What have we read on scaling early childhood development in 2024?

-Bet Caeyers

We established this newsletter to keep track of the growing body of evidence on scaling early childhood development, to identify emerging trends, and to digest what this means for policy and practice. As this niche in the early childhood development literature is still in its infancy and relatively small, in 2024, we were able to cover all newly published studies (72 journal articles and 28 working papers) that the editorial board considered high-quality and explicitly relevant to scaling.

Research on parenting is blooming

Parenting was by far the hottest research topic, covered in 39% of the studies reviewed, either evaluating the intended or unintended impacts (short- or long-term) of an innovative, scalable version or at-scale version of a parenting programme (14%), or assessing process implementation of such programmes (25%). Interventions ranged from counselling on health, nutrition, early learning or responsive caregiving to parental mental wellbeing and using multiple delivery modes, such as home visits, group sessions, text messages or distribution of growth charts in the homes.

Table 1: Areas of research focus

This new wave of evidence on parenting is pushing the knowledge frontier further in many ways. Examples of scaling success include the Early Journey of Life (EJOL) programme in Vietnam, for which the ingredients to success were carefully documented, and the Moments that Matter programme, which showcases how a process evaluation conducted early on in a project’s implementation can improve programme fidelity and quality. Group-based parenting interventions continue to be on the rise and effective – for example in the first-ever group-based adaptation of the Care for Child Development (CCD) programme. Complementary qualitative work on the Sugira Muryango programme in Rwanda produced valuable insights into how training, monthly supervision, in-person monitoring visits and audio recorders can be used to strengthen service provision by non-specialists.

At the same time, several studies this year cautioned against potential unintended and distributional consequences of some parenting interventions adapted to go to scale. For example, a paper in Ghana and another paper in India both document the negative impacts of a large-scale, light-touch, SMS-nudge parenting intervention. Other studies, such as this one in Brazil, find little to no impact of parenting programmes integrated into existing public infrastructure at scale, highlighting the continued importance of workload, supervision and buy-in from delivery actors to enhance programme fidelity.

The literature on ‘marginalised groups’ (the focus of 13% of the studies) covered a wide range of people with a wide range of needs – from children with disabilities to displaced families, caregivers with HIV and families subject to domestic violence. The same applies to systems research (6% of the studies), which covered various topics including systems-contextual approaches to sustainable development goals (SDGs), donor coordination and policy-practice gap analysis.

A further important focus this year (10% of the studies) has been the measurement of early childhood development outcomes and the quality of the early childhood development environment. There have been a substantial number of reviews (e.g. here) and validations of existing measures of early childhood development, such as the Early Childhood Development Index (ECDI2030) and the Global Scale for Early Development (GSED) (e.g. here, here and here). The ECD Measure Team of Nebraska University has made significant contributions to the measurement of the quality of early childhood care and education (e.g. here and here).

The emerging evidence on the crucial but complex issue of financing is fascinating – but was only covered in six studies. In one such example, a field experiment in China looked at the measurement of willingness to pay for early childhood development. We also came across some insightful ideas on innovative financing in education and an analysis of the returns on investment for scaling screening and psychological treatment.

Cash transfers, centre-based care, gender, women’s empowerment and fathers’ engagement also received less attention in the literature. The limited research focus on the scaling of centre-based care – typically targeting children between 2 and 5 years of age – is particularly striking, especially in contrast to the body of evidence available on the first 1000 days (from conception until age 2). It is not a coincidence that The Lancet recently launched its new series calling for investments in ‘the next 1000 days’. On cash transfers, there has been a substantial amount of new evidence more generally (nicely documented in Ugo Gentilini’s excellent blog), but, with some notable exceptions (for example, here), there have only been limited new insights related to the short- and long-term impacts of nationwide cash transfer or other social protection schemes on children, and on how these schemes interact with other early childhood development services (such as parenting programmes) in shaping child development.

More primary evidence using mixed methods is needed to strengthen the implementation science base

A sizable proportion (41%) of the 100 studies we reviewed during 2024 were systematic reviews or opinion pieces – only 59 generated new primary evidence on scaling early childhood development.

Figure 1: Research methods

While much of this synthesis work is of course incredibly valuable – such as this meta-analytic review of the implementation characteristics in parenting interventions – the findings of systematic reviews are not always directly relevant to specific policy contexts and settings. In addition, the scientific contribution of systematic reviews critically depends on the quantity and quality of papers available – and they often conclude that more implementation science evidence is needed to help inform the scale-up of effective interventions.

In terms of the primary evidence, 22 studies (including 20 randomised controlled trials) dealt with an impact evaluation of an early childhood intervention while 19 were qualitative studies focusing on intervention process evaluation. Only a couple of studies (here and here) used mixed methods (quantitative and qualitative data) to evaluate the process of an early childhood development intervention. Yet mixed methods are usually required to benefit from both the detailed, contextualised insights of qualitative data and the generalisable, externally valid insights using quantitative data. This was also the conclusion of a recent scoping review of process evaluations for the scale-up of complex interventions.

A decent geographic representation, except in the Pacific and conflict-prone regions

In proportion to the share of LMICs in the region, both South Asia and Latin America and the Caribbean were slightly overrepresented within the studies we reviewed during 2024. South Asia accounts for 21% of the studies and Latin America and the Caribbean for 17%, whereas these regions contain only 9% and 5% of the world’s LMICs, respectively. This is not particularly surprising as countries in Latin America and the Caribbean have always been prime movers in generating evidence on early childhood development – undoubtedly at least partially driven by Jamaica’s famous Reach Up programme, which has inspired much research in the region. Similarly, in South Asia, Bangladesh and India have both contributed substantial evidence on early childhood development.

Figure 2: Geographic spread

In contrast, both Middle East and North Africa and East Asia and Pacific were underrepresented in the research we reviewed. The Middle East and North Africa region has 12% of the world’s LMICs but only 3% of studies came from this region. Similarly, the East Asia and Pacific region is home to 17% of the world’s LMICs but was the focus of only 7% of studies. The only study in the former region is from Jordan, focusing on a phone-based parenting intervention in a displaced population. In many other countries in the region, it is hard to do research because of conflict and war. Four of the five studies from East Asia and the Pacific are from China, which, like Bangladesh and India, is at the forefront of early childhood development research. Many other countries in this region are scattered island economies (e.g. Kiribati), where remoteness makes research on scaling complex and challenging.

One region that is proportionally well represented is sub-Saharan Africa – whichis good news for a region that is home to the largest number of children who are not developmentally on track. Sub-Saharan Africa (containing 53% of the world’s LMICs) was the focus of 55% of all the studies we identified over the year, covering 15 of the region’s 41 LMICs.

Our wish for 2025

As we look ahead, we hope that 2025 will bring us an abundance of primary evidence explicitly focused on how early childhood development initiatives can genuinely scale to meet the needs of all children. We particularly hope to see studies employing mixed methods to evaluate programme feasibility, sustainability and impact. We would like to see more research on centre-based care, especially addressing the neglected ‘next 1000 days’ period. We also wish for innovations in financing and a more comprehensive systems perspective, providing practical guidance for national policymakers and service managers on maximising early childhood development impact with existing resources and those they aspire to secure in the future.

For our part, we are committed to ensuring that this newsletter remains a vital resource for researchers, policymakers and practitioners, fostering a deeper understanding of the essential elements required for successful early childhood development scaling in the evolving landscape of 2025 and beyond. Cheers to a productive new year ahead!