BRIEF

Evaluations - Early Childhood Development

October 6, 2016

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EARLY CHILDHOOD NUTRITION, DEVELOPMENT AND HEALTH

 

The building blocks for a successful and productive life are needed early on, when children’s brains and bodies begin to grow. Delays are hard to reverse. A solid body of evidence shows that young children who receive appropriate nutrition, health care and emotional and cognitive stimulation are better prepared for school and learning. Investing in children returns big payouts both in the short term and later on. Children who get the right start in life, starting with good nutrition and health care during their mothers’ pregnancies, will become healthier and more productive adults and are will be prepared for raising their own healthy children. SIEF-supported researchers are working to find the best and most cost-effective ways to deliver a range of early childhood nutrition, health and development programs in low-income countries. Read more about early childhood development and impact evaluation in our Cluster Note

 

PORTFOLIO OF IMPACT EVALUATIONS

 

Bangladesh: Building Parental Capacity to Help Child Nutrition and Health: A Randomized Controlled Trial

  • Principal investigator: Marjorie Chinen, American Institutes for Research; Johannes Bos, American Institutes for Research
  • Timeline: 2013 - 2016
  • Evaluation: In Bangladesh, malnutrition among children in poor rural areas leads to high incidents of stunting and poor health, delaying development. Supporting mothers to help their children has shown some positive results, but less is known about how to engage fathers. Researchers will evaluate low-cost integrated interventions, which will target pregnant women and parents with children under age three with programs for nutrition and child stimulation.

 

Bulgaria: Closing the Early Learning Gap between Roma and Non-Roma Children in Bulgaria through Pre-School Participation: Inclusive Outreach and (Un)conditional Support Approaches

  • Principal investigator: Elise Huillery, Sciences Po
  • Timeline: 2013 - 2016
  • Evaluation: In Bulgaria, the early learning gap between Roma and non-Roma children is a challenge for parents and policymakers. While more than 75 percent of all children aged three to six nationally are enrolled in school, the majority of Roma children are not. To address this challenge, the Trust for Social Achievement, a Bulgarian NGO supported by the America for Bulgaria Foundation, will implement a program in more than 150 poor communities that seeks to address preschool participation in a variety of ways: encouraging active outreach to parents by local NGOs and authorities, offering free preschool for selected beneficiaries, and providing a conditional financial grant for some selected communities. Researchers will measure the effectiveness of the components - jointly and independently - in order to help policymakers understand how they can boost the number of Roma children attending preschool and improve children’s cognitive and socio-emotional development.

 

Burkina Faso: Reducing poverty and malnutrition in Burkina Faso through integrated early childhood interventions

  • Principal investigator: Damien de Walque, World Bank
  • Timeline: 2014 - 2017
  • Evaluation: Proper infant and early childhood development is critical to give children a healthy start to life. The challenge is especially profound in sub-Saharan Africa, where millions of young children are at risk of cognitive and physical delays because of poverty, poor nutrition and lack of stimulation. The Government of Burkina Faso, with World Bank support, is rolling out a social safety net program to improve food security and child development by giving very poor families direct cash transfers. The evaluation will look at the added benefit of interventions to improve parenting and health and nutrition practices. The results will help inform a government scale up the cash transfer program to serve as a cornerstone of the national safety net system for reducing long-term chronic poverty and building household resilience.

 

Cambodia: Increasing Early Childhood Care and Development through Community Preschools: Evaluating the Impacts

  • Principal investigators: Deon Filmer, World Bank; Adrien Bouguen, University of Mannheim, Germany
  • Timeline: 2015-2019
  • Evaluation: In Cambodia, poverty, lack of access to improved water and sanitation, and limited early childhood development programs means that many young children aren’t getting the right start in life. The Government of Cambodia is implementing a program to improve access to and quality of early childhood eduction through preschool construction and refurbishment, door-to-door visits to inform parents of the value of early childhood education and monthly meetings on childhood development for parents with children under five. The evaluation will be carried out with the support of the Government of Cambodia, which will use the results to decide on next steps for its early childhood education programs.

