Early growth services in Tomislavgrad: “Anđela is about to begin to walk, and if it weren't for the therapies, none of this would have been possible…”

Little Anđela  is 20 months old and she and her mother Rosa regularly visit the physical therapist Antonija Jukić at the Tomislavgrad Health Care Centre for therapies. Anđela's mom tell us that Anđela was born at seven and a half months and has difficulties with walking, but she hopes that with the help of Antonija's therapies, which are part of the services offered by the Early Growth and Development Center at the Tomislavgrad Health Care Center, Anđela will overcome this problem.

"After each new therapy, we see progress. She moves much better, wants to get up on her feet, holds on to furniture and, compared to how it was before, she's doing great now and we hope that Anđelka will soon muster the courage to start walking on her own; I think we're almost there. If it weren't for this therapy, none of this would have been possible”, mom Rosa tells us while Antonija is encouraging Anđelka to move giving her a ball as she loughs stretching out her hands to grab the ball…

“What we want to achieve with this therapy is to avoid “forcing” anything. We want to win the baby’s maximum cooperation through games, stories and singing. Anđelina had been here before, then she was sick for a while and stayed home and now she is at the stage of adaptation again. She will now start getting up on her feet, ordering the toys, we'll follow how she moves and see what needs to be done next”, the physical therapist Antonija explains adding that everyone in the Center is always at parents' disposal, and there is no waiting with any therapy - not when it comes to school children, and especially not with babies.

“From the first visit until now, the progress has been 200 percent. We come here regularly, he gets adequate treatment here and the progress is visible”, father Robert tells us   

“When making any assessment, it is particularly important to listen to what moms say – what moms observe is very important for me. Moms will tell you whether anything happened at home, if we see that a child has a problem, we refer them back to a specialist for checkups and then the doctor and I, including a pediatrician, if required – see whether it is necessary to include our colleague Renata, the speech therapist, and a psychologist, if necessary. Most importantly - everything is done in this institution”, Antonija explains stressing the importance of team work in the process of early detection, which is the Center's priority. She shows us home videos of little Anđela brought by her mother, which are very useful to Antonija:                                            

“Children behave differently at home and it is of great help to get these home videos from moms showing us how children behave at home, get up on their feet holding on to the furniture, how they play…”.

“Our early growth services include a visiting nurse who makes house calls after moms return home from maternity clinics with their babies. We also have a speech therapists, who has a master's degree, and provides services to children aged one and older. She provides diagnostic and intervention services. We also have physical medicine and rehabilitation, and a pediatrician and two nurses in the children's clinic. Since the beginning, we have been cooperating with the Center for education of children and youth with disabilities, ‘Nova nada’, and their defectologist and other professionals come to our premises once a week and work with groups of children, while our teams also go to their premises”, Nada Tavra, the Health Care Center's head nurse, explains to us highlighting the UNICEF's support in the development of early growth and development services, especially the training attended by the staff at the “Edukacija za sve“ (EDUS) Association organized with the support of UNICEF as part of the improvement of early childhood growth and development:

“The training was specific and it improved the knowledge of our professionals working in the field of early growth and development. Many novelties have been introduced and the entire process has been modernized to the general satisfaction of children and parents, but also of our staff”, says Nada Tavra.

Kata Gašpar, professional instructor at the ‘Nova nada’ Center, says that, besides Tomislavgrad, children from Livno,  Kupres, Rama, Posušje, Uskoplje and other towns also come to ‘Nova nada’

While Anđela was practicing her first steps in the office of the physical therapist Antonija, the speech therapist, Renata Vukadin, was working with a five-year old boy who now has fewer difficulties in speech.                                       

“From the first visit until now, the progress has been 200 percent. We come here regularly, he gets adequate treatment here and the progress is visible”, father Robert tells us   

In her office, Renata practices with the boy the pronunciation of names of objects he sees on the pictures and forming sentences based on the pictures. The boy tells us he enjoys his sessions with Renata which he finds entertaining.                                                                                       

