International Perspectives: International Perspectives: Community-Based Community-Based

Strategies to Deliver ECD Strategies to Deliver ECD Around the WorldAround the World

Session: Hot Issues in Early Childhood Development: Session: Hot Issues in Early Childhood Development: Perspectives from the US and InternationallyPerspectives from the US and Internationally

Erika DunkelbergErika DunkelbergWorld BankWorld Bank

Children’s Defense Fund Emerging Leaders® Spring Institute

April 16th 2007

TopicsTopics

Part I. Community-based strategies to deliver ECD

around the world

Part II. Looking into the future – challenges in scaling

up The World Bank ECD agenda

Traditional Preschool ModelsTraditional Preschool Models

Infrastructure

Trained teachers

Government or privately driven

Community-based Strategies:Community-based Strategies:Home and center-based care and educationHome and center-based care and education

Minimum infrastructure – draw on local resources

Trained mothers

Flexible designs – comprehensive services nutrition, childcare, early stimulation, parenting

Individual sessions

Group sessions

Community-based Strategies:Community-based Strategies:Parent education and home visitingParent education and home visiting

Dolls

Balls

Pull-along toy

Stacking bottles and nesting toys

Wooden blocks

Boat

Made books

Community-based Strategies:Community-based Strategies:

Homemade toysHomemade toys

Source: Bangladesh parenting program

Community-based Strategies:Community-based Strategies:Participatory processParticipatory process

A response by communities to unmet needs

Community involvement and ownership

An effective mechanism to scale up ECD

Community-based Strategies Community-based Strategies Being Implemented Being Implemented WorldwideWorldwide

MENA: Yemen

Africa: Kenya, Uganda, Eritrea, Guinea Bissau, Senegal,

Malawi, Ghana, …

LAC: Cuba Peru, Bolivia,

Colombia, Chile, Ecuador, Panama, Nicaragua, Chile,

Brazil, Ecuador, Guatemala, Jamaica, Honduras

ECA: Kosovo, Macedonia, Albania, Turkey, Bulgaria, …

East/ South Asia: India,

Philippines, Indonesia, China, Nepal, Bangladesh, Vietnam

Cuba:Cuba: “Educate your Child” Program “Educate your Child” Program

Targets 70% of under 6 yrs old

Biweekly home visits for 0 to 2 yr olds

Group sessions for 2 to 6 yr olds

Cuba:Cuba: “Educate your Child” Program “Educate your Child” Program

Lessons learned:

Political will and support

Defined curriculum

Direct services to children

Sustained and continuous training and supervision

Bolivia:Bolivia: Integrated Child Development Project Integrated Child Development Project

Home-based daycare, nutritional and educational services

Poor children ages 6m to 6 yrs in urban areas

Local women trained Loans/grants ($500) to

upgrade facilitiesSource: UNICEF Bolivia

Bolivia:Bolivia: Integrated Child Development Project Integrated Child Development Project

Impact evaluation results:

Impacts on gross and fine motor skills, psychosocial skills, and language acquisition

Concentrated among children > ages 37 months +

Effects are most clearly for children exposed to PIDI > 1 yr

Source: Berhman, J.R., Y. Cheng & Todd (2000) The Impact of the Bolivian Integrated PIDI Preschool Program. Philadelphia University of Pennsylvania

Colombia:Colombia: Community Welfare Homes Community Welfare Homes

Home-based child care/nutrition program

Targets extremely poor 1 million <7 yrs

Supported by ICBF and financed ear-marked payroll taxes (3%)

Mothers receive a loan/grant

Source: Londono, Beatriz and Tatiana Romero Rey 2007: Colombia Challenges in Country Level Monitoring. In Proceedings of Symposium of ECD Priority for Sustained Economic Growth (in press)

Poor parents encouraged to form ‘parents committees’ that would elect one ‘madre comunitaria’;

The ‘madre comunitaria’ would have to satisfy certain conditions (for eg. education, large enough house);

Parents would pay a low monthly fee (about $4 per month) per child which is used to pay a small stipend to the mother;

Parents association receives funds to arrange the delivery of food to the hogar comunitario. The food is kept in the madre comunitaria’s refrigerator and is used to feed the children lunch and a snack. In addition offer a nutritional supplement bienestarina

Colombia:Colombia: Community Welfare Homes Community Welfare Homes

Colombia:Colombia: Community Welfare Homes Community Welfare Homes

Lessons learned:

Quality is a concern

Community mothers as agents for social change

Impact evaluation (underway) necessary

Source: Londono, Beatriz and Tatiana Romero Rey 2007: Colombia Challenges in Country Level Monitoring. In Proceedings of Symposium of ECD Priority for Sustained Economic Growth (in press)

Uganda:Uganda: Nutrition and Early Child Nutrition and Early Child Development ProjectDevelopment Project

Targeted 8,000 communities

Demand-driven community-based

Matching grants to support child development activities

Source: Alderman, Harold 2004. The Impact of Nutrition and Early Child Development Project in Uganda. Power point presentation

