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Executive Summary1. Introduction2. Forced Displacement and Education: A Global Overview3. State of Research, Policy, and Practice in Refugee Eduction4. The State of Research, Policy, and Practice in IDP Education5. Opportunities, Innovations, and Best Practice in Education for Forcibly Displaced PeopleAppendix

This topic guide is designed to support DFID advisors, education specialists, and other partners working on providing education for refugees and Internally Displaced Persons (IDPs). It provides an overview of the key issues, and signposts relevant sources for further information and reading. Section 1 provides a brief introduction to the guide. Section 2 gives a global overview of forced displacement and education. Section 3 maps the state of research, policy, and practice in refugee education. Section 4 maps the state of research, policy, and practice in IDP education. Section 5 seeks to identify and explore best practice, and existing and potential future opportunities and innovations, in the field of education and forced displacement.

Methodology and evidence base

This guide is based on an extensive (but not systematic) literature review. There are few sources of reliable data, robust evidence, and rigorous research in this field, especially with regard to IDP education and education for refugees living outside of camps. This guide has therefore also drawn upon grey literature, including project evaluations from international agencies working in the field. There remain large evidence gaps regarding the numbers of displaced children and the quantity and quality of education that they receive. The evidence base regarding the effectiveness of education interventions for displaced populations, covered in section 5 of this guide, is very limited. The strength of the evidence base is discussed in Appendix A.

Section 2: Forced displacement and education: a global overview

In 2015 there were 65.3 million people living in forced displacement due to conflict and persecution (UNHCR 2016i). The figure includes those who have fled across borders (refugees) and those who have stayed within their own countries (IDPs). The differences between refugees and IDPs are summarised in table 0.1.

Table 0.1 Summary of the differences between refugees and IDPs

  Refugees IDPs
Global numbers (2015) (see UNHCR 2016i)

 

21.3 million refugees
3.2 million asylum seekers
40.8 million internally displaced people, of which 8.6 million newly displaced in 2015
Causes of displacement Persecution Armed conflict, internal strife, systematic violations of human rights or natural or man-made disasters
Bodies responsible for ensuring the right to education UNHCR, host governments, UNRWA for Palestinian refugees National governments
UNICEF for returnees (see UNHCR 1997)
Global legal frameworks and conventions 1951 Convention and 1967 Protocol Relating to the Status of Refugees 1998 UN Guiding Principles on IDPs (not legally binding)

 

Coordinating bodies UNHCR, UNRWA Education Cluster

Displacement is usually long term. In 2012, 75% of refugees had been displaced for more than 5 years. In two thirds of all countries monitored in 2014, over half of all IDPs had been displaced for over three years.

Around half of refugees are under 18; similar data for IDPs is unavailable. However, education counts for only around 2% of humanitarian aid, and makes up 4% of UNHCR’s budget. Education in situations of protracted displacement faces funding shortages

Data availability

The UNHCR is mandated to collect and disseminate global statistics on refugees. The Internal Displacement Monitoring Centre (IDMC) compiles data on IDPs collected by other organisations but is only able to produce estimates. Little is known about the largest group of forcibly displaced people – IDPs outside of camp situations – regarding the numbers of children and their access to education. In terms of data, this group is virtually invisible to the international community.

Section 3: State of research, policy, and practice in refugee education

This guide focuses on the education of refugees in low- and middle-income countries, where the majority (≈75%) of refugees live, and does not cover education of refugees in high-income countries. The education of Palestinian refugees through UNRWA provides an example of how quality education for refugees in protracted displacement can be successfully delivered at scale, given sufficient resources.

Coordination

The UNHCR Education Strategy 2012-2016 promotes the integration of refugee learners within national systems. UNHCR has established formal partnerships with ministries of education in almost all the countries in which it works, and many host countries have adopted this approach.

Access to education for refugees

According to UNHCR:

  • Only 1 in every 2 primary-school-aged refugees accesses primary education
  • Only 1 in every 4 secondary-school-aged refugees accesses secondary education
  • Only 1 in every 100 refugees accesses higher education or skills-based education
  • 2 million school-aged refugee children and adolescents are out of school

Common barriers to access at all levels of education include shortage of school space, language barriers, curriculum, transport, lack of documentation (e.g. birth certificates, school-leaving certificates), child labour, school fees, and security concerns. Particular challenges for girls include pregnancy and/or marriage, and lack of access to sanitation facilities.

The limited available research suggests that mainstreaming into the host country’s education system has several major advantages compared with creating parallel and/or alternative education provision. Advantages include accountability, standardisation, and recognised certification of educational opportunities. However, the education systems in host countries are rarely equipped to deal with arrivals of refugee learners. National schools are sometimes associated with high costs and non-mother-tongue instruction leading to grade repetition.

Opportunities for higher education for refugees are particularly lacking.

