International Perspectives CommunityBased Strategies to Deliver ECD Around

International Perspectives: Community-Based Strategies to Deliver ECD Around the World Session: Hot Issues in Early Childhood Development: Perspectives from the US and Internationally Erika Dunkelberg World Bank Children’s Defense Fund Emerging Leaders® Spring Institute April 16 th 2007

Topics 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 Models ü Infrastructure ü Trained teachers ü Government or privately driven

Community-based Strategies: Home and center-based care and education ü Minimum infrastructure – draw on local resources ü Trained mothers ü Flexible designs – comprehensive services nutrition, childcare, early stimulation, parenting

Community-based Strategies: Parent education and home visiting Individual sessions Group sessions

Community-based Strategies: Homemade toys Made books Dolls Boat Pull-along toy Wooden blocks Balls Source: Bangladesh parenting program Stacking bottles and nesting toys

Community-based Strategies: Participatory process ü A response by communities to unmet needs ü Community involvement and ownership ü An effective mechanism to scale up ECD

Community-based Strategies Being Implemented Worldwide ECA: Kosovo, Macedonia, Albania, Turkey, Bulgaria, … East/ South Asia: India, Philippines, Indonesia, China, Nepal, Bangladesh, Vietnam MENA: Yemen LAC: Cuba Peru, Bolivia, Colombia, Chile, Ecuador, Panama, Nicaragua, Chile, Brazil, Ecuador, Guatemala, Jamaica, Honduras Uganda Africa: Kenya, , Eritrea, Guinea Bissau, Senegal, Malawi, Ghana, …

Cuba: “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: “Educate your Child” Program Lessons learned: § Political will and support § Defined curriculum § Direct services to children § Sustained and continuous training and supervision

Bolivia: Integrated Child Development Project § Home-based daycare, nutritional and educational services § Poor children ages 6 m to 6 yrs in urban areas § Local women trained § Loans/grants ($500) to upgrade facilities Source: UNICEF Bolivia

Bolivia: 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: 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)

Colombia: Community Welfare Homes § 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: 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: Nutrition and Early Child Development 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: Nutrition and Early Child Development Project Impact evaluation results: § Changes in caregivers behavior § 3 yr olds significant improvement in number concepts § <1 yr olds significant impact on nutrition status Source: Cabanero-Versoza, Cecilia. Counting on Communication. The Uganda Nutrition and Early Child Development Project. World Bank 2006

Philippines: Early Child Development Project § Integrated multi-sectoral approach to delivering a combination of services § New service provider: the Child Development Worker § Local and national commitment http: //www. dswd. gov. ph/ecd/pages/services/index. html

Philippines: Early Child Development Project Child age at initiation Impact evaluation results: § Increased utilization of services § Program impact of 1. 6 percent on cognitive and language tests Source: Armercin, G, Berhman, J et al 2006 ECD through an Integrated Program: Evidence from the

Indonesia: Early Childhood Education and Development Project § Targets 700, 000 poorest children in 50 districts § Community-driven § Flexible services § Financed by communities, local and central government

Indonesia: Early Childhood Education and Development Project Challenges ahead: § Clear guidelines for communities § Sustained training and support to providers from local governments § Monitoring and evaluation

Community-based Strategies: Lessons 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: Enabling 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: Challenges Design elements: § Care providers clamoring professionalization of their role § Ensuring quality standards of programs Institutional setup: § Multi-sectoral § Financing

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 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 outcomes Child Development Index (measure of child development outcome) § Developing international indicator on child development outcomes § Including child outcome questions in existing surveys (DHS/ LSMS)

2. Monitoring child development outcomes § Building monitoring systems § Collecting populationbased child outcome data

3. Learning from previous experiences Type of intervention Significant results (of total evaluations) Effect sizes Mainly centrebased 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 Need to do more on evaluating impact of programs in developing world Source: adapted from Lancet series on child development