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Answer & Explanation:HI ..I would like you to write for each article the two main points that were raised. I want you to quote from the articles if possible.The topic is early childhood education programs.
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THE WORLD BANK GROUP & SAVE THE CHILDREN [INSERT LOGOS/LETTERHEAD]
The Promise of Preschool in Africa:
A Randomized Impact Evaluation of Early Childhood
Development in Rural Mozambique
Sebastian Martinez
IDB
Sophie Naudeau
World Bank
Vitor Pereira*
PUC-Rio
February 6, 2012
*Acknowledgements: This report presents initial results of a community based preschool program implemented by Save the Children
in the Gaza Province of Mozambique. We thank a number of colleagues and institutions that have assisted at various stages of the
evaluation. Barbara Bruns played an instrumental role in launching this evaluation and formed an integral part of the evaluation design
team. Vitor Pereira and John Bunge provided in-country field work coordination and supervision of data collection and Michelle
Perez provided outstanding research assistance for this report. We received helpful comments from seminar participants at the World
Bank and the Ministry of Education in Mozambique and we thank Harold Alderman, Deon Filmer, Marito Garcia, Patrick Premand,
Renos Vakis and reviewers at Save the Children and 3ie for helpful comments on earlier versions of this report. We are grateful to all
Save the Children staff that provided guidance and assistance for this evaluation, especially Patricia Cavagnis, Jodie Fonseca, John
Grabowski, Melissa Kelly, Domingos Mahangue, Damião Mungoi, Chloe O’Gara, Arsenia Rodrigues, Pablo Stansbery, Ana Tenorio
and David Wright. We appreciate support from the Mozambique Ministry of Education, Ministry of Women and Social Action,
Ministry of Health, and the Early Childhood Development Working Group members who provided advice through the evaluation
steering committee. We thank the survey teams at Austral-Cowi, in particular Isabel da Costa, Ercilio Infante, Arsenia Paulo, Sandra
Roque and Elias Zavale. We gratefully acknowledge funding from the International Initiative for Impact Evaluation (3ie) and the
World Bank’s Bank Netherlands Partnership Program (BNPP) Basic Education Program and Spanish Impact Evaluation Fund
(SIEF). Funding for the Save the Children ECD program implementation was supported by America Gives Back and The ELMA
foundation. All findings and interpretations in this paper are those of the authors, and do not necessarily represent the views of their
respective institutions, Save the Children, America Gives Back, The ELMA Foundation, or the Government of Mozambique.
Authors: Sebastian Martinez: Inter American Development Bank, 1300 New York Avenue, NW, Washington DC 20577,
smartinez@iadb.org; Sophie Naudeau: The World Bank, 1818 H St NW Washington DC 20433, snaudeau@worldbank.org. Vitor
Pereira: Department of Economics, Pontifical Catholic University of Rio de Janeiro, Rua Marquês de São Vicente, 225- Gávea, 22451900, Rio de Janeiro, RJ, Brasil, vitpereira@gmail.com.
Contents
1.
Introduction …………………………………………………………………………………………………………………… 2
2.
Theoretical Framework and Existing Evidence ………………………………………………………………………. 5
3.
Save the Children’s Early Childhood Development Program ………………………………………………….. 10
4.
Data and Experimental Evaluation Design ………………………………………………………………………….. 13
5.
Identification Strategy ……………………………………………………………………………………………………. 16
6.
Results …………………………………………………………………………………………………………………………. 18
7.
6.1.
Impacts of Preschool on Primary School and Time Use …………………………………………… 20
6.2.
Impact of Preschool on Child Development Outcomes……………………………………………. 22
6.3.
Impact of Preschool on Child Growth and Health …………………………………………………… 26
6.4.
Impact of Preschool on School Enrollment of Older Siblings…………………………………….. 27
6.5.
Impact of Preschool on Adult Caregivers………………………………………………………………. 28
Conclusions ………………………………………………………………………………………………………………….. 29
References ………………………………………………………………………………………………………………………….. 31
Appendix 1: Program Cost Estimates ……………………………………………………………………………………….. 38
Appendix 2: Figures ………………………………………………………………………………………………………………. 43
Appendix 3: Tables ……………………………………………………………………………………………………………….. 45
1
1. Introduction
The earliest years of life are pivotal in forming the foundations for healthy development and
providing children and their societies the opportunity to reach their full potential. However, many
children in developing countries are not able to develop to their full potential because of serious
deficits in health, nutrition and proper cognitive and non-cognitive stimulation. The effects of the
delayed development in the early years can be deleterious and long lasting, reinforcing the
intergenerational transmission of poverty. Early Childhood Development (ECD) programs are seen
as a promising way to prevent such delays and foster early development. While there is a growing
evidence base on the effects of ECD programs in the United States, Latin America and elsewhere,
there is little evidence of the effectiveness and cost-effectiveness of such programs in the African
context.
