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Suggested Citation:"7 Indicators and Metrics." Institute of Medicine and National Research Council. 2014. The Cost of Inaction for Young Children Globally: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18845.
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7

Indicators and Metrics

Numerous metrics and indicators are currently in use by the ECD community, though today’s metrics may not be consistently applied and harmonized. Different types of indicators and metrics, as well as challenges associated with their use and widespread implementation, were discussed by the speakers.

EARLY CHILD DEVELOPMENT: MEASURING RESULTS BEYOND 20151

Tarun Dua pointed out that ECD resides in several sectors, including health, nutrition, education, social and child protection, poverty, and home and family environment. She emphasized the need for a harmonized framework for action that follows a transsectoral approach. She explained that measuring ECD is necessary to (1) understand the status and well-being of young children, (2) assess the level of skills and competencies of children, and (3) determine the services and supports necessary to promote child development. Dua also said that metrics are needed to understand thriving—whether lives saved early fare well throughout their development. She stated that what gets measured gets addressed; without measurement and consensus on the outcome, no action will take place.

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1 This section summarizes information presented by Tarun Dua, World Health Organization, as well as information from Patricia Kariger, University of California, Berkeley.

Suggested Citation:"7 Indicators and Metrics." Institute of Medicine and National Research Council. 2014. The Cost of Inaction for Young Children Globally: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18845.
×

BOX 7-1
Measures and Indicators of Child Development
and Learning as Presented by Dua

Some of the common early childhood development indicators are as follows:

  • The Multiple Indicator Cluster Survey (MICS) is a set of survey questionnaires developed by UNICEF and carried out by government agencies in each nation. The survey questions are designed to estimate indicators in the areas of health, education, child protection, and HIV/AIDS, and they are adapted to suit the local environment. See http://www.unicef.org/statistics/index_24302.html for more information.
  • The Early Childhood Development Indicators (ECDI) is a set of indicators added to the MICS survey in 2005. ECDI questions provide information about early schooling, learning materials, support for learning, and adequate care. See http://www.childinfo.org/ecd_indicators_mics.html for more information.
  • The Early Development Instrument (EDI) is a population measure to assess the development of young children in U.S. communities, measuring physical health and well-being, social competence, emotional maturity, language and cognitive skills, communication skills, and general knowledge. See http://teccs.net/about-edi for more information.
  • The Early Grade Reading Assessment (EGRA) is an oral assessment that measures the basic foundation for literacy, including letter recognition, reading simple words, understanding sentences, and listening with comprehension. See https://www.eddataglobal.org/reading for more information.

Dua explained that measurement and assessment take place at both the individual and population levels. At the individual level, measurement tools have been developed, and at the population level, several instruments have been developed as well (see Box 7-1 for some examples).

A number of indicators are in use, but Dua pointed out that measurement efforts are fragmented and should be harmonized. In addition, the current population-level assessments do not focus on younger children (ages 0 to 3) or provide holistic information about contextual factors. Without a comprehensive population-level assessment, it is difficult to implement ECD policies at scale, she noted. Dua also identified the need to link child survival and child development outcome assessments in a single, integrated monitoring framework.

Dua explained that many variables are being measured as part of an accountability framework for the Countdown to 2015: Maternal, New-

Suggested Citation:"7 Indicators and Metrics." Institute of Medicine and National Research Council. 2014. The Cost of Inaction for Young Children Globally: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18845.
×

born, and Child Survival project.2 She showed country profiles developed as part of the Countdown to 2015 program and noted particularly relevant indicators in different areas. These include child survival and nutrition indicators, including stunting, breastfeeding, sanitation and access to clean drinking water, and complementary feeding, as well as maternal education and access to preschool education.

Additional indicators not part of the Countdown to 2015 framework include contextual factors such as violence against children, mental health of mothers and caregivers and impact on caregiving practices, age-appropriate development, and child disability.

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2 Countdown to 2015 is a project established in 2005 to monitor health interventions proven to reduce maternal, newborn, and child mortality. It uses country-specific data to stimulate and support country progress toward Millennium Development Goals 4 and 5, to reduce child mortality and improve maternal health. See http://www.countdown2015mnch.org/about-countdown/accountability for more information (accessed May 12, 2014).

