1. Harvard Training Feedback Meeting – Upon return from Harvard University, the Governor organized for a feedback meeting at his home in Siaya County. The Smart Start Siaya Team shared with the County executives and community representatives the objective of the training and the plan developed.

2. Engagement of the First Lady as the Patron -The Smart Start  Siaya team organized for a feedback meeting after the Harvard training where they approached the First Lady and requested her to patronize the scale up of Nurturing Care in Siaya County. The First Lady accepted the proposal and immediately began to champion the nurturing care scale up process.

3. Prelaunch of ECD Scale up in Siaya County – the Governor took the initiative to prelaunch ECD scale up in the County. The meeting was attended by all key stakeholders both from the Government, Non-Governmental Organizations, Faith Based Organizations and the Community. The exercise was a turning point for Siaya County to address ECD holistically from conception to age 8 years.

4. Mapping of ECD Partners in the County through support from Hilton Foundation – Mapping of ECD partners were done by a contracted organization -Dalberg and the County had several partners that needed to be coordinated through a central office.

5. Formation of ECD Multi sectoral Committee that is led by the Government. The formation of ECD Multi sectoral Committee was spear headed by the team from the Governor’s Office, with representations from Non-governmental organizations and the Community.  The Committee organized a feedback meeting that brought together representatives from all the relevant government sectors(Health, Education, Agriculture, Social services, Child protection, Civil registration and Governance) and partners supporting ECD implementation(PATH, UNICEF, KMET, CRS, PLAN Int. Child Fund).In a bid to recognize the role played by all stakeholders in scale up of ECD in Siaya County, the ECD multi sectoral Coordinating Committee envisages having ECD services incorporated in all sector undertakings and emphasizes mutually accountable partnerships between relevant departments (Health, Education, Agriculture, Social services, Child protection, Civil registration and Governance). The Committee is chaired by the Governors Health advisor.

6. Strengthening political leadership commitment at county, sub-county and community levels – In the spirit of all-inclusiveness and getting all stakeholders to join the Nurturing Care Bus, the First Lady together with the ECD coordinator – Dr. Elizabeth Omondi, met with the Speaker of the Assembly and shared with him the nurturing care scale up plan. Through support from the Speaker, the team organized to have all the members of the County Assembly sensitized on the importance of Nurturing care. 

7. Creating enabling policy environment that supports nurturing care of young children and advocacy for the funding- the County has prioritized ECD to be one of the flagship programmes in the County Investment and Development Plan ( CIDP), Nurturing Care has been enshrined in the New County Health Bill and prioritized in the Departmental Work Plans. Continuous engagement, advocacy and buy in from the leadership has led to the passage of the Health Bill with nurturing care for ECD Enshrined in it. As a way of providing time for parents to provide nurturing care for their young children, the county provides 3 months paid maternity and 2 weeks paternity leave to working mothers and fathers respectively. Paid leave is also provided to parents caring for sick children upon recommendation by the doctor.

8. Build capacity of key actors to promote nurturing care for early child development– through partnership with PATH, Siaya County Health Management Team (CHMT) adopted the World Health Organization (WHO) and UNICEF’s Care for Child Development (CCD) training package for Healthcare workers. The trainings have been ongoing for al frontline workers (Healthcare providers & Community Health Volunteers) both from public, private and faith-based facilities. As a way of maximizing the use of available resources, The County has adopted a training model that is top up approach and not stand-alone training. The County Health Management Team (CHMT) is working with partners supporting Maternal, Child, Nutrition, Community health and HIV to include nurturing care content into existing curricula and capacity-building activities. This “top-up” approach is cost-effective and reinforces the inclusion of nurturing care as an essential component of the health system. The number of Community Health Volunteers (CHVs) trained on care for Child Development from 72 in 2017 to 1071 by September 2018, Health Providers trained on Care for Child Development from 44 in 2017 to 366 by end September 2018, Health facilities offering Nurturing care increased from 18 in 2017 to 70 by September 2018. The interventions have also increased uptake of services such as Skilled Delivery from 56% in December 2017 to 71% in September 2018 and 4thAntenatal Care from 46% in 2017 to 61%.

9. Awareness Creation and Community Mobilization -The ECD Multi sectoral Committee has been maximizing on all available opportunities to create awareness and mobilize communities to provide Nurturing Care Services. Various channels are being used to propagate Nurturing care messages including Local Media Houses. CHVs are also raising awareness in the community in order to reduce stigma and improve access to care especially by families with children enabled differently. The CHVs also provide social support to parents’ groups and empower caregivers and families to provide nurturing care services .In order to enhance further awareness and sensitization, the County through support from Catholic Relief Services (CRS) and UNICEF has established a Website for Nurturing care which is accessible and widely circulated.

10. Design and conduct multi-faceted nurturing care communication campaign – in the spirit of reaching all households and leaving no child behind, a firm (IDEO) has been contracted by Hilton Foundation, to support Siaya County to carry out Nurturing care campaign and saturate the County with Nurturing Care messages.