Uganda:Uganda: Nutrition and Early Child Nutrition and Early Child Development ProjectDevelopment Project

Source: Cabanero-Versoza, Cecilia. Counting on Communication. The Uganda Nutrition and Early Child Development Project. World Bank 2006

Impact evaluation results:

Changes in caregivers behavior

3 yr olds significant improvement in number concepts

<1 yr olds significant impact on nutrition status

Philippines:Philippines: Early Child Development Project Early Child Development Project

http://www.dswd.gov.ph/ecd/pages/services/index.html

Integrated multi-sectoral approach to delivering a combination of services

New service provider: the Child Development Worker

Local and national commitment

Philippines:Philippines: Early Child Development Project Early Child Development Project

-0.5

0

0.5

1

1.5

2

4 to 12 mos 13 to 16 mos 17 to 25 mos

Duration in months

Dev

elop

men

tal I

nde

x (z

-sco

re) 2 yrs

3 yrs

4 yrs

5 yrs

6 yrs

Source: Armercin, G, Berhman, J et al 2006 ECD through an Integrated Program: Evidence from the Philippines

Child age at initiation

Impact evaluation results:

Increased utilization of services

Program impact of 1.6 percent on cognitive and language tests

Indonesia:Indonesia: Early Childhood Education and Early Childhood Education and Development ProjectDevelopment Project

Targets 700,000 poorest children in 50 districts

Community-driven

Flexible services

Financed by communities, local and central government

Indonesia:Indonesia: Early Childhood Education and Early Childhood Education and Development ProjectDevelopment Project

Challenges ahead:

Clear guidelines for communities

Sustained training and support to providers from local governments

Monitoring and evaluation

Community-based Strategies:Community-based Strategies: Lessons LearnedLessons Learned

Quality of services matters:

Sufficient intensity and duration – longer exposure Direct contact with children, beginning early in life Integrated within a comprehensive package of

social and educational services

Targeting matters:

Deliver services to the poorest children

Community-based Strategies:Community-based Strategies:Enabling FactorsEnabling Factors

Successful strategies:

Are culturally relevant and tailored to local needs

Promote community involvement and participation

Provide continuous training and supervision

Are strongly supported by local and national governments to ensure financial sustainability

Are strengthened by inter-sectoral collaboration

Have solid monitoring and evaluation systems

Community-based Strategies: Community-based Strategies: ChallengesChallenges

Design elements:

Care providers clamoring professionalization of their role

Ensuring quality standards of programs

Institutional setup:

Multi-sectoral

Financing

Looking into the Future…Looking into the Future…

1. Scaling up ECD programs with a range of options adapted to local contexts

2. Monitoring effectiveness of programs with outcome measures of child development

3. Learning from previous experiences

1. Scaling up ECD1. Scaling up ECD

Missed opportunity – how to introduce more comprehensive parenting package through conditional cash transfer programs

Evidence from Mexico’s OPORTUNIDADES CCT program on motor development and socio emotional but no cognitive gains

CCT “Health” component underutilized resource

2. Monitoring child development outcomes2. Monitoring child development outcomes

ChildDevelopment

Index

(measureof child

developmentoutcome)

Developing international indicator on child development outcomes

Including child outcome questions in existing surveys (DHS/ LSMS)

2. Monitoring child development outcomes2. Monitoring child development outcomes

Building monitoring systems

Collecting population-based child outcome data

Type of intervention

Significant results (of total

evaluations)Effect sizes

Mainly centre-based

8 of 8 0.23 to 1.40

Mainly parent-child and parenting

5 of 6 0.45 to 0.8

Comprehensive 5 of 6 0.37 to 1.80

3. Learning from previous experiences3. Learning from previous experiences

Need to do more on evaluating impact of programs in developing world

Source: adapted from Lancet series on child development

World Bank Cumulative Lending for ECD

(1990-2006)

Lending in millions US$

# of projects

0

200

400

600

800

1000

1200

1400

1600

1800

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Total Lending in millions USD

0

10

20

30

40

50

60

70

80

90

100

Year of effectiveness

Number of Projects with ECD component

$1.7 billion over 16 years

ECD @ the World BankECD @ the World Bank

ECD @ the World BankECD @ the World BankKnowledge Sharing

Still Need to do Much More…Still Need to do Much More…to Close the Gapto Close the Gap

4.7

9.9

10.8

33.6

70.9

88.8

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

ECA

MENA

LAC

EAP

AFR

SA

Population of disadvantaged children under 5 years old; in millions, 2004

28.9

122.1

840.1

32.8

151.0

504.6

0.0 100.0 200.0 300.0 400.0 500.0 600.0 700.0 800.0 900.0

ECA

MENA

LAC

EAP

AFR

SA

Lending for ECD in millions (1990-2006)

Magnitude of Disadvantaged Children Bank Lending on ECD by Region

Thank you !