Country-Level Improvements in Nurturing Care and Child Development, 2010-2019

Abstract

Using data from UNICEF’s Multiple Indicator Cluster Surveys (MICS), we examined changes in nurturing care provision and child development outcomes over time in 31 low- and middle-income countries between 2010 and 2019. The sample included 220 759 children aged 3–4 years. Nurturing care was measured as the sum of 10 indicators spanning early learning, caregiving, safety, health, nutrition, and household conditions, and child development was assessed using the Early Childhood Development Index (ECDI). Country-level means were calculated using survey weights, with missing child-level data addressed through multiple imputation. We documented country-level changes in nurturing care and child development between survey waves and assessed whether changes in child development were associated with concurrent changes in nurturing care, adjusting for changes in the Human Development Index and time between surveys. Across a mean interval of 6.06 years, 21 of 31 countries showed improvements in nurturing care, with average provision increasing from 5.53 to 5.74 of 10 indicators, and annual changes ranging from −0.06 to 0.19 indicators per year.The 2017 Lancet Series, Advancing Early Childhood Development: From Science to Scale, estimated that 43% of children under 5 years in LMICs (250m children), were at risk of not reaching their potential because they had stunted linear growth or lived in extreme poverty. The proportion of children at risk increases appreciably when additional risk factors are considered, especially low maternal schooling and child maltreatment. Living in poor and unstimulating conditions affects young children's learning and development. Children exposed to poverty and adversity explore and learn less than children not exposed to these stresses; they learn less at school and achieve fewer school grades; earn less as adults; have more social problems, and poorer physical and mental health. We will study barriers and accelerators to learning in LMIC ECE programmes, at home and in communities, as well as associations between early learning and indicators of child development and school performance. We will estimate their longer-term effects on education and earnings in adulthood. We will use descriptive and statistical analyses of secondary data collected through representative country surveys and research studies. As an established group of multi-disciplinary and multi-country experts and collaborators, we build on prior success in sourcing and analysing data from 91 LMICs by including early education and expanding to 137 countries. Global data, presented along the continuum of the early years, breaks down the false dichotomy between ECD and ECE, between care and education, and between learning at home and in formal programmes, and supports multi-sectoral actions along different stages of the life-course. We will expand our global analyses of threats to ECD by examining gender, location and wealth, services and family supports for young children, and policies that create facilitating environments for families and children. We will, for the first time, link indicators of the structural quality of ECE (eg teacher-child ratios) to contexts and child outcomes in LMICs. Process quality (eg teacher- and caregiver-child interactions), on which there is as yet no global data, will be studied through case studies in 5 countries, one in each of five regions of the world. We will source data on government, development assistance and household expenditures on pre-primary education; extract further country micro-data on contexts in which young children develop and learn; update nationally representative data on young children, services and policies to the most recent survey dates available, and develop new composite indicators of barriers and accelerators of young children's learning and development. Through partnerships with regional networks of ECD-ECE government and stakeholder teams, the project will help to build research capacity in ECD-ECE, and increase the use of data for decision-making, action and monitoring in 20 countries. We will use the results to provide evidence-based support to engage international human rights law, especially the right to education and the rights of the child, in advancing progress towards achieving the SDG goals of universal access by 2030. This research will address the gap in the evidence base for a unified approach to ECD and ECE. The findings will support the development of the right to education by providing a holistic approach to guide early development and educational interventions. It will demonstrate the strength of interdisciplinary work in cross-fertilizing data analysis and legal research in building strong foundations for translation into policy and regulatory change. Given the evidence on the critical roles of ECD-ECE on learning and wellbeing in the short, medium and longer term, the project has important implications for development and welfare in countries on the DAC list. This large-scale global approach is critical to support and guide policy and investments.</p