Evaluating the Early Childhood Development (ECD) Program in the Philippines

Jere Behrman (U. of Pennsylvania)Paulita Duazo (OPS, U. of San Carlos)

Sharon Ghuman (U. of Michigan)Socorro Gultiano (OPS, U. of San Carlos)

Elizabeth King (World Bank)The ECD Study Team (Office of

Population Studies, University of San Carlos, Cebu)

World Bank April 5, 2005

Background

Health and nutrition at young ages affect important outcomes in childhood and later life

ECD programs increasingly seen as ways to: Reduce malnutrition Reduce infectious disease Provide better pre-school learning environments

Few evaluations of ECD programs in developing countries

World Bank Research Fund Project with Harold Alderman PI on Uganda, Bolivia and the Philippines

Behrman, Jere R., Yingmei Cheng and Petra Todd, 2004, “Evaluating Preschool Programs when Length of Exposure to the Program Varies: A Nonparametric Approach,” Review of Economics and Statistics 86:1, 108-132.

2002 ECCD Act: Objectives

To institutionalize a national program and a system for service delivery for children 0-6

To provide capability building for parents and caregivers

To raise public awareness about the importance of early child care and development

To mobilize resources and establish viable financing mechanisms for ECCD

To ensure survival and promote the total development of children, particularly those who are most vulnerable and disadvantaged (formalized in R.A. 8980/2002)

Reduce by 30% under-5 mortality Decrease by 40% proportion of underweight

children Reduce by 30% proportion of children under 6

with anemia Increase to 90% children aged 12-18 months

fully immunized Improve psychosocial & cognitive

development of children Increase to 75% children ages 3-5 attending

daycare centers Increase to 90% primary school completion

rate for Grade 1 entrants

Quantitative ECD Goals

Millennium Development GoalsEast Asia and Pacific CountriesBy 2015, reduce 1990 child mortality by two-thirds

Under 5 Mortality Rate (per 1,000)

010203040506070

1990 1995 2001 2015

East Asia Philippines

Infant Mortality Rate (per 1,000 live births)

010

2030

4050

6070

1990 1995 2001 2015

East Asia Philippines

Millennium Development GoalsBy 2015, halve 1990 child malnutrition ratesand 90% of children immunized for measles

Measles Immunization(% of children 12- 18 months)

60

70

80

90

100

1990 1995 2001 2015

East Asia P hilippines

Child Malnutrition(% of children under 5)

0

10

20

30

40

1990 1995 2001 2015

East Asia P hilippines

Millennium Development GoalsBy 2015, Net Primary Enrollment = 100%

Net Primary Enrollment Ratio

50

60

70

80

90

100

1990 1995 2001 2015

%

East Asia/Pacific Philippines

The Filipino ECD Program

Goal: improve the psycho-social development and nutrition of young children Began with pilot projects in 1999 Three regions Covers 10 provinces, 2.5 million households

ECD Program Mechanisms

Support to all provinces for select MCH programs:

Immunization Management of Child Illness Micronutrient Malnutrition Control Parent Effectiveness Seminars

Grants to pre-selected municipalities to invest in service-provider packages

Implementation Support

Service Provider Specific Components

Key Providers: Midwife Day Care Worker Child Development Worker Day Care Mother

Services Supported: Food and micronutrient supplementation Growth monitoring Child development monitoring and activities Educating parents Primary health care

ECD Evaluation Study

Aim: To evaluate Filipino ECD program through collection of longitudinal data in program and non-program regions

Baseline: representative sample of newborns and children below age 5 (N = 7,925) Two rounds of follow up data Evaluation analysis based on children who

remained in same sample barangay (N = 6,693)

Figure 1. ECD Study Regions

Region 6Region 7

Region 8

Program Areas: Regions 6 and 7 Control Area:Region 8

The Evaluation Study SampleThe Evaluation Study Sample

Region 6: 24 municipalities

96 barangays

Region 7: 14 municipalities

96 barangays

Region 8: 57 municipalities

96 barangays

Schedule of Data CollectionSchedule of Data CollectionSchedule of Data CollectionSchedule of Data Collection

ROUND 1: April 2001 - November 2001 (8 months)Region 6 Jun 2001 - Oct 2001Region 7 Apr 2001 - Oct 2001Region 8 Aug 2001 - Nov 2001

ROUND 2: September 2002 - March 2003 (7 months)Region 6 Sep 2002 - Mar 2003Region 7 Sep 2002 - Mar 2003Region 8 Sep 2002 - Feb 2003

ROUND 3: September 2003 - January 2004 (5 months)

Region 6 Sep 2003 - Jan 2004Region 7 Sep 2003 - Jan 2004Region 8 Sep 2003 - Dec 2003

Response Rates: HouseholdsResponse Rates: HouseholdsResponse Rates: HouseholdsResponse Rates: Households

NUMBER OF HOUSEHOLDS RESPONSE RATE

ROUND 1 ROUND2 ROUND3 R1-2 R1-3

REG 6 1,456 1,377 1,330 94.6 91.3

REG 7 1,959 1,849 1,817 94.4 92.8

REG 8 1,909 1,699 1,670 89.0 87.5

TOTAL 5,324 4.925 4,817 92.5 90.5

N.B. excludes migrants outside sample barangays (if incl., RP=92.8)

