Child Marriage: A Persistent Hurdle to Health and Prosperity

Yesterday, on October 11, the world marked the International Day of the Girl Child. While the day is an opportunity to advocate for girls’ rights across many sectors, one persistent, pernicious issue deserves renewed attention:  the high prevalence of child marriage. This is an issue of importance for governments, but also for NGOs, including service club organizations such as Rotary that are investing substantially in education and health.

Child marriage

Every year, 15 million girls marry before the age of 18. Child marriage is associated with higher health risks for these girls and their children. It also contributes to high population growth, thereby threatening access of households to the often scarce resources they need to thrive, and putting pressures on government budgets to deliver quality services.

The elimination of child, early and forced marriage is now part of the Sustainable Development Goals under Target 5 – achieving gender equality and empowering all women and girls. This is good news. But for governments, NGOs, and communities to take the challenge of the elimination of child marriage seriously, more evidence is needed on the negative impacts of child marriage, as well as what works to eliminate the practice.

The International Center for Research on Women (ICRW) and the World Bank are collaborating in an innovative, three-year research project to do just that. The project involves the most extensive data analysis – and for three countries, new data collection – undertaken so far to better understand and measure the economic costs of child marriage. Funding for the project is provided by the Bill and Melinda Gates Foundation and the Children’s Investment Fund Foundation.

A brief on selected preliminary results from the analysis was shared at a side event at the United Nations General Assembly last month. It suggests that child marriage has large negative effects on population, health, and nutrition.

Fertility and Population Growth

The number of children a woman has over her lifetime has significant impacts on her health, her ability to engage in activities outside of the household, and the poverty level of her household. Analysis of Demographic and Health Surveys for a half dozen countries suggests large impacts of child marriage on the number of live births for a woman over her lifetime. In Nigeria, for example, girls who married at age 12 have a number of births higher by 30% on average than women who married after the age of 18. Even marrying at age 17, rather than 18, increases the number of births by 18%.

On average, women marrying as children have 1.4 more children over their lifetime than if they marry after the age of 18. In some countries such as Egypt, the impact is smaller, but in other countries such as Ethiopia, it is larger.

Because girls who marry early have a higher number of births over their lifetime, child marriage contributes to higher population growth. Estimates suggest that in countries with a high incidence of child marriage, such as Niger, annual rates of population growth could be reduced substantially each year if child marriage were eliminated, and there were no increases in births outside of marriage by adolescent girls. The implications of these changes at the aggregate level for both government and private expenditures would be significant, placing less demand on often over-stretched services and infrastructure, as well as government and private budgets, and generating a potentially large “demographic dividend.”

Under-Five Mortality and Malnutrition

Child marriage increases the risk of maternal and under-five mortality and morbidity, leading to significant social and economic impacts from the individual level  to the national level. Analysis of Demographic and Health Surveys suggests that the risk of death before age five for children increases substantially when the child is born to a mother below 18 years of age, as compared to a child with similar characteristics born to an older mother. Delaying marriage therefore would help reduce infant and child mortality.

Children born to child brides also have a higher risk of malnutrition than children born to older mothers — a significant barrier to the health of the child, their educational prospects, and, in the longer term, their contribution to household and national economies through their labor. Analysis based on Demographic and Health Surveys suggests that children born from child brides have higher risks of stunting than children born from mothers older than 18, with additional risks resulting from a higher likelihood of low birthweight. In the Democratic Republic of Congo, for example, the effect is estimated at seven percentage points. At the aggregate level, this could have significant effects for countries seeking to enhance the human capacity and health of their population.

Multiple Impacts

It is often said that the process of development is multidimensional, with vulnerabilities in some areas affecting other areas. Child marriage is a perfect example of this, since it affects so many areas in the lives of the girls who marry early, their children, and their communities. This is true for health, nutrition, and population, but also for education, labor force participation and earnings, decision-making ability within the household, and even the risk of gender-based violence. As a result, the economic impacts and associated costs of child marriage are large and far-reaching.

Results from joint ICRW-World Bank research on this issue will be updated on the project website as they become available. A launch event for sharing the main results from the first phase of the research is planned for the second half of November 2015 at the World Bank.

