Transcript Association between % of people below the poverty line and

Young Children at Risk
Closing the Gap between what
we know and what we do
Mary Eming Young
Early Child Development Team
Human Development Network Children and Youth
The World Bank
This presentation will focus on
• Why early childhood?
– The magnitude of the problem: Young
children under threat
– Global, Science, and Business imperative
• Do we know what to do?
– is it doable?
• Challenges and Opportunities
2
•
Magnitude of Children at Risk
Magnitude of the Problem
% of Children < 5y who are Stunted by Region, 2004
World
27.9
SA
38.7
AFR
37.4
MENA
20.6
EAP
17.3
ECA
15.9
LAC
14.0
0.0
5.0
10.0
15.0
20.0
25.0
In %
30.0
35.0
40.0
45.0
50.0
WHO 2006
WHO 2006
¿Cómo podemos mejorar la nutrición?
La “ventanilla de oportunidad” para mejorar la nutrición es muy
pequeña…desde antes del embarazo hasta los 18-24 meses de edad
0.50
0.00
-0.25
América Latina y el Caribe
África
Asia
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
0.
00
3.
00
6.
00
9.
0
12 0
.0
15 0
.0
18 0
.0
21 0
.0
24 0
.0
27 0
.0
30 0
.0
33 0
.0
36 0
.0
39 0
.0
42 0
.0
45 0
.0
48 0
.0
51 0
.0
54 0
.0
57 0
.0
60 0
.0
0
Puntaje Z de peso para la edad (Centro Nacional de
Estadísticas de Salud de los Estados Unidos)
0.25
Edad (m eses)
Fuente de datos: Shrimpton y otros (2001)
% of Children < 5y who are Poor (<$1 per day)
by Region, 2004
World
22.5
AFR
46.4
SA
27.3
EAP
11.4
LAC
10.4
ECA
3.8
MENA
3.6
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
50.0
In %
WHO 2006
% of Children < 5y who are Disadvantaged
(stunted or poor or both) by Region, 2004
World
39.1
AFR
60.6
SA
52.5
EAP
23.1
MENA
22.4
19.1
LAC
ECA
17.8
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
In %
WHO 2006
Population of Children under 5 years & Disadvantaged
by Regions, 2004
169.3
SA
145.7
EAP
23.1%
MENA
ECA
33.6
117.0
AFR
LAC
88.8
52.5%
60.6%
70.9
56.5
10.8
19.1%
Population of children under 5 years
44.1
9.9
22.4%
Population of disadvantaged children
(stunted or poor or both)
26.4
4.7
17.8%
0.0
20.0
40.0
60.0
80.0
100.0
120.0
140.0
160.0
180.0
In millions, 2004
WHO 2006
% of Disadvantaged Children by Country
Source: S. Grantham-McGregor, Y.B. Cheung, S. Cueto, et.al.: Developmental potential in the first 5
years for children in developing countries, Lancet, 369:60-70, 2007.
•
What Do We Know?
Experience-Based Brain Development in
the early years of life sets neurological
and biological pathways that affect
throughout life:
• Health
• Learning
• Behavior
Conocimientos de la Neurociencia: Las
experiencias en la primaria infancia impactan:
Arquitectura cerebral
Química neuronal
Expresión de genes
Cognición
+
Emoción
+
Comportamiento
social
Todos estos
Elementos son
Pre-requisito para
el Desarrollo Humano,
Social y la Productividad Economica
en la adultez
The Global Imperatives
EFA Goals
1. Expand and improve
comprehensive early childhood
care and education
2. Universal primary education by
2015
3. Learning and life skills programs
for youth and adults
4. 50% increase in adult literacy
rates by 2015
5. Gender parity by 2005 and
gender equality by 2015
6. Improving quality of education
MDGs
1. Eradicate extreme poverty
and hunger
2. Achieve universal primary
education
3. Promote gender equality
and empower women
4. Reduce child mortality, and
other health goals
Rates of Return to Human Development
Investments Across All Ages
8
Return
Per $
Invested
6
Pre-school Programs
School
4
R
Job Training
2
Preschool
0
6
Post-school
School
Age
18
Source: P. Carneiro & J. Heckman, Human Capital Policy, NBER, 2003.
Regional trends in pre-primary
A three-fold increase in pre-primary enrolments over 30 years
More than 1 in 3 children now enrolled but huge regional differences
Gross enrolments ratios
in pre-primary (%)
80
Developed/transition countries
70
60
Latin America/Caribbean
50
40
East Asia/Pacific
30
South and West Asia
20
Arab States
10
Sub-Saharan Africa
0
1971
1976
1981
1986
1991
1999
2004
% of Children who Enter Grade 1 and Reach
Grade 5 by Region
98.0
100.0
91.0
93.0
MENA
EAP
83.0
80.0
66.0
61.0
In %
60.0
40.0
20.0
0.0
SA
AFR
LAC
ECA
UNESCO 2005
Gap in Children Development by Income
DQ
120
Urban middle class
n=78
110
Urban poor
n=268
100
90
6 to 17
18 to 29 30 to 41 42 to 53 54 to 59
Age months
Source:: Walker et al.
Vocabulary Scores by SES quartiles in
36 to 72 month old children Ecuador
age in months
Source: C. Paxson, N. Schady: Cognitive development among young children in Ecuador : The roles
of wealth, health and parenting, The World Bank, Policy Research Working Paper, 3605, 2005
.
Later cognitive deficits associated with being in
the lowest wealth quintile <3yrs in 5 longitudinal
studies (SD scores)
0.5
0.1
Philippines Indonesia
S Africa
-0.3
-0.7
-1.1
-1.5
^Grades attained
*boys
Brazil^
Guatemala*
IQ scores of stunted and non-stunted
Jamaican children from age 9-24 mo to 18 y
0.8
0.6
Non-stunted
SD score
0.4
0.2
0
-0.2
Stunted.