NUMBER OF CHILDREN RESPONSE RATE

ROUND 1 ROUND2 ROUND3 R1-2 R1-3

REG 6 2,115 1,968 1,877 93.0 88.7

REG 7 2,913 2,694 2,639 92.5 90.6

REG 8 2,894 2,543 2,646 87.9 85.2

TOTAL 7,922 7,205 6,982 90.9 88.1

Response Rates: ChildrenResponse Rates: ChildrenResponse Rates: ChildrenResponse Rates: Children

N.B. excludes migrants outside sample barangays (if incl., RP=92.1)

Evaluation Methodology

Relation of Interest:

∆Yp-∆Ynp = a(∆Pp-∆Pnp) + b(∆Xp-∆Xnp) + c(∆Zp-∆Znp) + (∆ep-∆enp)

where ∆Y = Y3 – Y1, etc.Y = ECD outcomesP = receive ECD programNP = not receive ECD programX = child, family, community variablesZ = unobserved variablese = error term

Participation in child feeding programs

Percentage of children 0-4 years who participated in feeding programs

2001 2003 Difference

Program regions 8.5 17.4 8.9

Control region 8.1 4.9 -3.2

Diff in Diff Impact a significance at p<.05

12.1a

Time

After intervention

Before intervention

For example, participation in infant feeding program

Legend:

Region 8

Regions 6 & 7

Counterfactual

Estimated diff-in-diff impact is 12.18.5

8.1

17.4

4.9

BUT NOT EXPERIMENT WITH RANDOM ASSIGMENT SO DIFFERENCES IN TREATMENT

VS CONTROLS:PERCENT DISTRIBUTION OF PROGRAM

MUNICIPALITIES BY INCOME CLASS Region and Income Class

Survey Round Round 1 Round 2 Round 3 Region 6 First class 17.4 13.0 13.0 Second or Third class 21.7 34.8 30.4 Fourth to Sixth class 60.9 52.2 56.5

Total 100.0 100.0 100.0 N 23 23 23

Region 7 First class - - - Second or Third class 25.0 58.3 53.8 Fourth to Sixth class 75.0 41.7 46.2

Total 100.0 100.0 100.0 N 8 12 13

Both regions First class 12.9 8.6 8.3 Second or Third class 22.6 42.9 38.9 Fourth to Sixth class 64.5 48.6 52.8

Total 100.0 100.0 100.0 N 31 35 36

Region 8 First class 5.3 5.3 7.0 Second or Third class 14.0 22.8 19.3 Fourth to Sixth class 80.7 71.9 73.7

Total 100.0 100.0 100.0 N 57 57 57

N.B. All Region 8 municipalities are non-program municipalities.

There were 9 program municipalities in Region 7 during Round 1 (1NR).

25.9

19.5

24.6

14.3

26.4

20.9

25.3

15.7

27.8

21.4

26.5

16.4

0

10

20

30

40

50

Region 6 Region 7 Reg 6&7 Region 8

Round 1 Round 2 Round 3

PERCENT OF HOUSEHOLD HEADS PERCENT OF HOUSEHOLD HEADS WITH COLLEGE EDUCATIONWITH COLLEGE EDUCATION

PERCENT OF HOUSEHOLD HEADS PERCENT OF HOUSEHOLD HEADS WITH COLLEGE EDUCATIONWITH COLLEGE EDUCATION

N.B. Households present in all three rounds

48.3

38.1

42.3

20.1

48.6

37.5

46.4

19.3

47.6

38.2

45.7

19.7

0

10

20

30

40

50

Region 6 Region 7 Reg 6&7 Region 8

Round 1 Round 2 Round 3

PERCENT OF HOUSEHOLDS RESIDING IN PERCENT OF HOUSEHOLDS RESIDING IN URBAN AREASURBAN AREAS

PERCENT OF HOUSEHOLDS RESIDING IN PERCENT OF HOUSEHOLDS RESIDING IN URBAN AREASURBAN AREAS

N.B. Households present in all three rounds

42.9 43.1 42.9

37.1

41.743.5

42

38.7

49.447.1

49

38.1

0

10

20

30

40

50

Region 6 Region 7 Reg 6&7 Region 8

Round 1 Round 2 Round 3

PERCENT OF HOUSEHOLDS WITH HOUSES PERCENT OF HOUSEHOLDS WITH HOUSES MADE OF STRONG MATERIALSMADE OF STRONG MATERIALS

PERCENT OF HOUSEHOLDS WITH HOUSES PERCENT OF HOUSEHOLDS WITH HOUSES MADE OF STRONG MATERIALSMADE OF STRONG MATERIALS

N.B. Households present in all three rounds

31.7

23.2

29.9

19.7

33

23.3

31.1

19.4

36.3

23.4

33.7

18.5

0

10

20

30

40

50

Region 6 Region 7 Reg 6&7 Region 8

Round 1 Round 2 Round 3

PERCENT OF HOUSEHOLDS WITH REFRIGERATORPERCENT OF HOUSEHOLDS WITH REFRIGERATORPERCENT OF HOUSEHOLDS WITH REFRIGERATORPERCENT OF HOUSEHOLDS WITH REFRIGERATOR

N.B. Households present in all three rounds