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Diagnostic Review of Early Childhood Development

Diagnostic Review of Early Childhood Development. Presentation to Portfolio Committee on Basic Education 18 June 2013. Background. Department Performance Monitoring & Evaluation in the Presidency and the Inter-Departmental Steering Committee on ECD commissioned:

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Diagnostic Review of Early Childhood Development

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  1. Diagnostic Review of Early Childhood Development Presentation to Portfolio Committee on Basic Education 18 June 2013

  2. Background Department Performance Monitoring & Evaluation in the Presidency and the Inter-Departmental Steering Committee on ECD commissioned: • A Diagnostic Review (HSRC-led team) In addition • Review of the National Integrated Plan (NIP) for Early Childhood Development in SA 2005-2010

  3. Review Team Prof Linda Richter (lead) Human Sciences Research Council Linda Biersteker Early Learning Resource Unit Prof Justine Burns University of Cape Town Dr Chris Desmond Consultant to HSRC Dr David Harrison DG Murray Trust Dr Nosisi Feza Human Sciences Research Council Prof Haroon SaloojeeUniversity of the Witwatersrand Patricia Martin Advocacy Aid Wiedaad Slemming University of Witwatersrand

  4. NIP 2005-2010 Definitions • Early childhood development (ECD) – a comprehensive approach to policies & programmes for children 0-9 years • Specific focus on 0-4 years

  5. Methods of the Review • Assembled a team of 9 people with specific expertise • Reviewed 112 background & policy documents on ECD in South Africa • Contacted or consulted more than 166 stakeholders • Held 4 provincial panels – Gauteng, KZN, WC and FS • Met 4 times with the Steering Committee • Produced 12 detailed Background Papers

  6. Presentation • Key Findings • Key recommendations • Progress to date

  7. Key findings • New science of development • Long term consequences of exposures • Health→(MORE DETAILS ON SLIDE 22) • Human Capital →(MORE DETAILS ON SLIDE 23) • Psychosocial adjustment →(MORE DETAILS ON SLIDE 24) 1000 days – window of influence 270 (pregnancy) + 365 (year 1) + 365 (year 2) = 1000 days

  8. Key findings …(2) • Poverty • Direct causes • Indirect causes • Resilience • Even in adversity – children do OK, some excel • Parenting critical • Intervention • Effective and cost effective

  9. Key Findings …(3) • Good progress • 87% households with young children have access to safe drinking water • 82% connected to mains electricity • 97% of women attend at least 1 antenatal clinic • 98% health facilities offer PMTCT • 91% of babies are delivered by a professional • 89% of children fully immunised by one year • 83% of births are registered • 73% of eligible young children receive the CSG • 80% of children enrolled in Grade R

  10. Key findings…(4) • We are doing very little to support parenting • We are doing almost nothing for the care of 0- 2-year-olds (28% of whose mothers work) • The per-child registered centre subsidy may be taking us in the wrong direction No access

  11. Main Recommendations • Build multi-sectoral support for an integrated approach • Led by an authoritative body with multi- stakeholder support • Increase funding, including to pay practitioners • Aim to reach the poorest children and families first • Through home and community based programmes • And multi-media campaigns to reinforce and support parenting

  12. Developmental Progression First 1000 days

  13. Special Window of Opportunity First 1000 days

  14. Integrated multi-sectoral approach

  15. Developmental Approach • Planned & safe pregnancy, delivery & aftercare • Nutrition and health care for pregnant women and children • Social protection for families • Preparation and support for parenting • Child care for working parents & other families needing assistance • Opportunities for learning – at home and with other children in structured activities • Preparation for formal schooling

  16. Planned Pregnancy • +50% of SA pregnancies are unplanned or unwanted (most teen pregnancies) • As many as 50% of these are terminated (self or services) • Unintended pregnancies are associated with: • Later and fewer antenatal clinic visits • Low birth weight, greater prematurity, congenital abnormalities • Shorter duration breastfeeding • Incomplete vaccinations • Higher likelihood of stunting • Greater risk of maternal depression

  17. Safe Pregnancy • Morbidity • Neonatal deaths – 38% of under-5 mortality • Maternal deaths – 237 per 100 000 • Child deaths - a child in a poor country who has lost their mother has 4* less chance of surviving to age 10 years •  Disability • Pre- and perinatal factors are the major cause of child disability in South Africa

  18. Good Nutrition, Health Promotion • Poor maternal nutrition  IUGR • Low birth weight (± 16%) • Best overall general predictor of child survival growth, health and wellbeing • Breastfeeding – 10% exclusive at 4mo • 13% deaths averted – highest proportion • Early growth – stunting (18%) • <2 SDs height = less 1 yr of schooling (SA) • Loss of adult earnings (up to 19%) • Affect birth weight & length in next generation

  19. Parenting … • ± 50% of women 1st child by 20 years, most single • Partner support – 60% men don’t live with their young children (22% in HH expenditure +R10 000; 71% below R1 200) • Mental health - maternal depression (31% PND in LMICs) • Alcohol/drug abuse – 13% among SAs • Intimate partner violence – 25% of women • Severe punishment of young children – 3-4yr olds r receive most ‘beatings’ (from women) • Retain beneficial practices – demand feeding, co-sleeping, carrying

  20. Next steps • Finalise the Improvement Plan • Development of an Integrated Programme of Action • Inter-sectoral collaboration • Joint vision • Joint targets • Joint budgets • Joint monitoring and evaluation

  21. THANK YOU!

  22. Health • Early growth patterns – during foetal development & infancy – • Influence adult height, offspring size • Increase risks for chronic disease – obesity, diabetes, cardiovascular disease • Increase risks for mental illness • Early exposure to adverse experiences (neglect, domestic violence, parental mental illness or substance use) • Increase risk of chronic disease, mental ill-health and social maladjustment←

  23. Human Capital Stunting before age 3 years (<2SD) is associated with: • Less education • Lower cognitive test scores • Fewer grades passed • Less learning = ± minus1 grade of schooling • Earnings – food supplemented <3 years • Up to 46% difference in income • Fewer hours worked←

  24. Psycho-social Adjustment • Poor growth  mental illness (famine studies) • Adverse childhood experiences (ACE)  • Tobacco, alcohol and drug use, suicide risk, depression • Toxic stress – stress responsivity - revving engine, hair trigger reaction • Influences ‘internal working models’ – or expectations - of relationships←

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