyen Quang) and will focus on topics emotional management and positive communication with their partners and children. [9] The innovation includes 2 components: component 1 – Two e-Module learning and component 2 – in-person practice at the factory-based workshop. This is a significant effort to prevent violence against women and violence against children (VAW and VAC) in Vietnam, expressed in a gentle way in the ECD domain. This new innovation will help to reduce violence against women in industrial zones and allow children to grow up in a safe environment.
RTCCD is currently working on a project called Integration window for children with Attention Deficit Hyperactivity Disorder [10] in Vietnam: Parent Education E-learning. This project, funded by the Australian Volunteer International, aims at developing an ADHD (Attention Deficit Hyperactivity Disorder) e-learning course for parents of children who have ADHD and who live in industrial areas with limited resources. The 12-month project goals are to improve parents’ knowledge about ADHD and improve behavior in child-parent interactions (Jul 2022 – Jun 2023). 119 persons, including parents and kindergarten teachers, are enrolled into the ADHD e-courses. Results of the pre-test and post-test indicated that learners had statistically significant improved knowledge of ADHD (mean score of correct answers at pre-test 52.1% [95%CI: 45.9 – 57.2] and of post-test 79.6% [95%CI: 77.3 – 81.8] with p-value <0.01).
RTCCD experts also held in-person [11] and Zoom talks to 3000+ industrial zone workers in Ha Noi [12], Ha Nam [13], Thanh Hoa, Hai Phong provinces. The organization also expanded their support to ChildFund Vietnam and Can Tho University of Medicine and Pharmacy by training their project officers, partners and health workers of ECD. They also shared selected parts of EJOL components to those NGOs.
With convincing evidence and warm feedback from workers, it is confirmed by the Vietnam General Confederation of Labour (VGCL) that the all 6 e-courses of the EJOL will be disseminated to further four provinces in 2023 and expanded to a wide network of industrial zones under the VGCL management. It is important to notice that although the pilot phase was conducted at 10 factories in Hanoi city and Ha Nam province, trade union leaders informally spread the news to their peers and then to their workers. The EJOL program observed a number of industrial zone workers from other 26 provinces that also enrolled into the e-learning website and completed e-courses.
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RESEARCH
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RTCCD has already done much work in the early child development area. For example, RTCCD in collaboration with Chan’s School of Public Health of Harvard Univeristy, provided an evaluation in 2019-2020 of [17]OneSky [17], a non-profit organization providing training to private small-scaled daycares in industrialized zones of Vietnam. RTCCD, with an experienced team of psychologists and public health workers, have conducted 2-hour observations using MELE, interviews with daycare owners and teachers, direct child assessment using MULLEN test and child anthropometric measurement at 480 private small-scaled daycares. RTCCD will collaborate with IDInsights to assess the OneSky training program in a cluster randomized controlled trial in Dong Nai province in 2023-2025. |
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RTCCD evaluated the sustainability of the A&T initiative in Vietnam [18] which focused on nutrition in the first 1000 years of children’s life. This infant and young child feeding innovation (IYCF) aimed to improve infant feeding practices in 3 countries, namely Vietnam, Bangladesh and Ethiopia in a 6 year period (from 2009 to 2014). The evaluation, using mixed methods, was conducted in 2016 and included interviews with people involved in the A&T program, expert health officials, health workers, and women in the last 3 months of pregnancy and mothers with children under the age of 2. The results [19] showed that the A&T program improved breastfeeding practices in Vietnam and the overall nutritional skills of mothers.
The RTCCD team also conducted a study on child safety at daycare centers in industrial zones in 2 provinces (Hanoi and Ha Nam) from 2022-2023. A survey was completed by 711 workers who sent their children to preschools or daycares. The findings of this study revealed that parents who were industrial zone workers have high demands for childcare services, and faced difficulties in finding childcare centers near home with reasonable costs. Overall, children had a good experience in daycare centers, but certain safety concerns still remained among parents regarding children’s physical and mental health.
