The ‘Promoting Early Childhood Development Through Combining Cash Transfers and Parenting Programmes’ webinar took place on 9 May 2019. It discussed the potential for bringing together cash transfer (CT) and parenting programmes focused on child stimulation to boost child development, particularly for children ages 0–3 years.
The webinar discussion was based on a recently published paper by the World Bank, which reviews the rationale for linking both types of programmes and the evidence to date on the impact of CT programmes, parenting programmes, and their combination.
The presenters summarised key conclusions from a review of ten examples of combining CTs and parenting interventions using four models for structuring the combination: Integrated, convergence, alignment, and piggy-backing. They highlighted promising evidence of improved parental practices and child development outcomes, such as cognition and language.
The event was moderated by Joan Lombardi (Director, Early Opportunities LLC) alongside presenters Laura Rawlings (Lead Social Protection Specialist, World Bank), Melissa Zumaeta-Aurazo (Consultant, World Bank) and Julieta Trias (Economist, World Bank).
Why invest in children’s early years?
Laura Rawlings began her presentation by highlighting the paper’s argument on the importance of investing in children’s early years. It combines scientific and economic evidence, along with a strong focus on legislation and rights. On the scientific side, evidence shows that appropriate nurturing and care during a child’s first thousand days represents an important window of opportunity for development around sensory pathways, language, and higher cognitive functions.
On the economic side, evidence shows that the rates of return on investments in early childhood are much higher than investments made at a later stage of children's lives. The third argument for investing in early childhood is its potential to combat inequality and the intergenerational cycle of poverty.
Rawlings also took the opportunity to present the World Bank's human capital index, which measures the future productivity of the current generation of a country, holding constant the investment in human capital made today. The human capital index has three components: (i) survival; (ii) school and; (iii) health.
The World Bank's Framework for the Early Years is similar to the well-known Early Nurturing Care Framework and rests on three pillars:
1) 1.000 days good health and nutrition: Maternal and child health, as well as nutrition sensitive and nutrition specific interventions.
2) Early stimulation and learning opportunities: Investment in pre-schools and positive parenting from the very beginning of a child's life.
3) Nurtured and protected children and families: Special attention to stresses, particularly those associated with extreme poverty.
Rawlings went on to argue that CTs have the potential to deliver human capital outcomes. CTs with a child-sensitive design and the targeting of poor children have impacts that are multisectoral in nature; enhancing education, nutrition, and health. They also have impacts on behavioural change among parents, which in turn promotes their children's human capital.
In the paper, CTs' potential to promote human capital is depicted in the following Theory of Change:
Rawlings ended her presentation by discussing how two main types of accompanying measures, often called cash +, which can boost the effects of CTs on child development, namely: Nutrition-specific and nutrition-sensitive interventions (e.g. nutrition education), and parenting interventions (e.g. training, support, and coaching to enhance child-parent interactions).
Combing CTs and parenting interventions: Design and delivery
Melissa Zumaeta-Aurazo followed, providing a summary of an analysis of ten CTs from various regions, both conditional and unconditional, that include parenting interventions. In the analysis, a classification of these interventions was built on four categories, defining the design and delivery of CT and parent intervention. This is explained in the table below.
The analysis presented by Melissa Zumaeta-Aurazo presented lessons learned in implementing parenting interventions along with CTs:
- The content needs to be better tailored to children’s developmental stage; consider the cultural relevance and situations; target both parents (mother and father) and other caregivers; and include opportunities to practice and receive feedback during the training sessions.
- The delivery systems need to include strong programme protocols and materials to ensure fidelity; strengthen social support among participating parents; and build on existing delivery platforms that the target population is already using.
- The workforce implementing parenting interventions need adequate training and access to necessary materials; and frequent and supportive supervision, including on-the job training and coaching for field staff.
- The basic building blocks of implementation need to be in place by, for instance, designing the intervention with a solid “logical framework”; investing in a monitoring and evaluation system for quality assurance; and managing performance against clear standards of quality.
Evidence of the impacts of cash transfers on the early years
Julieta Trias reviewed existing evidence on the impact of CTs on child development outcomes. The literature points to positive impacts on poverty, food consumption and use of health services but also on measures that could improve child stimulation environment, like reduced maternal depression and stress.
In addition, the impact literature shows that CTs can reduce illness, improve nutritional outcomes and improve children's cognitive and language skills; outcomes that are important for long-term human capital accumulation. Nonetheless, when implemented with accompanying measures in the areas of nutrition and parenting, these outcomes are found to be boosted in the four cases studied, especially cognitive and language skills.
In the long-term, CTs can help to mitigate shocks early in life, allowing children who receive CTs to have better education and labour outcomes later on.
Julieta Trias concluded the presentation by stressing the following key messages and conclusions:
- Window of opportunity: Interventions need to be put in place early while children's brains are plastic and still developing;
- Targeting: CTs allow interventions to reach the most disadvantaged households;
- CTs' are successful in improving outcomes: Evidence shows that CTs improve nutrition, health, and child development outcomes;
- Accompanying measures can boost these results;
- There are four models to combine CT and parenting-nutrition interventions: 1) integrated; 2) managed convergence; 3) alignment and; 4) piggybacking;
- Focus on the following when combining CT and parenting/nutrition programmes: a) quality of design and implementation; b) timing to focus on the “window of opportunity” in the first 1000 days and; c) scalability and cost effectiveness.
The webinar closed with a Q&A session, accessible here.
If you have any thoughts on the topic discussed, we would love to hear them, add your comments below!