In January 2014, the Board on Children, Youth, and Families of the Institute of Medicine (IOM) and the National Research Council (NRC), in collaboration with the IOM Board on Global Health, launched the Forum on Investing in Young Children Globally. At this meeting, the participants agreed to focus on creating and sustaining, over 3 years, an evidence-driven community of stakeholders that aims to explore existing, new, and innovative science and research from around the world and 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. Forum activities will highlight the science and economics of integrated investments in young children living in low-resourced regions of the world across the areas of health, nutrition, education, and social protection. As a result, the forum will explore a holistic view of children and caregivers by integrating analyses and disciplines that span from neurons to neighborhoods and discuss the science from the microbiome to culture.
1 The planning committee’s role was limited to planning the workshop. The workshop summary has been prepared by the rapporteurs (with the assistance of Kimber Bogard) as a factual account of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants and are not necessarily endorsed or verified by the Institute of Medicine. They should not be construed as reflecting any group consensus.
Moreover, the forum will support an integrative vision to strengthen human capital. This work will be done through the forum and will engage in a series of stakeholder consultative sessions or public workshops, each focusing on specific aspects of science integration, bridging equity gaps, and implementing and scaling evidence-informed efforts.
A set of forum goals includes supporting the development of integrated science on children’s health, nutrition, education, and social protection and working with policy makers, practitioners, and researchers to raise awareness of integrated approaches to improve the lives of children and their caregivers. Forum objectives to meet these goals are as follows:
- To shape a global vision of healthy child development across cultures and contexts, extending from preconception through at least age eight, and across currently siloed areas of health, nutrition, education, and social protection.
- To identify opportunities for intersectoral coordination among researchers, policy makers, implementers, practitioners, and advocates to improve quality practices in public and private settings and bring these practices to scale, in the context of the economics of strategic, integrated investing in young children.
- To inform ongoing conversations and activities of groups working on issues related to young children globally, such as the sustainable development goals and indicators being developed.
- To identify current models of program and policy financing across health, education, nutrition, and social protection within the framework of reproductive, maternal, newborn, and child health that aim to improve children’s developmental potential. This information could be used to illuminate opportunities for new financing structures and forms of investments that may be more effective in improving child outcomes and potentially drive economic development.
On August 26–27, 2014, the Forum on Investing in Young Children Globally hosted its second workshop in New Delhi, India. The forum’s first workshop, titled “The Cost of Inaction,” was held in Washington, DC, in April 2014 and focused on the science of promoting optimal development through investing in young children and the potential eco-
2 This section summarizes information presented by Ann Masten, University of Minnesota; Chandan Mukherjee and Venita Kaul, Ambedkar University, Delhi; and Pia Rebello Britto, UNICEF.
nomic consequences of inaction. This second workshop, on financing investments for young children, built on the first workshop and brought together stakeholders from such disciplines as social protection, nutrition, education, health, finance, economics, and law and included practitioners, advocates, researchers, and policy makers. A complete statement of task of this workshop is shown in Box 1-1.
Forum co-chair Ann Masten of the University of Minnesota opened the workshop with a description of the forum and noted that the science of early childhood has made many advances in recent years. Researchers and practitioners in the field now want to “raise the bar” and promote programs and policies that allow children not only to survive but to thrive. Stakeholders in the field of early childhood development now recognize that early childhood experiences are deeply linked to the health and well-being of both people and societies and the development of human capital. Thus, Masten asserted, there is now a desire to make strategic investments to reduce childhood adversity and promote healthy development. The vice chancellor of Ambedkar University, Chandan Mukherjee, echoed Masten’s views and highlighted the importance of the workshop in his welcome address by noting that investment in early childhood is
Workshop Statement of Task
The Forum on Investing in Young Children Globally (iYCG) of the U.S. National Academy of Sciences, in partnership with the Center for Early Childhood Education and Development, Ambedkar University, Delhi, will conduct an interactive public workshop featuring presentations and discussions that identify some of the current issues in financing investments across health, education, nutrition, and social protection that aim to improve children’s developmental potential. Speakers will explore issues across three broad domains of financing: (1) costs of programs for young children; (2) sources of funding, including public and private investments; and (3) allocation of these investments, including cash transfers, microcredit programs, block grants, and government restructuring. Some models of current financing structures will be presented in order to illuminate potential opportunities for new financing structures targeted toward improving child outcomes.
