Every child has the potential to contribute to a vibrant and prosperous Bulgaria. TSA aims to unlock this potential by working upstream to prepare children for a fulfilling, resilient future. We know that a child’s first 1000 days provide the foundation for cognitive, emotional, social, and physical development. Yet in Bulgaria, too many children from overlooked communities grow up without access to nurturing care, nutritious food, or healthcare. Poverty and systemic inequities deepen these disadvantages, leaving children vulnerable and perpetuating cycles of exclusion.
Bulgaria still lacks evidence-based early childhood policies. Success is often measured by numbers served, not quality or sustainability. Teenage pregnancy remains a challenge in isolated communities, and Roma women in particular face steep barriers to education and employment. Meanwhile, workforce shortages in healthcare compound the problem—nurses and midwives account for only 1.1% of Bulgaria’s workforce, the lowest rate in the EU. TSA works to equip Roma women with educational pathways to enter healthcare professions, helping to close this gap and build community resilience.
Our integrated approach links early childhood development, parental support, healthcare workforce strengthening, and community advocacy. At the heart of our work is the Nurse Family Partnership (NFP) program—Bulgaria is the first country in Eastern Europe licensed to implement it. Specially trained nurses and midwives provide individualized support to young, first-time mothers from pregnancy until the child turns two. Already serving hundreds of families in Sofia and Plovdiv, the program has improved maternal health, child development outcomes, and family stability.
Building on the NFP’s success, TSA empowers mothers and strengthens the workforce by providing scholarships to Roma women who are eager to re-enter the workforce after starting families. The program provides financial aid, mentoring, and professional guidance to help participants earn nursing or midwifery degrees.
TSA also supports parents through the Early Learning Spaces initiative, which creates stimulating environments for young children while engaging parents in their children’s development. Community engagement is woven into every step: local action groups of parents, civil society, and local stakeholders identify challenges and co-create solutions.
Partnerships are central to our success. Collaborations with universities in Bulgaria and abroad ensure quality training and reliable evaluations, while international partners such as the International Step by Step Association, Spring Impact, and NFP International provide global best practices and technical support.
TSA also acts as a convener and coalition builder, helping to establish advocacy groups like the We Care Network to amplify community voices and support policy reform. We work with ministries, experts, and civil society to promote access to prenatal care, nutritious food, and other key supports for early childhood development.
Looking ahead, the First Foundations team aims to embed NFP within Bulgaria’s public health infrastructure, secure public funding for its continuation, expand access to early learning spaces, increase Roma participation in healthcare professions, and strengthen local action groups to ensure parents and communities shape sustainable solutions.