Suggested Citation:"7 Indicators and Metrics." Institute of Medicine and National Research Council. 2014. The Cost of Inaction for Young Children Globally: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18845.
×

Dua concluded by summarizing her main points: (1) the need for a holistic assessment of early child development, with an integrated set of indicators; (2) the need to focus on the earliest years (ages 0 to 3), where current gaps exist; and (3) the need to consider child survival and child development (i.e., thriving) in an integrated manner. She argued that a harmonized, concerted effort is necessary to make a difference in early childhood development.

Patricia Kariger made similar points in her presentation on the caregiving environment in relation to measurement and indicators. She stated that ECD indicators are currently an active area of interest, and efforts in this area should be coordinated and shared to optimize individual efforts. Kariger proposed a single, online warehouse or repository for indicator storage, along with agreement and support for a core set of indicators. She hopes that this will provide greater consistency in application cross child outcomes and contextual areas that predict development.

Kariger proposed that measures and indicators should be well defined, evidence based, universally meaningful, easy to measure, capable of showing change, and in a format that is easy to understand. She pointed out that UNESCO recently reviewed indicators in different sectors and identified hundreds of them,3 but that these indicators are still applied inconsistently. For instance, Kariger noted reasonable consistency in measuring health and nutrition, poverty and wealth, and child protection, but less consistency in measuring education, early care, cognitive/ social/language development, and household supports. She argued that a set of indicators is needed to measure context at all levels, and that data on contextual variables can be collected via surveys of parents, clinicians, teachers, and government representatives.

MEASURING EARLY CHILDHOOD DEVELOPMENT IN LOW- AND MIDDLE-INCOME COUNTRIES: THE MICS4

Claudia Cappa explained that UNICEF supports the collection of data on children and women in low- and middle-income countries through the MICS.5 A standard MICS survey collects data on more than 100 indicators in such areas as health, nutrition, HIV, education, and disability. Since 1995, MICS data have been collected in more than 100 countries. MICS surveys are conducted by government organizations with the technical

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3 See http://www.unesco.org/new/en/education/themes/strengthening-educationsystems/early-childhood/monitoring-and-evaluation/holistic-ecdindex for more information (accessed May 8, 2014).

4 This section summarizes information presented by Claudia Cappa, UNICEF.

5 See http://www.unicef.org/statistics/index_24302.html for more information (accessed May 8, 2014).

Suggested Citation:"7 Indicators and Metrics." Institute of Medicine and National Research Council. 2014. The Cost of Inaction for Young Children Globally: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18845.
×

and financial support from UNICEF and other partners. Cappa noted that this is a collaborative effort that helps strengthen local capacity, while promoting data ownership and harmonization of statistics across countries. MICS data can be analyzed for disparities across different characteristics, such as sex, ethnicity, and wealth quintile. The fifth round of MICS (MICS-5) is currently under way in some 40 countries. The results can be used to assess whether countries have been able to attain the Millennium Development Goals,6 and may serve as baselines for post-2015 targets.

Relating MICS to early childhood development, Cappa explained that the first set of early childhood development questions were introduced in the second round of MICS (MICS-2) in 2000. ECD questions have been included in every round of MICS surveys since then. MICS-2 included questions on attendance in early childhood education programs. Starting from the third round of MICS (MICS-3) in 2005, a few questions pertaining to early childhood development were added, including questions on the availability of books and playthings, adult engagement in learning, and the adequacy of child care. In 2010, the Early Childhood Development Index (ECDI)7 was added to MICS-4.

Cappa briefly presented selected MICS data on ECD. The data show, for example, that just more than half of children are developmentally on track in most countries, and Cappa clarified that “on track” is limited to measures in the MICS ECD module, which asks mothers if their child can perform certain activities and functions; if the child can perform these activities in three of the four domains surveyed, then they are considered on track. She illustrated that children in the richest households tend to have more books in the home than poorer households. Moreover, the percentage of children attending early childhood education programs varies dramatically across countries, with less than half of children attending a program in most nations. In the least developed nations, around 12 percent of children attend a program. Finally, Cappa pointed out that literacy, numeracy, and learning are the domains where most children fall behind.

“READINESS TO LEARN” ASSESSMENT PROJECT8

Abbie Raikes proposed that it may be possible to identify a common set of items that are consistent across cultures and regions to inform

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6 See http://www.un.org/millenniumgoals/pdf/report-2013/mdg-report-2013-english.pdf for more information (accessed April 27, 2014).