At the same time, over the past decade countries in Sub-Saharan Africa have made progress
in expanding primary education. In Mozambique, net primary school enrollment rates increased
from 45% in 1998 to 95.5% by 2010 (The World Bank, 2011). Despite these gains, children
frequently experience delayed entry to school and present severe developmental delays, especially in
poor rural communities. Grantham-McGregor et al (2007) estimate that 61% of children in SubSaharan Africa fail to meet their development potential because of poverty. Inadequate health and
nutrition, cultural practices that limit communication between parents and children, and home
environments with few books, toys, and other learning opportunities may all contribute towards
inadequate physical and cognitive growth, particularly in the early periods of physical and brain
development. As a result, children arrive at school ill-prepared for a new learning and social
environment. Moreover, low levels of child development are associated with lower levels of school
participation and performance, higher rates of criminality, increased reliance on the health care
system, and lower future earnings and income (for a review on these topics, see Naudeau et al.,
2010). To address this situation, a number of Early Childhood Development (ECD) interventions
have been proposed, including nutrition programs, parenting programs and pre-school.
In this report we present initial results of what, to our knowledge, is the first randomized
evaluation of a pre-school intervention in a rural African setting1. By any measure, access to and
1
A recent Systematic Review on the impact of daycare programs in developing countries, conducted by the
International Initiative for Impact Evaluation (Leroy et al., 2011), identified no evaluations of daycare in the African
context that met the review’s inclusion criteria. Of the six studies included in the review (all in Latin America), none
were experimental.
2
enrollment in preschool in Mozambique is very low. By available estimates, only 4 percent of
children enroll in preschool, and the vast majority of these are in urban areas and amongst the more
affluent populations (The World Bank, 2011). This low participation rate likely reflects a
combination of supply-side constraints (i.e., lack of available programs for parents to enroll their
child) and demand-side constraints (including lack of information among parents about the benefits
of ECD). Starting in 2008, Save the Children implemented a center-based community driven
preschool model in rural areas of the Gaza Province of Mozambique. The project financed the
construction, equipment and training for 67 classrooms in 30 communities, at a cost of
approximately $2.47 dollars per student per month2
As part of its design, the program included an experimental impact evaluation whereby the
30 intervention communities were selected at random from a pool of 76 eligible sites. A detailed
baseline survey was collected in early 2008 on a sample of 2000 households with preschool aged
children as well as community leaders and first grade students in each of the 76 evaluation
communities. In addition to standard socio-economic questions, the survey includes a detailed
battery of tests to measure child development, including measures of cognitive ability (including
problem-solving skills, memory, and early math skills), gross motor skills (e.g., running, jumping),
fine motor skills (e.g., picking up objects, holding a pencil), language and communication (e.g.,
production and understanding of words, ability to identify letters), socio-emotional development
(e.g., getting along with peers and adults, following directions and cooperating, capacity to regulate
emotions positively in stressful situations) and health (including growth and prevalence of
morbidity). An endline survey was conducted in 2010, approximately 2 years after the start of the
program, with a 95% re-contact rate.
We find that primary school enrollment rates increase significantly in treatment
communities. Children who attended preschool are 24% more likely to be enrolled in primary school
at endline compared to the control group, and are more likely to enroll at the appropriate age.
Furthermore, beneficiary children spend an average of 7.2 additional hours per week on schooling
and homework related activities and reduce time spent working on the family farm and attending
community meetings.
Perhaps most importantly, participation in the preschool program results in significant
improvements along a number of child development outcomes. Results show consistent
2
The average cost for a 12 month program is estimated at US$29.1 per child. See Appendix 1 for more details on
the costing model.
3
improvements in cognitive and problem-solving abilities, improvements in fine-motor skills and
better socio-emotional and behavioral outcomes. As such, children are better prepared for school
and outperform their peers on these dimensions. On the other hand, some of our principal
measures of communication and language development are not significantly different between the
treatment and control groups, and continue to be alarmingly low for both groups.
While children’s health and nutrition were peripheral components of the preschool
intervention, the evaluation data revealed striking delays in physical growth amongst preschool aged
children, with over 40% of children being stunted at baseline. Given that a child’s growth potential
is largely determined by age 3 (the youngest age in our sample at baseline), and early delays in
physical growth are difficult to reverse (Martorell et al., 1994), it is not surprising that we find no
differences in rates of stunting and wasting between children in the treatment and control groups by
2010. The impacts of the program on children’s reported health are mixed. On one hand, we
observe hints of reductions in diarrhea and skin problems which may be linked to the program’s
emphasis on hand washing and self-care (though results are not statistically significant). On the
other hand, children who attend preschool are more likely to report being sick, and in particular to
have had a cough, which may simply reflect the increased exposure to colds from being in close
proximity to other children.
In addition to direct impacts of the program on children who attend preschool, we also
consider the effects on other household members, in particular caregivers and older siblings. We
find a striking result that children 10 to 15 years old at endline, a group that was too old to have
benefitted directly from the preschool program, are 6% more likely to have gone to school when a
younger child in the household has attended preschool. Furthermore, caregivers of preschoolers are
26% more likely to have worked in the 30 days prior to the interview. These results suggest that the
center based ECD model, where children are cared for out of the home, may produce added
benefits by freeing up time and resources for older children and adults in the household to engage in
other productive activities, whether that is school or work.