 

Colombia: The Medium Term Effects of a Home-based Early Childhood Development Intervention in Colombia

  • Principal investigator: Orazio Attanasio, University College London, Institute for Fiscal Studies
  • Timeline: 2012 - 2015
  • Evaluation: In Colombia, researchers will evaluate the medium-term effects of a home-based early childhood development intervention. The program seeks to improve nutrition and development in the first two years of life through home visits to encourage children’s psycho-social development and use of micronutrient supplements. The findings will be used to help policymakers and others understand the extent to which nutrition and parental involvement at an early age carry lasting effects into the medium term and how such programs can be scaled up effectively

 

Djibouti: Piloting the First Integrated Nutrition/Workfare Social Safety Net in Djibouti

  • Principal investigators: Stefanie Brodmann, World Bank; Florencia Devoto, Abdul Latif Jameel Poverty Action Lab; Emanuela Galasso, World Bank
  • Timeline: 2012 - 2016
  • Evaluation: In Djibouti, malnutrition, unemployment, and extreme poverty are key human development challenges. To address malnutrition among children younger than 24 months old, the Government of Djibouti piloted a safety net intervention that combines temporary employment (one beneficiary per household) with a component to promote better nutrition through informational classes. Researchers will examine the effectiveness of linking child nutrition and workfare as a means of reducing malnutrition in young children.

 

Ethiopia: Evaluation of the Accelerated School Readiness Strategy

  • Principal investigators: Elizabeth Spier, American Institutes for Research; Johannes Bos, American Institutes for Research
  • Timeline: 2016-2019
  • Evaluation: In Ethiopia, many children start primary school without the skills they need to learn. To raise school readiness levels, the Government of Ethiopa is searching for an affordable alternative to providing standard-length preschool education, and is piloting a two-month school readiness program. The evaluation will examine if the two pilot models that provide 150 hours of support either during the summer before children start grade 1, or during their first two months of grade 1, improves school readiness as well as academic learning.

 

Ghana: Testing and Scaling-Up Supply- and Demand-side Interventions to Improve Kindergarten Educational Quality

  • Principal investigators: J. Lawrence Aber, New York University; Sharon Wolf, University of Wisconsin-Madison
  • Timeline: 2015-2018
  • Evaluation: In Ghana, the majority of kindergarten teachers are untrained, parents’ knowledge of the importance of quality early childhood education is limited and children’s readiness for primary school is generally low. To improve the quality of early childhood education, the Government of Ghana is supporting a low-cost, short duration in-service teacher training combined with a parental awareness intervention pilot in six disadvantaged districts in the Greater Accra Region. The evaluation findings will be used by the Government to inform the decision of whether the pilot model should be scaled up to other urban and peri-urban communities in the country.

 

India: Early Childhood Development for the Poor: Evaluating the Impacts in India

  • Principal investigator: Costas Meghir, Yale University
  • Timeline: 2014 - 2017
  • Evaluation: In India, stunting from malnutrition and ill health remains a big obstacle for health child development. In the Indian state of Odisha, where more than half of young children are stunted, this evaluation will test the impact of psychosocial stimulation and nutritional education for children who are 9-15 months, providing evidence on the effectiveness of different approaches, including home visits and group meetings, for improving mother-child interaction and boosting nutrition.

 

India: Making Integration the Operative Concept in the Indian Integrated Child Development Strategy

  • Principal investigators: Harold Alderman, World Bank; Jed Friedman, World Bank
  • Timeline: 2013 - 2017
  • Evaluation: In India, researchers will measure the cost and impact of nutrition services and child stimulation in low-income settings by evaluating a package of services currently being offered to the youngest children in a nationwide child development program.

