Facts & Figures


Mali, Burkina Faso, Sierra Leone, Mozambique


Rural areas including Man, Danané, Siambly




22,000 caregivers


  • Community volunteers
  • Doctors and health workers
  • PATH technical assistance
  • HKI coaches


  • Groups of mothers, grandmothers, and fathers
  • Community health workers
  • Ministry of Health agents
  • Community schoolteachers


  • Communities in rural areas of Côte d’Ivoire actively contribute to ECD initiatives for parents and children.
  • Relevant ministries are committed to scaling up parental education interventions on a national scale.


Share this project:

About the project

Combined with the Essential Nutrition/Essential Hygiene Actions (ENA/EHA) modules, Care for Child Development (C4CD) is an innovative and integrated approach aiming to improve childhood development and nutritional outcomes during the first 1,000 days, a crucial period of life that starts at the beginning of a woman’s pregnancy and lasts until a child’s second birthday.


Malnutrition continues to be a pressing problem in Côte d’Ivoire, where over 59% of the population lives in poverty. Undernutrition early in life can lead to long-term deficits in physical and cognitive capacity. It affects brain development both directly by depriving the body of nutrients that are essential for neurodevelopmental processes and indirectly by reducing the energy for exploration and learning and potentially undermining emotional bonding with caregivers.

Multiple factors contribute to undernutrition, including poverty, which limits household access to nutrient-dense options, but also optimal care and hygiene practices for women, infants, and young children, particularly during the crucial first 1,000 days of life. Associated with malnutrition, the lack of stimulation further undermines children’s development potential. The first 1,000 days are also a crucial window of opportunity to build a child’s brain architecture, thereby optimizing its cerebral capacity. And to do so, infants and young children must receive nurturing stimulating care from their caregivers.


Teaching families a combination of improved nutrition, health, hygiene, and child development practices using communication for behavior change counseling and hands-on practical exercises delivered through mother and father support groups can advance good health, optimize child development, and thus contribute to human capital development.

The package of interventions proposed by this model focuses on interrelated factors documented and proven to underpin a successful start to life, which are improved nutrition, hygiene, and sanitation, as well as early childhood development achieved through appropriate play and communication. The training provided reinforces parenting and caregivers’ skills so that the latter are equipped to provide nurturing care to their young children.

The Care for Child Development/ENA/EHA approach is implemented in partnership with the Côte d’Ivoire Ministry of Health. A pool of master trainer doctors and other health workers are trained in the C4CD/ENA/EHA program. They then train community health agents and volunteers who facilitate discussions with groups of mothers, grandmothers, and fathers and conduct home visits.

Results to date

HKI successfully implemented the C4CD and ENA/EHA pilot in the western region of Côte d’Ivoire in 2018 with over 4,500 caregivers benefitting from the program, 311 caregiver groups created, and over 16,000 home visits for counseling. An independent evaluation by Innovations for Poverty Action (IPA) showcases positive results, especially in nutrition and hygiene knowledge and attitudes. Results on the non-nutrition and health aspects were not so obvious. In order to fine-tune the program and improve child stimulation and protection outcomes, TRECC proposed that HKI and the Ministry of Health’s National Nutrition Program (PNN) jointly conduct an adjustment phase in 2019 to address weaknesses highlighted in IPA’s independent evaluation results. The adjustment phase led to further refining of the curriculum, implementation methods, and sustainability plans. The project is expected to be extended to dozens of new communities between 2020 and 2022.

Scientific evidence

Several studies have shown the potential of the Care for Child Development and ENA/EHA models to yield significant positive results.

Get Involved