|Early Child Development: Investing in the Future (World Bank, 1996, 112 pages)|
|Part I. The theory|
|The case for early intervention|
By increasing early abilities, preschool programs increase both the prospective earnings potential from a given level of schooling and the net prospective benefits from additional schooling. Several U.S. studies have confirmed preschool programs' efficacy as a means to increase the return to primary and secondary school investments, contribute to human capital formation, raise participants' productivity and income levels, and-by lowering health, welfare, and education costs-reduce public expenditures. Even a few years of early schooling, it appears, can substantially increase the economic value of an individual's skills (Selowsky 1981; Psacharopoulos 1986).
The evidence. A review of seventy-one reports on U.S. Head Start preschool programs found evidence of positive effects on IQ, better developed abilities at the point of entry into school (school readiness), and greater achievement at the end of the early grades (Schweinhart 1992). Seven other long-term studies in the United States confirmed that
Box 2 UNICEF in Peru: the Wawa Wasi home child care program
Quality day care for young children is desperately needed in Peru, where more than half of families earn too little to cover their basic needs and 37 percent of working women are gone from the home ten hours a day. Yet as it now stands, child care services reach only a quarter of Peru's four-year-olds and just three of every 200 children under age three.
In 1993, therefore, the Ministry of Education and UNICEF initiated a plan to design, start, and regulate Wawa Wasi-a national home day care system that would work in conjunction with the National Food Aid Program. The system, coordinated jointly by the government and UNICEF, is designed and operated by government ministries, the National Family Welfare Institute, churches, and a confederation of grass roots organizations.
Located in urban shantytowns, Wawa Wasi sets up a "community educational home" in the house of a local woman who is designated as the community's caregiver and trained in health care, early stimulation, and basic nutrition. For a small fee, working mothers may leave all children under the age of three with the caregiver. Mothers using the Wawa Wasi services also organize into parents associations and are expected to try to involve other family members.
Meals for the children are arranged through communal kitchens, "Glass of Milk" committees, or other food aid programs. The 28.0 communal kitchens now serving roughly ten Wawa Wasi educational homes each, however, were originally set up to prepare food for adults and must be trained to make nutritious meals for children. Each day care home receives basic equipment-mattresses, water cylinders, tables, chairs, and toys-and, if needed, a loan to repair or install lavatories. Nearby schools often collect and recycle materials for toys, mobiles, and other items useful to the young children.
Wawa Wasi has established 5,500 community educational homes and provided roughly 700,000 children under the age of six with integrated care. It has also extended the coverage of nonformal preschool education programs (Pronoeis) by 10 percent. Successfully mobilizing community interest and resources, it has signed agreements to provide for the needs of preschoolers in forty-eight provinces. It has distributed material on maternal survival and child development, produced and donated by Peruvian Education Facts for Life, to an estimated 2 million poor women. And it has coordinated government, private, grassroots, and family efforts in a way that is promising for the program's enduring success.
Source: UNICEF 1995.
Educational child care programs for youngsters living in poverty have the potential to confer important long-term benefits. Parents' involvement in educating their children was also shown to be critical to the lasting success of Head Start (Zigler and Muenchow 1992).
The U.S.-based Abecedarian Study-replicated in Project CARE and in the Infant Health and Development Program-consistently found that the most vulnerable young children were also the most positively affected by high quality early intervention.
The Infant Health and Development Program was an eight-site, randomized, controlled trial of the efficacy of educational techniques developed in the preschool segments of the Abecedarian and CARE experiments. Most of the 985 low-birth-weight infants who participated were born to socially and economically disadvantaged mothers. Under the program, intensive early intervention was shown to prevent developmental delay. When compared with randomized controls, the incidence of mental retardation (that is, of IQs measured at less than 70) was reduced by an average factor of 2.7 (Ramey and others 1990). The stimulation program was started as early as three months of age, while in other programs it was started at about three years of age (Campbell and Ramey 1994).
Similar studies in Asia, the Middle East, and Latin America confirmed that early intervention can increase school readiness, promote timely school enrollment, lower repetition and dropout rates, and improve academic skills. R. G. Myers's (1995) review of nineteen longitudinal evaluations of the effect of early intervention in Latin America found that participating children were far less likely to have to repeat grades in primary school. The following benefits have been firmly linked to integrated interventions in early childhood:
· Improved nutrition and health. By providing psychosocial stimulation, early child development programs can enhance the efficacy of health care and nutrition initiatives. They can also help ensure that children receive health care. Children participating in the Colombia Community Child Care and Nutrition Project and the Bolivia Integrated Child Development projects, for instance, are required to complete their immunizations within six months of entering. Programs can also monitor growth and provide food supplements and micronutrients and can help with such existing public health efforts as mass immunizations.
· Higher intelligence. Children who participated in early child interventions under Jamaica's first Home Visiting Program, Colombia's Cali project, Peru's Programa No Formal de Educación Inicial (Pronoei), and the Turkey Early Enrichment Project scored higher, on average, on intellectual aptitude tests than did nonparticipants.
· Higher school enrollment. The Colombia Promesa program cited significantly higher enrollment rates among program children than among nonparticipants.
Box 3 Who is caring for the children in Eastern Europe?