 

India: Testing the Effect of Self-Help Groups to Improve Mother-Child Development

  • Principal Investigator: Neha Kumar, International Food Policy Research Institute (IFPRI)
  • Timeline: 2014-2016
  • Evaluation: Maternal and child undernutrition rates are exceptionally high in Bihar, India, with 56 percent of children stunted, 45 percent of women underweight, and 67 percent of women anemic.  Current programs to boost nutrition are not always successful, often due to poor implementation or utilization. This evaluation will measure the impact of a multisectoral pilot self-help group mode, called Jeevika-Multisectoral Convergence, implemented by the World Bank-funded Bihar Rural Livelihoods Program.

 

India and Pakistan: SPRING: Linking Implementation Strength, Outcomes and Lessons Learned to Inform Scale Up

  • Principal Investigator: Betty Kirkwood, London School of Hygiene and Tropical Medicine
  • Timeline: 2014 - 2017
  • Evaluation: India and Pakistan both have an enormous number of children at risk for poor development because of malnourishment and lack of appropriate stimulation when they are young. The Sustainable Program Incorporating Nutrition and Games, or SPRING, uses home visits by community-based health workers to improve development. In both countries, SPRING is being implemented in concert with government programs that support child development, and the results of the evaluations will help policymakers better understand what is effective and scalable. 

 

Indonesia: Early Childhood Nutrition, Availability of Health Service Providers and Life Outcomes as Young Adults: Evidence from Indonesia

  • Principal investigator: John Strauss, University of Southern California
  • Timeline: 2012 - 2016
  • Evaluation: In 1989, Indonesia began a program to expand access to midwives in villages. By the time the program reached scale in 1998, 54,000 nurses had been trained in midwifery and placed in communities. Researchers will evaluate the effects of the midwife program on the educational decisions and outcomes, cognitive abilities, employment, and life satisfaction of the children (who are now young adults) of mothers who had access to midwives.

 

Indonesia: Evaluating the Longer-Term Impact and Sustainability of Community-Based Early Childhood Development Centers in Rural Areas

  • Principal investigators: Menno Pradhan, University of Amsterdam, VU University and Amsterdam Institute for International Development; Amelia Maika, University of Gajah Mada; Sally Brinkman, University of Western Australia; Haeil Jung, Indiana University Bloomington
  • Timeline: 2015-2018
  • Evaluation: In Indonesia, large numbers of children don’t have access to improved water and sanitation, health services and early childhood education, especially in rural areas. The Government of Indonesia is seeking effective, sustainable ways to increase access to early childhood education to improve child development outcomes and learning. As part of its Early Childhood Education and Development project, the Government provides teacher training, community facilitation and village block grants to encourage communities in rural areas to establish and support playgroup centers. The evaluation team will examine if the project has an impact on development and learning outcomes by the time children are eight years old, and whether community-based playgroup centers provide a sustainable delivery model in rural areas.

 

Jamaica: 30 years later, does an early childhood program still have impact?

  • Principal investigator: Christel M. J. Vermeersch
  • Timeline: 2016-2018
  • Evaluation: For more than two decades, a group of stunted children whose mothers were taught how to play and talk to them have been tracked by researchers. The findings have shown that these children have done better in measures of education, employment and socio-emotional development. The children, now nearing 30 years old, will be re-evaluated to measure continuing effects, including on risk of risk of later cardiovascular diseases.

 

Kenya: EMERGE Reading

  • Principal investigators: Lia Fernald, University of California at Berkeley; Pamela Jakiela, University of Maryland; Owen Ozier, World Bank
  • Timeline: 2015 - 2019
  • Evaluation:  Kenya is one of the best-educated low-income countries in sub-Saharan Africa and yet many primary school students read below grade level. Reasons include poor quality of teaching and the fact that many children start primary school without having been introduced to reading and books beforehand. Researchers are evaluating a low-cost program that produces and distributes children’s storybooks to households with children between ages two and six, to increase school readiness. 

