Nurturing little hearts: Developing the Bloom programme for preschoolers’ socio–emotional well-being

By Mariska Oosthuizen-van Tonder

Our children are the foundation of South Africa’s future. Yet, many preschoolers face daily stressors that threaten their mental health and emotional development. The COVID-19 pandemic deepened these challenges, revealing an urgent need to prioritise young children’s socio–emotional well-being (SEWB) alongside their physical health.

As a mother, healthcare professional, and researcher, I realised how primary healthcare nurses, as the first point of contact for families, play a powerful role in early identification and prevention of socio-emotional challenges in young children. They have such a great opportunity and the potential to make a lasting difference in children's socio-emotional development, yet they mostly focus on physical aspects of health.  This identified gap inspired me to develop the Bloom SEWB programme, a structured, evidence-based promotion programme for preschool children aged three to five years, to develop their socio-emotional competence skills namely initiative, self-regulation and attachments/relationships.

The research journey

Using a convergent parallel mixed-method design, the study unfolded in three phases.

• Phase 1 reviewed 30 years of global and national evidence on SEWB programmes for children as part of an integrative literature review to synthesise the current programmes and identify what works and what does not work.

• Phase 2 explored the perspectives of both parents and primary healthcare nurses. Parents shared their concerns about the emotional and social struggles their children faced after the pandemic, including difficulties with concentration, speech, and social interaction. Parents completed a SEWB behavioural rating scale and answered 5 open-ended questions. Nurses highlighted the need for parent education, early emotional screening, and sustainable support structures during their interviews.

• Phase 3 integrated all findings into a contextually relevant and culturally sensitive programme, refined by a multidisciplinary expert panel of community and mental health nurses, psychologists, educators, and occupational therapists.

Key insights

Findings showed that preschoolers generally display typical socio–emotional skills but need development in attachments and emotional regulation skills. Parents expressed a desire for more guidance in nurturing emotional growth, while nurses emphasised the need for structured, developmental, and holistic approaches.

The Bloom SEWB programme

The resulting Bloom Programme uses the Pyramid Model as its foundation and follows a three-tiered approach:

1. Universal promotion – creating nurturing relationships and supportive environments for all children. All children are empowered through the Bloom's SEWB programme despite their risk factor.

2. Targeted prevention – supporting children at risk of SEWB difficulties.

3. Intensive intervention – providing specialised care and multidisciplinary referrals for those with persistent challenges.

Bloom emphasises play-based learning, parental involvement, and training for healthcare professionals in early socio-emotional support and referral systems.

Why it matters

Proactive, culturally relevant SEWB programmes can reduce long-term risks for mental health disorders in South African children. The Bloom Programme demonstrates how global research can be translated into local, sustainable practice—empowering parents, nurses, and communities to help every child thrive.

Together, we can help our youngest citizens bloom into emotionally strong, resilient, and confident leaders of tomorrow.