This post is reproduced with minor changes from a post by the author on the World Bank’s Investing in Health blog available at http://blogs.worldbank.org/health/.

Saving Mothers and Children in Nigeria (Partnerships Series No. 4)

Over their lifetime, one in every 30 women in Nigeria are likely to die due to pregnancy and childbearing. Nigeria alone accounts for one in seven maternal deaths observed in the world today. This post, the fourth in a series on partnerships, innovation, and evaluation in Rotary, tells the story of a project that has succeeded in reducing maternal mortality in Nigeria.

Nigeria saving lives

Project and Partners

Many factors lead to maternal mortality, but a key risk is that of obstetric fistula (a hole in the birth canal). The World Health Organization estimates that each year between 50,000 and 100,000 women suffer from obstetric fistula, which by obstructing labor can lead to maternal death.

Quality assurance mechanisms in hospitals can improve obstetric services and contribute to reducing maternal mortality. This was the premise of a series of Rotary projects aiming to reduce maternal (and fetal) mortality in Nigeria led by Robert Zinser and the Rotarian Action Group for Population Growth and Development (RFPD) between 2005 and 2010.

With support from RFPD and some 200 Rotary, Rotaract and Inner Wheel Clubs, Rotary implemented a first project to improve quality assurance mechanisms in ten hospitals in Kano and Kaduna States in Northern Nigeria. Apart from funding from Rotary clubs and the Rotary Foundation, support was also provided by the German Ministry for Economic Cooperation and Development (BMZ), the Aventis Foundation and the International Association for Maternal and Neonatal Health (IAMANEH). The project was implemented by Nigerian Rotarians.

Innovative Approach

Conceptually, reducing maternal and fetal morbidity and mortality can be achieved through an improvement in the quality of the infrastructure and other inputs used to provide treatment (availability of medicine, better hospital facilities, etc.) as well as improvements in the process of providing treatment (more experienced health personnel). The project team worked on both fronts.

In terms of improvements in infrastructure, a number of investments were made, including two specialized fistula wards (one for each of the two Nigerian states) with rehabilitation facilities. Medical equipment was provided to ten hospitals and some hospitals were equipped with better water supply and solar energy. Hospitals also received intrauterine devices for women requesting them for family planning as well as drugs preventing mother-to-child transmission of HIV.

To improve the capacity of hospital personnel, seven doctors were trained as fistula surgeons and 15 ward nurses were trained in fistula care. Many more doctors, nurses and midwives, and other health personnel such as traditional birth attendants were also trained on how to improve obstetric services. Hospital teams were trained in emergency obstetric care including (among others) in the use of magnesium sulfate to manage eclampsia and the use of an anti-shock garment to treat postpartum hemorrhage.

Apart from providing support to the hospitals participating in the project, support was also given to communities in the hospitals’ catchment areas. Mosquito nets were provided to reduce the risk of contracting malaria. Awareness and advocacy campaigns were held using radio, television, print media, and even drama (public plays on the streets) to inform the population about obstetric fistula, its causes and how to prevent it, and its impact on maternal and fetal mortality. These awareness campaigns enlisted the support of traditional and religious leaders who have substantial influence on behaviors in the community.

Perhaps the most important innovation was the development of a quality assurance mechanism that involved setting standards and systematically collecting data on the quality of the care being provided and the outcomes in terms of maternal and fetal mortality and morbidity. This was done through a “quality circle” process to monitor, review, and improve performance over time. Data were collected in participating hospitals, analyzed statistically, discussed by the teams, and used to assess improvements and take corrective measures as needed.

Evaluation

An evaluation based on the data collected by the hospitals as part of the quality assurance mechanism before, during and after the intervention suggests that the project achieved a 60 percent reduction in maternal mortality in participating hospitals and 15 percent reduction of newborn mortality.

Conclusion

RFPD’s obstetric fistula project combines all three ingredients of a winning combination for impact: partnerships, innovation, and evaluation.

The team established multiple partnerships for funding (the investment for the pilot project in the ten hospitals amounted to one million Euros) and implementation (securing buy-in from the hospitals, the state authorities, the communities, and even traditional and religious leaders).

