Evidence to Policy: Early Childhood Development Notes

This brief aggregates a group of summary evaluations from the World Bank Strategic Impact Evaluation Fund (SIEF)  on impct of seven early childhood development programmes in Niger, Nepal, Mozambique, Jamaica, Cambodia, Bangladesh, and Malawi.

The programmes, described here with brief communication-related impact notes, include the following:

• Malawi: Can steps to improve child centers help boost child development? - In Malawi, researchers studied the impact of a pilot programme in 2017 to improve the quality of the country’s Community-Based Childcare Centers for children aged 3-5 years old in rural areas to extend care beyond providing centers with play and learning kits, by "offering additional teacher training, paying teachers a small stipend, and holding classes for parents on child development. The evaluation found that teachers who were trained did more learning activities in the classroom, and when teachers also received a stipend or parents attended classes on child development, teachers did even more in the classroom with the children." However, children's initial gains dissipated over the primary school years. 

• Bangladesh: Can child stimulation messages be added to an existing platform for delivering health and nutrition information? The Government of Bangladesh, working in 2016 to improve early childhood development, partnered with Save the Children to provide new mothers with child development information during their visits to community health clinics and during regular home visits by health workers and family welfare assistants, including adding a child stimulation component to a national nutrition programme. "The evaluation found that almost all families that received the additional services, including informational cards on child development and picture books, reported using them, and their children showed small to modest gains in cognitive, linguistic and physical development compared with children whose families were not offered the program. The results show that it is possible to supplement existing health and nutrition programs with an additional component to improve children’s cognitive development in the early years, before they start any formal school program. However, almost 50 percent of households didn’t get the materials as expected, underscoring the challenges of using an already existing system of government community clinics and community outreach to deliver additional services."

• Cambodia: Challenges in scaling up preschools - Researchers worked with the Government of Cambodia in 2013 to evaluate the impact of three pilot early childhood development programmes, finding that expanding programmes presented new challenges, such as, in this case, "unforeseen implementation problems - some related to delays in building schools or problems paying teachers - limited the program’s reach and effectiveness. Parents who worked all day, or worked far from the village center, also found the part-time hours of the preschools difficult to manage, contributing to low use of the preschool services."

• Jamaica: Can disadvantaged kids ever catch up with better-off peers? - This policy note reviews the evaluation of a programme in Jamaica, 1986-1987, that enrolled 129 children aged 9-24 months, who were all stunted based on height-for-age measurements.  They were split into four groups: one received psychosocial stimulation; one received nutritional supplements; one received both; and the fourth group, the control group, received nothing. The treatment continued for two years and included free health care. "During the two-year program, households in the psychosocial stimulation treatment group received weekly, hour-long visits from trained community healthworkers, who taught mothers how to play educational games with their children and encouraged them to converse with their children. They also were encouraged to praise their children and improve the self-esteem of the child. Homemade toys were brought to each visit and exchanged the next week for other toys. Families that qualified for the nutritional supplement received one kilogram of fortified formula." Children were surveyed after the two years and then again at ages 7, 11, and 18. "Children in this treatment group - stimulation or stimulation plus nutritional supplements - had significantly higher earnings as young adults than the control group, regardless of whether they held a part-time, full-time or permanent job. They were doing equally better when compared with children whose families received nutritional supplements alone. In fact, they were doing so well that their earnings had caught up with earnings of their less-disadvantaged peers."

• Mozambique: Is preschool good for kids? - "To test the effectiveness of preschool programs on children’s enrollment in and readiness for primary school, the World Bank supported a study of an early childhood development preschool program in Mozambique run by Save the Children [2006-2008]. The evaluation showed that children enrolled in preschool were better prepared for the demands of schooling than children who did not attend preschool and that they were more likely to start primary school by age 6."

• Nepal: Can information and cash improve children’s development? - "In Nepal, researchers supported by the World Bank’s Strategic Impact Evaluation Fund worked with the government to develop a program to inform pregnant women and mothers of young children on how to best care for themselves and their children, using already ongoing community meetings to deliver messages. An impact evaluation was designed to measure the effectiveness of the information and to test whether combining this with a short-term cash transfer for mothers made it more effective. The evaluation found that mothers who received both information and cash reported a higher likelihood of breastfeeding their babies and reported that they took recommended vitamins and their households consumed more calories. Also, their children had better fine and gross motor skills as compared to the control group, which didn’t receive this intervention. But there weren’t any reductions in malnutrition."

• Niger: Can cash and behavioral change programs improve child development? - An evaluation of an effort to improve child development through a social safety nets programme (2012) that used monthly cash transfers to help combat poverty and improve food security combined with community meetings, group discussions, and home visits to provide information to women about healthy child development, found that behavioral change activities improved women's knowledge and practices. "But there was little impact on children’s physical growth or cognitive development, underscoring the complexity of the challenge and indicating that information isn’t always enough."