Community-Based Approaches to Enhancing Early Childhood Development Quality In Rural Northeastern Thailand: A Critical Ethnographic Study
DOI:
https://doi.org/10.60099/prijnr.2025.274388Keywords:
Community health services, Community participation, Child development, Cultural characteristics, Ethnology, Health policy, ThailandAbstract
Early childhood development is essential for sustained health, economic stability, and social welfare. Despite policy efforts, rural communities in northeastern Thailand continue to experience significant disparities in accessing essential early childhood development resources. Community engagement and the integration of local wisdom have been recognized as pivotal strategies for addressing these gaps and advancing the Sustainable Development Goals. This study examined community-driven approaches to early childhood development in rural Thailand, emphasizing integrated strategies for quality enhancement, enabling conditions, and operational mechanisms. A critical ethnographic methodology was employed, involving a 12-month data collection process that comprised participant and non-participant observations, in-depth interviews, focus group discussions, and document analysis. A purposive sample of 84 participants included caregivers, early childhood educators, healthcare professionals, community leaders, and local officials. Data credibility was ensured through triangulation, and thematic content analysis was applied.
The findings demonstrate that sustainable early childhood development in rural Thailand does not arise solely from formal institutional systems but from the dynamic interplay between indigenous knowledge, informal social structures, and locally grounded multisectoral collaboration. The rich findings revealed three key dimensions: 1) an integrated framework for early childhood development improvement, encompassing healthcare access, nutrition, culturally responsive education, and supportive infrastructure; 2) enabling factors such as human resource capacity, data-driven strategies, resource mobilization, and policy alignment; and 3) sustainable governance structures, particularly the “Heet Home Huen Hug” network and “Wong Sole,” an informal community dialogue platform fostering participatory decision-making. These findings inform policies that promote culturally responsive, sustainable, equitable, and inclusive community-based early childhood development.
References
World Health Organization. Improving early childhood development: WHO guideline [Internet]. Geneva: World Health Organization; 2020 Apr 3 [cited 2024 Dec 15]. Available from: https://www.who.int/publications/i/item/9789240063726
Daelmans B, Manji SA, Raina N. Nurturing care for early childhood development: global perspective and guidance. Indian Pediatr. 2021 Oct;58(Suppl 1):11-15. doi:10.1007/s13312-021-2349-5. DOI: https://doi.org/10.1007/s13312-021-2349-5
United Nations Department of Economic and Social Affairs, Population Division. World population prospects 2024: summary of results. UN DESA/POP/2024/TR/NO. 9. New York: United Nations; 2024.
United Nations, Department of Economic and Social Affairs, Population Division. World population prospects 2022: summary of results. New York: United Nations; 2022.
Thai Gerontology Research and Development Institute (TGRDI). Thailand’s elderly situation in 2020. Nakhon Pathom: Institute for Population and Social Research; 2021. (in Thai)
Social Development and Social Welfare Development Division, National Economic and Social Development Council (NESDC). Impact assessment and sustainability of elderly consumption under Thailand’s pension system. Bangkok: National Economic and Social Development Council; 2023. Available from: https://www.nesdc.go.th/ewt_dl_link.php?nid=14368
National Scientific Council on the Developing Child. Connecting the brain to the rest of the body: Early childhood development and lifelong health are deeply intertwined. Working Paper No. 15. 2020.
United Nations. Resolution A/RES/70/1. Transforming our world: the 2030 Agenda for Sustainable Development. New York: United Nations; 2015 [cited 2024 Dec 15]. Available from: https://sdgs.un.org/2030agenda
McCoy DC, Seiden J, Cuartas J, Pisani L, Waldman M. Estimates of a multidimensional index of nurturing care in the next 1000 days of life for children in low-income and middle-income countries: a modelling study. Lancet Child Adolesc Health. 2022;6(5):324–334. doi:10.1016/s2352-4642(22)00076-1 DOI: https://doi.org/10.1016/S2352-4642(22)00076-1
Black MM, Walker S, Fernald L, Andersen CT, DiGirolamo A, Lu C, et al. Early childhood development coming of age: science through the life course. Lancet. 2017 Oct 8;389(10064):77–90. doi: 10.1016/s0140-6736(16)31389-7. DOI: https://doi.org/10.1016/S0140-6736(16)31389-7
Emmers D, Jiang Q, Xue H, Zhang Y, Zhang Y, Zhao Y, et al. Early childhood development and parental training interventions in rural China: a systematic review and meta-analysis. BMJ Global Health. 2021 Aug 1;6(8):e005578. doi: 10.1136/bmjgh-2021-005578. DOI: https://doi.org/10.1136/bmjgh-2021-005578
Engle PL, Fernald LC, Alderman H, Behrman J, O’Gara C, Yousafzai A, et al. Strategies for reducing inequalities and improving developmental outcomes for young children in low-income and middle-income countries. Lancet. 2011 Oct;378(9799):1339–1353. doi:10.1016/S0140-6736(11)60889-1. DOI: https://doi.org/10.1016/S0140-6736(11)60889-1
Puinean G, Gokiert R, Taylor M, Jun S, de Vos P. Evaluation in the field of early childhood development: a scoping review. Eval J Australasia. 2022 Jun;22(2):63-89. doi: 10.1177/1035719X221080575. DOI: https://doi.org/10.1177/1035719X221080575
Zhang L, Ssewanyana D, Martin M-C, Lye SJ, Moran G, Abubakar A, et al. Supporting child development through parenting interventions in low- to middle-income countries: an updated systematic review. Front Public Health. 2021 Jul 16;9:671988.
