Early Childhood Development Systems in East and Southern Africa

A child’s first years have profound effects on well-being over the lifetime, as well as the well-being of the next generation. The Nurturing Care Framework outlined by the World Health Organization provides a roadmap for addressing the needs of the whole child and their caregivers from pregnancy through age 5 by identifying and linking five key components: health, nutrition, responsive caregiving, security and safety, and opportunities for early learning. Given the interconnectedness of these components, systems-level approaches offer advantages over single-sector interventions by leveraging multisectoral coordination and improved governance, policy, and financing structures in support of the whole child. But given the traditionally siloed nature of the sectors responsible for each of these components, systems-level approaches are inherently challenging for governments to implement, and perhaps even more challenging to measure. 

Mathematica, the ECD Network for Kenya, Ifakara Health Institute in Tanzania, and KixiQuila Consultores in Mozambique have partnered with the Conrad N. Hilton Foundation to conduct a systems-level evaluation as part of the Foundation’s ECD strategy. This evaluation provides critical evidence about the state of the system serving young children, the barriers and facilitators of systems change, and progress toward realizing the promise of nurturing care.