7 The Early Child Development Index (ECDI) is a 10-item index designed to assess the developmental level of children ages 3 to 5 in four areas: literacy-numeracy, physical, social-emotional, and learning. See http://www.childinfo.org/ecd_indicators_mics.html for more information (accessed April 28, 2014).

8 This section summarizes information presented by Abbie Raikes, UNESCO.

Suggested Citation:"7 Indicators and Metrics." Institute of Medicine and National Research Council. 2014. The Cost of Inaction for Young Children Globally: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18845.
×

global tracking of children’s learning and development. However, currently national-level measures do not contain the same items to be able to compare globally. National-level measurements have very high value, given they are longer in duration, more frequent, and adapted to the local environment. Raikes introduced the Readiness to Learn Assessment Project as an effort to develop prototype learning and development measurements for children ages 4 to 6, with an emphasis on low-income countries.

The Readiness to Learn Assessment Project was mandated by the UNESCO Learning Metrics Task Force, and partners include the World Bank, Brookings Institution, and UNICEF. The project is in its early stages, and completion is expected by early 2016. The priority for this project is a national-level measure that identifies the quality of the learning environment. Raikes explained that the core assumption to the Readiness to Learn Assessment Project is that measurement contributes to improvement. By understanding the current quality of the learning environment, improvements can be made to policies, teacher support, and parent knowledge accordingly. Also, measurement results can encourage citizens to increase their focus on and advocacy for ECD to create both national and international pressure to improve conditions.

Raikes stated that, to build a useful measurement system, two ideas must be addressed. First, related to the content, one must ensure that items are reliable, relevant, and technically sound, with an emphasis on actionable items. Second, on issues of usability, it is important to identify how measurement systems will be designed and how data will be collected and shared. Third, field testing and validation are critical. Raikes mentioned that countries have dedicated few resources to validation. Finally, information sharing has been minimal because of data privacy concerns and technical obstacles.

Raikes concluded by stating that national measurements of education readiness can complement global efforts, while recognizing the challenges associated with item comparability and proper use. Specifically, she noted potential challenges in identifying a common core of indicators, while still adjusting to the local context.

EARLY CHILDHOOD RIGHTS INDICATORS (ECRI): A RIGHTS-BASED APPROACH TO ENHANCING EARLY CHILD DEVELOPMENT9

Ziba Vaghri focused on a rights-based approach to early childhood development. She began by noting that life expectancy in Burundi is 50,

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9 This section summarizes information presented by Ziba Vaghri, University of British Columbia.

Suggested Citation:"7 Indicators and Metrics." Institute of Medicine and National Research Council. 2014. The Cost of Inaction for Young Children Globally: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18845.
×

while life expectancy in Sweden is 81, and she presented data that indicate a correlation between average income and life expectancy. She argued that health should be a more equitable commodity.

Vaghri highlighted an effort by WHO to study the social determinants of health from 2005 to 2008, called the Commission on the Social Determinants of Health (CSDH). During this time, another effort was launched, called the Total Environment Assessment Model of ECD (TEAM-ECD). TEAM-ECD is a framework developed by the Human Early Learning Partnership (HELP), which was acting as the ECD knowledge hub for CSDH.

A specific effort to promote children’s development and health at the country level entered into force in 1990—namely the Convention on the Rights of the Child, which is an international human rights treaty, and to this day 194 nations have ratified it (United Nations, 2014). Vaghri pointed out that by virtue of ratification the governments have the obligation of submitting a report on the state of the rights of their children to the United Nations Committee on the Rights of the Child (the monitoring body of CRC) every 5 years (OHCHR, 2014).

Vaghri described several articles of the convention. For example, Article 6 states the right of a child to health. Article 26 states that the government must support a child if his or her family cannot. Article 31 guarantees a child safety and security. Articles 43 to 54 discuss how to respect and protect the rights of the child internationally. She then drew the attention of the audience to the alignment between TEAM-ECD and the articles of the convention, both designed to promote children’s development through improving their experiences within many layers of environments surrounding them. After more than a decade of reviewing the reports from different governments, the committee observed that the majority of government reports focused primarily on the older cohorts, and that younger children were often overlooked. The reports on young children were limited to a number of health indicators (such as under-5 mortality rate) and civil rights indicators (such as birth registration), said Vaghri. In response to this discovery, General Comment 7 (GC7): Implementing CRC for Young Children was released as a comprehensive guide meant to aid governments with their reports. However, it remained underused.