 

Kenya: Evaluation of an Early Childhood Education Project

  • Principal investigators: Isaac Mbiti, University of Virginia; Owen Ozier, World Bank; Anthony Keats, Wesleyan University; Michael Kremer, Harvard University and the Brookings Institution
  • Timeline: 2015-2019
  • Evaluation: In Kenya, private low-cost preprimary education has expanded rapidly, partly in response to inadequate coverage and the varying quality of government preprimary schools. Researchers are looking at the effects of these innovative low-cost preschools on child development and learning outcomes and will compare the effectiveness of these schools with government preschools.

 

Madagascar: Evaluation of a Behavioral Approach to Improve Outcomes in Early Childhood

  • Principal investigators: Laura Rawlings, World Bank; Saugato Datta, ideas 42 
  • Timeline: 2016-2019
  • Evaluation: Improving early childhood development parenting practices and nutrition is a critical first step in preparing children for school and productive working lives. With nearly 80 percent of Madagascar’s population of 22 million living below $1.25 per day, around half of Malagasy children are chronically malnourished. As part of the roll out of a World Bank supported social safety net project that gives cash transfers to the poorest households, SIEF researchers will test the impact of adding in community meetings on healthy development with behavioral “nudges” to boost mothers’ self-esteem and help them take positive steps for their children’s future. 

 

Madagascar: Addressing Chronic Malnutrition in Madagascar

  • Principal investigator: Lia Fernald, University of California, Berkeley; Emanuela Galasso, World Bank; Christine Stewart, University of California, Davis; Ann Weber, University of California, Berkeley
  • Timeline: 2012 - 2017
  • Evaluation: Madagascar has one of the highest rates of childhood stunting in the world. Over half of children are chronically malnourished, and more than one-fourth are severely malnourished. Researchers will evaluate the impact and cost-effectiveness of combining different nutrition and child development interventions to help the government of Madagascar optimize the impact of its community-based nutrition program on nutritional and child development outcomes.

 

Malawi: Effects of Quality Improvement Strategies on Early Childhood Development in Community-Based Childcare Centers in Malawi: A Randomized Trial

  • Principal investigators: Lia Fernald, University of California, Berkeley; Berk Ozler, World Bank
  • Timeline: Completed
  • Evaluation: Children’s social and cognitive readiness for school is crucial for later success. In Malawi, the government seeks to improve child development outcomes through better preschools. Researchers will study the effects of teacher incentives and training, parental education, and learning materials for children on their physical, emotional, and cognitive development and their readiness for primary school.

 

Malawi: Long-Term Effects of Quality Improvement Strategies on Early Childhood Development in Community-Based Childcare Centers

  • Principal investigators: Berk Özler, World Bank; Lia C. H. Fernald, University of California-Berkeley; Patricia Kariger, University of California-Berkeley; Michelle Neuman, University of Pennsylvania; Christin McConnell, World Bank
  • Timeline: 2018-2019
  • Evaluation: In rural Malawi, access to quality childcare is very limited and school readiness and learning levels in the early grades of primary school are low. To increase the quality of early childhood education, the Government of Malawi implemented a project that provides parenting education and improves the quality of the community-based childcare centers for three and four year old children. An evaluation of the program found that the initial gains in child development outcomes for children in the centers seemed to disappear after two to three years. The research team will conduct a follow-up survey to examine if the project had a longer-term impact by assessing physical, cognitive and socio-emotional skills of the children at age 10-11 years.  

 

Mali: Impact and cost effectiveness of an integrated parenting, nutrition and malaria prevention package in Mali

  • Principal Investigators: Siân Clarke, London School of Hygiene and Tropical Medicine; Natalie Roschnik, Save the Children
  • Timeline: 2014 - 2017
  • Evaluation: Mali is one of the world’s least developed countries and suffers from some of the highest rates of anemia and malaria in the world. In Sikasso region in southern Mali, where this evaluation is taking place, 45 percent of children under the age of five are stunted, over 80 percent are anemic and malaria is rampant. Save the Children supports Early Childhood Care and Development centers to help prepare young children for primary school, but many children already arrive malnourished or stunted from chronic disease and nutritional deficiencies. The evaluation will measure the impact and cost effectiveness of home fortification with micronutrient powders combined with seasonal malaria chemoprevention and parenting education delivered through ECCD centers on children’s health, nutrition and child development.

