UNIVERSITY OF GUYANA

COLLEGE OF MEDICINE

DEPARTMENT OF MEDICAL REHABILITATION

BMR2201 - Human Growth and Development

Lecturer: Dawn Stewart

Name of Student: Sundar Persaud

USI: 1034182
Introduction

Early Childhood Intervention (ECI) programs are essential for providing support to children with

developmental delays, disabilities, and behavioural or mental health needs. However, the

provision of ECI services varies widely from country to country, and many families don’t have

access to the services they need. Through an analysis of the efforts of Croatia and Serbia to

develop and improve their ECI systems, this case study highlights the importance of a

coordinated and integrated approach to providing ECI services and the potential benefits of

investing in early childhood development. Through an examination of the challenges faced by

these countries in providing ECI services, the strategies they have employed to address these

challenges, and the outcomes of their efforts, we can gain insights into the key factors that

contribute to the success of ECI programs and the ways in which these programs can be

improved to better serve the needs of children and their families. Specifically, the focus will be

on the situation analysis conducted in Croatia in 2019 to identify the strengths and weaknesses of

existing ECI services, and the series of studies conducted in Serbia to identify the conditions for

developing a phased process towards building a national ECI system.

Background

This study focuses on the growth of early childhood intervention (ECI) operations in Croatia and

Serbia. After examining both countries, it was revealed that ECI services vary between them and

are provided by different entities such as ministries, NGOs, municipalities, and disability

organizations. One major setback these two nations face is their lack of integration or

coordination among policies catered to young children with developmental issues; an obstacle

for families who require assistance from various sectors. Scarcity in availability when it comes

down to receiving appropriate ECI services along with professionals lacking adequate capacity
within innovative approaches places emphasis on this issue even more so. In regard to Serbia

specifically, paediatricians often recognize child development delays too late due partly because

standardized tools aren't implemented during assessments. The medical approach currently being

exercised pursues fixing 'defects' rather than placing focus on correcting interventions which

themselves may be detrimental towards recovery. Persisting prejudice, stigma, and

discrimination alongside institutionalization regarding disabilities outside a given environment

remain significant obstacles. Henceforth, it's imperative there remains ongoing building upon

professional capability while simultaneously pursuing advocacy through outreach at federal

levels. Encouragingly enough, a well-developed legal foundation alongside effective

management mechanisms could support positive changes moving forward.

Alternatives

Some of the possible alternatives for improving ECI services in Croatia and Serbia include:

1. Advocating for policy changes that support the development of ECI services and ensuring

equitable access to these services for all children and families.

2. Strengthening the legal foundation for ECI services to ensure that they are sustainable,

accountable, and responsive to the needs of children and families.

3. Establishing effective management and coordination mechanisms to ensure that ECI

services are integrated and coordinated across different sectors and levels of government.

4. Providing outreach and advocacy services to raise awareness about the importance of ECI

services and promote the use of standardized assessment tools among paediatricians and

other professionals.
The alternatives here were not entirely rejected, but some constraints and reasons may limit their

implementation. For example, advocating for policy changes may face resistance from

stakeholders who are not convinced of the importance of ECI services or who have competing

priorities. Strengthening the legal foundation for ECI services may require changes to existing

laws and regulations, which can be a lengthy and complex process. Establishing effective

management and coordination mechanisms may require significant changes to existing structures

and systems, which can be challenging to implement. While providing outreach and advocacy

services may require significant resources and sustained efforts over time to achieve the desired

impact.

Solution & Evidence

A realistic solution to improve ECI services in Croatia and Serbia is to establish a national ECI

program that provides comprehensive and integrated services to all children and families in need.

This solution was chosen because it aligns with the recommendations of UNICEF and other

international organizations, which emphasize the importance of developing a country-wide

organizational structure for program coordination, planning, and accountability.

Evidence from the case study supports the need for a national ECI program, as the situation

analysis conducted in Croatia in 2019 revealed that the current ECI system is fragmented and

lacks coordination, resulting in inequitable access to services and poor outcomes for children and

families. Similarly, in Serbia, the lack of integration and coordination among policies and

services that respond to the complex needs of young children with developmental difficulties and

their families is a major issue.

Additionally, a national ECI program would address these issues by providing a coordinated and

integrated system of services accessible to all children and families in need. This program would

include a range of services, such as early identification and assessment, family support and

counselling, therapy and intervention services, and transition planning to other services as

needed. The program would also provide ongoing capacity-building for professionals and

advocacy and outreach services led from the central level.

To reiterate, this solution aligns with the concept of a comprehensive and coordinated system of

care, which is a key principle of ECI. It also aligns with the recommendations of UNICEF and

other international organizations, which emphasize the importance of developing a country-wide

organizational structure for program coordination, planning, and accountability.

Recommendations

To accomplish the proposed solution of establishing a national ECI program in Croatia and

Serbia, the following strategies could be implemented:

• Develop a national policy framework: A national policy framework should be developed

to guide the development and implementation of the ECI program. This framework

should include guidelines and procedures, service and personnel standards, and

performance standards.

• Establish a national coordinating body: to oversee the development and implementation

of the ECI program. This body should be responsible for coordinating services,

monitoring progress, and ensuring accountability.

 • Develop a comprehensive service delivery model: this includes a range of services, such

as early identification and assessment, family support and counselling, therapy and

intervention services, and transition planning to other services as needed.

• Provide ongoing capacity-building for professionals: to ensure that they have the

knowledge and skills needed to provide high-quality ECI services.

• Provide advocacy and outreach services: to raise awareness about the importance of ECI

services and promote the use of standardized assessment tools among paediatricians and

other professionals.

The national coordinating body should be responsible for overseeing the development and

implementation of the ECI program. This body could be composed of representatives from

relevant ministries, NGOs, and organizations of people with disabilities. The development of the

national policy framework and service delivery model could be led by a team of experts in ECI,

with input from stakeholders and families. Ongoing capacity-building for professionals could be

provided by universities and training institutions, with support from the national coordinating

body. Advocacy and outreach services could be provided by NGOs and other organizations, with

support from the national coordinating body.

Further action may be needed to address some of the issues that could arise during the

implementation of the ECI program. For example, there may be resistance from stakeholders

who are not convinced of the importance of ECI services or who have competing priorities. To

address this issue, advocacy and outreach services could be provided to raise awareness about

the benefits of ECI services and the importance of investing in early childhood development.

Additionally, ongoing monitoring and evaluation of the ECI program could be conducted to

ensure that it is meeting the needs of children and families and achieving its goals.
References
UNICEF. (2022). FAMILY-CENTRED SERVICES FOR EARLY CHILDHOOD

INTERVENTION: HIGHLIGHTING INITIATIVES IN CROATIA AND SERBIA.