Quality of education for refugees

The quality of education for refugees who are enrolled in schools is often very low, with high student–teacher ratios, poor facilities, and lack of safety for children in schools and on the way to school.

Curriculum: The curriculum of the country of origin is the one that is most relevant to the recently displaced, since qualifications gained can be recognised on their return. But most refugees live in protracted displacement and few return to their place of origin. Integration into the host education system and its curriculum is the preferred norm of the UNHCR. Educators often include elements from the country of origin curricula to teach alongside host country curricula, and may add subjects like human rights and peacebuilding.

Medium of instruction and language learning: Having to learn the language of the host country and adapt to education in a new medium of instruction is a major barrier. Strategies used to address this include the provision of language classes for refugees, and using a bilingual curriculum in refugee schools to support transition into local schools.

Pedagogy and teacher competence: Teachers recruited to teach in refugee schools are often unqualified. Their training courses are often short and do not lead to formal qualifications. In some contexts these teachers lack confidence, and do not see themselves as real teachers. Overcrowded classrooms, lack of materials, and unfamiliarity with the language of instruction also have a negative impact on the quality of teaching.

Assessment: Refugees face a number of challenges concerning assessment. These include:

  • lack of access to formal assessment opportunities such as national examinations
  • lack of recognition of certain credentials and qualifications
  • lack of recognition of prior learning

Protection and wellbeing of refugees in and through education

Education can be a source of protection for refugee children. However, the protective effects of education are diminished when it is of low quality. Schools and other educational interventions can themselves be sites of violence or targets for attack. In addition, teachers who lack adequate training may use corporal punishment to maintain classroom discipline.

Section 4: The state of research, policy, and Practice in IDP Education

The situation of IDPs is often less visible to the international community than that of refugees.

  • IDPs in camps may have access to non-formal learning spaces or primary schools supported by the international community, but have very limited access to secondary education
  • IDPs outside of camps tend to receive less access and support from international humanitarian organisations, but may have better access to local schools
  • Returning IDPs may face challenges in having their learning during displacement recognised
  • For demobilised child soldiers, education is an important part of the reintegration process, as it provides social and emotional development as well as academic learning

Coordination and funding of IDP education

The legal responsibility for provision of education to IDPs lies with the national government. In the absence of provision by the state, IDP communities often set up their own schools.

International support for education for IDPs is generally treated as a short-term humanitarian response; however, many IDPs live in protracted displacement. Education tends to be a high priority for IDPs themselves, but has tended to be a low priority for humanitarian actors.

The education cluster plays a central role in coordinating support for IDP education. It can provide an effective platform for partnership with the international community and national governments.

Access to education for IDPs

A substantial proportion of IDP children are not enrolled in school, although the exact numbers are unknown. Access to education for IDPs is highly context-dependent.

IDPs face numerous barriers to education, especially girls and women. Many of the barriers are similar to those faced by other conflict and crisis-affected populations, but IDPs are more vulnerable due to the loss of livelihood, home, and possessions. School fees are one of the most significant barriers for IDPs. Other barriers particular to IDPs include:

  • lack of education providers within or near camps and other IDP settlements
  • loss of documentation
  • inability to meet residency requirements for school enrolment

Common strategies used by national governments in providing education for IDPs include:

  • expanding school capacity in host areas through multi-shift schooling
  • relaxing requirements for IDPs to have uniforms or documentation for enrolment
  • fee waivers

Strategies commonly used by the international community, often in partnership with national governments, include:

  • child-friendly spaces and temporary learning spaces
  • supplying teaching and learning materials such as “school in a box”
  • hiring IDP teachers, especially female teachers, to teach in IDP camps
  • issuing IDPs with temporary documentation
  • school feeding programmes and take-home rations
  • providing alternative education classes, including accelerated learning classes
  • school voucher programmes

In the first instance, UNICEF and other actors often provide Child Friendly Spaces. However, IDP children and families have voiced that they prefer formal education over structured play and non-formal education.

UNICEF uses “school in a box” kits that contain basic teaching and learning materials. It keeps a stockpile which can be rapidly deployed in emergencies. In prolonged displacement, locally procured kits provide a more culturally appropriate and value-for-money approach.

There are often very few opportunities for IDPs to continue studying post-primary. Education programming for “youth” (generally 15 years and older) in IDP situations often focuses on providing technical and vocational skills.

Quality of education and learning outcomes

In many cases the quality of education available to IDPs is far below the INEE’s Minimum Standards for Education.

There are very few studies on the learning outcomes of IDPs. A study in Sri Lanka found that there was a significant learning achievement deficit (1.5 to 3 years) associated with displacement. Evaluations of the Norwegian Refugee Council’s alternative education programmes for IDPs indicate that completion rates and learning outcomes for children in these programmes were similar to or better than those of children in mainstream schools.

