Melissa Buchholz and Sandipan Paul
This article addresses considerations around investing in early childhood efforts across the globe. The authors describe diverse early childhood approaches with a specific focus on strategies to fund and sustain this work. They also discuss the leadership efforts necessary to advocate for funding early childhood services and reflect on challenges and opportunities related to financing this important work.
Financing early childhood services is an essential component of successful implementation of programs that address the full continuum of care for young children–from support and prevention services, such as child care and early learning settings, to identification of developmental and behavioral needs, to comprehensive intervention services that address significant mental health concerns. Without adequate funding, these essential programs and services would not exist, yet identifying sustainable funding streams continues to be challenging (Colorado Health Institute, 2019). To that end, we share our experiences with identifying mechanisms for financing early childhood programs and strategies used domestically and internationally to support these efforts. In addition, we examine the leadership roles necessary to navigate the challenges that accompany this work.
The Early Years Matter
Understanding the rationale for financing early childhood services and early childhood care and education (ECCE) programs requires an understanding of why the early years matter, beginning with the brain science now widely available. Research in the field of early childhood has clearly demonstrated that the development of the brain is most rapid in the first few years of life. By 5 years old, 90% of brain growth is already completed, thus establishing these early years as the foundation for lifelong learning and development (Brown & Jernigan, 2012). For this reason, children who have access to early prevention services and who participate in quality early childhood programs gain benefits that continue beyond their early school years.
Children who have access to high-quality ECCE programs show higher cognitive skills and more advanced social skills than children who do not participate in ECCE. This difference is especially true for the most vulnerable children (Child Trends, 2018). By enhancing the cognitive development of the children and making them more proficient learners, ECCE is the foundation for children to be more productive citizens in adulthood (Gormley, 2007). Research has further indicated that the academic benefits of high-quality, model programs are very strong (Barnett & Belfield, 2006) with particular short- and long-term benefits for young children who are most at-risk for developmental delays and needs (Currie, 2007). Moreover, there is now considerable research showing the effectiveness of large-scale, state-wide programs, suggesting the need to increase access by scaling up and broadening the reach of early prevention and ECCE opportunities (Gilliam & Zigler, 2004; Henry, Gordon, & Rickman, 2006).
Consequently, the eminent economist and Nobel laureate James Heckman has concluded that investments in the early years produce the highest economic benefits later in life. Heckman’s research (2011) concluded that education is an intergenerational investment in human capital that yields returns for the individual and for the economy in general. More specifically, investment in young children brings a higher rate of return when compared to school children, and that rate of return to investment on human capital gradually declines with increases in age. Investment in young children’s development is therefore imperative internationally as this contributes to a productive population, optimal human development, and high economic growth across the globe.
Early childhood investments generate both private and public benefits. Citizens that are more productive pay more taxes and rely less on government health and public assistance programs, and they are less likely to engage in criminal activities. The local community also gains through enhanced economic growth and safer, more prosperous neighborhoods. Various studies provide evidence of effects of early childhood investment into the elementary school years and beyond (Aos, Lieb, Mayfield, Miller, & Pennucci, 2004; Barnett, 2008; Karoly, Kilburn, & Cannon, 2005). Meta-analyses show significant lasting effects on classroom behavior, grade repetition, special education placement, and high school graduation (Aos et al., 2004; Camilli, Vargas, Ryan, & Barnett, 2010). One of the oldest and most cited early childhood interventions, the Perry Preschool study, which demonstrated a $7.16 return on investment for each dollar spent, serves as a flagship for policymakers advocating for public support for early childhood programs (Parks, 2000).
As a result of this compelling research, there have been international and domestic efforts to build systems that focus on early prevention services and early education programming that leverage public resources. This effort is to ensure sustainability and broaden access by integrating services into the public sector, but it requires collective action and education. Specifically, efforts to adequately invest in the early years for all young children require defining and formalizing early childhood and economic policies at the state and national levels while promoting buy-in among stakeholders who understand the broad benefits of investing in the early years. The following discussions highlight opportunities for systems-building and policy development in these areas.
Rationale for Investing in Early Childhood Care and Education: The International Context
There are three broad justifications for investing public resources toward high-quality ECCE in different parts of the world: significant economic and social pay offs; support for parents and boosting employment (especially for mothers); and government responsibility to educate children, combat child poverty, and help children overcome educational and social disadvantage through affirmative action.
Benefits to Children
The process of developing human capability begins with a solid foundation in the childhood years from the point of conception to infancy, then preschool and then on to the school stage. It is well established that the first 6 years of life lay the basis for lifelong development. Environmental conditions like nutrition security, health, and psychological stimulation influence the ways in which a child’s neural pathways grow and the brain’s circuitry gets wired. This head start continues for the first decade of life, making it all the more important for the child to have access to environments and experiences that will enhance brain development and optimize potential (The World Bank, 2004).