“I am responsible for the treatment of linguistic and speech difficulties in children from early age to school age. Children come here once a week because we have a very busy schedule. The ideal situation would be to have them come here several times a week, but I give them exercises that they can do at home with their parents. I currently have treatment sessions with 30 children, who are mainly referred to me by our pediatrician; they rarely come without referral. If I suspect, during the treatment, that a child might have other difficulties as well, I refer them to my colleagues. We have excellent cooperation as a team”, says Renata Vukadin, Master of Science in speech therapy. She also says she attended the training organized by EDUS, which helped her a lot to improve the process and introduce some new methods, which, according to her, give significant results.

 Kata Gašpar, ‘Nova nada': “We are at children's disposal around the clock”

The services provided by the Early Growth and Development Center include the services of the said  ‘Nova nada’ Center, whose acting director is the director of the Tomislavgrad Health Care Center, which, although they do not share the same premises, contributes to their cooperation. He says he works at 'Nova nada' as a volunteer.

“We don't want the Early Growth and Development Center to be just another building, our goal is to make it a network of services where each child will receive the services they need at any moment; an institution which will adequately monitor the children from the earliest age in order to detect any difficulties in time to be able to provide adequate care. The Center's premises, whose refurbishment is almost finished, will serve as a meeting point for all members of the network, a place where children and their parents can visit, a place where all participants in the network will meet and improve their cooperation in joint provision of early growth and development services”, doctor Ivan Bagarić, the Director, explains reminding us that the Tomislavgrad Municipality has signed the Protocol on Cooperation in Improving Early Childhood Development in the Tomislavgrad Municipality, which guarantees the cooperation between municipal authorities, Health Care Center, Social Welfare Center, kindergarten, elementary schools, UNICEF and ‘Nova nada’.

“All children with disabilities can attend regular schools and have teaching assistants - this is something that puts our Canton ahead of many others. Children who still need additional professional services, spend part of their time at school and part of the time at the ‘Nova nada’ Center, Health Care Center or other parts of our network, where they have individual or group sessions. ‘Nova nada’ works with children with serious disabilities, 16 of them, and they are educated there. All other children - around 60 of them, who attend school regularly, also visit the Center occasionally”, doctor Bagarić explains adding that their end goal is to include diagnostics into the Center's services and change the Center's official name into ‘Nova nada’ Center for early diagnostics and education of children and youth with disabilities.


Kata Gašpar, professional instructor at the ‘Nova nada’ Center, says that, besides Tomislavgrad, children from Livno,  Kupres, Rama, Posušje, Uskoplje and other towns also come to ‘Nova nada’. Kata and some other members of the staff also attended the EDUS training and they apply the acquired knowledge in their daily work.  

“Our professional staff includes a defectologist, speech therapist, psychologist, physical therapist and occupational therapist. Children who are not here full time visit us for individual work depending on their needs. Children who are full-time beneficiaries are educated in educational groups. We have already introduced the early growth and development program in the group of children with autism. We have a group of children who come here and also attend regular school and an older group that comes here for occupational training”, says Kata Gašpar adding that young people who attend the occupational training are included in the work outside of the institution.                                      

“Children have organized transportation to the Center and parents' reactions are good; they are satisfied with our work and they say they notice progress in their children. We are at their disposal around the clock”, she says and adds that the ‘Nova nada’ psychologist also works with the kindergarten for observation purposes and if she notices any difficulties at the earliest stage of development, she refers such children to one of the professionals working in the network of the Early Growth and Development Center, where they get adequate and timely services.

Tomislavgrad is one of the municipalities that have signed the Protocol on Cooperation in Improving Early Childhood Development. The signing of the Protocol and the introduction of early childhood growth and development services is part of the project ’Applying the Human Security Concept to Stabilize Communities in Canton 10' funded by UN Trust Fund for Human Security and implemented by UN agencies in BIH (UNICEF, IOM, UNHCR and UNDP).