The project included innovative components in the Nigerian context, especially the quality assurance mechanism and data collection process to improve the quality of obstetric care.

The project was evaluated using data from the quality assurance mechanism and the evaluation was published in an academic journal.

The project has been considered a success by stakeholders and the Kano and Kaduna state governments. This led to a subsequent project to continue to build capacity in the original 10 participating hospitals, and extend the model to 15 more hospitals (five rural hospitals in FCT Abuja, five hospitals in Ondo State, and five more in Enugu State). Additional scaling up is being considered by the RFPD team.

A brief on the project and the Nigerian context is available here.

Providing Water and Sanitation in Uganda (Partnerships Series No. 3)

As in other low income African countries, access to water and sanitation remains limited in Uganda, especially for the poor. This third post in a series on partnerships, innovation, and evaluation tells the story of how Rotary is playing an important role in helping to meet some of the water and sanitation needs of Uganda’s population.

Apac

Water Projects

A first important initiative is the Uganda Rotary Water Plus (URWP) program. URWP coordinates work on water and sanitation done by 78 Rotary clubs (virtually all the clubs in Uganda). The program was launched by the Ugandan Minister for Water and Environment in October 2011. It promotes effective service delivery to rural and less privileged communities.

Clubs develop projects for the communities they wish to serve. For this purpose, they must first build strong relationships with the community and develop a needs assessment. Having identified needs, clubs then select partners to meet those needs, including other Rotary clubs for fund raising, non-profits and/or business partners for implementations, and local authorities. Co-funding is typically provided by the Rotary Foundation (TRF) and in some cases other funding agencies.

The design of projects must be based on adequate technologies for the community context, with attention paid to gender and environmental issues. Clubs are encouraged to link the projects to other areas of focus of TRF, for example by providing water and sanitation to schools or health clinics.

The idea is that water and sanitation alone can’t transform a community; the “Plus” in URWP refers to other areas of focus of TRF such as supporting education or fighting disease.

The model also encourages local management committees to oversee facilities cost recovery through tariffs so that funds are available for maintenance.

URWP aims to raise $7 million for more than 30 projects. Rotary International is also partnering in Uganda with USAID to invest $4 million over four years through additional projects, following previous successful similar collaborations in the Dominican Republic, Ghana, and the Philippines (this broader partnership is referred to as the International H20 Collaboration).

Beyond the mobilization of funds, the URWP initiative has also succeeded in uniting 4,000 Ugandan Rotarians, more than 3,000 Rotaractors and many members of Rotary Community Corps (RCCs) behind countrywide water and sanitation initiatives. Many have volunteered their time and financial resources to support the projects.

Community Needs Assessments

Another interesting initiative that is part of URWP has been the implementation of a detailed diagnostic of water and sanitation facilities in communities of Apac District located 250 kilometers north of Kampala.

The idea behind the water and sanitation community needs assessment was to prepare an inventory of resources as well as gaps to be used by the Ministry of Water and the Environment as well as Rotary and other funders for the prioritization of investments. Teams visited communities. After an initial meeting in each community, data collection involved implementing a survey, conducting interviews and focus groups, establishing an inventory of all water and sanitation assets in the community, and conducting community mapping exercise.

Data were collected using the FLOW (Field Level Operations Watch) system developed by Water for People. The application relies on Android cell phones together with GPS data and Google Earth software to document water and sanitation infrastructure as well as its functionality.

The community needs assessments was implemented with support from the Apac government and 16 organizations. Rotaractors served as field enumerators. Data were collected for communities as well as public institutions such as schools and health centers, with ratings provided on the quality of facilities and the satisfaction of users. Tests of water quality have also been conducted in some of the areas.

Conclusion

URWP represents a prime example of efforts by Rotary to invest in projects that have a larger impact through partnerships, innovation, and monitoring and evaluation.

The URWP team has established partnerships with multiple NGOs as well as USAID and Ministry of Water and the Environment. It has been innovative in project design to ensure a higher likelihood of sustainability. Evaluations of the projects are not yet available (many projects are still at the design or implementation stage), but monitoring systems are being put in place.

