Li Quan, a 3-year-old boy, lives in Shiying Village of Dayin Town in Bijie, southwest China's Guizhou Province. Every week Li's home welcomes a special guest—a parenting coach, who encourages and guides his mother or grandmother to play, talk, read and sing with him.

On the afternoon of December 18, 2023, the silence in the small living room of Li's home would occasionally be broken by a burst of laughter, lending the cold winter a warm touch. The laughter erupted whenever Li would successfully complete a puzzle or actively react to his mother or the coach.

The coach's home visit is an "active involvement" method of the China Rural Education and Child Health (China REACH) program, which provides rural families with children aged 6 to 36 months with one-hour in-home parenting guidance once a week.

China REACH was first launched in 2015 in Huachi County of Gansu Province in northwest China, by the China Development Research Foundation (CDRF), a think tank that conducts research and analysis on China's developmental issues, in cooperation with the National Health Commission, the country's highest healthcare authority, and local governments.

The time between birth and age 3 is a period of rapid brain development when billions of connections between individual neurons are established.

Promoting the early development of rural infants and toddlers will promote the structural and functional development of children's brains, laying a good foundation for later learning, social interaction, psychological development and social adjustment, the CDRF believes.

According to the CDRF, as of November 2023, the program had covered 19 counties in 10 provinces and regions, benefiting about 37,000 children—with around 8,000 of them in Bijie.

On December 18, 2023, a group of experts in early childhood education from the United States, Mexico, Brazil, Chile, South Africa and the UNICEF traveled to Bijie to explore local efforts promoting children's optimal development. They also visited Li's home, a 1.5-hour drive from the city center, to observe the parenting coach's visit.

Taking the long view 

Li joined the program when he was just 6 months old. Previously, he lived with his 62-year-old grandmother as his father and mother were working in places far away from their hometown.

This is a common scenario in rural China. As their parents often have to leave the rural setting they call home to find work in urban areas, many children are left behind and raised by rapidly aging grandparents.

Under the program, the parenting coaches usually are local (village) women aged 25 to 35 who have at least completed their junior high school education and received related training before getting involved with their designated families. One coach works with 15 to 20 children.

During home visits, coaches work with children and their caregivers to complete several activities, including games, drawing, reading, singing, etc., following the flow of activities outlined in the teaching materials. The home visits cost an average of 3,000 yuan ($450) per child per year, including the coach's salary, teaching materials and other expenses. This fee is jointly funded by donations and local government budgets, according to the CDRF.

"Through home-based early parenting guidance, caregivers can learn how to guide their children and improve their children's language skills, social development abilities and emotional skills," said Guo Qiong, a parenting coach, at a work exchange meeting between the experts, coaches and local officials on the evening of December 18, 2023. Guo used to be a homemaker.

"I once met a child who lived with his 80-year-old great-grandmother and had severe speech problems. The great-grandmother had previously assumed he would grow out of it, but that did not happen, and the problem in turn negatively affected the child's psychological development," Guo said. The program helped her understand the importance of the active involvement of parenting coaches.

They also record the progress of these children and upload related data to an application for further analysis, another coach said.

"Analyzing data is important because it contributes to the process of planning, implementation; better quality needs a process of continuous improvement," commented Bernardo Aguilar Montiel, Director of Quality and Innovation at Mexico's Infant Development Centers of Frente Popular Tierra y Libertad (CENDI), at the work exchange meeting.

Home visits aside, the program also offers other services. The Dayin Town Early Child Development Center, where the parenting coaches also work, provide parent-child group activities, including story-reading, games and musical events, all based on the physical and mental development patterns and learning characteristics of infants and toddlers, with a strong emphasis on caregiver-child interaction. The center is open from Sunday to Thursday.

"Their mother and I bring them here three to four times a week," the grandmother of a boy and a girl told Beijing Review. According to her, the activities at the center bring joy and fun to the children.

The program also provides nutrition packages to local children, bringing the rate of nutritional-deficiency anemia in Dayin down from 24 percent in 2017 to 13 percent in 2022, Wang Limei, chief supervisor of the program in Dayin, told Beijing Review. 

But children aren't the only ones benefiting from the project's wide-ranging undertakings. Notably, the program is also creating job opportunities for local women.

In Dayin, for example, the coaches and program supervisors can respectively earn 1,800 ($252) to 3,000 yuan ($420) per month, a respectable income from the local viewpoint.

Fang Jin, Vice Chairman and Secretary General of the CDRF, said at a symposium in Beijing on December 16, 2023, that more than 1,300 parenting coaches and program supervisors are currently involved in the program.

According to the CDRF, the program was evaluated by a research team led by Professor James Heckman, a Nobel laureate in economics, and the results were encouraging. Their study found that the trial in Gansu's Huachi had a significant impact, as 84 percent of the children who received home visits from parenting coaches outperformed the control group in cognitive, socioemotional and language domains. When compared to similar programs in the United States, Ireland and Jamaica, the program was found to be similarly effective at a much lower cost (only 3-5 percent of the U.S. program). 

During the Beijing symposium, the CDRF launched the Home Visiting Action Plan for 100,000 Rural Infants and Toddlers (2023-25), an extension of the China REACH program, which aims to provide early childhood parenting services to a broader range of rural children under the age of 3.

No effort should be spared to bring rural infants and toddlers up to the same developmental level as their urban counterparts, the plan read.

The more, the merrier 

"It is a multigenerational approach to early childhood development, which is a global challenge. We don't have enough models in many countries to, for example, effectively support grandparents and show them how they can encourage their grandchildren's learning. One very positive thing I saw today was how grandparents are being supported. This is necessary in the context of Guizhou Province," said Hirokazu Yoshikawa, a professor of Globalization and Education at the NYU Steinhardt School of Culture, Education and Human Development in New York City, at the work exchange meeting.

Ely Harasawa, former National Secretary for the Promotion of Human Development of Brazil's Ministry of Citizenship, commented at the meeting that "the parenting coach can be a 'complementary companion' for the parents because the sharing of emotions, worries, doubts, difficulties and happiness with a peer can be a very rich experience." This feeling of connection can in turn help the program to better benefit families, she added.

In 2021, based on the experiences amassed and results generated by the program in Bijie and other regions, the CDRF and the Bijie Municipal Government jointly launched the Rural Child Demonstration Development Zone in the Bijie Pilot Area, aka the first rural children development demonstration area project in an underdeveloped area of China.

Today, the Bijie Pilot Area focuses on children's nutrition, education, healthcare and overall protection, and conducts comprehensive active involvement work at the different developmental stages of rural children aged 0 to 18. 

"It's so exciting to see a leadership so committed to early childhood development that understands that it is the heart of the family, the community, society, the economy and nation as well," said David Harrison, CEO of South Africa's DG Murray Trust, adding that the role that the local government plays in ensuring infrastructure is in place has been essential to the project's success.

The international experts also had some suggestions for the local government to look into. "I think a future direction for multigenerational programs is to pay attention to the mental health of both adults and children simultaneously," Yoshikawa added. For example, postpartum depression affects many young mothers, so people need to take a better approach during the prenatal period and in the first six months after childbirth to reduce the chances of it occurring. 

Bijie has already taken the first steps to get more actively involved in this field, and the local completion rates of prenatal examinations are on the up.

"I come from Chile, a small country on the other side of the world. But we have the same problems. I think this work is important, but it is also necessary for all children in all of China, in all of the rest of the world," concluded Helia Molina, Chile's former Minister of Health and a professor at the Faculty of Medical Sciences at the University of Santiago, at the meeting.

（Print Edition Title: A Poster Child） 

Copyedited by Elsbeth van Paridon 

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