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Subsequent to a review of the Roving Caregivers Programme conducted in 2006, it was proposed that options for consolidation of their concepts and methodologies (using the “High Scope 0-3 manual) be converged, to extend its reach in a national context.

The Early Childhood Health Outreach (ECHO) was developed out of this consultative effort to conceptualize the integration of various aspects of the RCP into the Maternal and Child Health (MCH) services.

The Caribbean Child Support Initiative (CCSI); United Nations International Children Education Fund (UNICEF); Pan American Health Organization (PAHO); with support from Bernard van Leer Foundation (BvLF) and the Ministry of Health, Wellness & the Environment joined in partnership to converge the ECHO concepts into the Primary Health Care system for “at risk” children 0 - 3 years, by establishing a two-year pilot project in the Calliaqua health district with a view of institutionalizing the program.

The Calliaqua health district was identified due to the following indicators:workshop (pastoral center)

  • A high level of poverty

  • The Roving Caregivers Program does not exist in this community

  • The unavailability of day care centers

  • The high migrant activities

At the end of this pilot project the children involved would have received stimulation, which would put them on an even platform so that at the entrance to pre and primary schools they would be well prepared and would have reached their developmental milestones. Parents would also be empowered to assist their children in areas of health, education and social development.

Description of ECHO

The Early Childhood Health Outreach (ECHO) is a programme in Saint Vincent and the Grenadines which was designed to link early childhood development and the health care services for ‘at risk’ children and families.

ECHO uses methods of an informal home-visiting programme for children (birth to three years) which support parents in communities with limited access to these services giving them access to early stimulation and parenting education.

The program addresses the development needs of the very young in disadvantaged conditions where children benefit from: quality care, development of basic skills, better health and nutrition and at the next level, better performance in pre-school; and future education.


“Providing quality Early Childhood Health stimulation readily accessible to “at risk” children & parents”.


“To ensure that adequate resources are provided to enable the environment where young children from all social and economic backgrounds have equal opportunities in reaching their maximum potential.


“To provide non-formal early childhood intervention services in disadvantaged communities for families with children from birth to three years to realize the immediate and long-term benefits of good quality early childhood development experiences”.


  • To offer early stimulation to young children and improve parenting practices in disadvantaged communities.

  • Promote and monitor good health and early development of young children.

  • To train community health aides (CHAs) within the communities to assist in the delivery of parent support services.

  • To transfer the CHAs newly acquired knowledge and skills in working with families and communities to produce a range of local support agencies.

  • To promote friendly and healthy relationships between parents/guardians and children.

ECHO integrated Core Aspects of Roving Caregivers Programme

Appropriate training for nursing and other health personnel have been undertaken prior to the implementation of the programme. Training manuals were developed which incorporates the RCP concepts as well as the new World Health Organization (WHO) growth charts and feeding suggestions for children 0-5 years.

Regular meetings and ongoing consultations have been held and will continue to be held with stakeholders in collaborating agencies for the smooth running and sustainability of the ECHO programme. Saint Vincent and the Grenadines has a robust health infrastructure that lends to the sustainability of most of the practices and knowledge from the programme.

How does ECHO Operate

Who is it for

  • Echo provides a safety net for children 0-3 years old who do not have any form of early stimulation and are generally exposed to inappropriate practices.

  • ECHO is especially targeting parents and guardians of children within the above-mentioned age group, to help strengthen their parenting skills.

  • Expectant parents (male and female)

Who is the Home Visitor?

  • Trained Community Health Aides (CHAs) who were trained at the Division of Nursing Education in Saint Vincent and the Grenadines with basic knowledge of early childhood health development principles to conduct home stimulations.

What happens at Home Visits?

  • CHAs make regular visits and spend 30 to 60 minutes with children.

  • They guide and support parent-child stimulation activities, such as play, storytelling and other suitable activities for the 0-3 age group.

  • The CHA engage parents by demonstrating the activities to strengthen their understanding and for them to continue the process after the home visits.

Children Worked with by ECHO:

By July 27, 2011 Community Health Aides across Saint Vincent and the Grenadines in the ECHO program had reached 425 children. This number has been calculated from the 496 visits during the period July 2010 – June 2011.


Forty-one (41) Community Health Aides had ECHO training and are executing the ECHO principles and methodologies. Training was done in two parts:

  • 1st Training - Theoretical and Practical conducted June - July 2010 involving 19 CHAs.

  • 2nd Training - Theoretical and Practical conducted January - March 2011 involving 22 CHAs.

Training topics included:

  • Growth and Development at various stages of the life cycle.

  • Detection of Abnormalities related to growth and development 3 year olds.

  • Learning Cycle

  • Adult Child Interaction

  • Nutrition 0 - 3yrs

  • Neuro-developmental Principles

One batch of CHAs was trained in Family Literacy in February 2011 and another batch was trained in September 2011.

Parenting Workshops

A method ECHO uses to reach parents involved in the program is through parenting workshops. One-day workshops involve practical methods of equipping parents with knowledge and skills of early childhood health development. These parent workshops are ongoing.

Institutionalizing of the ECHO programme

For the sustainability of the ECHO programme efforts have been made to integrate ECHO concepts into existing maternal and child health services in Saint Vincent and the Grenadines.

  • March - May 2011 - Meetings were held with the Senior Nursing Officer, Community Nursing Officer and the Health Nursing Supervisor with regards to:
    • duplicating the Ages and Stages Questionnaire and incorporating ECHO training into the school’s curriculum.

    • Storage area for data

    • Submission of ECHO program in Advance Proposal

    • Inclusion of ECHO activities in CHA job description
  • Discussions held with tutors from the Division of Nursing Education, ECHO consultants, and ECHO coordinator, outline the integration process of the ECHO program into the school’s curriculum from September 2011 (RN & NA batches).

The Child Support Initiative in partnership with the Caribbean Internship Project (CIP) and the University of the West Indies started a regional initiative that has seen University students in the field of media and communication, research and psychology working in early childhood development in Eastern Caribbean countries. Saint Vincent and the Grenadines has benefitted from this integration through students attachment to the Roving Caregivers Programme (RCP) and the Early Childhood Health Outreach (ECHO).

Contact Information:
Mrs. Kathleen Mandeville (Coordinator)
c/o Sion Hill Health Cente
Saint Vincent and the Grenadines
Telephone: 784-532-4436
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Sis. Ferosa Roache (Senior Nursing Officer)
Environmental Health Building
Saint Vincent and the Grenadines
Telephone: 784-485-6133
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