Scaling early child development: what are the barriers and enablers?

Journal: Archives of disease in childhood

Volume: 104

Issue: Suppl 1

Year of Publication: 2020

Affiliated Institutions:  Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland. Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa. Munk School of Global Affairs and Public Policy, University of Toronto, Toronto, Ontario, Canada. Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland. Children's Investment Fund Foundation, London, UK. Office of Public Health Practice, Yale School of Public Health, New Haven, Connecticut, USA. Grand Challenges Canada, Toronto, Ontario, Canada.

Abstract summary 

The Sustainable Development Goals, (2016-2030) and Nurturing Care Framework all include targets to ensure children However, many projects to support early childhood development (ECD) do not 'scale well' and leave large numbers of children unreached. This paper is the fifth in a series examining effective scaling of ECD programmes. This qualitative study explored experiences of scaling-up among purposively recruited implementers of ECD projects in low- and middle-income countries. Participants were sampled, by means of snowball sampling, from existing networks notably through Saving Brains®, Grand Challenges Canada®. Findings of a recent literature review on scaling-up frameworks, by the WHO, informed the development of a semistructured interview schedule. All interviews were conducted in English, via Skype, audio recorded and transcribed verbatim. Interviews were analysed using framework analysis. Framework analysis identified six major themes based on a standard programme cycle: planning and strategic choices, project design, human resources, financing and resource mobilisation, monitoring and evaluation, and leadership and partnerships. Key informants also identified an overarching theme regarding what scaling-up means. Stakeholders have not found existing literature and available frameworks helpful in guiding them to successful scale-up. Our research suggests that rather than proposing yet more theoretical guidelines or frameworks, it would be better to support stakeholders in developing organisational leadership capacity and partnership strategies to enable them to effectively apply a practical programme cycle or systematic process in their own contexts.

Authors & Co-authors:  Cavallera Vanessa V Tomlinson Mark M Radner James J Coetzee Bronwynè B Daelmans Bernadette B Hughes Rob R Pérez-Escamilla Rafael R Silver Karlee L KL Dua Tarun T

Study Outcome 

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Statistics
Citations :  World Health Organisation, UNICEF, World Bank Group. Nurturing care for early childhood development: A framework for linking survive and thrive to transform health and human potential. Geneva: World Health Organisation, 2018.
Authors :  9
Identifiers
Doi : 10.1136/archdischild-2018-315425
SSN : 1468-2044
Study Population
Male,Female
Mesh Terms
Child
Other Terms
early child development;health policy;international child health;low and middle-income countries;scaling-up implementation
Study Design
Cross Sectional Study
Study Approach
Qualitative,Systemic Review
Country of Study
Publication Country
England