doi: 10.3389/fpubh.2021.671988. DOI: https://doi.org/10.3389/fpubh.2021.671988
Thisara P, Chotibang J, Fongkaew W, Jintrawet U. Perceptions and experiences of mothers on parenting to promote executive functions in preschool children. Pac Rim Int J Nurs Res. 2022;26(1):105-120.
Britto PR, Lye SJ, Proulx K, Yousafzai AK, Matthews SG, Vaivada T, et al. Nurturing care: Promoting early childhood development. Lancet. 2017 Jan 7;389(10064):91–102. doi:10.1016/S0140-6736(16)31390-3. DOI: https://doi.org/10.1016/S0140-6736(16)31390-3
Yoshikawa H, Wuermli AJ, Raikes A, Kim S, Kabay SB. Toward high‐quality early childhood development programs and policies at national scale: directions for research in global contexts. Soc Policy Rep. 2018 Mar;31(1):1–36. doi:10.1002/j.2379-3988.2018.tb00091.x. DOI: https://doi.org/10.1002/j.2379-3988.2018.tb00091.x
Shawar YR, Shiffman J. Generation of global political priority for early childhood development: the challenges of framing and governance. Lancet. 2017 Jan 7;389(10064):119–124. doi:10.1016/S0140-6736(16)31574-4. DOI: https://doi.org/10.1016/S0140-6736(16)31574-4
Leininger MM, McFarland MR. Culture care diversity and universality: A worldwide nursing theory. Burlington (MA): Jones & Bartlett Learning; 2006.
Spradley JP, McCurdy DW. Anthropology: The cultural perspective. New York: John Wiley & Sons; 1980.
Spradley J. The ethnographic interview. New York: Holt, Rinehart & Winston; 1979.
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007 Dec 1;19(6):349-357. doi:10.1093/intqhc/mzm042. DOI: https://doi.org/10.1093/intqhc/mzm042
Thai Health Promotion Foundation (ThaiHealth). Master Plan of the Thai Health Promotion Foundation 2023-2027. Bangkok: Thai Health Promotion Foundation; 2023. [cited 2024 Dec 15]. Available from: https://www.thaihealth.or.th/wp-content/uploads/2023/01/สสส-แผนหลัก-66-70-Final.pdf [in Thai]
Nuntaboot K, Boonsawatkulchai P, Piyabanditkul L, Jiratanawonna N, Watthanamorn S, Chantarasiri J, et al. Krop krapwanniwiset chumchon: su tambon sukkhapap [Community research framework: towards a healthy subdistrict]. Bangkok: TQP; 2010. (in Thai).
Wolf ZR. Ethnography: the method. In: Munhall PL, editor. Nursing research: a qualitative perspective. 4th ed. Sudbury (MA): Jones & Bartlett; 2012. p. 293-330.
Subdistrict Administrative Organization. Community research report (Rapid Ethnographic Community Assessment: RECAP). Bangkok: Thai Health Promotion Foundation (ThaiHealth), Office of Community Health Promotion (Office 3); 2022. (in Thai)
Ray MA, Morris E, McFarland M. Ethnonursing method of Dr. Madeleine Leininger. In: Beck CT, editor. Routledge International handbook of qualitative nursing research. London: Routledge; 2013. p. 213–229.
Creswell JW. Qualitative inquiry and research design: Choosing among five approaches. 3rd ed. Thousand Oaks (CA): SAGE Publications; 2013.
Speziale HS, Streubert HJ, Carpenter DR. Qualitative research in nursing: advancing the humanistic imperative. Philadelphia (PA): Lippincott Williams & Wilkins; 2011.
Leininger M. Overview of the theory of culture care with the ethnonursing research method. J Transcult Nurs. 1997 Jan;8(2):32-52. doi:10.1177/104365969700800205. DOI: https://doi.org/10.1177/104365969700800205
Leininger M. Overview of Leininger’s ethnonursing research method and process [Internet]. 2005 May [cited 2024 Dec 15]. Available from: http://www.madeleine-leininger.com/cc/researchmethod.pdf
Germain CP. Ethnography: the method. In: Munhall PL, Boyd CO, editors. Nursing research: a qualitative perspective. 2nd ed. Sudbury (MA): Jones and Bartlett Publishers; 2000.
Fetterman DM. Ethnography: Step-by-step. Sage publications; 2019 Sep 19. DOI: https://doi.org/10.4135/9781071909874
LeCompte MD, Schensul JJ. Analyzing & interpreting ethnographic data. Rowman Altamira; 1999.
