Toward an adequate ECD centre subsidy for children under 5 in South Africa: a costing of centre delivery

The South African government has increasingly recognised the significance of investment in ECD services of different kinds to support child development and protect child rights. Primary health care is free for young children and for pregnant and lactating women, and 2.86 million children from birth to age 4 access a government-financed cash transfer via the Child Support Grant Programme. Since 2001, the government has invested significantly in expanding services for 5-year-olds in a reception year of formal schooling, falling under the Department of Education. This service will be universally available to nearly 1 million children by 2010. Norms and standards for funding the reception year have been legislated, and provincial budget allocations are increasing toward providing for the access and quality requirements. More recently, attention has shifted to the greater challenge of meeting the needs of South Africa's 4.98 million children under 5 years. In 2005 the government produced the National Integrated Plan for ECD, providing for an integrated service package for under-5s, with a focus on poor and vulnerable children. The Plan includes primary health care services, birth registration, child support grants, and early stimulation. These services can be offered via the home, through a range of community programmes, or at early childhood centres. Budgeting for the age group 0-5 falls to three departments at the provincial level: the Department of Health for provision of health services; Education for training of personnel, curriculum guidelines, and learning materials; and Social Development for monitoring and providing funding (not full cost) to agencies offering ECD programmes. To date the latter has largely been for ECD centres, which are estimated to cover only 22.6% of children. Currently a drive to increase centre access and quality is being coordinated through one of the government's leading short-term measures to address poverty, the Expanded Public Works Programme (EPWP). The political commitment for service expansion for under-5s has been demonstrated by the inclusion of ECD in the EPWP and in the APEX3 priorities announced by the president in February 2008. This article examines the costs of sustaining a centre programme at a minimum level of quality and draws out some implications for current budgets. The need to establish an adequate ECD centre subsidy and to scale up ECD provision for under-5s must be understood in the context of the scale of poverty, and its impact on children, in South Africa, as well as in the tradition of limited funding for ECD programmes.

Prevalence and characteristics of overweight and obesity in indigenous Australian children: A systematic review

Evidence-based profiling of obesity and overweight in Indigenous Australian children has been poor. This study systematically reviewed evidence of the prevalence and patterns of obesity/overweight, with respect to gender, age, remoteness, and birth weight, in Indigenous Australian children, 0-18 years (PROSPERO CRD42014007626). Study quality and risk of bias were assessed. Twenty-five publications (21 studies) met inclusion criteria, with large variations in prevalence for obesity or overweight (11 to 54%) reported. A high degree of heterogeneity in study design was observed, few studies (6/21) were representative of the target population, and few appropriately recruited Indigenous children (8/21). Variability in study design, conduct, and small sample sizes mean that it is not possible to derive a single estimate for prevalence although two high-quality studies indicate at least one in four Indigenous Australian children are overweight or obese. Four of six studies reporting on gender, found overweight/obesity higher in girls and eight studies reporting on overweight/obesity by age suggest prevalence increases with age with one high quality large national study reporting total overweight/obesity as 22.4% of children aged 2-4 years, 27.5% of those aged 5-9, 38.5% aged 10-14, and 36.3% aged 15-17. Three of four studies, reporting obesity/overweight by region, found lower rates for children living in more remote areas than urban areas

Agave Harvest (Mexico)

Postcard depicting an agave harvester, called a Tlachiquero, at an agave plantation