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Begin New Search Topic Children Content Type Working Paper Publishing Institution Center for Global Development Publication Year within 10 Years

1. Prioritizing Public Spending on Health in Lower-Income Countries: The Role of the Global Financing Facility for Women, Children and Adolescents

Author:
Janeen Madan Keller, Rachel Silverman, Julia Kaufman, and Amanda Glassman
Publication Date:
12-2022
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
The Global Financing Facility (GFF), launched in 2015, is a partnership backed by a multi-donor World Bank trust fund that aims to “prioritize and scale-up evidence-driven investments to improve reproductive, maternal, newborn, child, and adolescent health and nutrition (RMNCAH-N) interventions” in low- and lower middle-income countries. A major component of the GFF’s operational model is centered around the investment case, described by the GFF as “a description of the changes that a country wants to see with regard to reproductive, maternal, newborn, child, and adolescent health (RMNCAH) and a prioritized set of investments required to achieve these results.” Looking retrospectively at investment cases and associated ongoing World Bank operations, this paper aims to shed light on specific aspects of the GFF’s operating model, approach, theory of change, and results to date related to the “development of a costed and prioritized investment case,” and whether the investment case helps to prioritize public spending on health in the real world. The portfolio-wide findings suggest that the GFF delivers a clear value-add within the global health architecture by directing more funding to flow directly through governments via increased World Bank lending for RMNCAH-N (especially in the context of COVID-19-related service disruptions and fiscal contractions). The role of the investment case in aligning and prioritizing resources behind a consensus set of highest-value RMNCAH-N interventions within a specific funding envelope is less well documented in the public domain; GFF efforts to directly influence government RMNCAH-N spending decisions and their efficiency seem to occur primarily through follow-on resource mapping and expenditure tracking. The paper concludes with three recommendations for the GFF and its donors: (1) pursue a deliberate strategy for prioritization of RMNCAH-N services and products within the realistic budget constraint to advance evidence-based decisions on certain trade-offs; (2) increase transparency and public visibility into GFF-supported activities and funding, especially related to RMNCAH-N product procurement and overall resource tracking; and (3) explore incentives for increased donor co-financing within the framework of World Bank projects as a strategy to pool and channel more resources through government coffers.
Topic:
Health, Children, Women, Public Spending, and Gender
Political Geography:
Global Focus

2. Enhancing Young Children’s Language Acquisition through Parent-Child Book-Sharing: A Randomized Trial in Rural Kenya

Author:
Heather A. Knauer, Pamela Jakiela, Owen Ozier, Frances Aboud, and Lia C.H. Fernald
Publication Date:
02-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Worldwide, 250 million children under five (43 percent) are not meeting their developmental potential because they lack adequate nutrition and cognitive stimulation in early childhood. Several parent support programs have shown significant benefits for children’s development, but the programs are often expensive and resource intensive. The objective of this study was to test several variants of a potentially scalable, cost-effective intervention to increase cognitive stimulation by parents and improve emergent literacy skills in children. The intervention was a modified dialogic reading training program that used culturally and linguistically appropriate books adapted for a low-literacy population. We used a cluster randomized controlled trial with four intervention arms and one control arm in a sample of caregivers (n = 357) and their 24- to 83-month-old children (n = 510) in rural Kenya. The first treatment group received storybooks, while the other treatment arms received storybooks paired with varying quantities of modified dialogic reading training for parents. Main effects of each arm of the trial were examined, and tests of heterogeneity were conducted to examine differential effects among children of illiterate vs. literate caregivers. Parent training paired with the provision of culturally appropriate children’s books increased reading frequency and improved the quality of caregiver-child reading interactions among preschool-aged children. Treatments involving training improved storybook-specific expressive vocabulary. The children of illiterate caregivers benefited at least as much as the children of literate caregivers. For some outcomes, effects were comparable; for other outcomes, there were differentially larger effects for children of illiterate caregivers.
Topic:
Children, Language, Rural, Parenting, and Reading
Political Geography:
Kenya

3. Vaccine Introduction and Coverage in Gavi-Supported Countries 2015-2018: Implications for Gavi 5.0

Author:
Roxanne Oroxom and Amanda Glassman
Publication Date:
06-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
With a vision of “creating equal access to new and underused vaccines,” Gavi set several coverage-specific targets for 2020 as part of its Phase IV strategy, including the immunization of an additional 300 million children, increased pentavalent 3 and measles-containing vaccine (MCV) 1 coverage, and greater equity in coverage across wealth quintiles.[1] The strategy also called for broadening protection through improved routine coverage and the introduction of new vaccines.[2]
Topic:
Health, Children, Public Health, and Vaccine
Political Geography:
Global Focus