In 2007, subsequent to a discussion of an international team of experts, the committee wrote a letter of invitation to HELP asking it to act as the secretariat of an ad hoc group of international experts to work on operationalizing GC7 in an attempt to make it a user-friendly guide for the governments to facilitate implementation. The result of this 7-year collaboration was a tool titled Early Childhood Rights Indicators (ECRI), which monitors the rights of young children in an integrated way, using 17 indicators. ECRI contains three categories of questions: structure related

Suggested Citation:"7 Indicators and Metrics." Institute of Medicine and National Research Council. 2014. The Cost of Inaction for Young Children Globally: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18845.
×

(such as policies and laws), process related (programs and initiatives), and outcome related (how children have changed and what progress has been made over time). The 17 indicators are shown below10:

  1. Dissemination of GC7
  2. Constructing and implementing a positive agenda
  3. Human rights training
  4. Data collection system
  5. Early child development
  6. Birth registration
  7. Participation in family decision making
  8. Violence against young children
  9. Basic material needs
  10. Breastfeeding and complementary feeding
  11. Access to and use of health services
  12. Age-appropriate health education
  13. Provision of early childhood education and care services
  14. Educational provision for vulnerable young children
  15. Knowledge of right and capacity to support their realization
  16. Play, leisure, and rest opportunities
  17. Inclusive policy and provisions for marginalized groups

Two ECRI pilot programs were launched in Chile and Tanzania. Both pilot programs demonstrated the efficacy of ECRI as a monitoring tool. The purpose of this tool is to track progress within a country, and not to develop comparisons across countries. Vaghri explained that ECRI is a tool that monitors and enhances early childhood development through (1) taking an inventory of existing capacities in early childhood development and child rights; (2) advocacy, by drawing the attention of policy makers to gaps; and (3) planning and capacity building by serving as a blueprint for action. Vaghri concluded by saying that such carefully designed and methodically validated tools can facilitate data collection and action plans on ECD, as well as promote good governance.

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10 Adapted from Early Childhood Rights Indicators (ECRI). See http://crc-indicators.earlylearning.ubc.ca/index.php/content/overview (accessed September 2013).

Suggested Citation:"7 Indicators and Metrics." Institute of Medicine and National Research Council. 2014. The Cost of Inaction for Young Children Globally: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18845.
×
Page 39
Suggested Citation:"7 Indicators and Metrics." Institute of Medicine and National Research Council. 2014. The Cost of Inaction for Young Children Globally: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18845.
×
Page 40
Suggested Citation:"7 Indicators and Metrics." Institute of Medicine and National Research Council. 2014. The Cost of Inaction for Young Children Globally: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18845.
×
Page 41
Suggested Citation:"7 Indicators and Metrics." Institute of Medicine and National Research Council. 2014. The Cost of Inaction for Young Children Globally: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18845.
×
Page 42
Suggested Citation:"7 Indicators and Metrics." Institute of Medicine and National Research Council. 2014. The Cost of Inaction for Young Children Globally: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18845.
×
Page 43
Suggested Citation:"7 Indicators and Metrics." Institute of Medicine and National Research Council. 2014. The Cost of Inaction for Young Children Globally: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18845.
×
Page 44
Suggested Citation:"7 Indicators and Metrics." Institute of Medicine and National Research Council. 2014. The Cost of Inaction for Young Children Globally: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18845.
×
Page 45
Suggested Citation:"7 Indicators and Metrics." Institute of Medicine and National Research Council. 2014. The Cost of Inaction for Young Children Globally: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18845.
×
Page 46
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The Cost of Inaction for Young Children Globally is the summary of a workshop hosted by the Institute of Medicine Forum on Investing in Young Children Globally in April 2014 to focus on investments in young children and the cost of inaction. Participants explored existing, new, and innovative science and research from around the world to translate this evidence into sound and strategic investments in policies and practices that will make a difference in the lives of children and their caregivers. This report discusses intersections across health, education, nutrition, living conditions, and social protection and how investments of economic, natural, social, and other resources can sustain or promote early childhood development and well-being.

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