I am at Aga Khan Hospital Pediatric unit in Tanzania’s commercial capital Dar es Salaam on Saturday morning. Mothers and a few fathers have brought their children to the clinic and from my obsewsrvation, some parents are playing with their children by throwing them into the air and then catching them midway and this ends in giggles. Other parents are busy on their phones and would only look at their children when their cries draw their attention. They are seemingly oblivious of the importance of interacting with their young children or playing altogether.
Play is important part of a child’s life and parents should play with their children most of the time, this is according to Lisa Ferla, a senior manager Early Childhood Development at Elizabeth Glaser Pediatric Aids Foundation (EGPAF), Tanzania. She points out that there is opportunity for integrating early stimulation in the country’s health system.
According to the Encyclopedia of Early Childhood Development (ECD), early stimulation are activities that arouse or stimulate a baby’s sense of sight, sound, touch, taste, and smell. Infant stimulation can help improve the baby’s attention span, memory, curiosity, and nervous system development. It is used in children from birth to age 6, with the aim of optimising their cognitive, physical, emotional and social well being, to avoid undesired states in development and help parents effectively in the care of their infant.
Ms Ferla states that this is very important for all children though their organisation’s focus is on children living with HIV or live in communities affected by HIV.
She explains that children in Tanzania just like the rest of the world simply need interaction, play and communication with their parents and caregivers.
“This needs to be done right from the beginning - conception. As it is understood that 80 per cent of brain development process takes place in the first 3 years of child’s life,” Ms Ferla outlines adding that the important message parents need to understand is that babies/children can hear and understand even before they begin to talk because they use their senses to communicate their needs and learn about their surroundings.
On how parents should interact or play with newborns and young children, she explains that both parents and caregivers need to understand that they don’t need to go out of their way to accommodate play and interaction with their children but instead embrace the use of daily routines opportunities to interact with their babies.
“For instance during breastfeeding time, a mother need to look at the baby’s face and smile, touch gently and sing. Parents can also use opportunities such as meal time to talk to their children about their day, praising them in small achievements they get and much more,” Ms Ferla states adding that they need to know simple available items in the households such as colourful cups and spoons that can be used as a toy for a child to play with.
She emphasises that play materials don’t need to be expensive or purchased all the time as locally available materials such as boxes could be used to make cars, water bottle and small stones can make a rattle for a baby. She underscores the need for parents to interact with the child and not to leave him or her alone playing.
On what mistakes parents make, she is of the view that some parents don’t stimulate their children enough.
“I don’t think you can ever over do it, the misunderstanding we have is that babies especially those newborns cannot hear, see or understand anything, while evidence shows us this period is the ‘window of opportunity’ for brain development which is important foundation for the child,” she points out.
“There is no dosage, what matters is quality, so even if a parent gets 10 minutes to spend with her or his child then they should do it well by providing time to talk and listen to the child, engaging in a simple activity such as reading a book or story telling plus encouraging and praising the child.
She says lack of child stimulation comes with consequences since not interacting with babies right from early stage is akin to closing the doors for the window of opportunities in their life. It means these children may miss out to reach their developmental potential later in life such as not performing well in schools and eventually get employment. Thus it comes with a very long-term impact.
Because many parents and care givers are oblivious of the dangers associated with lack of stimulation, the interaction with the children is very little in Tanzania just like the rest of the world.
“Especially with understanding on babies abilities and with the use of mobile phones and TV, these children are missing out on the opportunity to improve their language skills through interaction. There are studies on this,” Ms Ferla sounds the warning bells.
There is also Lancet series on ECD which gives evidence based study that through quality ECD intervention, even children from poor and vulnerable families like those who are affected with HIV, poverty, malnutrition have the chance to reach their developmental potentials.
“This is why, at EGPAF, we are pushing for this, so to also target many vulnerable children in our country,” she concludes.