4. What We Learn about Girls’ Education from Interventions that Do Not Focus on Girls

Author:
David Evans and Fei Yuan
Publication Date:
07-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Despite dramatic global gains in access to education, 130 million girls of school age remain out of school. Among those who do enter, too many do not gain the essential skills to succeed after they complete their schooling. Previous efforts to synthesize evidence on how to improve educational outcomes for girls have tended to focus on interventions that are principally targeted to girls, such as girls’ latrines or girls’ scholarships. But if general, non-targeted interventions—those that benefit both girls and boys—significantly improve girls’ education, then focusing only on girl-targeted interventions may miss some of the best investments for improving educational opportunities for girls in absolute terms. This review brings together evidence from 270 educational interventions from 177 studies in 54 low- and middle-income countries and identifies their impacts on girls, regardless of whether the interventions specifically target girls. The review finds that to improve access and learning, general interventions deliver gains for girls that are comparable to girl-targeted interventions. At the same time, many more general interventions have been tested, providing a broader menu of options for policy makers. General interventions have similar impacts for girls as for boys. Many of the most effective interventions to improve access for girls are household-based (such as cash transfer programs), and many of the most effective interventions to improve learning for girls involve improving the pedagogy of teachers. Girl-targeted interventions may make the most sense when addressing constraints that are unique to girls.
Topic:
Education, Children, Women, and Feminism
Political Geography:
Global Focus

5. The Political Economy of Testing in Latin America and Sub-Saharan Africa

Author:
Barbara Bruns, Maryam Akmal, and Nancy Birdsall
Publication Date:
09-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Most countries in sub-Saharan Africa have not implemented testing of children’s learning that can be benchmarked regionally or globally. In contrast, in the last two decades, almost all countries in Latin America have participated in regionally and globally benchmarked testing initiatives. Our analysis of the political economy of cross-national learning measurement in Latin America suggests that policymakers perceive the risks of exposing their education system’s performance by joining cross-national assessments, but they also value the quality of the data generated, the strengthening of domestic technical capacity, and the political benefits in using comparative results to argue for reforms or to advertise progress. We document that in Ecuador and Peru cross-national tests played an important role in both stimulating and justifying reforms that have produced major improvements in learning. In sub-Saharan Africa, no cross-national test has been implemented as consistently or widely as the Latin American regional test. The context in Africa makes regional cooperation on cross-national testing more daunting—countries are poorer and more linguistically diverse than in Latin America, raising the relative costs of developing and administering cross-national tests. The experience of Latin America suggests that a coordinated and efficient application of resources in implementing cross-national tests in Africa, on the part of countries and with support of the international community, could help build countries’ national capacity, strengthen focus on learning, support better research, and help diffuse reforms that raise learning.
Topic:
Education, Political Economy, Children, and Social Services
Political Geography:
Africa, South America, Latin America, North America, and Sub-Saharan Africa

6. Multilingual Assessment of Early Child Development: Analyses from Repeated Observations of Children in Kenya

Author:
Heather A. Knauer, Patricia Kariger, Pamela Jakiela, Owen Ozier, and Lia C.H. Fernald
Publication Date:
10-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
In many low- and middle-income countries, young children learn a mother tongue or indigenous language at home before entering the formal education system where they will need to understand and speak a country’s official language(s). Thus, assessments of children before school age, conducted in a nation’s official language, may not fully reflect a child’s development, underscoring the importance of test translation and adaptation. To examine differences in vocabulary development by language of assessment, we adapted and validated instruments to measure developmental outcomes, including expressive and receptive vocabulary. We assessed 505 2-to-6- year-old children in rural communities in Western Kenya with comparable vocabulary tests in three languages: Luo (the local language or mother tongue), Swahili, and English (official languages) at two time points, 5–6 weeks apart, between September 2015 and October 2016. Younger children responded to the expressive vocabulary measure exclusively in Luo (44–59% of 2-to-4-year-olds) much more frequently than did older children (20–21% of 5-to-6-year-olds). Baseline receptive vocabulary scores in Luo (β = 0.26, SE = 0.05, p < 0.001) and Swahili (β = 0.10, SE = 0.05, p = 0.032) were strongly associated with receptive vocabulary in English at follow-up, even after controlling for English vocabulary at baseline. Parental Luo literacy at baseline (β = 0.11, SE = 0.05, p = 0.045) was associated with child English vocabulary at follow-up, while parental English literacy at baseline was not. Our findings suggest that multilingual testing is essential to understanding the developmental environment and cognitive growth of multilingual children.
Topic:
Development, Children, Linguistics, and Language
Political Geography:
Kenya and Africa