Teacher recruitment, training, compensation, and wellbeing

Teachers in schools serving IDPs are often given incentives rather than a salary. International agencies are reluctant to support salaries due to concerns over sustainability and funding. But incentives often fail to attract qualified teachers. As a result, organisations often have to seek new potential teachers and provide basic training. Governments rarely agree to recognise these unqualified teachers, hence teachers in IDP camps can remain reliant on NGO incentives.

Many NGOs have developed their own teacher training courses. The most effective ones tend to place a heavy emphasis on classroom-based support, classroom observations, regular supervision, and ongoing workshops.

Refugees who qualify as teachers under a host country system may find that their government does not recognise their qualifications on their return. Regional certification of teachers can help to address this issue.

Protection and wellbeing of IDPs in and through education

Some IDP schools have become targets for attack and recruitment of child soldiers. However, quality education can also help to protect IDP children, including by:

  • providing a safe space for children to spend time
  • teaching skills and knowledge to children to protect themselves from exploitation, health risks, gender-based violence, land mines, and other risks
  • supporting children’s psychosocial well-being
  • providing sites where children can receive other support such as vaccinations and counselling

Impacts on host communities and education systems

In many emergencies, schools are used to provide temporary accommodation for IDPs, reducing access to education for host communities. Tensions can arise when IDPs are seen as being in competition for limited resources, or when they are seen as being given preferential treatment.

Gaps and challenges

Evidence and knowledge gaps

There is a need for more robust data, analysis, and research, including data on needs, availability, quality, and outcomes of education for IDPs and refugees living outside of camps.

There is a gap in the research when it comes to understanding the protracted nature of forced displacement and the individual and community educational trajectories and experiences. Robust longitudinal data are lacking.

Common challenges to education for refugees and IDPs

Provision of post-primary education and training opportunities for adolescents and youth remains a major gap, requiring increased support from national and international actors, and exploration of innovative means of providing cost-effective access to education for this group.

Given the protracted nature of forced displacement, the international donor community needs to develop medium- to long-term flexible funding and implementation mechanisms for education for refugees and IDPs. Progress has been made through the Global Partnership for Education, and it is hoped that the new education in emergencies platform will address this gap.

Challenges specific to refugee education

Since mainstreaming of refugees into national education systems has become a preferred option, there is an urgent need for relevant and meaningful curriculum and assessment systems and a better understanding of how to meet specific learning needs, including those to do with language of instruction and assessment, disabilities, gender, and ethnicity.

The quality of UNRWA schools relative to other schools in the region has been attributed in part to UNRWA’s teacher training programmes and ongoing support mechanisms, but standards are falling. There is a need to determine how to maintain standards and to transfer lessons learned to other protracted refugee situations.

Challenges specific to IDP education

National capacity to address IDP education needs to be strengthened. This should cover inclusion of IDPs in education sector plans, Educational Management Information Systems and budgets, and contingency planning to reduce the disruption of education in the event of unforeseen future displacement crises.

Improved national-level planning and international support is needed to improve teacher recruitment and compensation in IDP situations, including strategies to retain qualified teachers.

Governments’ legal responsibility to protect IDPs’ right to education needs to be strengthened through the development of legal frameworks at global, regional, and national levels.

Section 5: Opportunities, innovations, and best practice in education for forcibly displaced people

The range of approaches described in section 5 of the report, summarized here in table 0.2, represents a menu of potentially productive strategies, rather than a definitive list of “what works”.

Table 0.2   Potentially productive strategies

Issue addressed Strategies and interventions
Supporting impacted communities
  • Support to education interventions initiated by displaced people themselves
  • Cash transfers
Ensuring protection, psychosocial support, and safe spaces, and building resilience
  • Training teachers and parents to cope with traumatised children, alongside self-regulation exercises for children
  • After-school programmes providing academic support, problem-solving skills and nurturing positive peer relationships.
  • Using schools as a site for delivering mental health interventions
Addressing disruptions in learning
  • Accelerated learning programmes (ALPs) support overage children to catch up on missed learning time.
  • The Youth Education Pack, developed by the NRC, is a one-year full-time education package which provides training in literacy and numeracy, livelihood skills training and life-skills for youth aged 15-24, who have missed out on schooling
Addressing problems of space
  • Using mobile money transfers to pay teachers
  • Using mobiles for real-time school data collection
  • Using radio to deliver lesson content
  • Using mobile phones and tablets to enable interactive learning
  • Mobile schools (e.g. schools in a boat or bus)
Building teaching capacity and wellbeing
  • The Teacher Emergency Package: a package of self-study materials, on-going training and school materials
  • Deploying female teaching assistants to support girls
  • Interagency collaboration in the sharing and development of new teacher training and management resources
Improving higher education
  • Albert Einstein German Academic Refugee Initiative Fund (DAFI) scholarship programme
  • Learning hubs in Kenyan refugee camps, offering blended higher education courses including humanitarian interpreter training
  • Borderless Higher Education for Refugees (BHER) which provides modular certificated courses that build incrementally to a degree
Strengthening capacity for accreditation and certification
  • Cross-border and regional examinations
  • Accreditation of distance-learning by universities in the country of origin
  • Development of recognition agreements between governments
  • Use of placement tests to enable students lacking documentation to enrol in the most appropriate grade
  • Working with governments to enable IDPs to sit examinations (e.g. logistical support, changing examination dates to accommodate IDPs)
Improving data and monitoring
  • OpenEMIS
  • Use of GPS technology to access school data in remote areas
  • Satellite and drone imagery to identify IDP settlements and shelters in hard-to-access areas

