Scaling Early Childhood Development – what to read this month | May 2026

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).

A recent paper by Desmond et al. challenges the assumption that early childhood investments automatically generate high and equitable returns in low- and middle-income countries (LMICs). Building on the Heckman Curve, the authors propose a human development framework, showing that benefits depend on whether developmental potential is later realised and utilised through supportive environments, services and opportunities across the life course. Drawing on Martha Nussbaum’s capabilities approach, the framework shifts attention from skills and productivity toward human flourishing. Crucially, persistent adversity – including poverty, poor schooling, unsafe environments and weak services – can dampen or even reverse returns on early investment. The paper argues that maximising returns requires coordinated investments across the life course, particularly for the most disadvantaged children.

Insightful lessons for scaling parenting programmes emerge from a qualitative evaluation of Brazil’s Programa Criança Feliz (PCF) – the world’s largest home visitation programme for ECD, reaching more than 1.3 million children and pregnant women. Drawing on interviews and focus groups across 11 municipalities, Westgard et al. examine why PCF has struggled to achieve consistent ECD improvements despite (or because of?) its extraordinary reach. Key barriers included: the absence of a structured, age-sequenced curriculum, forcing home visitors to improvise activities using sources such as YouTube; weak frontline training systems; high staff turnover linked to short-term contracts and political cycles; funding mechanisms that excluded remote families; and burdensome monitoring systems. The study highlights a central challenge for scaling parenting programmes: flexibility to adapt locally matters, but without clear guidance, training and standards, adaptation can undermine implementation quality and impact.

Why do so many family-focused ECD programmes struggle outside research settings? A scoping review by Noyek et al. synthesising evidence from 31 studies across 19 countries identifies 204 barriers and 183 facilitators to implementation. Families’ limited ability to engage – shaped by work and caregiving demands, transport challenges and broader contextual constraints – emerged as the most common barrier. System-level challenges included weak financing, limited resources, disability-related stigma and poor coordination across sectors. The strongest facilitators were thoughtful programme design, local adaptation and services perceived as more useful or accessible than existing alternatives. The review reinforces a familiar but important message for scaling ECD: sustainable implementation depends on understanding local context, engaging families, securing stable financing and strengthening coordination across sectors.

Volunteer-based delivery models may struggle to remain sustainable as parenting programmes scale in low-resource settings, according to a new qualitative study by Wamoyi et al. The paper examines Tanzania’s Furaha-Teens programme, adapted from Parenting for Lifelong Health and reaching more than 75,000 beneficiaries across three regions. Interviews with facilitators, coaches and implementing partners identified several enablers of scale, including strong government and community buy-in, integration into existing school structures, and implementers’ strong belief in the programme’s value for families. However, scale also created important workforce and delivery pressures: long travel distances, low compensation, facilitator shortages, language mismatches and competing programme demands all threatened implementation quality and consistency. The authors argue that sustaining parenting programmes at scale requires greater investment in workforce support, locally matched facilitators, and delivery models that reduce logistical burdens.

Several papers this month also examine what scaling ECD looks like in humanitarian and highly fragile contexts. A cluster randomised trial by Iqbal et al. evaluated a father-focused ECD intervention delivered through home visits and group sessions to more than 2,000 Rohingya refugee and host-community fathers in Cox’s Bazar, Bangladesh. Added to an existing mother-focused intervention, the programme improved fathers’ engagement with children and spouses, including greater stimulation, co-parenting and household support for mothers. While no significant gains were found on directly assessed cognitive or language outcomes, positive effects emerged for children’s socio-emotional development, particularly in families with lower baseline stimulation and poorer maternal health. The findings suggest that community-delivered father engagement models can achieve high participation and improve caregiving, even in fragile displacement settings.

Violence prevention may need to become a far more explicit part of ECD programming in humanitarian settings. Embedded within the endline of a parenting trial in Cox’s Bazar, Shiraji et al. found very high levels of violence in both Rohingya refugee and host communities: over two-thirds of mothers and more than three-quarters of fathers reported violence against children, while over 45% of mothers reported intimate partner violence. Mothers experiencing intimate partner violence were more than twice as likely to report using violence against children, reinforcing how violence within couples and against children often co-occurs. Although the parenting intervention did not directly address violence, it reduced mothers’ acceptance of violence against children, suggesting ECD platforms could become important entry points for preventing both child maltreatment and intimate partner violence if designed intentionally.

Can cash strengthen caregiving and child wellbeing in shock-prone settings? A cluster-randomised trial by de Groot et al. evaluated a shock-responsive cash-plus programme for women’s savings groups in rural Mali. The programme combined cash transfers with complementary services delivered through the Mama Yeleen model, which trained role-model mothers on nutrition, breastfeeding, child development and women’s empowerment. The full cash-plus package improved a composite child wellbeing index by 0.34 standard deviations, while the services-only arm showed no significant effects, suggesting cash was critical for translating group-based support into child gains. Impacts were strongest for early stimulation and nutrition, including reductions in wasting and underweight. The findings suggest that combining cash with behaviour-change support may have helped households translate knowledge into improved caregiving and nutrition practices, although the mechanisms driving these gains remain unclear.

A critical commentary in The Lancet Regional Health Southeast Asia calls for a fundamental shift in child brain health priorities in South Asia – from survival to prevention. Drawing on evidence from Sri Lanka, India and Pakistan, the authors argue that health systems remain disproportionately focused on neonatal survival rather than the upstream biological and social determinants of neurodevelopment. The piece makes the case that maternal literacy, nutrition, adolescent health, girls’ education and pregnancy preparedness should be treated as core child brain health priorities, alongside scaling proven newborn interventions such as neonatal resuscitation, kangaroo mother care, breastfeeding support and immunisation. Importantly, the authors stress that within-country inequalities can be as important as cross-country differences. For ECD policy and practice, the message is clear: protecting children’s neurological potential at scale requires shifting financing and policy attention upstream to women’s health before and during pregnancy.

Beyond parenting interventions, two reviews this month focus on the broader childcare and early childhood care and education (ECCE) systems needed to support families at scale. A scoping review by Izugbara et al. maps the organisation and challenges of childcare services across sub-Saharan Africa, describing a fragmented landscape spanning public, private, community-based and informal providers. While this diversity reflects strong demand and contextual adaptability, it also produces major inequalities in quality and oversight. Across settings, services largely prioritise child minding and safety over developmental stimulation, with limited play-based learning and responsive caregiving. Oversight focuses mainly on infrastructure in formal centres, leaving the informal sector largely unsupported and unregulated. Chronic underfunding, weak workforce training and poor caregiver-to-child ratios further constrain quality. The review calls for greater public financing, workforce professionalisation and regulatory systems that support rather than exclude informal providers.

A second review, commissioned for UNESCO’s 2026 Global Education Monitoring Report, synthesises global evidence on policies to increase participation in ECCE. Reviewing 84 studies and reports, Dabrowski et al. organise evidence across four policy areas: universal ECCE system expansion, targeted support within services, preventative policies addressing barriers before enrolment, and alternative provision for children unable to access formal services. Across all four, the review identifies common priorities: child safeguarding, holistic child development, cohesive governance and financing, and equity-focused monitoring. The authors also highlight major evidence gaps, including weak causal evidence and limited data on the most disadvantaged children. The review concludes that expanding access alone is insufficient: scaling ECCE requires stronger data systems, attention to quality alongside enrolment, and policies tailored to local inequities and barriers to participation.