Wehbe-Alamah HB, McFarland MR. Leininger’s enablers for use with the ethnonursing research method. In: Leininger M, McFarland MR, editors. Culture care diversity and universality: a worldwide nursing theory. 3rd ed. Burlington (MA): Jones & Bartlett Learning; 2015. p. 73–99.
Flick U, Schreier M. Qualitative content analysis. In: Qualitative content analysis. SAGE Publications; 2014. p. 170-183. doi:10.4135/9781446282243. DOI: https://doi.org/10.4135/9781446282243.n12
UNICEF. The State of the World’s Children 2021: On My Mind — Promoting, Protecting and Caring for Children’s Mental Health. United Nations Children’s Fund; 2021. Available from: https://www.unicef.org/reports/state-worlds-children-2021.
Chiari AP, Senna MI, Gomes VE, Freire MD, Soares AR, Alves CR, et al. Intersectoral collaboration to promote child development: the contributions of the actor-network theory. Qual Health Res. 2023 Apr;33(5):451–467. DOI: https://doi.org/10.1177/10497323231153534
World Health Organization. Nurturing care for early childhood development: a framework for helping children survive and thrive to transform health and human potential. Geneva: World Health Organization; 2018. Available from: https://iris.who.int/handle/10665/272603.
Black MM, Behrman JR, Daelmans B, Prado EL, Richter L, Tomlinson M, et al. The principles of nurturing care promote human capital and mitigate adversities from preconception through adolescence. BMJ Glob Health. 2021 Apr 19;6(4):e004436. https://doi.org/10.1136/bmjgh-2020-004436 DOI: https://doi.org/10.1136/bmjgh-2020-004436
Barboza M, Marttila A, Burström B, Kulane A. Contributions of preventive social services in early childhood home visiting in a disadvantaged area of Sweden: the practice of the parental advisor. Qual Health Res. 2021 Jul;31(8):1380–1391. https://doi.org/10.1177/1049732321994538 DOI: https://doi.org/10.1177/1049732321994538
World Health Organization. Report of the regional multi-sectoral meeting to promote nurturing care for early childhood development. New Delhi: WHO Regional Office for South-East Asia; 2021 [cited 2024 Dec 15]. Available from: https://iris.who.int/handle/10665/345287
Tesar M, Pangastuti Y. From colonial legacies to inclusive futures: transforming and reconceptualising early childhood education in Indonesia. Glob Stud Child. 2024 Sep;14(3):264–282. https://doi.org/10.1177/204361062412681 DOI: https://doi.org/10.1177/20436106241268149
Wu X, Li X, Miao J. Early childhood development and social mobility in China. ECNU Rev Educ. 2024;7(4):991-1008. https://doi.org/10.1177/209653112412404 DOI: https://doi.org/10.1177/20965311241240479
Vicente JB, Pegorin TC, Santos AL, Veríssimo MD. Interventions for child development based on the Touchpoints Model: Scoping review. Rev Latino-Am Enfermagem. 2023;31:e4034. https://doi.org/10.1590/1518-8345.6732.4035 DOI: https://doi.org/10.1590/1518-8345.6732.4035
Abboah-Offei M, Amboka P, Nampijja M, Owino GE, Okelo K, Kitsao-Wekulo P, et al. Improving early childhood development in the context of the nurturing care framework in Kenya: A policy review and qualitative exploration of emerging issues with policymakers. Front Public Health. 2022;10:1016156. https://doi.org/10.3389/fpubh.2022.1016156 DOI: https://doi.org/10.3389/fpubh.2022.1016156
Raikes A, Sayre R, Davis D. Mini-review on capacity-building for data-driven early childhood systems: The consortium for pre-primary data and measurement in sub-Saharan Africa. Front Public Health. 2021;8:595821. https://doi.org/10.3389/fpubh.2020.595821 DOI: https://doi.org/10.3389/fpubh.2020.595821
Lucas JE, Richter LM, Daelmans B. Care for child development: An intervention in support of responsive caregiving and early child development. Child Care Health Dev. 2018;44(1):41-49. https://doi.org/10.1111/cch.12544 DOI: https://doi.org/10.1111/cch.12544
Somprattana D, Nanthabut K. Community-based care systems for children aged 0–5 years. J Nurs Sci Health. 2017;40(1):30-40. Available from: https://he01.tci-thaijo.org/index.php/nah/article/view/91728.
Bandelj N, Spiegel M. Pricing the priceless child 2.0: Children as human capital investment. Theory Soc. 2023;52(5):805-830. https://doi.org/10.1007/s11186-022-09508-x DOI: https://doi.org/10.1007/s11186-022-09508-x
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2025 Pacific Rim International Journal of Nursing Research

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright: The Pacific Rim International Journal of Nursing Research, Thailand Nursing & Midwifery Council has exclusive rights to publish, reproduce and distribute the manuscript and all contents therein.





.png)

