KEYNOTE ADDRESS BY MS RAHAYU MAHZAM, PARLIAMENTARY SECRETARY, MINISTRY OF COMMUNICATIONS AND INFORMATION AND MINISTRY OF HEALTH, AT THE CHILD EVIDENCE TO POLICY AND PRACTICE WEBINAR SERIES

Mr Hsieh Fu Hua,
Chairman, NUS Board of Trustees, NUS & NUHS 

Prof Yeoh Khay Guan,
Chief Executive, NUHS

Mr Lawrence Lien,
Chairman, Lien Foundation

Mr Lee Poh Wah,
CEO, Lien Foundation 

Mr Peter Hodgson,
Chair, Centre for Evidence and Implementation (CEI)

Professor Johan Eriksson,
Deputy Executive Director, Singapore Institute for Clinical Sciences (SICS)

Esteemed speakers and Panellists,

Distinguished Participants,

Ladies and gentlemen,

       Good morning. I am delighted to join you this morning at the inaugural Evidence to Policy and Practice Webinar Series, in conjunction with the launch of the Centre for Holistic Initiatives for Learning and Development, or in short, CHILD. It is my honour to be in the presence of many established academics and practitioners in the area of early childhood development. 

Child and Maternal Health and Well-being Strategy and Taskforce

2.      As a mother with a young child, today’s topic is close to my heart. As parents, our greatest concern is how we can help our children grow up well and achieve their aspirations. We believe that every child deserves the best start in life and be given the opportunity to develop well throughout his life so as to reach his full potential. To enable this, we need to extend more support to the family, especially the mother, because her health and well-being exert a significant influence on her child’s development, even before her child is born. We also cannot undermine the influence  of the family and parenting practices on the trajectory of a child’s development.

3.      To this end, we have set up an inter-agency Taskforce earlier this year to develop a national Child and Maternal Health and Well-being Strategy that will focus on supporting women and their children to attain good health and well-being, leading to a healthier next generation.

4.      This will be a five-year strategy, adopting a life-course approach – starting as early as pre-conception to adolescents aged 18 years old. As the needs of a child and his family extend beyond healthcare, we have brought together various agencies, including those from the education and social domains, to jointly address cross-cutting issues that require close collaboration across agencies.  
 
5.     We recognise that there could be many aspects of child and maternal health and well-being that we could focus on. We are therefore prioritising key areas with clear measurable health, social and education outcomes for our young that would benefit multiple generations. 

6.     Let me elaborate. I would broadly group the Taskforce’s efforts into three key thrusts:

a.  First, we are focusing on translating evidence-based findings into policies and programmes to address risk factors, and going further upstream on preventive health efforts for women and children. This is where platforms like today’s could be leveraged to support the efforts.

b.  A few months ago, we had a very fruitful session, learning from Prof Chong and his team on the GUSTO findings. We explored how some of these evidence-based findings could be translated into programmes to address the specific needs of the child at different life stages and developmental milestones. One of the topics we discussed was on screen time for young children and how early screen and TV viewing could impact the cognitive development of a child. This is also the focus of today’s webinar series and I look forward to further discussions later.  

c.  Second, we are reviewing our service delivery for children and their families.  We want to better integrate our services across the domains to deliver holistic and seamless care to children and their families. By wrapping services around the mother-child dyad, we hope to  make it easier for families to access services. This would also help us to provide better support for mothers who may otherwise neglect their own healthcare needs. 

d. In the last few months, I had the privilege of joining colleagues from the health, social and education domains in several conversations with our frontline officers to understand their key challenges in service delivery and to jointly identify opportunities, where we could further strengthen collaboration across the health-social-education domains. These had been insightful sessions where issues and suggestions raised helped us to crystalise our thinking further as we work towards extending more integrated and holistic support to the mother and child. 

e. Third, we are reviewing our approaches to engage stakeholders and the public and to hear what matters most to them. A big part of this effort that I am leading involves public education to raise awareness and communicate our key messages to parents, grandparents, educators, caregivers and the general public, to shape positive behaviours. We will continue to engage these stakeholders to understand their concerns, common pain points and aspirations in order to ensure that our messages and support to them are relevant.

Launch of CHILD and its significance to support the Strategy

7.      To achieve the desired health outcomes at the individual and population level, it is important for the recommendations of the Taskforce and the Strategy to be grounded on sound scientific basis.  While we have identified research as one of the key enablers for the Child and Maternal Health and Well-being Strategy, I would like to highlight that the translation of these scientific research and evidence-based findings into policies and programme interventions would be the key to making a real difference to individuals..
 
8.      I am heartened to know that CHILD would focus on doing this, and its launch today signifies the start of more conversations to consider how research could better inform policies and programmes to benefit more children and their families. Let me offer three suggestions where I think research could help to sharpen our efforts.

9.      Firstly, we need a good basis for policy making and programme intervention. Evidence-based findings from robust research and analysis could better inform our policies and help refine our recommendations and interventions to make them relevant and effective. For example, through distilling evidence-based findings, we could design better screening tools to accurately and reliably detect and identify at-risk children so that targeted interventions or relevant services could be provided to meet their needs holistically.

10.      Secondly, we need to better communicate scientific research findings into clear, salient messages easily understood by  key stakeholders, like parents and educators who are non-researchers. For example, parents need to understand the key implications of screen-time on their child’s cognitive development and the evidence-based guidance that they could take reference from. We need to make sure that such messages and guidance which originate from rigorous research are simple and comprehensible.     

11.      Thirdly, it is important to keep our translation of research and knowledge current; we need to communicate such messages faster to key stakeholders to address any information lag. This would enable interventions to start as early as possible to benefit children and their families. 

12.      Take screen time as an example. Like myself, some of us sitting here could be parents of young children, and we may have some questions about the negative impact of screen time on young children. The GUSTO study had found that exposure to passive viewing screen time below the age of 18 months is associated with poor cognitive and language outcomes. The duration of infant television viewing at one year of age was also negatively associated with subsequent cognitive and language skills at four and a half years of age. This remains significant even after accounting for perinatal, child and family circumstances. In addition, screen time between one and one and a half years has been associated with a variety of social skills deficits commonly found in children on the autism spectrum. Such a vital piece of evidence would certainly influence and guide how we provide care for our children. 

13.      The setting up of CHILD is a timely and significant boost to enable the process of translating evidence-based findings into policies and programmes in early childhood development. With its intent to engage and bring together key local stakeholders from both the public and private sector who are interested in the emotional, cognitive, and social well-being of children from conception to primary school years, we welcome the further conversations that CHILD could generate and contribute towards a healthier next generation. 

Closing

14.      In closing, I would like to congratulate NUS Yong Loo Lin School of Medicine, Professor Chong Yap Seng and the team at CHILD on its launch. Thank you and have a fruitful webinar.