Worldwide 200 million children under five years of age are not achieving their development potential due to poverty, poor health and nutrition, and lack of stimulation and learning opportunities. The vast majority of these children are from disadvantaged households and communities in low-income countries.
Early childhood lays critical foundations for a person’s entire life – a finding demonstrated not only by the latest advanced research in neuroscience and genetics but by nutrition and child development studies and programme evaluation data, including data from AKDN’s own programmes. Investments in Early Childhood Development (ECD) offer outstanding returns – both in human and financial terms. Numerous studies have demonstrated the improvements in education, health, social development and economic growth indicators attributable to ECD. World Bank economists conclude that, “well targeted ECD programmes cost less and produce more dramatic and lasting results than education investments at any other level”. ECD programmes help reduce the social and economic disparities and gender inequalities that divide societies and perpetuate poverty and are preferable to costly remedial action.
What are Early Childhood Development programmes?
Early Childhood Development (ECD) programmes are concerned with ensuring young children have a good start in life. They address health, nutrition and protection from harm. They offer opportunities for enjoyable learning and promote a sense of identity and self-worth. They enable students to communicate effectively and get along with others.
ECD programmes are about influencing people and influencing the contexts in which children are growing up so that the overall development of children is supported. Social, cultural, economic, geographical and political contexts are key. Within the lives of young children, “contexts” translates into the different environments which impact on them, including families, communities, health services, ECD centres, schools, district bodies and national policy. ECD programmes are about influencing these factors and addressing issues which undermine children's development.
ECD programmes are defined internationally as being concerned with children from before birth to the age of eight years. A wide range of initiatives fall under the ECD umbrella – from working with families to changing systems which marginalize, neglect or exclude some children. They are about a range of supports for families, communities and institutions that strengthen the ability to care for and nurture children.
Early Childhood Development programmes are therefore concerned with:
- Interactions within the family:Parenting/ caregiving programmes (within maternal and child health, nutrition, or education initiatives) emphasise parents and other family caregivers as the first and most important carers and teachers of children;
- ECD centres: Structured programmes aim to provide a safe and secure environment, warm and responsive caregivers, and stimulating learning activities for children. These may be formal or informal centres/spaces in the community, homes, local schools or work sites;
- Community planning and mobilisation: Community-level initiatives work to create enabling and safe environments for young children and promote access to food, healthcare, ECD provision, safe water, adequate sanitation, etc.;
- Influencing community-based health service provision, disease prevention and health promotion: ECD initiatives in health care promote services that are supportive of the continuum of maternal and child health, nutrition, and overall development (including pre- and post-natal care, immunisation, growth monitoring, mental health, etc.);
- Influencing the early years of primary education: These initiatives work with government and non-government primary schools to promote the implementation of child-centred, active-learning methods in early primary grades and support a smooth transition for children as they enter school from home or ECD programme;
- Resource and training institutions: Diverse institutions and programmes provide leadership and capacity-building to community/government programmes. They also conduct research, influence policy and provide networking opportunities;
- Research: Specific studies, in addition to regular monitoring, enable analyses of the inputs, processes, outcomes and wider impact of different interventions;
- Advocacy: Local and macro-level initiatives work towards systemic change by promoting ECD at the government level through efforts such as advocating for specific policies and budget allocations;
- Public awareness: Initiatives at many different levels (community to national) use media, well-known figures, study findings etc. to highlight the importance of attention to the early years.
As the bullet points above suggest, early childhood programmes are concerned with many players and all aspects of children’s development.
Keys to Early Childhood Development and Poverty Reduction
Mothers and Child Health: A key to healthy early childhood development is a continuum of care for mothers, neonates, infants and young children at a time when they are all particularly vulnerable to a range of risks. In the very early years, health care and a healthy environment play pivotal roles in child survival and development and build the basis for a healthy adult life. Mothers and children need the continuum of care from pre-pregnancy through pregnancy and childbirth and through to the early days and years of life. Safe and healthy environments, including good quality housing, clean water and adequate sanitation facilities, safe neighbourhoods, and protection against violence, are all essential. Good nutrition begins in utero and depends on adequately nourished mothers. The initiation of early and exclusive breastfeeding for the first six months of life is as important as ensuring access to healthy diets for infants and young children. These measures can be assured by improving food security and changing prevailing knowledge, attitudes and practice.
Child Development and Well-being: The psycho-social aspects of development also have profound significance, both for individual success, quality of life, and long-term social change. This is particularly important in many of the countries where AKDN works – impoverished areas where people’s child-rearing practices are often dictated by the demands of daily survival. In these situations, people naturally focus on keeping children fed, enhancing their physical skills and teaching social responsibility. They tend to underestimate the significance of their key role in supporting children’s broader learning, language development and sense of themselves.