Finally, in the case of Apac district, extensive data collection has been conducted on water and sanitation assets and gaps at the level of communities in order to inform prioritization of future investments. This should also help in achieving higher impact through targeted interventions.

A brief on the URWP initiative as well as the water and sanitation context in Uganda is available here.

Partnerships, Innovation, and Evaluation, 1: Introduction

This post is the first in a series on increasing the impact of Rotary. The series will feature case studies of great service projects that have achieved larger impact through partnerships, innovation, and evaluation. The hope is that the case studies will encourage clubs and districts to think bigger in their service work.  The series will cover each of the areas of focus of the Rotary Foundation, as well as polio.

Service work through volunteering or projects is at the heart of what Rotary is all about. Membership surveys suggest that the main reason why members join and remain in Rotary is the opportunity to serve (see my recent book on Rotary). Fellowship and networking are also very important, but service is first.

Rotary is a fairly decentralized organization with at its core the Rotary club. Rotarians come in many shapes and forms, beliefs and passions. There is amazing diversity in the types of service work that Rotarians engage in. This is a strength as members choose to contribute to the causes they are most passionate about.

Most of the service work that Rotarians engage in is done through volunteering, not through service projects that benefit from financial support from the Rotary Foundation (TRF). In adition, many projects implemented with TRF support are small and based on local opportunities identified by clubs. These projects may not rely on partnerships, they may not be especially innovative, and they may not be evaluated in depth. As long as it is clear to clubs and local communities that the projects are helpful, a lack of partnership, innovation or evaluation is not necessarily a major drawback. One straitjacket does not fit all in Rotary.

At the same time however, if Rotary is to have a larger impact globally, there is also a need to put together more and larger projects that do rely on partnerships, are innovative, and are monitored and evaluated properly.

Partnerships help to implement larger projects and benefit from the expertise of organizations that are among the best in their field. Partnerships may also generate visibility and media coverage for Rotary (polio is the best example). Partnerships have a cost since effort is required for collaborations to work. But if partnerships deliver scale, expertise, or visibility, gains outweigh the costs.

Innovation is even more important than partnerships to achieve larger impact and discover better ways to serve communities. Without innovation, the contribution of TRF is a drop in the development assistance bucket. TRF does have a respectable size, but in comparison to development funding, it is very small.

Total annual giving by the foundation represents less than half a percent of what the World Bank provides in development assistance every year, and this is just one of a number of development agencies. But if Rotary experiments and innovates, pilots that prove successful can be scaled up by other organizations with deeper pockets, thereby achieving larger impact.

Without serious monitoring and evaluation, innovation does not help much because impact on the ground must first be demonstrated at the pilot stage for a promising intervention to be scaled up. Innovation and evaluation are like twins: they work best as a pair. Evaluation is also needed for Rotary to learn internally from both successes and mistakes.

All three ingredients ̶ partnerships, innovation, and evaluation, can help increase the impact of Rotary’s service work. In order to encourage clubs and districts to move in that direction, this series will show how partnerships, innovation, and evaluation can be harnessed to serve Rotary’s mission of service above self.

The series will tell the story of projects in each of the areas of focus of TRF: promoting peace, fighting disease, providing clean water, saving mothers and children, supporting education, growing local economies, and eradicating polio.

You will learn about an innovative financing mechanism for polio eradication; an award winning project reducing under five mortality in Mali; a program that is transforming teaching and learning in Nepali classrooms; a project to save the life of mothers and children in Nigeria; a program to invest in the writing skills of disadvantaged youth in the United States; projects and initiatives to improve access to water and sanitation in Uganda; and the work done by Rotary with Peace Centers.

All these projects are in one way or another innovative. They all leverage partnerships. And virtually all build on solid monitoring and evaluation mechanisms. Hopefully, the series will give you additional insights into some of the great projects that clubs and districts are implementing around the world.

Please do not hesitate to send me an email through the Contact Me page of this blog if you believe other projects should be featured (perhaps in another series), and feel free to post comments on the projects that you find particularly inspiring.

