Reaching children with quality ECD services in impoverished rural and informal urban settlements: The Sobambisana Evaluation Linda Biersteker, Andy Dawes & Lynn Hendricks Presentation at the National ECD Conference East London 27 – 30 March 2012

Introducing Ilifa Labantwana Ilifa Labantwana is a national Early Childhood Development (ECD) Programme. It is a collaborative initiative of three donor agencies; the ELMA Foundation, the UBS Optimus Foundation and the DG Murray Trust. The Ilifa programme supports ECD innovation in South Africa. It seeks specifically to enhance and increase the delivery of integrated, quality ECD services and programmes to marginalised and poverty- affected children living in rural or isolated communities.

Core strategic thrusts 1.Design and test a scalable, integrated ECD Package in South Africa 2.Generate evidence for scalable, affordable models (which is where the Sobambisana research fits into the big Ilifa picture) 3.Strengthen the capacity of the ECD NGO sector 4.Advocate for expanded access to public funding for ECD 5.Increase the capacity of the state to implement and support ECD services and programmes 6.Increase public demand for ECD services and programmes of quality and advance ECD provision and access

Purpose of the Sobambisana ECD Project To present and further refine new and creative models of ECD provision that: Dramatically increase access to developmental opportunities for children under the age of 6 years; (REACH) Are of a high standard and address the very real issue of quality of implementation; (QUALITY) Ensure the seamless transition between school and the ECD site; (TRANSITION) Define the relationship between participating NGOs and the State (INTER-SECTORAL)

CECD TREE ELRU Limpopo Ntataise Khululeka Location of Five Participating ECD NPOs

7 PROGRAMME BENEFICIARIES PROGRAMME INPUTS Sensori -motor Social Emotional Cognition Child Outcomes at School SOBAMBISANA PROGRAMME INPUTS AND DESIRED OUTCOMES FOR CHILDREN AT SCHOOL Language PLAYGROUPS HOME VISITING TRAINING EDUCATION HOME VISITING ADVOCACY CAREGIVERS CHILDREN PRACTIONERS & SCHOOLS

Key Outcome Evaluation Questions 1.Does home visiting (HV) change: carer early stimulation behaviour, home hygiene and safety; service access? 2.Does HV change child cognitive and language outcomes? 3.Do community playgroups improve cognitive and language outcomes? 4.Is there a difference in development outcomes between Sobambisana children and those with no ECD in Grade R? 5.What effects do programme attendance, child growth and age have on child outcomes? 6.What are the effects of initiatives to enrich low capacity preschools on the quality of the learning environment?

Project Phases: – Start-up Develop Eval. Designs & M&E systems, select measures Cohorts 1 and 2 Baseline and follow up Child Outcome Measures WHO measures of underweight and stunting Grover Counter Scale McAffee Vocabulary Test Service Access Caregiver Outcome Measures Bradley HOME Hygiene and Safety Checklist Brief Cope Cohort 2 Follow-up Grade R Child Impact Measures WHO measures of underweight and stunting Grover Counter Scale Peabody Picture Vocabulary Test Herbst – Counting Number Concepts SACAS: Resilience Academic readiness

Example of Outcome Evaluation Design: Effects of an early stimulation intervention through Home- Visiting on Language, & Cognition Time 1 Time 2 Home visiting (holistic service access, parenting skills & and early stimulation) Wait-list Comparison Group Baseline Follow- up

Home Visiting Interventions Home visiting outcomes Very effective for increasing access to ECD services for poor and vulnerable young children. Caregiver early stimulation Hygiene and Safety Service Access Caregiver coping HV did not significantly change children’s scores on standardised cognitive and language measures.

Community Playgroups Community Playgroups (two different programmes) Very effective for increasing access to ECD services for poor and vulnerable young children. A highly structured weekly playgroup programme with a focus on school readiness activities and run by an experienced practitioner significantly improved children’s scores on a standardised cognitive measures, if they attended 14 or more sessions. Parent attendance was irregular.

Parent Education Programmes Parent education workshops failed to attract regular participation in two sites. In a third site, a parent workshop programme linked to an informal playgroup had the following outcomes Caregiver early stimulation Hygiene and Safety Child cognitive and language scores Cognitive scores improved more the more often children attended. Caregiver attendance at the workshops predicted language scores.

ECD Site Enrichment Findings: Classroom quality – language & reasoning, activities and interaction Partners undertook different interventions – – workshops with site visits to untrained or previously trained – Level 1 and 4 training All showed improvements in classroom quality measured on subscales of the ECERS – R Smaller gains in public Grade R than in community preschools Value of including management/HOD and principals demonstrated

Grade R Findings : Overall Question: At Grade R, are there differences between children who attended ECD and whose teachers were trained and those who had no exposure to ECD prior to Grade R? MeasureFindings No ECDTeacher Training (All) Cognition Language Numeracy (Counting Raw Score) Numeracy (Number Concept Raw Score) Emotional Dev. (Academic Readiness)

16 Sensori -motor Social Emotional Cognition SOBAMBISANA PROGRAMME INPUTS AND OUTCOMES: MODERATORS OF EFFECTS Language CHILDREN CAREGIVERS PRACTITIONER & SCHOOL MODERATORS OF PROGRAMME EFFECTS PROGRAMME FACTORS CARER Socio-cultural Health & Well- Being CHILD Health Growth Status Cognitive Level DOSE INTERVENTION QUALITY ALIGNMENT WITH OUTCOMES AT SCHOOL PRACTITIONER Socio-cultural Motivation School Variables BENEFICIARY

Findings: Malnutrition in all sites % Stunting % Underweight National 2005 (0-4yrs) 23%11% Rammulotsi (N= 54)18.5%13% Queenstown (N=49)24%8.2% Indaka (N=60)17%20% Grabouw (N=34)32%23.5% Lusikisiki (N= 83)37.5%12%

Findings: Cognitive Development All % Children Within Norm for Age at Baseline Average across sites 14% of children are performing as expected for age. Grover counter test using rural norms

Conclusion On these measures: Group learning experiences – ECD centres and playgroup programmes with content well aligned to academic capacities had the best results on cognitive and language measures But we need to be careful of selection effects - which children go to preschools/group programmes? This does not mean that the other interventions did not benefit the children to some extent on these variables, or that they did not benefit children in other ways.

YRS WHAT HAVE WE FOUND OUT? HOW AND WHEN TO INTERVENE HOME-BASED (CHILD & CARER) (HEALTH; NUTRITION; WELFARE; PROTECTION; PSYCHO-SOCIAL SUPPORT TO CAREGIVER) ECD PRACTITIONER & SCHOOL TRAINING AND SUPPORT MONTHS 0 – 36 MONTHS HIGH DOSE PLAYGROUP INPUTS ALLIGNED TO SCHOOL READINESS QUALITY ECD SITES ANTENATAL CLINIC-BASED CAREGIVER AND CHILD SUPPORT GREATEST PROBABILITY OF IMPROVING READINESS FOR SCHOOL