In developing countries, many children are exposed to poverty, malnutrition, illnesses, and non-stimulating home environments during this vital period. These factors are likely to have a detrimental effect on children’s cognitive, motor, and social–emotional development, as well as on their health, thus prohibiting them from reaching their full developmental potential (Grantham-McGregor et al., 2007). In particular, children growing up under these circumstances are likely to have poorer health, lower school achievement, and lower earnings potential. As adults, they are less likely to provide adequate stimulation and resources for their children, thus contributing to the intergenerational transmission of poverty and economic inequality (Sen, 1999). Thus, it is imperative to invest in high-quality ECCE at this critical stage of life to ensure that the child crosses each sub-stage of the development continuum successfully.
Benefits to Working Parents
Investment in early childhood also has direct benefits for working parents. In many countries across the world, governments have worked toward expanding pre-school programs in rural areas to allow parents (and especially women who are the primary caregivers in many countries) to participate in paid work outside the home. Support for quality pre-school programs allows working parents to financially sustain their own families while contributing economically and socially to the wider community and society.
Government Responsibility Toward Children
In countries across the globe, it is understood that the government is responsible for providing effective educational environments to children, both to combat child poverty and to overcome educational disadvantage. In 1948, the Universal Declaration of Human Rights of the United Nations stated that children are entitled to special care and assistance. The Declaration also set out the right to education, which would be free at least in the elementary level. The UN Convention on the Rights of the Child in 1989 reiterated children’s right to education and in particular committed ratifying countries to make primary education compulsory and available free to all. In 1990, the Education for All movement was launched as a global commitment to provide quality basic education for all children, youth, and adults.
Together, these justifications outline an international perspective for investing in the early years. This perspective reflects a broad understanding of the social and economic benefits of investing in young children that translates to intergenerational growth and development that impact all layers of society— individuals, families, communities, and entire countries. This perspective also reflects an inherent moral responsibility to acknowledge young children beyond basic care and to instead see young children as future contributors to a thriving society. Such future-oriented perspectives can propel societies forward, but only if investments in their well-being are sound and sustained.
Financing Health Promotion and Prevention Work: The Domestic Context
In the United States, early childhood programs fall on a continuum of care from prevention to high-level interventions. A comprehensive early childhood system of care provides services and supports at all levels of the continuum. However, identifying funding mechanisms for programs that support prevention and health-promotion efforts can be challenging. Prevention work can be easily overlooked as less important or impactful than interventions that address significant mental health problems. At the same time, prevention programs are a vital component of the continuum of care and are often less costly than higher-level interventions.
When identifying funding opportunities, several challenges present themselves. Commonly, there are limited resources within a system, leading to multiple programs and services vying for the same pots of money. Also, returns on investment for programs that focus on prevention strategies in early childhood are often realized much later and across a wide variety of sectors. Finally, effectively financing any early childhood initiative requires garnering support from a wide variety of partners and organizations, locally, regionally, statewide, and nationally (Talmi, Buchholz, & Muther, 2016). These relationships take time and energy to cultivate yet are unlikely to remain the same indefinitely. Changes in political climate and in leadership at the local, state, and national levels can have significant impacts on financing priorities, making it more or less difficult to advocate for investments in prevention and health-promotion strategies.
The challenges described here are just a few examples to illustrate the truly complex domestic landscape of early childhood financing in the United States. In an effort to grow an evidence-based early childhood program focused on prevention and health-promotion in primary care (e.g., HealthySteps, 2020) several lessons have been learned to develop strategies to confront these common challenges.
Addressing Competing Agendas
Maintaining a focus on the full continuum of care for young children and the needs for interventions at all levels can help address competing agendas. There must be system-level buy-in and commitment to investing in all levels of the continuum. In order to garner this level of support, efforts must be made to broaden the vision of building a comprehensive system of care for all young children to provide support at all levels of care. This effort includes helping others to see themselves and the work they do as being intimately connected to the prevention end of the continuum and mutually beneficial to all. HealthySteps, for example, provides the opportunity to expose young children and their families very early on to mental health in a non-stigmatizing environment, identifying families that may need more intense support at a higher level of care. Programs further down the continuum of care benefit from the prevention and early identification elements of the HealthySteps model.
Communicating Long-Term Benefits
It is critical to communicate clearly with partners and potential investors that the outcomes and benefits realized by implementation of prevention strategies are most often going to be realized in the long term and may be seen in other sectors other than the one that made the initial investment. In the case of HealthySteps, young children and their families are supported in the context of pediatric primary care in the first 3 years of life. The model is implemented in a health setting and although initial returns of the investment will be seen in the health system (Buchholz, Burnett, Margolis, Millar, & Talmi, 2018), the adult health system, education system, and child welfare systems are also likely to see benefits from the model’s implementation.