 

 

Technology in Nepal’s classrooms: Using impact evaluation as a learning device

Students use laptops and digital resources provided by OLE Nepal
Students use laptops and digital resources provided by OLE Nepal

Impact evaluations are becoming essential in the way we think about development and service projects. Pilot programs suggesting statistically significant impacts are hailed as breakthroughs and as candidates for scaling up. Programs without such clear impact tend to be looked down upon and may be terminated. This may not be warranted. A primary function of impact evaluations should be to improve existing programs, especially in fields where evidence of positive impacts remains scarce. The experience of OLE Nepal, which is part of the OLE network and aims to improve learning and teaching through technology, is instructive in this regard.

Last week, Rabi Karmacharya shared his experience at OLE Nepal at a seminar co-sponsored by the World Bank, the Global Partnership for Education and the Rotary Club of Capitol Hill, a supporter of Rotary Club of Kathmandu Mid Town in expanding OLE Nepal’s programs. After a successful career in engineering and technology in California, he launched OLE Nepal in 2007. Now a social entrepreneur, Rabi wants to use technology to transform the way children learn through engagement, exploration and experimentation.

OLE Nepal has achieved quite a bit over the last eight years: deploying 5,000+ laptops in 100+ schools, training 600+ teachers on integrating ICT in the classroom teaching-learning process, developing 600+ learning modules for use by teachers, and creating a digital library with 6000+ books and other items used in schools and community libraries. Its ultimate objective is to help transform and improve Nepal’s education system with technology, working closely with the Ministry of Education and other partners.

What I found most interesting about Rabi’s presentation is how OLE Nepal – as well as donors that support the NGO such as the World Food Program, responded to an evaluation of its programs in 2009-11. The evaluation used a quasi-experimental design: English and mathematics tests administered to students, with collection of additional data through student, teacher and household surveys.

The results were disappointing, with no effect on student test scores even though both teachers and students reported liking the digital contents and finding them useful. The results contradicted field observations and other evidence from teachers and students on the fact that the program was making a difference.

Several factors may have led to an apparent lack of impact on student learning, according to Rabi. First, the program had been implemented only for a relatively short period of time, and improving student learning takes time. Second, it turned out that not all teachers reported to the one-week intensive training session that was held before launching the program, which may have decreased overall impacts in the schools that benefitted from the program. Third, some teachers may not have used as the available digital resources as much as expected due to the increase in workload that this entailed. Fourth, after the initial training, the support provided to teachers was limited. Fifth, it could be that the digital content, while following the curriculum taught in school, was too difficult for students to grasp.

These and a number of factors (including questions about variations in exam difficulty between the baseline and endline tests in the evaluation, and the possibility that some students spent more time on games available through the digital libraries rather than on study for examinations) may have led to the results.

What is important is that the evaluation did not lead to the demise of the program. Witnessing firsthand the changes in classroom dynamic and student engagement brought about by the program, donors continued to fund the NGO, which has been able to grow with support from the World Food Program, the Embassies of Denmark and Finland, and most recently the Air Asia Foundation.

In response to the evaluation, OLE Nepal introduced a number improvements in its programs:

  • It now promotes a shared model between grades for a more effective use of laptops and digital resources by schools and teachers;
  • The use of resources by students is better supervised and teachers receive more extensive support after the initial one-week training. In addition, a volunteers program is available for additional support;
  • The educational contents have been revised to follow the curriculum even more closely; and
  • More emphasis will be put on enhancing the ability of students to read in early grades, since this is a prerequisite for them to be able to learn subsequently and use digital resources effectively.

OLE Nepal’s experience is a great lesson in social entrepreneurship, humility, and resilience from an innovative NGO that strives to help teachers and students harness the power of technology in the classroom.

Note: this post is reproduced with minor changes from a post by the author for the World Bank’s Education for Global Development blog, available at http://blogs.worldbank.org/education/.

Webinar with Rotarian Founder of OLE Nepal: Learning from Pilots and Scaling Up

Established in September 2007, OLE (Open Learning Exchange) Nepal has pioneered the integration of technology in classroom teaching-learning process. OLE Nepal partnered with Nepal’s Department of Education to launch laptop-based integrated learning initiative in 2008, and has gradually expanded the program to more schools over the years. It has also designed and developed digital learning materials, trained teachers to use them to enhance student learning, and set up appropriate infrastructure in schools to enable learning using technology.

