A global call to action for early childhood

Strong foundations: Early childhood care and education
9
Good programmes can significantly
enhance young children’s well-being in
these formative years and complement
the care received at home.
Adequate health and
nutrition required for learning
More than 10 million children under
age 5 die every year, with over half
of that number dying from five
transmittable diseases that can be
prevented or treated. Worldwide,
about 86 of every 1,000 children born
in recent years will not reach age 5.
Infant mortality rates are highest in
Sub-Saharan Africa and South and West
Asia (over 100 per 1,000 live births).
Poor nutrition has a negative
impact on school participation and
achievement. Stunted children (those
short for their age) are less likely to
enrol in school and more likely to
enrol later and to drop out. A severe
or chronic lack of essential nutrients
in childhood impairs language, motor,
and socioemotional development.
Extending the provision of safe
drinking water and proper sanitation
globally would reduce infant and
child mortality dramatically. Access
to treatment for HIV/AIDS is crucial
for the survival and development
of young children. The limited
coverage of organised early childhood
programmes in Sub-Saharan Africa
makes it all the more difficult to
detect and treat health problems
linked to poor nutrition. In Latin
America and the Caribbean, early
childhood programmes have reduced
the prevalence of malnutrition and
stunting and contributed to children’s
well-being and school readiness.
Measures designed to reduce mortality
and morbidity are a first step towards
establishing comprehensive care and
education programmes for young
children. Four types of intervention
have been found to have a large
impact on cognitive outcomes
in malnourished children: iron
supplements, extra food, deworming,
and psychosocial stimulation. A more
holistic view of child development
is gaining ground, informed by the
links between health and nutrition,
on the one hand, and education
on the other. In East Delhi, India, a
programme providing deworming and
iron supplements resulted in higher
preschool attendance. Interventions
combining nutrition and education
are more likely to succeed than those
focusing on nutrition alone. Studies in
Guatemala and Vietnam found that
nutrition packages had a longer-lasting
impact when children also received
sufficient cognitive stimulation.
Education should be considered an
integral dimension of programmes
designed to address young children’s
health and nutrition problems.
Improving access to and
progress in primary school
ECCE programmes enhance children’s
physical well-being, cognitive and
language skills, and social and
emotional development. The impact
of such programmes on participation
in primary education and beyond
is well documented. Preschool
experience in the United Kingdom,
for example, was shown to result in
improved intellectual development,
independence, concentration, and
sociability during the first three years
of primary school.
Studies of programmes in several
developing countries point to links
between participation in early
childhood programmes, primary school
enrolment, and better results over at
least three to four years, particularly
for disadvantaged children. In a poor
district of Nepal, 95% of children
who attended an early childhood
programme went on to primary school,
as opposed to 75% who did not.
Participants had significantly higher
marks on exams at the end of grade 1.
The Turkish Early Enrichment Project,
which provided preschool experience
to children and support to mothers in
low-income areas of Istanbul, resulted
in 86% of the children still being in
school after seven years, compared to
67% for non-participants. Controlling
for GDP, the higher an African
country’s pre-primary enrolment
ratio, the higher its primary school
completion rate and the lower its
primary repetition rate.
The economic case
Given their positive impact on health,
nutrition, and education outcomes,
early childhood programmes represent
a good investment in human capital.
Although research is limited, especially
in developing countries, returns to
investing in ECCE programmes are
positive, and indeed generally higher
than those to investing in other
education interventions. Returns to
ECCE investments are reaped over a
longer period than those targeting
older children, youth, or adults.
Furthermore, the skills acquired in
ECCE programmes are a foundation
for all further learning.
The most widely cited evidence on
early childhood programmes comes
from the longitudinal High/Scope
Perry Preschool Program in the United
States. Between 1962 and 1967, the
programme targeted low-income
African-American children assessed
to be at high risk of school failure.
Participants and a control group were
tracked annually from ages 3 to 11
and again several times until age 40.
Participation led to increased IQ at age
5, higher rates of graduation from high
school, and higher earnings at age 40.
Detailed cost-benefit analysis suggests
that the programme yielded a 17:1
benefit/cost ratio.
Evidence from developing countries
is slowly accumulating. A preschool
health programme in Delhi increased
average school participation by 7.7
COORDINATORS’ NOTEBOOK: ISSUE 29