However, research and practice shows that parenting programmes can help build children’s knowledge, skills and, equally important, confidence and sense of agency. The value of centre-based ECD programmes has also been demonstrated across multiple contexts. These programmes provide an expanded range of experience for young children, helping them develop skills and form attitudes that will enable them to make good use of learning opportunities both within and beyond formal education. ECD programmes emphasise the development of children’s ability to interact effectively with their world. They support the development of confident, life-long learners who are more likely to gain the skills needed to break out of the cycle of poverty and become active, healthy members of society.
A programme for young children, therefore, can be seen as an entry point for responding effectively to many of the factors underlying poverty. The direct benefits for children’s healthy physical, social, emotional and academic development are an important and well-known part of this. In addition, safe and stimulating childcare frees up caregivers to work. Parenting/caregiving programmes can be very effective in giving families an increased sense of control over their lives while providing them with information and building a sense of agency to act on their own behalf and on behalf of their children.
ECD Initiatives in the Aga Khan Development Network
The Aga Khan Development Network (AKDN) has been supporting ECD initiatives for several decades. Earlier AKDN agencies and institutions were amongst the few international bodies which recognised the critical long-term impact of ECD for both individuals and society.
The different parts of the network work in ECD in a variety of ways reflecting each agency or institution’s own particular mandate. However, they are all guided by the principle that ECD interventions should be appropriate to the cultural context, affordable for families, based on sound and current evidence on child development, genuinely involve families and communities, and be sustainable over the longer-term.
The Aga Khan Education Services (AKES) supports pre-primary classes within AKES primary schools in Pakistan, India and Bangladesh, independent nursery schools in East Africa, and community-based day care centres in rural Gujarat in India. More recently, a new Early Learning Centre established in Dubai is set to begin operations in 2009. Additional planning is underway to significantly expand access to ECD in the coming years in Central Asia, Pakistan and India.
The Aga Khan Health Services (AKHS), which works in eight countries in Central and South Asia, East Africa and the Middle-East, focuses particularly on mothers and children under five years of age. Programmes include safe motherhood, child survival and health promotion and disease prevention education activities at the community level. Community-based health care is linked with health service delivery units – from basic health centres up to full-fledged hospitals. Many of these initiatives are undertaken in partnership with the Health Programme of the Aga Khan Foundation (AKF), including, for example, the support to maternal and child health programmes in Afghanistan and Syria.
The AKF Education Programme established its early childhood work in the early 1980s, starting in Kenya, India and Portugal. For many years, the East African Madrasa Early Childhood Programme was AKF’s flagship ECD initiative in Kenya, Tanzania and Uganda. However, the ECD portfolio has expanded significantly both within countries and into 12 additional countries, often through partnerships with other AKDN institutions and initiatives.
Through these activities, AKF has piloted and established a range of ECD programme models, including centre-based pre-schools, outreach pre-schools that are linked to central centres, transition programmes with the lower grades of primary schools, a growing cluster of parenting/ caregiving initiatives to strengthen families’ supports for their children, and a few day care models (home-based, centre-based and work-based). An additional area of work has been to establish new ECD training and resource centres -- or strengthen existing ones -- in order to help catalyse and drive ECD programming demand and quality (e.g., Madrasa Resource Centres (MRCs) in East Africa, the Teachers’ Resource Centre in Pakistan, and the planned ECD centres in Lisbon and Cairo).
AKF also responds to, and often creates, opportunities for policy dialogue and influence as countries start to formulate ECD policies and plans (e.g., in Kenya, Zanzibar, Uganda, Syria and Kyrgyzstan). In recent years, AKF has also been collaborating with the Aga Khan Trust for Culture (AKTC) to establish ECD programmes in Cairo (Egypt), and Delhi (India). These efforts are jointly supported by the AKTC Historic Cities Programme and AKF.
ECD initiatives at the Aga Khan University (AKU) in Pakistan and East Africa are more recent additions, but they are critically important to AKDN’s efforts in the area of ECD. This work is led by the two Institutes of Educational Development (IED), the Department of Paediatrics and Child Health (DPCH), and the Human Development Programme (HDP). Specialised courses (certificate and/or diploma-level) for ECD teachers and professionals offered through the IEDs in East Africa and Pakistan and through HDP are beginning to meet some of the human resource development needs for ECD in these regions.
