Give me a child

THERE are no nurseries in Bulakabya, a hamlet hacked out of sugar-cane fields in eastern Uganda. That is not for a lack of children: most women will have at least eight and, since polygamy is widespread, some fathers have more. Until recently these children had few chances to learn. Parents often left them to their own devices until they could hold a hoe.

This is changing. On a tarpaulin mat in a church built from wood and mud, toddlers take turns at playing games that help them count, spell and get on with peers. Lively Minds, a charity, teaches the mothers how to foster children’s cognitive and social skills. It also advises them on nutrition and hygiene. It says its intervention doubles the number of children scoring highly enough on cognitive tests to be thought of as “school-ready”. Cases of diarrhoea and malaria have also fallen.

This is just one example of the multiple benefits that come from putting more emphasis on early childhood development (ECD), a term that includes everything that can be done to boost the physical and intellectual health of youngsters before they reach the age of eight.

According to the Lancet, a medical journal, in 2000 just seven developing countries had a comprehensive approach to ECD. Now almost half do. The UN’s Sustainable Development Goals, a well-meaning set of targets launched in January, call for universal access to good-quality ECD by 2030.

As well as concern for children, the new zeal among development economists and poor-world governments for ECD reflects a desire to make it easier for their mothers to work. Globally just 55.3% of women of working age are employed or looking for a job—less than in 1990. But the usefulness to society of early development goes far beyond giving parents a place to park a kid.

The youngsters themselves are the main, though not the sole, beneficiaries. Another recent study in the Lancet reckons that 43% of under-fives in poor countries, in other words about 250m kids, will fail to meet their “developmental potential” because of avoidable deficiencies in ECD.

Their young brains are sensitive. In the first three or so years after birth, when up to 1,000 synapses are formed per second, they are vulnerable to trauma which triggers stress hormones. Though some stress is fine, too much is thought to hinder development. Neglect is also corrosive. Young children benefit from lots of back-and-forth dealings with adults. Research by the Rural Education Action Programme, based at Stanford University, suggests that rural children in China have “systematically low cognition”, partly as a result of being reared by grandparents who pay them little attention while parents work in cities.

The evidence from neuroscience is sometimes exaggerated. Researchers still have a patchy understanding of the timeline for brain development. Some early adversity can be overcome. But the longer trauma or neglect goes on, the harder it is to counteract. And lots of studies now suggest that intelligent policy can help. One landmark programme began in the 1980s, when health workers started visiting Jamaican mothers to tell them about nutrition and learning through play. Compared with peers whose mothers had no such advice, these children had higher IQs, were less violent and earned 25% more at age 22.

Supporters of ECD add that its benefits go well beyond the children. Better-raised toddlers mean less need to cope with dysfunctional adults at public expense. The World Bank says every dollar spent on pre-school education earns between $6 and $17 of public benefits, in the form of a healthier and more productive workforce with fewer wrongdoers. Many developing countries seem to have accepted this case. China has vowed to provide pre-school facilities for all youngsters; India has the same goal. African countries are also investing in toddlers. Ethiopia says it will increase pre-school enrolment to 80% by 2020, from 4% in 2009; Ghana has added two years of pre-school education to its system. Uganda wants every state primary school to have a nursery.

This burst of enthusiasm is welcome and overdue. In the OECD club of mainly rich countries, spending on ECD amounts to around 2.4% of GNP; in poorer countries, where there is so much scope for improvement, the share is less than 1%, says the World Bank. Poor countries spend far more on regular schools. In Latin America, for every dollar spent on children under five, $3 is spent on those between six and 11.

The case for boosting the share benefiting from ECD is strong, but expenditure has to be well-aimed. Subsidies for all children to attend nursery are popular among parents and politicians; but unless kids get the right kind of attention, they are little better off than those who stay at home.

A report in May by Harvard University’s Centre for the Developing Child found that the average impact of ECD experiments studied over the past 50 years has fallen. “There is huge potential in ECD intervention,” says Orazio Attanasio of University College London. “The danger is to assume that any intervention no matter how ill-conceived and ill-designed will work.” Although getting the right answers can improve tens of millions of young lives, there is a real risk that the current wave of enthusiasm for ECD will crash if bad methods are adopted and results disappoint. The latest research suggests at least four things which governments should keep in mind.

