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The Quality of Care in Early Childhood: A Challenge for Everyone, Both Big and Small

October 14, 2013 por Florencia Lopez Boo Leave a Comment


“The quality of early childhood services is critical for two main reasons. The first reason is humanistic in nature, because it constitutes a basic element of children’s wellbeing, and the second is that without an educated, skilled and productive population, the region cannot compete in terms of the global economy,” noted Santiago Levy, Vice President for Sectors and Knowledge at the IDB, during his opening remarks at the most recent Regional Policy Dialogue.

I think it would be helpful to provide a bit of background. The Regional Policy Dialogues held annually by the IDB stem from an institutional mandate to provide a forum for Latin American and Caribbean policymakers from different sectors to come together, allowing these stakeholders’ visions to fuel the work of the Bank. Thus, the approach behind these events is to provide multiple forums driven by presentations from specialists and academics. This year the dialogue centered on one of our favorite topics: the quality of child development services.

The goal of this event was to get a handle on how countries manage the quality of early childhood services and to promote discussion about what it takes to ensure quality services. The presence of participants from various sectors including social development, family, education, and health as well as representatives from the office of the president and national inter-sectoral committees and councils, served as confirmation that, fortunately, the issue of early childhood development is becoming an increasingly important topic on the social policy agendas of the countries in our region.

Our regular readers will recall that in a previous post on this blog, we solicited suggestions on topics to be discussed at the meeting. Good news! Not only were those topics addressed at the meeting, but they were closely aligned with the interests of the participants. Thanks a lot for your ideas!.

The meeting was organized around two central themes:

  • The importance of quality early childhood development services and the challenges to achieve it
  • The challenges of inter-sectoral coordination entailed by the provision of quality early childhood services

Given the wealth of material discussed over the course of those two days, in this post, I’d especially like to share the incredibly motivating and interesting reflections that were a “warm-up” to the meeting.

Norbert Schady, Principal Advisor for the Social Sector, emphasized that “we have to stop creating public policy in the dark.” Schady feels that there is insufficient data on many dimensions of early childhood development (ECD) and the impacts of different types of interventions, and he emphasized the importance of having robust impact assessments that generate a virtuous cycle of learning-reform-evaluation-learning and of contributing to the political sustainability of the programs.    

Very much in line with the issue of quality vs. quantity raised by one of our readers in Peru, the presenter Lynn Kagan brought attention to the fact that most children do not have access to high-quality early childhood services, a problem that constitutes a global challenge. The issue of quality has been avoided, especially since decision makers have focused on increasing the number of services rather than their quality. In part, this corresponds to a limited understanding of the relationship between the quality of programs and their impact and a widespread (yet mistaken) belief that quality is a luxury.

On another note, Prof. Kagan recognizes that most of the impact assessments and instruments from which these conclusions are derived were designed in the United States and, consequently, need to be adapted for different contexts. For this reason, she reflected on the need for a comprehensive approach to quality and a great variety of programs that work synergistically and in a coordinated manner, and she stressed that the important thing is not to adopt a single standard of quality but rather to take into account the values and culture of each context.

On the issue of inter-sectoral coordination, Maureen Samms-Vaughan of the University of the West Indies and former president of Jamaica’s Early Childhood Commission, presented that country’s experience.  In recognition of the multi-dimensionality of early childhood development, Jamaica created a multi-sectoral Board of Commissioners with representatives from the Ministries of Health, Education, Labor, Social Security and Finance, and a five-year National Strategic Plan was developed with quality benchmarks.

The main achievements stemming from this experience are the establishment of a unique organization that developed a comprehensive strategic plan that included quality measures. Furthermore, in areas with regulatory agencies, quality is constantly monitored.  Among the challenges, Maureen highlighted the excessive focus on measuring the quality of preschool services rather than broadening it to all services offered for children. She also noted that quality measurement turns out to be complex since there are neither standards against which to measure quality nor internationally-accepted indicators. Limitations in terms of personnel and financial resources also create obstacles.

Consistent with comments from several blog readers, Steve Barnett said in his presentation that it is necessary for early childhood development programs to 1) address all aspects of child development in parallel, 2) be staffed with qualified and adequately-paid personnel, with a strong monitoring and supervision system, and 3) use evidence to inform and reform their practices. He also stressed the importance of using continuous quality improvement cycles that involve the development of standards, the measurement and evaluation of progress, data analysis and planning, and the introduction of mechanisms for technical assistance and professional development.

Lastly, Milagros Nores reflected on whether quality measurements may be too general thus lacking a relationship to children’s social-emotional and cognitive development. For example, if measurements exclusively cover areas such as health and safe environments, these indicators—while they should certainly be taken into account—do not explain the quality of the processes, which is what ultimately relates to children’s experiences and learning.

The presentations were rich with information but so were the panel discussions, chaired by Joan Lombardi,  which addressed the following questions about the challenges of implementing quality early childhood programs: How do we create an architecture that makes provisions for governance, convening power and guidance? How do we strengthen capabilities in the sectors responsible for each issue? The challenges put forward were related to training of personnel, social and community participation in some countries, the development of monitoring and evaluation systems, provision of care in rural areas, the integration of databases from different sectors, financial sustainability of the programs, and the comprehensiveness of the approach.

In short, I think the goal of the Dialogue was achieved in terms of getting a handle on how to manage quality in these countries. Some of the main conclusions were that 1) achieving quality services is an extremely complex task requiring resources and 2) to successfully manage these services, it is necessary to have data and evidence to inform the reform process, in addition to personnel and highly-developed information systems.

It is clear that a commitment to working together for the development of children exists in the region, in big countries as well as in the smallest ones. The key is to better understand institutional designs, program offerings, and management tools that address the provision of quality services.

If you would like to read more on this topic, you can download the complete presentation from the meeting’s webpage.


Filed Under: Uncategorized

Florencia Lopez Boo

Florencia Lopez Boo is a Director, Global TIES; Economics and Applied Psychology at NYU. Prior to joining NYU, she was a Lead Economist at the Social Protection and Health Unit of the Inter-American Development Bank (IDB), where she led the Early Childhood Development (ECD) agenda, the IDB ECD Innovation Fund, the knowledge agenda of her unit, and an initiative on behavioral economics and social policies. She was a professor at the University of Louvain and worked at the World Bank and UNIDO. She has a PhD in Economics from Oxford University (Clarendon-Oxford University Press award). She is also a Young Lives Research Associate at the University of Oxford and the Institute for Labor Studies (IZA) in Bonn. Twitter: @florlopezboo

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Early Childhood Development

The first years of life are essential to establish the future foundation of a person´s productivity and wellbeing. In this blog, experts from the IDB and thought leaders in the topic, share information and international experiences related to early childhood development. Join us to talk about initiatives implemented in your country in this area

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