ing or housekeeping. This traditional practice deprives the babies of
the chance to explore the world through touch and exercising motor
skills. The lack of interaction with caregivers with this practice also
leaves them bereft of the stimulus they need for neural development.
Some toddlers Liu and her colleagues visited responded with only
“empty eyes” to toys given to them, Liu told ChinaReport.
Save the Children and NHFPC also found 64 percent of the 448
babies in their survey had anaemia due to insufficient micronutrients
and improper feeding practices, including being weaned off breast-
feeding too early. Not many caregivers had read, sang to or played
with their babies the day before the survey. A REAP survey of more
than 1,800 babies aged six to 12 months in poor villages in Shaanxi
in 2013 found that many parents knew more about the importance
of micronutrients for their pigs than for their infants. The babies re-
ceived sufficient food – but not the right food.
Actions
Both Chinese and international institutions have been working on
improving infant development through better nutrition and parent-
ing instructions. The CDRF is cooperating with the Bill & Melinda
Gates Foundation on promoting breastfeeding in China through
nationwide research, building communication platforms for all
stakeholders, putting forward public policy proposals and intensify-
ing public advocacy. The aim is to increase breastfeeding for Chinese
infants up to six months to 50 percent by 2020, or even 60 to 70
percent in rural areas, from the national average of 20 percent now,
noted Lu Mai in his Tsinghua speech. In their pilot projects, rural
mothers are paid to be trained in breastfeeding. For babies and tod-
dlers between six and 24 months in some rural areas, organisations
including CDRF and REAP, with the support of China’s government
agencies, have been giving them “nutrition packets” of vitamins and
minerals. Save the Children is planning to offer packaged nutrient
supplements in their project after realising feeding courses alone are
not enough. The Chinese government is doing the same in some
poor rural areas.
More difficult trials have been conducted on parenting training.
The programme Rao Yue’s mother joined is China Rural Education
and Child Health (REACH) sponsored by the CDRF in partnership
with the local network of public health care centres for women and
children. About 1,600 babies between six and 36 months old are di-
vided into a treatment group and a control group for comparison for
the parenting training, though both groups receive nutrient packages.
Since the programme began in September 2015, parenting trainers
had paid 44,200 visits to families in 56 villages by the end of May
2017, according to Zhang Yongli, county supervisor in Huachi. In
September 2014, REAP launched its parenting training programme
for 275 intervention households and 425 control households in
Shaanxi Province. During the 26-week programme, 70 parent-
ing trainers provided a once-a-week curriculum for children 18-42
months of age.
During the hour-long training, held weekly, trainer Zhang Lili
checked how well Rao’s mother had played with her using the lessons
taught the week before, and suggested new stories, games and songs
for the next week. This is standard practice in the programme, which
uses locally-recruited trainers, mostly drawn from the ranks of moth-
ers and housewives looking for extra income and the chance to help
other children. They are trained by supervisors who are typically local
medical graduates or village doctors, who in turn have been trained
by international experts.
Save the Children and the NHFPC launched a project in January- The four-year action has designed 124 games based on REAP’s
proposals and a number of picture books for interaction between
more than 700 babies and their caregivers in poor areas of Hebei and
Yunnan provinces. They visit the families once a fortnight. In the 40
to 50 minutes of each visit, they assess the child-caring progress of
parents, and babies’ physical development, and show caregivers how
to play with babies.
In an earlier programme started by Save the Children in partner-
ship with the NHFPC in 2014, families in a rural county in Xinjiang
Uygur Autonomous Region were put in groups. A volunteer family
organised regular gatherings of the group where children and parents
in the group played together in a way they have learned from the
parenting course.
Lifetime Impact
The efforts have paid off. The CDRF concluded in 2016 that the
“nutrition packet” project in partnership with Chinese Centre for
Disease Control and Prevention for 3,800 six-to-24-month-olds be-
tween 2009 and 2012 in Qinghai Province had produced a much
lower incidence of anaemia, diarrhea and fever, and much better mo-
tor and adaptive development, compared both with conditions before
the intervention and with the control group.
In October 2016, a mid-term survey on the Huachi project in
Gansu was completed by CDRF and the National Survey Research
Centre at Renmin University of China. The result was the proportion
of “borderline” and “abnormal” results in the Denver-II test, another
international exam, being about 10 percent lower in the treatment
group than in the control group. The improvement was particularly
evident in verbal development. In the programme by Save the Chil-
dren, babies and toddlers in the intervention group performed better
than those in the control group in terms of cognitive development in
the Barley III test one year after the intervention.
Organisers of the programmes found that babies loved the games
and toys brought by parenting trainers. Visible progress in their chil-
dren’s development is an important motivator for parents who wel-
come this programme. Parenting trainers in the CDRF and Save the
Children projects we have interviewed said infants who had received
the intervention typically knew the names of more plants and ani-