Babies and children need, and deserve, good levels of health, as is clearly stated in Article 24 of the United Nations Convention on the Rights of the Child (1989). Despite the global view that children have a right to receive the highest attainable level of health, for many years there have been concerns about the poor state of our children’s health.
Back in 2003, a report warned us about the ‘epidemic of obesity’ that was emerging. In 2017, the Royal College of Paediatrics and Child Health highlighted the increasing levels of mental health and tooth decay affecting very young children. Post-Covid, the state of children’s health has deteriorated further. For children living in poverty, the impact on their health is even more profound.
A CALL FOR ACTION
The newly elected Government made a pledge to address the child health crisis, stating that it intends ‘to create the healthiest generation of children ever’ (Labour Party 2024). Bridget Phillipson, the Education Secretary, two weeks after election expressed her intention to work with early childhood settings to improve the life chances for children.
But we need to make sure the Government is not missing a trick in demonstrating how nurseries can improve children’s life chances by improving their health. After all, as an Academy of Medical Sciences report (2024) states, ‘Health in the early years… forms the basis for mental and physical health and wellbeing through the rest of the life course with consequent benefits to population health, national productivity, innovation and the prosperity of the nation.’
So, what can we do to improve children’s health? In many settings, staff provide tooth-brushing equipment for the children and teach them how to clean their teeth correctly. They work with parents to teach them about healthy eating.
These examples demonstrate how nurseries promote better health for children, and how practitioners, possibly without realising it, play a significant role as promoters of health for children. However, there are limited resources available that support practitioners in promoting children’s health in a way that is relevant to the children and families in their nurseries. With this in mind, I worked with a nursery, located in an area of high deprivation, to create the Early Childhood Health Promotion Toolkit, which informs nurseries about the important role they can (and do) play in improving children’s health.
THE EARLY CHILDHOOD HEALTH PROMOTION TOOLKIT
The Toolkit is a free downloadable resource in two parts. The first part includes an overview of contemporary childhood health issues and resources that can be used to meet the health-related aims of the EYFS. Part two is dedicated to the ‘Five Step Approach’, with each of the five steps helping settings to identify, implement and evaluate a health promotion intervention that is relevant to the children in their setting.
THE FIVE STEP APPROACH
The setting where the toolkit was piloted chose healthy eating as its focus; the staff wanted to improve the quality of the food and drink they provided in nursery, and they wanted to become a ‘water only’ nursery. Staff had noticed how many of the children’s packed lunches included unhealthy food and drinks. They were acutely aware of the reasons why some parents could only provide fast-food leftovers or high-sugar-content food, but they wanted to find out whether they could work with parents in sensitive and supportive ways to provide healthier food and drink to their children. The following case study is based on the pilot carried out.
THE SUGAR CONTENT DISPLAY
Karen, who was employed as a family support worker, displayed some of the items that were frequently included in the packed lunches; then she measured out the amount of sugar and poured it into a plastic bag. To maximise impact, the display was erected just inside the entrance to the setting where parents needed to wait until their appointment. Many of the parents expressed their surprise.
Karen was able to pick up on comments that the parents made, and in an informed and sensitive way she was able to open up the conversation with the parents. She had also extended the information to include leaflets about healthy drinking and oral health. This is because she had noted in the response to a parent questionnaire that some parents had demonstrated that they needed to know more about how to care for this aspect of health.
Many parents said they were not confident that they could provide healthy food at home for children, this was because of lack of time, knowledge and, in some cases, inadequate cooking facilities.
There was also a level of parental scepticism about whether their children would eat some of the recipes. To counter this, the practitioners took photos of the children tucking into an African stew laden with spinach, or a chickpea curry, and sent them to parents. The recipes contained readily available and inexpensive ingredients that were simple to prepare. They were printed off and made available for parents.
RECIPE CARDS FOR PARENTS
Many parents worked with the nursery and cooked the meals at home, reporting back their surprise at the ease with which they had managed to replicate the recipes at home and, more importantly, that their children had eaten them.
USING THE TOOLKIT
Since the pilot research of the toolkit, it has been used in other nurseries and by a childminder to guide them in identifying, implementing and evaluating health priorities relevant to the children and families in their settings. Feedback has been very positive about how the five steps help to guide their thinking and planning.
So please, think about an area of health that you would like to address in your nursery, and have a go at using the toolkit to support you in carrying out your role in improving the foundations of good health for our children – they deserve no less.
CASE STUDY: health education campaign
After completing Step 1 of the five steps of the toolkit, Karen had built up a picture of the parents of the 105 children in the setting. This helped her to become aware of the situations of the families. For instance, some parents did not have English as a first language, some were illiterate, some children were in the care of the state, and some parents were engaged in higher education courses.
The approach therefore needed careful consideration. To find out more, Karen developed a questionnaire to find out more about health practices at home. These revealed that many parents were short of time, and many were very honest about the mealtime routines and content of food at home. Their responses revealed that some parents lacked knowledge about what healthy eating is, or how to go about providing healthy food and hydration. Many stated that they did not have the time to make meals from scratch, and some parents didn’t have the spare cash to spend on food that their children may not eat.
Considering parents’ comments and concerns about healthy eating, Karen planned a health education campaign based on this topic. She wanted to capture the interest and attention of as many parents as possible, so she decided to launch the campaign at the setting’s parents’ evening.
This was attended by 96 per cent of parents. As they needed to wait in the entrance hall until their appointment time – and were in less of a rush than on a normal day – they had time to look at the information provided.
Karen had thought carefully about how to present the information, and thinking about the diversity of the families, she wanted to develop an inclusive approach to the resources used in the campaign.
She produced several visual displays aimed at educating parents about healthy eating and drinking for children.
More Information
- The Early Childhood Health Promotion Toolkit is available to download for free at https://oro.open.ac.uk/95887
- Free courses from the Open University: https://bit.ly/4f9aLts; https://bit.ly/3ONyiFv; https://bit.ly/3Vyh5nr
REFERENCES
- The Academy of Medical Sciences (2024) Prioritising early childhood to promote the nation’s health, wellbeing and prosperity
- Hall D. and Elliman D. (2006) Health for All Children. Revised 4th Edn. OUP
- Labour Party (2024) Child Health Action Plan
- UN(1989) UN Convention on the Rights of the Child
