1. 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

2. 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

3. Traditional Preschool Models Infrastructure Trained teachers Government or privately driven

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

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

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

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

8. Community-based Strategies Being Implemented Worldwide 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

9. 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

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

11. Bolivia: 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 facilities Source: UNICEF Bolivia

12. 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

13. 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)

14.  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

15. 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)

16. 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

17. Uganda: Nutrition and Early Child Development 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

18. Philippines: 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

19. Philippines: Early Child Development Project 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

20. 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

21. 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

22. 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

23. 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

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

25. 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

26. 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

27. 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)

28. 2. Monitoring child development outcomes  Building monitoring systems  Collecting population- based child outcome data

29. Type of intervention Significant results (of total evaluations) Effect sizes Mainly centre- based 8 of 80.23 to 1.40 Mainly parent-child and parenting 5 of 60.45 to 0.8 Comprehensive5 of 60.37 to 1.80 3. Learning from previous experiences Need to do more on evaluating impact of programs in developing world Source: adapted from Lancet series on child development

30. World Bank Cumulative Lending for ECD (1990-2006) $1.7 billion over 16 years ECD @ the World Bank

31. ECD @ the World Bank ECD @ the World Bank Knowledge Sharing

32. Still Need to do Much More… to Close the Gap Magnitude of Disadvantaged ChildrenBank Lending on ECD by Region

33. Thank you !