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Counting outcomes, coverage and quality for early child development programmes.

Kate M Milner1,2, Sunil Bhopal3,4, Maureen Black5

  • 1Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK.

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|March 20, 2019
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Summary
This summary is machine-generated.

Effective measurement is crucial for scaling early child development (ECD) programs in low-income countries. The Saving Brains portfolio highlights the need for better quality, coverage, and outcome measurement, especially for vulnerable children.

Keywords:
child developmentcoveragedisabilitylow- and middle-income countriesoutcomesquality

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Area of Science:

  • Global Health
  • Developmental Psychology
  • Program Evaluation

Background:

  • Improved measurement in early child development (ECD) is a key focus of global initiatives like the Nurturing Care Framework.
  • There is a recognized gap in evidence-based monitoring and evaluation (M&E) approaches for ECD projects in low- and middle-income countries (LMICs).

Purpose of the Study:

  • To explore M&E approaches for ECD programs within diverse settings using the Saving Brains® portfolio.
  • To identify findings related to the measurement of quality, coverage, and outcomes essential for scaling ECD initiatives.

Main Methods:

  • A focused literature review and a participatory mixed-method evaluation of 39 ECD projects across 23 LMICs funded by Grand Challenges Canada®.
  • Utilized an adapted impact framework and a 'theory of change' based M&E approach.

Main Results:

  • Most projects measured cognitive, language, motor, and socioemotional outcomes, with 18 using developmental screening tools, balancing feasibility and best practice.
  • Environmental inputs, such as the home environment, were measured in 15 projects.
  • Qualitative data underscored the importance of measuring project quality and coverage, despite contextual challenges.

Conclusions:

  • Scaling ECD programs requires improved measurement of intervention quality and coverage, necessitating clear definitions for numerator and denominator.
  • Innovation in outcome measurement, including feasible intermediary measures and disaggregated data, is vital to target interventions effectively and ensure equitable reach for all children.