 

Mozambique: Randomized Impact Evaluation of Integrated ECD (Early Childhood Development) and Intensive Early Nutrition Activities among Vulnerable Communities in Mozambique

  • Principal investigators: Sophie Naudeau, World Bank; Marie-Helene Cloutier, World Bank
  • Timeline: 2013 - 2019
  • Evaluation: In Mozambique, researchers will measure the effectiveness of two related programs that provide nutrition, early child stimulation, and parenting information sessions to children, pregnant women, and parents of young children. The project builds on a successful small-scale pilot intervention and will help experts in this field determine the scalability, cost-effectiveness, and sustainability of such projects, and the usefulness of integrating early childhood development and nutrition programs rather than pursuing them separately.

 

Nepal: Can Information and Cash Make a Difference in Children’s Development?

  • Principal investigator: Gayatri Acharya, World Bank; Prashant Bharadwaj, University of California, San Diego
  • Timeline: Completed
  • Evaluation: Children under the age of five in Nepal suffer from one of the highest rates of malnutrition and stunting in the world. Moreover pregnant women tend to have sub-optimal weight gain during pregnancy. The Government of Nepal seeks to rectify these problems by removing two barriers to good nutrition: lack of knowledge about nutrition and lack of income needed to make better nutritional choices. Researchers will evaluate the effectiveness of providing information alone, or information and cash, on improved nutrition for pregnant women and young children.

 

Nicaragua: Long-Term Impacts of Exposure in Early Childhood to Home-Based Parenting Training in Rural Areas

  • Principal investigators: Karen Macours, Paris School of Economics; Renos Vakis, World Bank; Patrick Premand, World Bank
  • Timeline: 2015-2019
  • Evaluation: In Nicaragua, children in poor rural areas frequently don’t have access to adequate nutrition and early childhood stimulation, and begin primary school without adequate preparation. The Government of Nicaragua has made substantial efforts to promote early childhood development and in 2008-09, piloted a low-cost home-visit program to improve parenting practices through bi-monthly home-visits, community workshops and provision of toys and children’s books. This evaluation will measure the program’s impact on parenting practices and children’s development and learning outcomes nine years after participation in the program.

 

Niger: Cash Transfers, Parenting Training and Holistic Early Childhood Development in Niger

  • Principal investigator: Patrick Premand, World Bank
  • Timeline: Completed
  • Evaluation: In Niger, a large share of the population suffers from chronic food insecurity and 45 percent of children under age five are stunted. The Office of the Prime Minister of the Government of Niger is implementing a large-scale safety nets project. As part of the project, poor rural women receive a regular cash transfer, while also participating in accompanying measures that aim to improve a range of parenting practices. A team of researchers is working with project implementers to evaluate the effectiveness of the cash transfers and the value-added of the parenting training on nutrition, health and cognitive development of children under the age of five.

 

Rwanda: Promoting School Readiness for Vulnerable Children: A Cluster Randomized Trial

  • Principal investigators: Theresa S. Betancourt, Harvard University; Laura Rawlings, World Bank; Robert T. Brennan, Harvard University
  • Timeline: 2016-2019
  • Evaluation: In Rwanda, large numbers of children are stunted and lack access to early childhood education and stimulation and start primary school without skills critical for learning. The Government of Rwanda is strongly committed to reducing poverty and promoting early child development and is seeking to develop models that can deliver early childhood services effectively and sustainably. This evaluation will test the effectiveness of a Government-led home-visit family-strengthening intervention that includes parenting coaching, nutrition education, early learning and stimulation activities, in improving parenting practices and children’s development outcomes.