-0.4
-0.6
Griffiths on Griffiths
Enrollment (33-48 mo)
(9-24 mo)
StanfordBinet
(7-8 y)
WISC-R
(11-12 y)
WAIS
(17-18 y)
Source: S. Grantham-McGregor, and J. Habadani: Preventing the loss of children’s developmental potential, Centre of
Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
Intergenerational Transmission of Poverty
preschool child
low IQ, behavior problems
school
Poor stimulation,
health and nutrition
poor school achievement,
behavior problems
adult
National
Economy
low education
low skilled/no work
high fertility
depressed/stressed
10
If all these were true, do we
know what to do?
To start with,
• better nutrition,
• essential mother and
child care, and
• early sustained
sensory and social
stimulation
Program Options:
• Delivery of services to young
children
• Education and support of
parents
• training and support of
caregivers/paraprofessionals
• Sensitization of the public,
through the mass media, to
the value of ECD
• Promoting and
strengthening communitybased activities
10
Lancet paper 3 - Effects of interventions on
cognitive and social-emotional development
Significant results
(of total
evaluations)
Effect sizes
Mainly centrebased
8 of 8
0.23 to 1.40
Mainly parentchild and
parenting
5 of 6
0.45 to 0.8
Comprehensive
5 of 6
0.37 to 1.80
Type of
intervention
Philippines Early Child
Development Program
Child age at
initiation
Developmental Index
(z-score)
2
1.5
2 yrs
3 yrs
4 yrs
1
0.5
5 yrs
6 yrs
0
-0.5
4 to 12 mos
13 to 16 mos
17 to 25 mos
Duration in months
Developmental index varies by child’s age and duration of time in program,
favoring younger children with longer duration.
Closing the Gap…
Opportunities and Challenges
Opportunities..
Source of Brain Stimulation
parent-oriented
child-oriented
age 0
1
2
3
4
5
6
Components of Early Childhood Development and
Parenting Centers:
ECD & care (parental and non-parental) arrangements
Play-based learning
Prenatal & postnatal supports
Nutrition programs
Implement an Overall ECD Strategy
 Intervene early, often and effectively
 Allocate sufficient resources
 Ensure relevant training
New generation competent in the understanding
of human development
 Build systems, not just projects.
Emphasize equity, sustainability, and population health.
 Monitor and evaluate.
Measure child development outcomes
Barriers to Implementing ECD Programs
1. Economics
2. Lack of understanding (public and
professional)
3. Lack of qualified staff
4. Lack of community ECD data
5. No commitment to equality of opportunity
for all young children
World Bank Cumulative Lending for ECD by Regions (1990-2006)
$1.7 billion over 16 years
840.1
LAC
504.6
SA
151.0
AFR
122.1
MENA
EAP
32.8
ECA
28.9
0.0
100.0
200.0
300.0
400.0
500.0
600.0
700.0
Lending for ECD in millions (1990-2006)
800.0
900.0
Still need to do much more…
to close the gap
SA
88.8
AFR
SA
AFR
70.9
EAP
33.6
LAC
10.0
840.1
MENA
4.7
0.0
32.8
LAC
9.9
ECA
151.0
EAP
10.8
MENA
504.6
122.1
ECA
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
28.9
0.0
Population of disadvantaged children under 5 years old; in millions, 2004
Magnitude of Disadvantaged Children
100.0
200.0
300.0
400.0
500.0
600.0
700.0
800.0
Lending for ECD in millions (1990-2006)
Lending by Region
900.0
Indicators to Monitor Differ Significantly
Child
Development
Index
(measure
of child
development
outcome)
Monitoring Child Development Outcomes
 Building
monitoring
systems
 Collecting
populationbased child
outcome data
Challenges.. Where does ECD fit in?
…where cross-sector policies/programs are
essential to human capital development
Age
24
Youth Development
Social
Protection
Education
14
Health and
Nutrition
18
(School-to-work, Second-chance programs,
Risky behaviors, participation, crime and violence)
5
0
Early Child Development
(Health/Nutrition, School Readiness, Parenting)
Challenges.. A Diverse Field
Organized care and education
Primary education (age 6 up)
ECCE policies and programs for ages 3 and up
-pre-primary education
-non-formal education
ECCE policies and programs for ages 0 to 2
-organized care and education
-non-formal care or education
-support to parents
- parental leave
Providers
• Governments (national, sub-national)
• Private sector (non-profit and for-profit)
• International non-governmental organizations
• Community-based organizations
Informal care
and child
rearing
Informal provision
of care for children
aged 0 to 8, by
parents or extended
family, mainly at
home but sometimes
in other family or
community settings.
Chaos
Health
Public
health
Preschools
Social
services
Parks &
recreation
Early
intervention
Municipalities
Parenting
centres
Family
support
Education
Community
services
Local school
authorities
Kindergartens
Child care
Children’s
mental health
centres
Challenges …
Optimal vs. Actual Investment
Example of the U.S
Cumulative Public
Investment
Optimal Investment
Levels
Pre-school
0
Post-school
School
Age
Source: P. Carneiro & J. Heckman, Human Capital Policy, NBER, 2003; Voices for America and the Child and Family Policy
Center, Early Learning Left Out An Examination of Public Investment in Education and Development by Child Age, 2004.
Sweden’s Public Expenditure for Children
0-17 age old - Ultimate Goal!!
Source: S. Bremberg (2006), National Institute of Public Health, Karolinska Institute, Stockholm, Sweden