A set of research presentations will highlight the links among sources of funding, types of funding mechanisms, and the pathways through which they operate with respect to maternal and child health, education, and social protection outcomes. Existing and emerging research will address the following thematic areas: (1) how to incorporate the issues of access and quality into costing models of early childhood programs, and (2) the impact of alternative models of financing (such as public–private partnerships) on child outcomes.
crucial to ensuring the development of future citizens. This theme was supported by several other participants who suggested that such investments required an exploration of and attention to creating sustainable mechanisms of finance.
Following Masten’s remarks, Venita Kaul and Pia Rebello Britto expounded on the workshop’s aims. Kaul, whose Center for Early Childhood Education and Development, Ambedkar University, Delhi, cohosted the workshop, noted that appropriate financing is necessary to enhance the development of youth. She said that financing creates an enabling environment for universal early childhood development with the establishment of laws, policies, and institutional capacity. In addition, Kaul emphasized the importance of examining not just the means of financing but also the target of financing and looking at how financing flows from donors to recipients. She closed by noting three domains discussed at the workshop: costs of programs, sources of funding, and allocation of investments.
Britto discussed the presence of a funding gap in early childhood development. Although this gap has existed for some time, Britto argued that now is the time to close it because the science of early childhood development has come of age; it has successfully moved past proof of concept with a new goal of scaling up. She pointed out that there is a considerable amount of knowledge on the design and implementation of successful programs and on measurement of child outcomes. She said that these programs and measurement tools should now be scaled up and applied across the globe, a process that would require significant financing at various levels. To accomplish this goal, she stressed the need to continue to find ways to move the conversation beyond silos and across disciplines. For her, finding a common vocabulary among researchers, practitioners, and investors is key to increasing investment. In particular, whereas health and well-being outcomes have been well delineated in the scientific literature, there is little understanding of how these outcomes translate to financial and economic domains. To bridge the divide, Britto stated, those in the early childhood development field need to learn both the language of investment and the means of communicating their own research to those from other sectors.
Several foci of discussion were raised during the workshop. A few participants brought up the role of the various sources of funding that might be available for early childhood development. Some speakers noted that although the public sector is the largest source, it is not always the most responsive. Other speakers suggested that the private sector can be
more innovative than the public sector but not always more sustainable. Various models of integration of funding, partnerships, and coordination were presented, all of which contain their own unique challenges and opportunities.
The challenge of ensuring that funding reaches its intended recipients was also explored. In some circumstances, this challenge differed by source of funding; in others, the type of programming, requirements for reporting, and means of monitoring and evaluation complicated the flow of funding. Participants shared their diverse experiences with this issue and commented on solutions and additional obstacles raised. Another challenge raised by a few speakers was demonstrating value for investment. They mentioned that much is known about what is needed in early childhood development and how to implement it, but noted that additional work is needed to demonstrate that programs not only provide value, but that refusing to act creates negative consequences, including financial ones.
Speakers also discussed issues of financing the expansion of services versus the quality of services. Some speakers cautioned against an either/or approach, while others said that quality was not something that could be addressed merely by increasing funding. In addition, a couple of speakers noted that while the goal might be to increase financing of early childhood development programs and services overall, access to the services and the quality of those services were gaps that needed further attention.
This summary report details presentations given during the public workshop. Each section corresponds to a presentation from an individual speaker or moderator, and on three occasions summarizes discussions held during one of three concurrent breakout sessions. These sessions are then grouped into thematic chapters.
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