Finally, we show that through its parenting component, the program produces changes in
care-giving knowledge and practices. Caregivers in the treatment group are less likely to report that
physical punishment is appropriate, and report increases in the practice of daily routines and self
sufficiency activities with their young children. Caregivers also report a significant increase in
satisfaction with their child’s preparation for future school.
4
Taken together, these results lead us to believe that preschool programs are a promising
policy option for improving the school readiness and later success of poor and disadvantaged
children in rural Africa. In addition to the positive effects on children, the low-cost center based
model studied here has added benefits for older children and parents of preschool aged children.
This evaluation also reveals that by age 3, many children arrive at pre-school with severe delays in
physical growth (as evidenced by the high rates of stunting) and signs of strong lacunas in
vocabulary development. We propose that in addition to preschool, children in poor rural settings
may benefit from complementary health, nutrition and early stimulation interventions starting much
earlier in life.3 Finally, it is important to emphasize upfront that this report presents the results of a
small and well managed program implemented in three Mozambican districts, and the analysis is
focused on results achieved by the approximately 55% of children who actually enrolled in
preschool. Whether or not similar results can be replicated in other parts of Africa with large scale
programs or with close to universal enrollment remains an empirical question and should be tested
in future research.
This report is structured as follows. In the next section we provide a brief overview of the
theory of change underpinning ECD and discuss relevant empirical evidence, followed by a
summary of the primary research questions we posed at the outset of this evaluation. Section 3
provides an overview of Save the Children’s preschool program in Mozambique. Section 4 discuses
the data and evaluation design and section 5 outlines the identification strategy used in the analysis.
Section 6 presents the main results for the impact of preschool on children and their families, and
section 7 concludes.
2. Theoretical Framework and Existing Evidence
Traditional models of human capital acquisition treat ability as an innate, uni-dimensional
and age-invariant skill (Becker, 1964; Ben Porah, 1967; Becker and Tomes, 1979). While this
literature had been very successful in explaining how individuals and families choose optimal levels
3
It is important to note that the Save the Children program evaluated here includes a parenting component that
provides information about how to promote hygiene, health, adequate nutrition, and early stimulation among children
below age 3. However, the potential effects of this specific parenting component of the Save the Children program
package could not be assessed in this first wave of impact data since the focus was on target children (ages 3 to 5 at
baseline) and no health and nutrition measures were collected on their younger siblings. Future waves of data collection
may include such measures.
5
of investments in health and education of children, it treated childhood as a single period and it
assumed that, given a pre-determined innate ability, investments at different stages of childhood
were substitutes. It is well documented, however, that individuals possess a wide variety of abilities,
which account for a significant proportion of their success in life, and that the timing of the
investments in education matter. Recently, a body of literature has emerged that presents a richer
picture of schooling, life cycle skill formation, and wage determination. In an influential article,
Cunha et al (2005) adapted the traditional models of human capital formation, incorporating a series
of important insights from related literature in psychology, education and neuroscience. Here we
summarize the most important features of their model.
The first observation from their model is that abilities matter in determining wages,
schooling, criminality, or early pregnancy, but they include a vast array of non-cognitive abilities in
addition to pure cognitive ability. Abilities are multiple in nature and include perseverance,
motivation, self control, self-esteem, risk aversion, patience and time preferences, for example. All
those traits have genetic components but are susceptible to environmental influences. Parents and
primary caregivers play a key role in influencing children at an early age, while additional influences
(e.g., extended family, peers, teachers, and others) progressively play an increasing role as children
grow older.
Second, the human skill formation process is driven by a multistage technology. Each stage
corresponds to a different period in the life cycle of the child. Technologies can be different
according to the life period of the child. Different skills can be more productively developed at
certain stages, generating sensitive and critical periods for the development of each skill. Stages in
which a child may be more productive in developing certain skills are called sensitive periods. Other
abilities can only be developed at critical periods of life. Skills are self-reinforcing. Abilities acquired
in one period persist to later stages. This is termed the ―self productivity‖ of skill formation. Skills
acquired in one dimension make it easier to acquire skills in other dimensions. In other words,
development in one domain often act as a catalyst for development in another. For example, after
learning to walk, children are faced with new demands on self-control, as parents are more likely to
restrict their behavior and to say ―no‖ (Fernald et al., 2009). In this example, a child’s development
in the gross motor domain triggers the need for him/her to develop new socio-emotional skills. Skill
formation is also ―complementary‖—skills produced in one stage increase productivity of
investments in subsequent stages. Together, self productivity and complementarities produce
multiplier effects in abilities formation.
6
One of the most important facts explained by the model is that ability gaps – cognitive and
non-cognitive—between individuals and socioeconomic groups develop very early on. Paxon and
Schady (2007), illustrate this point clearly in their Ecuador Study. The authors show that while
differences in age-adjusted vocabulary among 3-year-old children in their sample are generally small,
by age 6, children in less wealthy or less educated households have fallen far behind their
counterparts in wealthier or more educated households. This pattern occurs in part because poor
children tend to receive l …
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