In addition, new research in ECD is being under-taken at AKU in Pakistan, providing critically needed evidence on best practices in ECD. One example is the project, being conducted by the DPCH, which will compare the impact of different interventions (standard M/CH support, M/CH plus child development, and M/CH plus enhanced nutrition supplements) to mothers through the Lady Health Workers in rural Sindh. The study examines the relative (and combined) effects of these interventions on mother and child outcomes, and will follow children up until eight years of age. The potential for the IEDs, HDP, and DPCH to serve as leading resource institutions in their countries (and regions) is considerable. There is a growing need for such hubs for the development of professionals and leaders in the field and where multi-disciplinary research can be undertaken. Such research might include further exploration of the basic science of child development, the testing of hypotheses regarding key factors contributing to child outcomes, as well as rigorous assessments of programme impact.
The Aga Khan Fund for Economic Development (AKFED) is also looking to do more to meet the ECD needs of young children whose parents work for the various AKFED-related companies in Africa. In Kenya, the Frigoken and Alltex companies together serve around 60 children aged six months to three years for mothers working in the factories. Assessments are planned for additional companies in West Africa in 2009 in order to ascertain the needs and opportunities for linked ECD services. The Aga Khan Agency for Microfinance (AKAM) is also about to pilot some new financial products which will directly benefit young children and their mothers.
AKDN ECD Programme Data
AKDN agencies are beginning to consolidate programme data to understand the array and nature of current investments in ECD and to assess gaps and opportunities. Global coverage data for ECD programmes led or supported by AKDN in 2008 follows:
ECD activities EXCLUDING
work at lower Primary
ECD efforts INCLUDING work with primary grades 1-3
# ECD centres/ classes
# parents in parenting/ caregiving programmes
# teachers/ ECD workers
1,982 / 190
3,632 / 210
Beyond the basic coverage statistics, AKDN agencies and programmes are increasingly concerned with core education outcome indicators including school enrolment, retention, and achievement. For example, in Uganda, a study led by the Madrasa Regional Researcher found the repetition rate in Grade 1 for children who had participated in an ECD programme was 3.5 percent -- less than half that for those who had not (7.3 percent). In a regional MRC study (Uganda, Kenya, Zanzibar), preschool experience was significantly associated with higher cognitive ability. In Pakistan, AKDN supports a project working to improve access to and the quality of pre-primary and early primary classes in 287 government and community schools. The government’s national figure for drop-out in Grade 1 stands at 23 percent, while for schools supported by this programme, the figure is only 1.5 percent. In both Kyrgyzstan and Tajikistan, children from AKDN-supported pre-schools (including home-based pre-schools) are out-performing children who have not been to pre-school when they go to primary school. Beyond the numbers, parents and teachers in all of the very diverse contexts in which these programmes operate strongly endorse their importance. More studies tracking children through school, and combining both quantitative and qualitative data, are needed.
# children < 5 targeted in community/primary programmes
# women targeted in community/ primary programmes
# Community Health Workers
# Basic health centres (AKHS/ gov. / others)
# Comprehensive Health Centres (AKHS/ gov./ others)
# Hospitals (AKU/ AKHS/ others)
# communities / districts
2,108 / 107
Other core health outcome indicators being tracked within AKDN programmes include rates for infant and child mortality, immunisation, skilled attendant delivery (also ante- and post-natal visits), and stunting, as well as percentages of households with safe water and adequate sanitation. There are significant differences between and within regions, countries and districts. Health programme achievements include, for example, increased immunisation coverage (e.g., from 62 percent to 98 percent in the programme area of the Community-Led Child Survival programme in Maharashtra, India), increased use of impregnated bed-nets for under-fives and pregnant women (e.g., from 7 percent to 47 percent in the health programme area in Mozambique), and increased use of ante-natal and institutional delivery services across programmes. Monitoring and research studies are critical to demonstrate the outcomes of health programme interventions and their interaction with education-focussed interventions.
AKDN agencies are working to strengthen resource institutions, build local capacity for the sustainability and local appropriateness of ECD programmes, and contribute to the growing field of ECD research and knowledge in their different locations. Moreover, staff involved in ECD across AKDN agencies and institutions are building complementarity and convergence across the different initiatives. The sheer size and dynamism of the different agencies’ and institutions’ programmes makes this complex but it is vital given the potential synergies. Partnerships with others (including a range of academic institutions) involved in the field of ECD) will continue and be further expanded to ensure maximum impact.
In 2009 inventories of services, programmes and resource institutions across and beyond AKDN will be completed. These together with a number of detailed situation analyses will be used to improve planning, address gaps and reach many more young children and their families in areas where AKDN operates. The aim is to improve the reach, quality and effectiveness of ECD programmes across sectors.
[ii] van der Gaag, J.; Tan, J. P. 1998. The Benefits of Early Childhood Development Programmes: An Economic Analysis. Washington, DC, World Bank.