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EARLY CHILDHOOD DEVELOPMENT:BUILDING EVIDENCE IN LOW-INCOME SETTINGS

Examples from Mozambique and Cambodia

Sophie Naudeau (HDNCY), Sebastian Martinez (HDNCE) & Deon Filmer (DECRG)

APEIE Workshop Ghana, May 11th, 2010

Overview1) Context for these

studies

2) ECD interventions in Mozambique and Cambodia

3) Impact evaluation designs

4) How are children doing at baseline?

5) Summary and policy implications

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1. ECD is a Critical First Step in HD

Strong evidence on the importance and cost-effectiveness of investing in children’s development early in life (see Heckman, etc.): Improved school readiness, success, and

completion Improved health / reduced risky behavior and

crime Higher productivity and income

Delays in early childhood are difficult to reverse later in life Stunting at age 2 predicts children’s growth

trajectories A large proportion of the brain is wired by age 5

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But How to Invest More and Better?

There is scarce evidence on how to best invest in ECD in the context of limited resources, especially in developing countries Only19 rigorous (i.e. valid counterfactual)

evaluations of ECD in developing countries over the past 20 years (Lancet 2007).

Of these, very few randomized studies, and many with samples < 500

Key knowledge gap: What types of ECD programs are most cost-effective in low-income settings?

These questions need to be addressed for effective policy dialogue and to boost sustainable investments in ECD

The WB is helping to fill the knowledge gap with rigorous, large scale IEs of ECD

These IEs of ECD in Mozambique and Cambodia are part of a broader ECD Impact Evaluation agenda at the World Bank/and with various partners (Governments, NGOs, Academics).

4 World Bank IEs were selected to be financed through Dfid/SIEF support: Mozambique: IE of the Save “escolinha” program Cambodia: IE of 3 types of ECD interventions (i.e., formal

preschools, community preschools, home-based programs) Nicaragua: IE of “Atencion a crisis” ECD & CCT programs Chile: IE of the “Nadie es Perfecto” program to improve

parenting skills Several other IEs of ECD are ongoing with other

sources of support

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2. ECD interventions in Mozambique and Cambodia

Mozambique: The Save the Children “escolinha” program (community-based preschool) in Mozambique has 3 key features:

Enriched learning environments Low and sustainable costs (US$ 50/ child/year) Intensive support through community agents

Cambodia: The Government is experimenting with 3 models through an FTI-CF:

Formal preschools (attached to primary schools) Community-based preschools Home based (parenting information) programs

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3. Impact Evaluation Designs

In both Mozambique and Cambodia: Randomized treatment/control studies with large samples

2000 households in 76 communities in Mozambique 5600 households in 139 communities in Cambodia

Rich socio-economic data, cognitive/language/social-emotional and physical development measures of young children

More on this tomorrow!

3. (…) Research Questions Do the interventions help children develop to their full

potential? Cognitive development Language and vocabulary development Social, emotional, and physical development

Do the interventions change parenting practices / time spent with children in educational activities?

Do the interventions improve health/nutrition practices and outcomes (i.e., nutrition, stunting, morbidity)

Do the intervention improve school readiness upon Grade 1 entry?

Are there any spill-over effects on younger sibblings? What is the Cost-Effectiveness of the various ECD

models?

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3 (…) Timeline and Preview of Findings

Timeline of impact evaluation for both countries:

Baseline data were collected in 2008 (prior to ECD interventions) – and show us the magnitude of the problem

Follow up (i.e., impact) data to be collected in 2010 Impact results expected in 2010 / 2011 In between: Ongoing monitoring evaluations and

costing analysis

Preview of main findings at baseline: In the absence of ECD intervention, poor children significantly lag behind in terms of physical, linguistic, and cognitive development, well before they enter primary school.

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4. Snapshot of Baseline Findings: Physical Development

42% of children are stunted in Mozambique (see below):

Similarly, 48% of children are stunted in Cambodia.

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4. (…) Linguistic development: Dramatic deterioration between ages 3 and 5

While 3-year-olds Mozambican children score slightly below the standardized mean, 5-year-olds score (on average) below the 5th percentile:

Mozambique:

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4. (…) This trend is consistent across low-income settings: In Ecuador…

Average ChanganaAverage Portuguese

Ecuador data are from Paxson & Schady (2005)

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4. (…) and in Cambodia Same trend as in Mozambique and Ecuador (lowest quartile), with some

emerging differences by wealth

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4. (…) Cognitive development: Similar deterioration occurs

WJ (short term memory) in Cambodia:Scores are also very low - 5-year-old children score (on average) below the 20th percentile of the normative distribution

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5. Summary and Policy Implications

1. ECD is important but our knowledge base (re: type of interventions) is limited

2. The WB is currently leading a cutting-edge research agenda in this area through IEs in multiple countries ( # expanding thanks to new DFID financing) – in partnership with Governments, NGOs, and academics

3. Baseline results show that poor children fall through the cracks early in life (particularly in the areas of physical, linguistic, and cognitive development)

Policy implications include: Making the case for increased public investments in ECD

(e.g., in Mozambique) Providing clients with the latest (and most rigorous) evidence

on the types of ECD models that are most cost-effective and scalable (e.g., in Cambodia)

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Thank You

For further information:Snaudeau@worldbank.org