Skip to main content

Mother plays with her 9 month old daughter, outside their home
Photo Credit: Kate Holt/MCSP

All five components of nurturing care—good health, adequate nutrition, safety and security, responsive caregiving, and opportunities for early learning—are critical to improve early childhood development (ECD) outcomes. Integrating responsive care and early learning messages into existing nutrition counseling has significant potential to improve both nutrition and ECD outcomes.

Responsive Care and Early Learning Addendum

To address gaps in existing nutrition counseling packages, USAID Advancing Nutrition and a technical advisory group of ECD, nutrition, and social and behavior change experts developed a set of counseling cards and accompanying training and implementation materials—the Responsive Care and Early Learning (RCEL) Addendum—to integrate counseling on responsive caregiving and opportunities for early learning into existing child health and nutrition platforms.

USAID Advancing Nutrition tested the RCEL Addendum in Ghana and the Kyrgyz Republic to assess the feasibility, acceptability, and effectiveness of the package in both community and health facility settings. The implementation research found that health workers and caregivers understood, accepted, and appreciated the material; responsive caregiving practices improved; and caregiver engagement with children to support learning was enhanced. Full results are detailed in an implementation brief and companion report, and two manuscripts as part of a collection in the Public Health Nutrition journal.

Responsive Care and Early Learning Video Series

USAID Advancing Nutrition, in collaboration with Global Health Media, created 10 videos showcasing real-life responsive caregiving moments between caregivers and their children. The Responsive Care and Early Learning (RCEL) Video Series demonstrates, explains, and promotes positive responsive caregiving practices and counseling skills for health workers and complements the RCEL Addendum package. The videos are designed to be used both as part of the RCEL Addendum training curriculum and as a stand-alone training/learning aid for health workers. The videos are available in English, Arabic, French, Kyrgyz, Portuguese, Russian, and Spanish.

Integrating Responsive Care and Early Learning in Mozambique

In Mozambique, USAID Advancing Nutrition provided technical assistance to Transform Nutrition to integrate and deliver responsive care, early learning, and development monitoring within a nutrition, sanitation, and hygiene intervention. Full results on the testing of this intervention are detailed in a forthcoming manuscript (anticipated in mid-2024).


USAID Advancing Nutrition worked with the Ghana Health Service to test the feasibility, acceptability, and effectiveness of integrating responsive care and early learning.