Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
National Institute of Health Research, TehranUniversity of Medical Sciences, No. 70, Bozorgmehr Ava., Vesal St., Keshavars Blvd., Tehran, 1416833481, Iran.
BMC Public Health. 2021 Apr 2;21(1):649. doi: 10.1186/s12889-021-10646-7.
Integrated early childhood development (IECD) is a comprehensive approach to optimal development of children in different developmental domains from fetal stage to eight years of age. The aim of this study was to identify the factors affecting the process of policy-making for early childhood development and to clarify how these factors affect decision-making and create challenges in this regard.
In a qualitative study, we used two main data sources including document analyses and interviews. Using purposive sampling, forty semi-structured interviews with policymakers and informants in the fields related to children were conducted in Tehran from October 2017 to June 2018. Also, 62 national and 10 international relevant documents were reviewed. A deductive-inductive approach was used to analyze the data. We used the MAXQDA11 software for data management.
we identified 13 themes and 29 subthemes related to the stages of policymaking process including: Agenda setting (problem stream, policy stream, politics stream), Policy formulation (formulation and approval process, policy sustainability, mechanisms of stakeholders' participation in policymaking), Policy implementation (conceptual ambiguity, intersectoral and trans-sectoral issues, structural capacities, mobilization of resources), and Policy evaluation (continuous and routine data registry system, comprehensiveness of indexes). We propose 19 policy recommendations to improve the situation.
As a multidisciplinary and multi-sectoral field with different domains, early childhood development (ECD) requires a more active role on the part of policymakers in governmental levels in supporting the related policies. Unless policymakers change their approach to decrease nonintegrated and non-comprehensive policymaking for ECD, child development will be compromised, which endangers the eventual sustainability of the society since improved IECD policy-making process improves developmental outcomes in children. In this regard, attention should be paid to the role of reinforcing intersectoral collaboration through incorporating it in the missions and the evaluation items of organizations, creating commitment in high organizational levels, and developing an inter-ministerial policymaking framework that clearly specifies the roles and responsibilities of every single sector and their interactions and collaborations.
综合性儿童早期发展（IECD）是一种综合方法，旨在促进儿童在胎儿期到八岁期间在不同发展领域的最佳发展。本研究旨在确定影响儿童早期发展政策制定过程的因素，并阐明这些因素如何影响决策并在此方面带来挑战。
在一项定性研究中，我们使用了两个主要数据源，包括文件分析和访谈。采用目的抽样法，于 2017 年 10 月至 2018 年 6 月在德黑兰对与儿童相关领域的政策制定者和知情人进行了 40 次半结构化访谈。此外，还审查了 62 份国家文件和 10 份国际相关文件。采用演绎归纳方法对数据进行分析。我们使用 MAXQDA11 软件进行数据管理。
我们确定了 13 个主题和 29 个子主题，涉及政策制定过程的各个阶段，包括：议程设置（问题流、政策流、政治流）、政策制定（制定和批准过程、政策可持续性、利益相关者参与政策制定的机制）、政策实施（概念模糊、跨部门和跨部门问题、结构能力、资源动员）和政策评估（连续和常规数据登记系统、指标的全面性）。我们提出了 19 项政策建议以改善这种情况。
作为一个多学科和多部门领域，儿童早期发展（ECD）需要政府层面的政策制定者在支持相关政策方面发挥更积极的作用。除非政策制定者改变他们的方法，减少对 ECD 的非综合和非全面政策制定，否则儿童的发展将受到影响，从而危及社会的最终可持续性，因为改善 IECD 政策制定过程可以提高儿童的发展成果。在这方面，应注意通过将其纳入组织的使命和评估项目来加强部门间合作的作用，在较高组织层面树立承诺，并制定部际政策制定框架，明确规定每个部门的角色和责任以及它们的相互作用和合作。