On August 4, 2015 at 12:30 PM (EST), Rabi Karmacharya will present at the World Bank a seminar/webinar on Learning from Pilots and Scaling Up: Integrating Technology in Classrooms in Nepal. Rabi will discuss successes and challenges in implementing OLE’s programs from their pilot phases to scaling up.

Rabi is a social entrepreneur who helped launch OLE Nepal with the vision to use technology to improve the quality of primary education in Nepal’s public schools, and to transform the way children learn through engagement, exploration and experimentation. He has extensive experience in technological innovation and management, and a conviction that young educated Nepalis have a critical role to play in nation building.

Prior to launching OLE Nepal in 2007, he headed HimalayanTechies, one of the first successful software outsourcing companies that he co-founded in Nepal in 2001. He currently serves as the Chair of the company’s Board of Directors. Rabi holds M.Eng and B.Sc. Degrees in Electrical Engineering & Computer Science from the Massachusetts Institute of Technology (MIT). He worked at 3Com Corporation in Santa Clara, California for three years as design engineer prior to his return to Nepal. Rabi is Asia Society’s Asia 21 Young Leader (2010) and Asia 21 Fellow (2011). He is also an active Rotarian from the Rotary club of Kathmandu Mid Town.

The seminar/webinar will be held at the World Bank “G” building (701 18th Street, NW, Washington D.C.) in room J7-044, It will be accessible remotely through WebEx (please send me an email through the Contact Me page if you would like to get the web link). If you live in the Washington DC area and would like to attend this seminar in person, please let me know as well through the Contact Me page. Light Lunch will be served.

This seminar and webinar is sponsored by the Education Global Practice at the World Bank, the Global Partnership for Education, and the Rotary Club of Capitol Hill that is helping to put together a global Rotary grant to expand OLE’s digital library program.

Video on Award-Winning Muso: Reducing Child Mortality by a Factor of Ten in Mali

by Quentin Wodon

One of the great Rotary-funded projects that has been featured on this blog is Muso. The NGO has reduced child mortality by a factor of ten in its catchment area in Mali thanks in part to an innovative community health workers model. The project has received several awards as a best practice model for saving lives.

Muso baby

I hope you will enjoy the video on Muso and Rotary’s role in supporting the project now available on this blog here (the video was prepared by one of my daughters using footage made available by the Muso team). A short brief on the Muso model and Rotary’s contribution was published earlier on this blog and is available here.

If you would like to submit a video, brief, or paper on your project for this blog’s series, please send me an email through the Contact Me page.

 

 

Innovative Books for Children in Rural Burkina Faso

by Quentin Wodon

One of the aims of this blog is to showcase innovative service projects. These projects will be featured on the blog through 4-6 page briefs that will be publicized through a short post (short, because the idea is for you to read the brief, not a long post about it!)

FAVL

Today’s featured project was implemented in Burkina Faso with support from a global grant from The Rotary Foundation. More than 60 photo books have been created, printed and distributed to community libraries in rural areas. Michael Kevane, a Professor at Santa Clara University and the Co-Director for West Africa of FAVL (Friends of African Village Libraries) has written a brief on the project. I encourage you to read the brief, which is available here.

If you would like to submit a brief about your project, please send me an email through the Contact Me page of this blog.

Investing in Young Children: Two New Resources on Early Childhood Development

by Quentin Wodon

In recent years, a broad consensus has emerged on the fact that investing in young children is one of the best investments countries can make. And yet while investments in early childhood development (ECD) should be a priority, many countries and communities still fall short.

Tomorrow, the World Bank will release two new publications to serve as resources for those aiming to invest in ECD, whether they are government agencies, nongovernmental organizations (NGOs) including service clubs, or private firms. Both publications can be downloaded electronically free of charge.

Essential Interventions and Policy Principles
The first publication, titled Stepping up Early Childhood Development: Investing in Young Children for High Returns, provides a simple framework for thinking about investments in ECD. It describes and reviews available evidence on 25 essential interventions that have been identified as essential for a child’s growth and development (see figure below).