In post-communist Bulgaria, Hungary, Poland, and Romania social services once provided by the state-such as comprehensive maternity benefits, maternity cash grants, monthly child allowances, liberal parental leave (including paid leave to care for sick children), housing subsidies for families with children, and crèches and kindergartens-are being progressively pared away. State-run enterprises are divesting themselves of the nonprofit making responsibility of providing child care for workers. National governments have shifted responsibility for such services to local authorities, who are poorer and less well equipped to supply them at the same level of quality. Local governments are introducing user fees to help defray expenses. And yet even as state-run child care facilities are being closed or priced out of reach, more mothers of young children are forced to go to work. Because families cannot survive on a single wage, in Bulgaria, for instance, 20 percent of working women hold two jobs. Who, then, is minding the children?
At its best the old system of state-supported child care centers provided appropriate, high-quality care-including mental stimulation activities, health care, and three to five meals a day. Yet even so, many mothers, supported by state grants, chose to stay home with their infants. In the four countries studied, crèche enrollments never exceeded 14 percent of the age group, and enrollment rates were even lower in other communist countries. But kindergartens for children aged three to seven, with a 17 year tradition in Eastern Europe, were widely used.
All of the countries studied (except Romania) have decentralized the responsibility for social services and cut family support services. Only provisions for parental leave have been left intact, or even strengthened, with the idea of promoting home-based child care. And more young women than ever are now out of work, for private businesses seeking to avoid paying maternity benefits either put young women on short-term contracts or do not hire them at all.
· Less repetition. Children who participated in an early childhood program repeated fewer grades and made better progress through school than did nonparticipants in similar circumstances. Children in the Colombia Promesa study, in the Alagoas and Fortaleza study in Northeast Brazil, and in the Argentina study all had, on average, lower rates of repetition.
· Fewer dropouts. Dropout rates were lower for program children in three of four studies. In the India Dalmau program-the only study in which attendance was measured-attendance rose by 16 percent for program children between the ages of six and eight. In the Colombia
Despite young families' desperate need for income, 70 percent of unemployed women in Bulgaria are under the age of thirty (UNICEF 1994). Thus, most of Eastern Europe's youngest children today spend their earliest years at home with their mothers or with extended family. But in many of these homes, incomes, housing, and even food supplies are insufficient and unpredictable.
Over the past decade, the region's birth rate has dropped. Although the percentage of children attending kindergartens has not yet changed dramatically, enrollments are declining. Of the countries studied, all but Poland had more preschool places available than children seeking them. Without state funding, the quality of center-based care is also declining. And as user fees put child care centers out of poor parents' reach, new issues of equity are coming to the fore.
What can be done
· Explore alternative forms of child care. With center-based care's accessibility and quality in question, Eastern Europeans today need to seek ways to strengthen family and community-based child care.
· Invest in materials and classes to educate parents. Parents who grew up under a state-centered approach need to learn the techniques and practices best suited to home-based care.
· Support nongovernmental organizations. NGOs, emerging as important actors in the social service sector, need financial support and training to devise and implement new family service models.
· Monitor the effects of government policy. Monitoring systems and studies are needed to determine the impact of economic and social policy changes and to plan the most effective response.
· Focus policymakers' attention on early child development. Policymakers need to seek ways to keep early childhood interventions-which benefit the whole society-widely accessible and to keep standards uniform and high.
Source: Evans 1995.
Promesa project, third-grade enrollment rates rose by 100 percent, reflecting lower dropout and repetition rates. Moreover, 60 percent of program children reached the fourth grade, compared with only 30 percent of the comparison group.
Help for the disadvantaged. There is mounting evidence that interventions in early childhood particularly benefit the poor and disadvantaged. In India's Haryana project, for instance, dropout rates did not change significantly for children from the higher caste but fell a dramatic 46 percent for the lower caste and an astonishing 80 percent for the middle caste (Chaturvedi and others 1987). The Jamaica study gives unequivocal proof that nutritional supplementation for undernourished children-who are most likely to come from disadvantaged families-improves mental development (Grantham-McGregor and others 1991). A program in Argentina was especially successful in lowering the enrollment ages of rural and low-income groups, while in Indian and Guatemalan programs, enrollment ages only declined significantly for another traditionally disadvantaged group-girls (Myers 1995).
Girls derive considerable benefit from early childhood interventions, for the barrier of gender inequality frequently affects them even before they enter school. In many African countries fewer than half as many girls as boys are enrolled in primary school. Studies from diverse cultures show that girls who participate in early child interventions are better prepared for and more likely to attend school. And where girls' success in school changes parents' expectations, many are allowed to continue their education.
Achieving gender equity in education is now known to be economically as well as ethically desirable. Educated women have fewer children and take better care of them. Mother's level of schooling is a better predictor of a child's cognitive growth, health, and reproductive outcomes than are family income, breadwinner's occupation, or other household variables.
Early interventions targeting girls reduce maternal fertility and infant and child mortality rates. Expanding girls' school enrollment therefore offers developing countries a cost-effective way to improve life expectancy and health and control fertility (Levine and others 1994).
Investment in education associated with early stimulation and sensorymotor readiness yields a far higher rate of return than does equal investment in secondary or higher education (Psacharopoulos 1986). In the High/Scope Perry Preschool Program initiated in 1962, for instance, an investment of US$1.00 was estimated to yield US$7.16 in savings from lower education and welfare expenditures combined with gains in productivity (Schweinhart, Barnes, and Weikart 1993). Such a cost benefit ratio may be overestimated if applied to developing countries, however, because it includes benefit outcomes (such as lower welfare expenditures) that developing countries simply do not have.