First, ECD must focus as much on physical well-being as on training the mind. That element is now missing: most ECD policies put the stress simply on educating kids aged four or five. In fact, health and nutrition are at least as important. A paper in 2008 by Cesar Victora of Federal University of Pelotas in Brazil tracked cohorts of children in five countries (Brazil, Guatemala, India, the Philippines and South Africa) and found a strong correlation between height at the age of two, school results and wages in later life. So correcting the bad nutrition (of expectant mothers as well as infants) that leads to stunting should be a priority. Supplements like iodine and iron for pregnant mothers and vulnerable babies can boost educational performance.

A second problem is that efforts to boost development in the first years of life can be shoddily run because they fall in the bureaucratic gaps between health and education policies. There are exceptions, such as a good Chilean initiative: known as Chile Crece Contigo (Chile Grows with You),the project has operated across the country since 2007, reaching 80% of the poorest mothers before they give birth and continuing until the child is four.

It offers a personalised service, from home visits to screening (for inherited diseases, for example) and there are cash incentives for taking part. Another lesson from Chile: what matters is how, not where, adults and children interact. In other countries, ECD policy amounts to building new subsidised child-care centres with little regard to what happens there. “Too often ECD is just child care,” says Sonja Giese, director of Innovation Edge, part of a South African early-development foundation. Few parents see the need for all-round development of mind and body, she laments.

Colombia offers examples of good and bad spending. In 2011, the government launched De Cero a Siempre (From Zero to Forever). Children were moved from small local facilities to larger ones costing twice as much per child. The shift to an impersonal setting harmed children’s language and motor development, according to a study led by Raquel Bernal of the University of Los Andes, in Bogotá. A cheaper home-visit programme for even younger children had better results.

One reason for its success was that its curriculum suited the age of the children. Few toddlers are like John Stuart Mill, the thinker who began ancient Greek at three; and in some east African countries, the teaching of toddlers is utterly ill-adapted to their age. In those places, expanding ECD simply means putting kids in traditional schools a year or two earlier. In Kenya’s state sector, for example, pre-school classes resemble a mini-secondary school, with tiny desks and chairs. Teaching is dull and based on rote learning; results are bad. About 40% of Kenyan seven-year-olds cannot read a word. Across the region, figures are even worse.

As researchers from Cambridge University found, a good ECD curriculum is the opposite of Kenya’s. It needs play-based learning and lots of speaking, or just babbling, back and forth. But Betsy Chumo, who runs a play-based centre in a Nairobi slum, finds parents sceptical. “They want strict teachers and children behind desks.”

As a third big pointer, experience suggests that private efforts are often the most innovative; governments should avoid getting in their way. Chile’s programme, for example, is a healthy mix of private and public. In many countries, private initiatives become franchises that spread fast with only a touch of state encouragement. One case is Kidogo, co-founded by Sabrina Habib after she nearly stumbled over supine infants on the floor of a badly-run day-care centre in Nairobi. Kidogo trains “mamapreneurs” such as Ms Chumo to run centres that offer healthy meals and an age-appropriate curriculum while also making a profit. Another voluntary effort is SmartStart, in South Africa, which wants to bring ECD to the 1m kids between three and five who have none. The charity hires unemployed people to set up franchises, trains them in care methods based on good research and monitors their quality.

Where such franchises work, governments offer incentives, such as vouchers for poor parents. For all the differences, expertise gained from private-public partnerships in rich-world educational outfits (like American charter schools or England’s semi-independent academies) can have a bearing on ECD. Ark, a group of English academies, will soon help test a new ECD model at nearly 100 places around Nairobi.

Fourth, technology can help in places where finding and paying decent staff is hard. Most child-care workers get little training and are paid a pittance. But new inventions boost teachers’ skills cheaply and fast. Take a project in Kenya called Tayari; this involves issuing teaching instructors with tablets so they can monitor the performance of pre-school teachers equipped with dedicated instruction guides. In South Africa, Innovation Edge funds dozens of similar projects, from an app containing an ECD curriculum to a virtual-reality (VR) game showing good teachers at work.

Some claims for the benefits of all this excellent work may be overblown; ECD is not the only thing required to turn most children into successful adults. But it is one of the necessary conditions. Whether it is done through VR headsets or by playing on mats in a mud church, improving ECD can give millions of youngsters a better shot at overcoming life’s other problems.

Clarification (November 4th): A previous version of this article said that the Tayari project in Kenya involved giving tablets to pre-school teachers. In fact they are given to teaching instructors. This has been updated.