POLICY ADVOCACY
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In the past six year, RTCCD has maintained a close partnership with the Ministry of Health Vietnam, the UNICEF and WHO Vietnam Office and kept them informed with the EJOL implementation and research. On 23 May 2023, RTCCD, in collaboration with the Ministry of Health Vietnam, the Vietnam General Confederation of Labour and the Monash University, conducted the national workshop [20]“Early Childhood Development: Leveraging Evidence for Policy and Practice in Vietnam”. This effort was successful in pooling leaders from the Ministry of Health, Ministry of Labour and Invalid Affairs, Vietnam General Confederation of Labours. |
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The goal was to sit down to discuss solutions for an inter-sectoral collaboration for promoting ECD practice at large scale in Vietnam. Positive promises and ‘green light’ was given to EJOL for the scale-up.
RTCCD supports the approval of the national guideline [21] on early childhood development examination and counseling for children younger than five years old by the Ministry of Health in Vietnam on January 6th, 2023 (Decision 40/2023/QD-MOH). The EJOL team led the initiative for this national guideline development and now the EJOL education package is used as the primary learning source for parents recommended by health workers nation-wide. RTCCD will support the MOH to develop the practice-based manual that will consist of e-course and in-person training for health workers in the country in 2023-2024.
On March 12th, 2019 RTCCD met over 40 ARNEC [22] (Asia-Pacific Regional Network for Early Childhood) delegates from many different countries to visit the innovation showcase “The Learning Clubs on the first 1000 days” (former name of EJOL). Delegates visited two different communes (Thuy Loi and Ngoc Son) to observe the local ECD innovation. Delegates observed the quality of the project materials (video clips, posters and family books) and the club sessions in operation. Some delegates, including from Nepal and Myanmar, expressed their interest in the project material packages and innovating a similar model in their countries.
MEDIA COMMUNICATION
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In the past ten years, the experts of the RTCCD team engaged in 50+ interviews on national print and broadcast media to talk about ECD and raising public awareness of ECD in the first 1000 years of children’s lives. The team also wrote three books [23] to general parents on care for child development which were published by Nha Nam publishing house and sold nation-wide. In addition, the organization actively posted ECD on Facebook [24], Youtube [25] and Zoom talks. In view of improving knowledge and skills of parents in Vietnam in ECD, RTCCD has a clear pathway of public population and policy maker’s awareness raising. The organization maintains strong and close collaboration with media, NGOs and government agencies to promote ECD policy and practice at large scale. |
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RTCCD PLAN WITH ECD VIETNAM
Expected outcome in 2023 – 2030: we commit to devote our effort to achieve the following outcomes:
- 1 million children in Vietnam will benefit from the EJOL (equivalent to 30 provinces)
- Vietnam will have national ECD’s action framework, good national M&E system, and have region-built innovations to scale up nation-wide
Our plan of actions from 2023 – 2030:
- Conduct a cRCT to measure impact of hybrid and online modes
- Scale up the EJOL (3 modes: in-person, hybrid and online) to 30 provinces in Vietnam
- Collaborate with international and local NGOs in Vietnam to adapt the EJOL in-person mode for mountainous and highland region (local dialects and culture)
- Support MOH to develop practice-based training on ECD examination and counseling (in-person training and e-courses for health workers nation-wide)
- Promote the inter-sectoral collaboration between Ministry of Health, Ministry of Labour and Invalids Affairs (Child Department), the Vietnam General Confederation of Labour and the Ministry of Education and Training to scale up ECD innovations
We are looking for support and collaboration to bring big impacts to the system and help children in Vietnam reach their full potential at this early stage of life. Please contact:
| Mrs. Tran Thi Thu Ha, MPH. Director The Research and Training Centre for Community Development (RTCCD Email: ha.tran@rtccd.org.vn |
Professor Jane Fisher, PhD Finkel Professor of Global Health Co-Director Division of Planetary Health Director Global and Women’s Health Monash University – Australia Email: Jane.fisher@monash.edu.au |