Investing Early Makes - PowerPoint Presentation

Slide1

Investing Early Makes Sense and Dollars

Paul Gertler

University of California, Berkeley

Global Business Case for Early Childhood Development Webinar

GBC-Education,

ReadyNation

/America’s Edge and

CUE, Brookings

April 4, 2014Slide2

200 million children are at riskof not reaching their full potentia

l

Lancet, 2011Slide3

Malnourished mothers lead to malnourished babies

In low income countries

:

10-20 % of pregnant women are malnourishedAnemia affects 42% of pregnant women Only 40% of pregnant women have access to acceptable antenatal care 16% of babies born have

low birth weight

(

27% in S. Asia)Slide4

1 in 4 children in LICs under 5 are stunted

UNICEF, 2012 and figure adapted from World BankSlide5

Only 17% of children in LICs are in preschool – the poor even less likelySlide6

Poor children do worse on language tests

Source: Lancet, 2011. Data from Young Lives Longitudinal StudySlide7

Scientific case for early

i

nvestment (1)

Source: Shore, 1997Slide8

Scientific case for early investment (2)Slide9

Wealth Disparities in Cognitive Development Begin EarlySlide10

Non-stunted

Stunted

-0.6

-

0.4

-0.2

0

0.2

0.4

0.6

0.8

Griffiths on

Enrollment

(

9-24 mo)

Griffiths

(33-48 mo)

Stanford-

Binet

(7-8 y)

WISC-R

(11-12 y)

WAIS

(17-18 y)

SD score

Source: Walker, Pediatrics, 2010

DQ or IQ scores of stunted and non-stunted Jamaican

children, age

9-24

mos.

to

18 yrs.

Early gaps can last a lifetimeSlide11

Economic case for early investment

Early intervention

saves money

on costly services later onElimination of malnutrition could lead to annual gains of 1-2% to GDP (World Bank)

preschool enrollment to 50% in LMICs has a

ROI of 8-18%

in future labor productivitySlide12

Equity case for early investment

ECD investments

especially benefit disadvantaged children

which levels the playing fieldSlide13

ECD Interventions from conception to school entry

Source: World Bank, 2010Slide14

Two Successful Early Interventions Slide15

Argentina’s Plan Nacer

2002 Financial Crisis

Many lost jobs and health insuranceMaternal and child health

Uninsured

Access to quality care

Mechanisms

Uninsured use of public facilities

More money to public systemSlide16

16

NATIONAL GOVERNMENT

PROVINCIAL GOVERNMENTS

Health

outcomes

Enrollment

Pay

for

performance

HEALTH

FACILITIES

Fee

for

service

Umbrella

Agreements

EXTERNAL AUDIT

Provincial

Health

Insurance

Performance

Agreements

EXTERNAL AUDIT

Facility decides on use of funds

Financing scheme drives

i

ncentivesSlide17

Plan Nacer improves newborn outcomes

Low Birth WeightSlide18

Plan Nacer Very Cost-EffectiveSlide19

Jamaica Psycho-Social Stimulation Intervention for Disadvantaged Children

Stunted Children age 9-18 months

Home-based play sessions by

Community Health Aid 1 hr per week for 2 years

P

romoted cognitive & socio-emotional development

Name & label things, actions in the environment, play games, praise, build self-esteem

At 24 months introduce size, shapes, position,

colors

etc

Improve quality of mother-child interaction

Taught mothers how to play

w

/ children

Encouraged daily play & stimulation

Home

-made toys were left

after

each visitSlide20

Effect of stimulation on Cognitive DevelopmentSlide21

Long Term Impact of Jamaica Stimulation

at age 9-18 Months Amazing

Cognitive and socio-emotional

skillsIncreased

Earnings

of Stunted by 25%,

E

nough to catch up to non-stunted

Raised earnings of disadvantaged and eliminated inequalitySlide22

Conclusions

Early disadvantage leads to long-term disadvantage

Hard & expensive to compensate later in life

ECD investment can Cost-effectively minimize long-term effectsCreate a healthy productive work forceGood for the individual and good for the economy