Cultivating Multisector Partnerships
Finally, forging relationships with a wide variety of partners from multiple sectors is a critical component of this work. It can be challenging and frustrating when close partners transition to other roles or when there is a change in political landscape. The antidote to these challenging transitions is perseverance and maintaining a common vision. Returning to the vision as a starting point in forming new relationships has a significant impact on efforts to adequately finance early childhood services at all levels of the continuum.
Identifying financing is a challenge and requires partnerships and innovation to leverage and capitalize on every opportunity. It is important to align agendas in an effort to maintain a focus on the vision. Finally, this work is sustainable only by focusing on the small wins. Opportunities to sit at the same table with unlikely partners, identifying areas of alignment among partners, and forming new relationships are examples of small wins. Every step, even the smallest one, is a step toward realizing the vision of comprehensive funding mechanisms to sustain prevention and health promotion programs for young children.
Making the Case for Investment in Early Childhood
There is ample research demonstrating that public and private investments in high-quality domestic and international early childhood programs can yield high economic rates of return. However, largely these returns are more likely if programs are tailored to the needs of the target population. In most contexts, this tailored approach means addressing both the educational and mental health needs of children and the child care and emotional/psychosocial needs of parents. Thus it is important to lay down concrete approaches toward promoting public investment in early childhood. The following sections attempt to capture some of the approaches that can be used in diverse parts of the world.
Tracking Public Investments in Early Childhood
In countries such as India and other South Asian countries, there is an acute necessity to develop a database on public investment in ECCE settings across different time periods. This information will help in developing an understanding about the historic situation and present scenario with respect to investment of public resources on ECCE.
The Role of Research
It is also important for national and local governments to promote research in this area. There must be mechanisms to estimate the magnitude and adequacy of public investment needed that includes the present level of investment and additional requirement in proportion of gross domestic product. This information quantifies benefits in ways that can be leveraged when budgets and economic policies are prepared.
Reframing Investments to Increase Public Buy-in
It is important that lower income countries should not view public investments in early childhood as a luxury to be enjoyed only after higher incomes are attained. Public investments in early childhood should be viewed as one policy that contributes to a dynamic process of change that boosts the economy indirectly as well as directly through improvements in workforce quality, political stability, and safety. Again, the goal is to establish a foundation for healthy societies by investing in all young children.
Re-Examining the Role of Economic Policy
Sound policy that supports economic growth is important everywhere, but especially in developing countries. The longer period required for child development gains to translate into economic growth can make other policies that produce faster results seem more crucial. Properly designed early childhood policies present policymakers with an opportunity to increase economic growth and reduce inequality. Investment in early childhood can be an important component of a larger economic strategy that produces more balanced and, therefore, more sustainable growth. When designed to increase maternal employment as well as enhance child development, public investments in ECCE also can generate short-term increases in earnings, which is highly desirable from both economic and political perspective. These opportunities need to be clearly articulated to increase buy-in and successful integration in policies that impact young children and families.
Understanding the importance of high-quality programs and supports for young children and their families in the earliest part of life is well-documented. However, the advocacy work required to meet the financing needs to support the implementation and scale of programs designed to meet the educational, emotional, psychosocial, and physical needs of young children is ongoing. As ZERO TO THREE Fellows, we have worked to amplify the voices of so many who are advocating for adequate public and private investments for young children across the world. Advancing investments in early childhood, however, requires more leaders who understand the critical role of policy in financing early prevention and education programming. To that end, readers are encouraged to consider their own contexts and how each can leverage their voices to inform policies and legislation in local, state, and national forums. There is an opportunity to learn from the gains in one’s own community, in other states, and in other countries in order to advocate for equitable early childhood policies that benefit all.
Melissa Buchholz, PsyD, is a licensed clinical psychologist and assistant professor at the University of Colorado School of Medicine in the Harris Program for Child Development and Infant Mental Health. Dr. Buchholz teaches courses and provides reflective supervision to postdoctoral fellows who are specializing in infant and early childhood mental health. She is dedicated to building a workforce that will be equipped to meet the mental health needs of young children and families and increase the availability of early childhood mental health services. Dr. Buchholz is the director of HealthySteps for the state of Colorado and has worked to scale this model across the state since 2012. In addition, she provides consultation and technical assistance to assist pediatric practices with expanding behavioral health services to include a focus on young children and their families.
Sandipan Paul works as education specialist with UNICEF Office for Pacific Island Countries based in Fiji. He provides technical support and advice to the development, implementation, monitoring, evaluation, and reporting of the early learning systems element of the Education program, for the purpose of strengthening and expanding systems-level support to country-specific (Pacific Island countries) and regional goals for early learning. Prior to the current role, Sandipan has been working as international consultant in early childhood development across 17 countries and Regional Organizations and Networks, providing technical support for developing early childhood development policies, strategies and national plans, competencies, and standards for quality improvement and program evaluations, most of which have with UNICEF Head Quarters and country offices, World Bank, private philanthropies, and humanitarian organizations. He has authored several reports commissioned by UNICEF as well as in an international journal titled Early Childhood Matters.
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