25 Essential ECD Interventions
25 Essential ECD Interventions

These interventions can be delivered through five packages at different stages in a child’s life: (i) a family support package to be provided throughout the ECD period, (ii) a pregnancy package, (iii) a birth package (from birth to 6 months), (iv) a child health and development package, and (v) a preschool package. In addition to these essential interventions and integrated packages, in order to create well-performing ECD systems, the guide calls for countries to be mindful of four policy principles. Countries should (1) prepare a multi-sectoral ECD diagnostic and strategy; (2) implement widely through effective coordination mechanisms; (3) create synergies and cost savings among interventions; and finally (4) monitor, evaluate, and scale up successful interventions. To a large extent these common sense principles are also likely to apply to NGOs, service clubs, and private firms.

Lessons from Past Investments

The second publication, Investing in Early Childhood Development: Review of the World Bank’s Recent Experience, indicates that operational and analytical investments in ECD have increased sharply in recent years at the World Bank. The review considered activities implemented from June 2000 to July 2013 within the Bank’s Education, Health-Nutrition-Population, and Social Protection-Labor Global Practices. Over 13 years, the three Global Practices invested $3.6 billion in ECD in 2013 U.S. dollars (in nominal terms, the amount was $3.3 billion). All geographic regions invested substantially, but the Africa and Latin America and Caribbean regions led the way with the largest IBRD and IDA investments, respectively.

Between fiscal years 2001 and 2011, commitments remained relatively stable in real terms, but in fiscal years 2012 and 2013, they more than doubled, and the trend has continued in 2014. An increase has been observed for both operations and analytical and advisory work. This increase in investments in ECD was related in part to a number of recent policy statements made by the World Bank on the importance of ECD, among others for nutrition, education, and social protection.

For NGOs or organizations such as service clubs, some of the lessons learned from the investments matter probably more than the level of the investments. To gain an understanding of which investments worked well, or required improvements, seven operations were selected for a more detailed analysis. The review highlights six lessons from those case studies that are probably relevant not only for governments but also for NGOs, service clubs, and private firms: (1) Designing ECD projects, due to their complexity and the time lag between investments and impacts on children’s development, requires careful attention to results frameworks, monitoring and evaluation, and a clear definition of roles and responsibilities of all actors; (2) Commitment from all levels of government as well as local communities is crucial; (3) Parents are key stakeholders who should be included in project design and implementation; (4) Coordination across sectors and administrative levels is essential; (5) Projects should be designed to ensure that quality interventions are accessible and culturally relevant to all children, and especially those facing disadvantage; and finally (6) Knowledge exchange (e.g., south-south activities) can be valuable exercises to improve ECD systems. None of these findings are surprising, but the case studies suggest how good practice in these areas leads to better outcomes.

Finally the review mentions a number of new initiatives taken over the last few years, including (1) the ECD module of the Systems Approach for Better Education Results (SABER) framework, which aims to provide a holistic multi-sectoral assessment of programs and policies that affect young children’s development; (2) the eLearning ECD module of the World Bank’s Education Staff Development Program, which brings together theory, practice, and shared experiences so that ECD policymakers and practitioners can engage in informed policy dialogue and decision making (this resource is also available free of charge; see this blog post series); and (3) the Early Learning Partnership (ELP) initiative, an innovative program initially focusing on the Africa region to promote scalable, sustainable, and impactful approaches for young children’s development and early learning. The ELP program is now becoming global and is being scaled up substantially thanks to support from the Children Investment Fund Foundation.

Conclusion

The evidence in the literature on the returns to investments in ECD is clear. Investing in ECD has high potential to help eliminate extreme poverty and promote shared prosperity. The demand from World Bank client countries for investments in ECD is rising, and the World Bank has scaled up its operational and analytical portfolio in this area. But this rising demand is also likely to be observed among communities, and NGOs and service clubs as well as private firms can play a key role in this area. The private sector can probably learn from the lessons learned over the last dozen years by the research and implementation communities, including multilateral donors such as the World Bank, on how to ensure the largest possible impact for investments in young children.

Note: This post is reproduced with minor changes from a post published today by the author on the World Bank’s education blog at http://blogs.worldbank.org/education/.