World Development Report 2018: Learning to Realize Education’s Promise

Schools cannot produce learning without prepared, present, motivated learners. Around the world, many children receive too little investment in nutrition and stimulation during their early years, and many lack access to quality early learning opportunities that can prepare them for first grade. The one in four children worldwide who are stunted cannot achieve their potential in school. Nor can the 263 million young people who do not make it to school at all. Among those who do attend, motivation to learn often suffers when the quality of education is low. A poor-quality basic education also means that learners who should be gaining advanced skills from tertiary education or technical training lack the preparation to do so. Thus, just as the fundamental investments needed for primary education must be made before a child enters school, the same is true for skills training. In many cases, the failure to invest effectively can be understood through models of human behavior, which also point the way to solutions (table 5.1). A synthesis of the evidence in these areas reveals three key principles for improving learning:

• To set children on high-development trajectories, foster cognitive and socioemotional development through early child nutrition, care, stimulation, and learning opportunities. • To get children into school—an essential first step to learning—lower school costs and then use other tools to boost motivation for learning.

• To address the fact that so many youth leave basic education lacking skills, recognize that remediation often needs to be the first step in further education and training.

Investing in their early years prepares children for school

Children’s early years offer a rare window for societies to make investments in their children with extremely high returns (figure 5.1). Efforts to improve children’s lives can significantly increase individual and societal productivity while reducing inequality. Children cannot thrive with stunted bodies and brains, and early gaps in learning and skills trap them in lower developmental trajectories from which it becomes increasingly difficult to escape (spotlight 2). Though children’s bodies are resilient, and catch-up after early childhood may be possible when inputs improve, it is extremely difficult to reverse the effects of exposure to risk factors in the first few years of a child’s life. Doing so entails costly, high-quality interventions that typically need to happen at a sufficiently young age to be effective.

Children need quality environmental inputs to grow in a healthy, timely fashion. Essential physical inputs include quality pre- and postnatal nutrition, health diseases, and chemically toxic or physically dancare, and safe physical environments. Equally crucial gerous environments affect many poor children are social inputs, including nurturing, protection, and not only after birth, but also in the womb. Exposure stimulation. Interactions between children and their to any of these factors during sensitive periods can caregivers—who are often, but not always, their parinhibit normal biological development (spotlight 1), ents—leave a significant imprint, literally shaping the but poor children often encounter these factors in developing brain. Yet poor children’s access to these tandem and over time. At the same time, the strains inputs—along with caregivers’ awareness of their associated with poverty can disrupt parents’ deciimportance—is often limited. So are programs that sion making and limit their availability, sensitivity, invest in children’s early development and the policies and responsiveness. As a result, poorer children not that guide them.

only have fewer resources such as books or toys, but

Poor children are more exposed to health shocks also receive less stimulation, direction, and support.

and less likely to receive stimulation, care, and proPoor children are also more likely to experience tection from stress. Nutrient deprivation, infectious neglect and harsher discipline, which disrupts early emotional organization—the keystone of socioemotional abilities—and is associated with worse school performance.

Early childhood development programs are insufficient in number and quality to compensate for poor children’s disadvantages, especially in the developing world. In poor communities, resources that stimulate early development outside the home— including quality child care, libraries, recreation centers, and preschool programs—tend to be limited and low in quality. Only half of 3-to 6-year-olds have access to preprimary education. Coverage is strongly associated with income, ranging from 19 percent in low-income countries to 86 percent in high-income countries, with poorer children enrolled at the lowest rates in every country. Children under 3 are widely underserved, with access to services for this age group especially inequitable and uncoordinated. Moreover, reliance on poorly compensated child care workers who receive little to no training, mentoring, or monitoring undermines sustainability, retention, and quality.

Governments do not invest enough in young children. Insufficient understanding of the high payoffs to early interventions, budget constraints, and the challenges of delivering wide-ranging early childhood interventions—health, nutrition, early learning— result in low public investment in young children in most regions. In Sub-Saharan Africa, on average just 2 percent of the education budget goes to preprimary education. In Latin America, the average per capita government spending on children under 5 is a third of that for children ages 6–11. Investments in the early years have increased in developing countries, but strategies often focus on building preschools, neglecting children who have not yet reached preschool age. Though preschool can help, foundations across developmental dimensions are set before age 3. Yet this age group typically receives little government coverage beyond health and nutrition checkups—not enough for healthy overall development.

