Scaling Early Childhood Development- What to read | August 2025

Scaling Early Childhood Development – what to read this month is curated by Bet Caeyers (Lead Editor, Chr. Michelsen Institute), Meghan Taylor (Editor, Oxford Policy Management) and Tanvi (Editor, Oxford Policy Management).

First up, Beukes et al. reviewed 21 studies conducted between 2019 and 2024 across 13 sub-Saharan African countries, focusing on the integration of the 5 Nurturing Care Framework components into early childhood development (ECD) interventions. Most of this research has been from Eastern and Southern Africa (especially Tanzania, Zimbabwe and Kenya), while Western and Central Africa are underrepresented. Nearly all interventions targeted only one or two components of the Nurturing Care Framework (nutrition being most common); none addressed all five. While multi-component programmes face implementation challenges, they tend to produce results on a wider range of outcomes than those focusing on just one domain. More longitudinal, context-specific research on multifaceted ECD programmes in African contexts is needed to overcome structural barriers and to improve child development in all of its dimensions. Evidence from high-income countries repeatedly shows that continuous provision of good-quality ECD services can deliver significantly better child outcomes than patchy and inconsistent services.

A recent study by Sultana et al. examines a large-scale, group-based multi-component parenting intervention implemented through the government health system in rural Bangladesh. The programme focused on responsive caregiving, early learning, mental health, lead exposure prevention, WASH and nutrition. The study makes a significant contribution to the scaling literature, not only by including multiple components of the Nurturing Care Framework but also by targeting all 7,718 eligible families in the study area – unlike other pilot studies with study participation restrictions. Results indicate that participating caregivers engaged in more play, had more toys and books, and better understood risks associated with lead exposure. Although the study was non-experimental and likely influenced by self-selection bias, these positive associations are promising. Attendance was low, however, with half of the caregivers not attending any session, and most attending fewer than 4 of 18 sessions. The authors suggest that using public infrastructure for parenting programmes could improve scalability, but recommend changes like alternative venues, fewer attendance barriers, and pre-recorded media to enhance reach and quality.

Another study in South Asia, by Gopalakrishnan et al., focuses on factors associated with effective delivery of ECD and parenting support services by Anganwadi workers — a type of community health worker — through India’s Integrated Child Development Services (ICDS) programme. Results show that coverage of ICDS service has been low, with only 47% of eligible women receiving growth monitoring services for their children, 45% of women receiving counselling on infant and young child feeding practices, and 52% of women receiving take-home rations. The study uses an adapted version of the Means, Motives, and Opportunities Framework to understand health worker performance (see Figure 1). Overall, opportunity-related factors were the most important predictors of performance – more so than motivation or means. Training, supervision, timely salary payments, resource availability and caste significantly affect workers’ ability to deliver the services. The authors conclude that strengthening of the Anganwadi workers’ support system and addressing structural barriers are important when designing strategies to improve both one of the world’s largest health worker communities and ECD outcomes.

Figure 1: Adapted Means, Motives, Opportunity Framework to study Anganwadi workers’ service delivery/performance (Gopalakrishnan et al. 2025). Note: AWW = Anganwadi worker.

In Tanzania, Jeong et al. document the process of development and adaptation of a structured, father-inclusive parenting curriculum called Familia Bora, filling a gap in interventions in low and middle-income countries (LMICs), which mostly target mothers. Few parenting programmes actively engage fathers or address gender norms, and those that do, like Tanzania’s EFFECTS, or Rwanda’s Bandebereho and Sugira Muryango, often lack content and delivery mechanisms that are tailored specifically to fathers’ needs and barriers. The study used a co-design approach, iteratively involving researchers and stakeholders working collaboratively to create a culturally relevant curriculum covering fatherhood, couples´ relationships, mental health, and early childhood development. Further research is needed to evaluate the intervention´s feasibility, acceptability and effectiveness. The study highlights the importance of co-design and father-inclusive approaches to promote nurturing care and gender equity in LMICs.

Next up, a compelling insight by Yahner and Elaraby on the critical importance of well-managed close-outs in donor-funded health initiatives. This thought-provoking perspective from the Connect family planning project in Tanzania is sure to serve as a wake-up call for many readers of this newsletter. It sheds light on how community health workers, the ‘backbone’ of many community interventions, experience project closures. Positive close-out practices – such as timely communication about project timelines, sharing results, recognising worker contributions, ensuring payment of incentives, and leaving behind essential resources – foster continued motivation and sustain community health efforts. Conversely, abrupt or poorly managed closures risk undermining goodwill, leaving frontline community health workers feeling undervalued and uncertain about their role going forward. The study underscores the need for donors and implementers to plan project close-outs thoughtfully, prioritising respect and communication with workers to support lasting health impacts beyond the life of individual projects.

Switching now to all things early childhood care and education! In Cambodia, Chea et al. explore persistent challenges with pre-school teacher deployment. Their research shows a familiar global pattern: well-trained, newly graduated teachers are concentrated in urban areas, while rural pre-schools struggle with acute shortages and less-qualified staff. This imbalance undermines classroom quality and deepens Cambodia’s rural-urban education gap. The situation is compounded by limited career pathways, insufficient incentives for teachers to work in disadvantaged regions, and only one dedicated pre-school teacher training institution serving a steadily increasing number of pre-schools. There is also a lack of ongoing professional development and robust data systems, making it hard for policymakers to diagnose and address deployment gaps effectively. The authors emphasise the urgent need for more training institutions, better teacher retention strategies, targeted incentives, stronger education management information system (EMIS) data, and innovative financing to support equitable teacher distribution and quality improvement.

In Ghana, Kidman et al. are the first to assess the impact of a national, free pre-primary education (PPE) policy on paid maternal employment in Africa. Through a natural experiment, using country-level policy data and individual-level economic data, the authors show that making PPE universal in Ghana boosted paid employment for mothers of young children by 4 percentage points. Crucially, the gains were strongest for women with the least education and those in rural communities – in other words, groups that typically face the steepest hurdles to entering the workforce. The research reveals that rolling out formal PPE has ripple effects beyond child development, directly supporting mothers’ economic participation and building gender equity. With most LMICs yet to offer free PPE, this evidence – combined with prior evidence that PPE benefits child development – makes a powerful case for scaling up PPE to drive social and economic progress (with the obvious caveat that impacts may depend on PPE quality and on context more generally).

Let´s wrap up with Theirworld’s latest donor scorecard, which reveals notable progress alongside persistent challenges for PPE. Since 2015, funding for pre-primary schooling has more than doubled, reaching US$250 million in 2023 – the second-highest amount recorded to date. Yet this accounts for only 1.2% of total education aid, representing a decline from the previous year and still far short of the 10% target championed by leading global education organisations. The vast majority of this funding comes from a small group of donors, with the World Bank alone contributing 57.3% of all pre-primary aid in 2023 (see Table 1 on p. 17 for the detailed breakdown). Just five countries – Tanzania, Rwanda, Jordan, Bangladesh, and Ethiopia – received half of the total aid, while many of the world’s poorest and conflict-affected nations, such as Burundi, Sudan, and Yemen, received less than 20 cents per child. Strikingly, aid for post-secondary education in 2023 was 24 times higher than that for pre-primary education. It is important to note that this report does not capture data from 2024 or early 2025, so the most current funding landscape may show significant changes.