Nurturing care framework: early childhood development in crises
- Page updated onJuly 7, 2026
Pregnancy and the first three years of a child's life is the period of child development when they are most vulnerable to infections, hunger, and malnutrition (both acute and chronic). In this regard, the main protection they have comes from the people who care for them: their mothers, fathers, and families. However, in humanitarian emergencies and as a result of insecurity, displacement, and lack of access to essential services, caregivers lose the support systems they need to assist them.
Table of contents:
The nurturing care framework: five dimensions for early childhood development.
With the necessary resources, environments and opportunities, this period represents an important window of opportunity for child development (WHO & UNICEF, 2021). However, in order to develop their full physical and cognitive potential, the care these children receive must cover at least five dimensions (WHO et al., 2018):
- Responsive and nurturing care. Children also need their mothers, fathers and other caregivers to be present and to engage with them affectionately. This helps them establish an important emotional and affective bond (Britto et al., 2017).
- Protection and safety. A safe environment is not only one in which there is food and water security or dignified living conditions. It is also one in which children are protected from abuse, physical punishment, and neglect.
- Opportunities for learning. How children interact with their environment determines how they learn to relate, play, move, imagine and create.
- Health. Children need sufficient activity and sleep, attention to their needs, and their health situation. In addition, they must have access to preventive and curative health services and live in adequate hygienic conditions that minimize the risks of infection.
- Nutrition. The nutritional status of these children will depend largely on adequate feeding adapted to their age and responsive to their demand. From birth until six months of age, this feeding should ideally consist of exclusive breastfeeding. From six months onwards, it requires continued breastfeeding and the progressive introduction of nutritious and safe complementary foods. If at risk of malnutrition in their first months of life, or if suffering from acute malnutrition, they will also need early diagnosis and access to treatment (UNICEF, 2025).
Supporting caregivers is key to early child development
Guaranteeing child development is not possible without paying special attention to the wellbeing and care of caregivers. They often face very adverse situations in the absence of social support and essential services and have significant needs that must also be addressed. These include aspects related to their emotional wellbeing and mental health and even their safety (for example, in cases of gender-based violence) (UNICEF, 2024).
The support provided to these individuals, in addition to covering their basic needs and protection, must also contribute to their ability and confidence to face difficult times and solve problems. Therefore, it should be done with a gender perspective. This allows for challenging social norms and established roles that place the burden of caregiving on mothers and women. Additionally, it helps promote the shared responsibility of men.
Parenting support interventions in humanitarian contexts make it possible to provide education about child development and the importance of adequate nutrition, health, play, hygiene and education. Caregivers may also need information about behavioural changes throughout the course of development, techniques for responsive caregiving that attends to children's expressed needs, skills for interpersonal communication and conflict and problem resolution (without the use of physical punishment or violence) (Backhaus et al., 2024). They may even be supported with guidance on addressing trauma and loss, or with advice on relaxation techniques and stress management. Some of these interventions can be offered through home visits, group meetings with caregivers in the community, the creation of mutual support networks, or through the strengthening of existing social services.
🧠 Let's pause and reflect
Given that primary health care services are often the main point of contact in emergencies, in what practical ways can we reimagine routine consultations to function as platforms for promoting nurturing care without overburdening healthcare staff?
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Child-friendly spaces provide protection, play and psychosocial support in emergencies
Some of the key elements for child development in emergencies can be addressed through child-friendly spaces (World Vision International & IFRC, 2018). These inclusive safe spaces for children of different ages offer them the opportunity to meet and play with other children in an age-appropriate manner, always with the presence of professionals who accompany them. They also allow for educational activities that help restore a relative sense of "normality" in the midst of adversity. These spaces also contribute to child protection against abuse, exploitation and violence, enable psychosocial support activities to develop self-esteem and emotional regulation, and serve as a support for caregivers.
These spaces play a particularly important role in the first months of the crisis and displacement, at least until schools and nurseries begin functioning again. On occasion, they can also continue to complement existing community services after the emergency with other activities. However, there are significant differences in the quality and adaptation of these initiatives, which do not always demonstrate results (Hermosilla et al., 2019).
Some of these spaces can be adapted to meet the specific needs of younger children, including infants, and their mothers (or other caregivers). Furthermore, this intervention model allows for addressing the protection of breastfeeding and feeding during these critical early stages of extreme vulnerability.
References
- Backhaus, S., Blackwell, A., & Gardner, F. (2024). The effectiveness of parenting interventions in reducing violence against children in humanitarian settings in low- and middle-income countries: A systematic review and meta-analysis. Child Abuse & Neglect, 162(Pt 2), 106850. https://doi.org/10.1016/j.chiabu.2024.106850
- Britto, P. R., Lye, S. J., Proulx, K., Yousafzai, A. K., Matthews, S. G., Vaivada, T., Perez-Escamilla, R., Rao, N., Ip, P., Fernald, L. C. H., MacMillan, H., Hanson, M., Wachs, T. D., Yao, H., Yoshikawa, H., Cerezo, A., Leckman, J. F., & Bhutta, Z. A. (2017). Nurturing care: Promoting early childhood development. The Lancet, 389(10064), 91–102. https://doi.org/10.1016/S0140-6736(16)31390-3
- Hermosilla, S., Metzler, J., Savage, K., Musa, M., & Ager, A. (2019). Child friendly spaces impact across five humanitarian settings: A meta-analysis. BMC Public Health, 19(1), 576. https://doi.org/10.1186/s12889-019-6939-2
- UNICEF. (2024). Caring for the caregiver. https://www.unicef.org/documents/caring-caregiver
- UNICEF. (2025). Critical child development interventions for wasting programmes in humanitarian action. https://www.childwasting.org/critical-child-development-interventions-wasting-programmes-humanitarian-action
- World Health Organization & UNICEF. (2021). Nurturing care handbook. World Health Organization. https://www.who.int/publications/i/item/9789240058415
- World Health Organization, UNICEF, & World Bank Group. (2018). Nurturing care for early childhood development: A framework for helping children survive and thrive to transform health and human potential. World Health Organization. https://www.who.int/publications/i/item/9789241514064
- World Vision International & IFRC Reference Centre for Psychosocial Support. (2018). Operational guidance for child friendly spaces in humanitarian settings. https://pscentre.org/wp-content/uploads/2018/11/Operational-Guidance-for-Child-friendly-spaces-low-res.pdf
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How to cite this page
Abarca, B. (July 7, 2026). Nurturing care framework: early childhood development in crises. Salud Everywhere. https://saludeverywhere.com/en/health-in-humanitarian-crises/care-for-early-childhood-development/