Early exposure to risks associated with poverty may prevent children from realizing the promise of education. Intense deprivation can result in poor developmental outcomes—such as stunted growth or impaired brain development—that are difficult to address (figure 5.2; spotlight 2). Children who have fallen behind in their physical, cognitive, linguistic, or socioemotional development are more likely to enter grade 1 late, score poorly in school, repeat grades, drop out before they complete primary school, experience poor health throughout their lives, engage in high-risk behavior (particularly in adolescence), be less productive, and have lower earnings. The scale of the problem is vast: nearly half of children under 5 in developing countries are stunted or live in extreme poverty, threatening their prospects of benefiting from the opportunities education can provide.

Effective early childhood interventions can signifi - cantly improve poor children’s ability to learn. In the United States, at-risk children who participated in well-designed interventions—Perry Preschool, Abecedarian, the Nurse-Family Partnership—benefited well beyond their early years: their school performance, employment, income, overall welfare, and social integration all improved. Such interventions have substantial potential in developing countries because of their lower baselines. In Jamaica, the Reach Up and Learn program, which promoted early child stimulation, led to lower crime rates, better mental health, and 25 percent higher earnings two decades later. There is a consensus on what children need: nutrition, care, stimulation, nurturing, and protection. The evidence on when to implement programs is in line with biological evidence: prevention and early remediation are most cost-effective at specific points in development because adjustments beyond sensitive periods are difficult, costly, and usually incomplete. But identifying the most effective approaches to improving poor children’s developmental outcomes has proven challenging because of the enormous heterogeneity in interventions as well as contexts. Still, several approaches show promise.

Health and nutrition interventions during the first 1,000 days of life (starting at conception) improve children’s development. Programs that increase access to maternal health services improve maternal nutrition through diet, supplements, and fortification, while reducing child mortality and early health problems. In isolation, nutritional interventions for children have only modest effects on height or stunting. But when combined with improved sanitation, along with access to child health services, nutritional interventions can yield significant benefits. Breastfeeding and micronutrient supplements are associated with better health and greater cognitive ability, leading to better educational outcomes in developing countries. Deworming, iodine supplements, and immunizations have also led to major improvements in children’s ability to learn.

Programs that build caregivers’ capacity to support healthy development can substantially improve children’s outcomes. Interventions include coaching caregivers at home on positive discipline, as well as promoting increased frequency of quality interventions through nurturing, protection, and stimulating activities (storytelling, singing, playing with household objects). Such interventions have been delivered in diverse ways, including home visits, community meetings, and health checkups. The most effective programs have systematic training and curriculums, as well as opportunities for caregivers to practice and receive feedback. An emerging generation of programs is offering parents incentives through positive reinforcements, with indirect “nudges” when providing information is insufficient or when beliefs or norms are detrimental.

Programs that provide caregivers with cash or psychosocial support complement interventions to improve parenting. Cash transfer programs can address acute material deprivation in households and improve developmental outcomes, particularly when provided alongside—or conditional on—prenatal care and child services. For example, conditional cash transfer (CCT) programs in Ecuador, Mexico, and Nicaragua have reduced stunting, improved cognitive development, and promoted better parenting practices. In Mexico, parenting support programs integrated with CCT programs improved child outcomes beyond the direct effects of the transfers. Also important, transfer programs can alleviate parental time and psychological constraints. In addition, interventions delivered by supervised, nonspecialist health or community workers to address acute maternal stress, depression, and anxiety have led to better cognitive development, more physical growth, less diarrhea, and higher immunization rates.

Center-based care can promote foundational skills. In countries from Ethiopia to the United States, high-quality, center-based programs have shown substantial benefits in developing children’s language, cognitive, motor, and socioemotional skills. By contrast, attending a low-quality, center-based program can be worse than attending none at all. The quality of child-caregiver interactions is a key determinant of such programs’ impacts, as Indonesia and Mozambique demonstrated with effective center-based preschool programs for children ages 3 to 6. These programs included minimal infrastructure investments but improved children’s cognitive abilities thanks to their interactions with well-trained caregivers (box 5.1). Delivering quality, center-based interventions for children under 3 is harder because they require costlier structural investments (such as lower child-to-staffratios). Consequently, programs to build parenting capacity might be most cost-effective for children under 3 in resource-constrained environments or to reach marginalized populations.

Integrating programs can lead to better development outcomes. Poor children are exposed to multiple risk factors that cannot be adequately addressed by any single intervention. Multifactor programs capture the complex, complementary nature of early childhood development and exploit complementarities (figure 5.3). To be effective, interventions must be delivered during specific stages of development. Packaging interventions to address sequential or related developmental goals can increase effectiveness, especially if intervention packages incorporate benefits for caregivers as well. Integrated intervention packages can build on existing platforms such as community-based strategies or social safety nets, though the effectiveness of any specific strategy will depend on contextual factors. Quality should not be diluted in the effort to increase investments in the early years— say, by relying on volunteers or unqualified workers to deliver services, which is common.