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 !
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