Health Care for ECD
Thematic Area :
Health Systems For Early Child Development

Although we as parents and professionals use different technologies daily, and some telehealth resources have been used for decades — including telephone calls, TV and radio shows, and online materials such as instructional videos — for many of us it was the COVID-19 pandemic that made us think about different ways technology could be used to support families.

Many of the services we as home visitors provide for families rely on face-to-face contact, and due to the pandemic, these were no longer possible to implement. We were faced with the fact that many families would be left without the support they expect and need to provide efficient and high-quality childcare. This made us question how flexible our services were in reality and how available we were for the families we worked with, and led us to think about which resources we could use to continuously support them, enable learning, and monitor their progress, and how creative we could be in finding the best ways to support these families.

I have had the privilege of working with home visitors from Serbia where we introduced telehealth resources in home visiting services. I learned from them, explored joint possibilities, and supported them. They key learnings and takeaways of that journey are summarised below:

Using technology

Many families are willing and able to use technology to connect with healthcare workers.  However, for this to work effectively, health professionals must embrace technological solutions in our work — we have to master technology and be creative and flexible when thinking about ways that families could benefit from it. This means thinking of different resources, sharing them with families to provide parents knowledge, information, and opportunities for supported learning — which includes talking about experiences, feelings, and practising parenting skills. When health-care workers are flexible, they are able to find different ways of combining resources, such as video recordings of meetings, text messages, video and text exchanges and joint analysis, social media posts, chats, video conferences, telephone calls, and mobile applications, among others.

Families reach out through technology

Families search for online content as well as virtual parenting communities to obtain information and learn about parenting and childcare. However, they are often unaware that some of the available content may just be  personal opinions or experiences and not scientifically proven evidence. They may compare their parenting experience with experiences seen online  or expect from the child what they have  seen shared in the virtual world. When supporting a family, it is important to refer them to useful and evidence-based resources and be there for them as they integrate the knowledge and tips into their everyday childcare routine.

Building relationships without face-to-face interaction

One of the biggest challenges associated with telehealth is building quality relationships with family members without face-to-face interactions and nonverbal communication (i.e., touch, leaning towards a person, hand gestures, or demonstrations). Telehealth relies on words and the way we talk. When supporting a family, it is important to ask open-ended questions, encourage conversation, enable interaction among family members, talk to all family members, and ask them to listen to one another’s experiences.

Observing interactions and monitoring children's progress

Another challenge is how to observe family interactions and monitor children’s progress using technology as some people — especially young children — may be distracted or feel embarrassed when using the technology, and so do not behave as they usually would. When working with families, encourage them to make home videos of different family interactions, and analyse them with the parents (e.g., comment on what you observe in the recorded interactions). 

Change might be stressful

Change might be stressful, however, professional stress can be prevented. Connecting with other colleagues in learning communities and supervisory groups can be a good way to reflect on your experiences with the families you work with, but also to reflect on your own beliefs, attitudes, knowledge and skills related to using telehealth resources with families. Building professional self-esteem and belonging to a professional community may help health-care professionals to feel more resilient and aware of both their own needs and those of the families they work with.

Opportunities for use beyond the pandemic

When we started using telehealth resources in Serbia, we found ourselves thinking of opportunities where telehealth could be incorporated beyond the pandemic. For example, families may temporarily be in  situations where they cannot receive health-care workers in their homes — when one of the family members has an illness or the apartment is being renovated etc. In other cases, some family members cannot be present during home visits (i.e., they may be absent because of work, or may be in another country or city). Alternatively, families may live in a context that creates barriers for the implementation of home visits. For example, they may live in remote, poorly accessible places, or they may have moved to another city. Telehealth resources allow health-care workers not to delay the visit if a family needs support, and allow you to send the family a message that you, as a health-care worker, are with them and are available in different ways that suit their current life circumstances.

The best results come from a blended approach

Finally, it is important to remember that while families are often willing and able to use technology to connect with home visitors, they usually prefer having you by their side, in their homes whenever possible. Thus, telehealth resources must not completely replace working directly with families in their homes. You will achieve the best results using a blended approach — combining resources and approaches in the ways that meet the individual family’s needs.



Ivana Mihić is a psychologist with PhD in developmental psychology and family relations. She teaches licensed courses for the professional development of home visiting nurses, ECEC staff and social workers in the area of early childhood development and parenting. Her research interests are focused on the development of evidence-based practice in ECD, family and parenting support programs. <

She has been participating in numerous projects supported by UNICEF in the area of early childhood development, early intervention and early childhood education and care (as a researcher, consultant, trainer and supervisor for home visiting nurses and other health care professionals, ECEC staff, and providers of child protection services). She is the author, or co-author of several evidence based early childhood and parenting support programs.



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