 

Section 1: Introduction

1.1 Introduction and overview

According to UNICEF (2016), nearly 50 million children have migrated across borders around the world, or been forcibly displaced. Given that such displacement can last the duration of a typical school career, failure to provide education for these groups risks the emergence of a “lost generation”.

The umbrella term “forcibly displaced person” covers both refugee.s, i.e. those who have been forced to flee across national borders, and Internally Displaced Persons (IDPs), i.e. those who have had to move within their own countries. Refugees and IDPs are defined differently in relation to international law, and their situations differ markedly regarding level of access to education, assistance/protection available from governments (whether the host government or that of their own country) and the international community, and continuity/discontinuity in educational experiences (Smith Ellison and Smith 2012). Some sections of this guide cover issues relevant to both groups, other sections treat them separately.

This topic guide serves as a technical guide to support DFID advisors, education specialists, and other partners working on providing education for refugees and IDPs. Its purpose is threefold:

  • to map the state of research, policy, and practice in refugee education today
  • to map the state of research, policy, and practice in IDP education today
  • to identify and explore best practice, and existing and potential future opportunities and innovations in the field of education and forced displacement

This topic guide is not intended to be a comprehensive document covering all the issues relating to the right to education for forcibly displaced persons. Rather, it is an overview of the key issues facing decision-makers and other education stakeholders, and it signposts relevant sources for further information and reading. For a review of the wider literature on Education in Emergencies (including some research on forcibly displaced people), which also evaluates the quality of research according to DFID’s (2014) guidelines Assessing the Strength of Evidence, readers are referred to Burde et al. (2015).

1.2 Methodology and sources used for this review

This guide is based on an extensive (though not systematic) review of scholarly and grey literature (e.g. agency reports, evaluations, guidance documents). In consultation with an academic advisor, the authors conducted an initial purposive literature search using key academic and practitioner databases, including Education Resources Information Center (ERIC), Education Research Complete, EBSCOHost, Eldis, and the International Initiative for Impact Evaluation. The list of resources generated from these searches was reviewed and supplemented with documents suggested by individuals working at the global level with DFID, INEE, UNHCR, and UNICEF.

In general, there is a limited evidence base on the effectiveness of educational interventions for refugees and IDPs; this is in large part due to the challenging environments in which displaced people find themselves, which hinders systematic study. Nevertheless, a number of useful studies are available. Appendix A provides a full review and discussion of the strength of evidence in the sources referred to throughout this report.

1.3 How to use this guide

This guide has been written for a wide range of audiences, with differing background knowledge and information needs. It is designed so that readers can select the sections most relevant to themselves.

Section 2 sets out the global situation in terms of the numbers of forcibly displaced people, their locations, and the international aid architecture. The first part (2.1 to 2.3) relates to forced displacement in general. It gives the definitions, the numbers, the distribution and the trajectories of populations in forced displacement. This is aimed at education experts who are relatively new to the field of forced displacement. Those already familiar with the field may wish to skip these sections. The second part (2.3 to 2.7) gives a global overview of education and forced displacement. It includes a discussion on education for refugees and IDPs, challenges of data collection and monitoring, and an overview of the global coordinating structures for the international response to the needs. Readers seeking a quick overview of the defining characteristics of refugee and IDP education should refer to table 2.3 in section 2.4.

Sections 3 and 4 set out the state of research, policy, and practice in education for refugees and IDPs respectively. These have been written as stand-alone sections so that users of this guide can select the section most relevant to their own work.

Section 5 reviews innovations and best practice in education for forcibly displaced populations; many of these innovations are, or have the potential to be, applied to both refugee and IDP contexts. This section will be useful to those wanting to consider a range of possible solutions for providing education in these contexts. Many of the interventions discussed are relatively new or have been led by implementing organisations with limited research capacity, and therefore the evidence base for this section is relatively weak. A full discussion of the quality of evidence of the sources used throughout this report is provided in Appendix A.

Section 2: Forced Displacement and Education: A Global Overview

section-2-summary-box

2.1   What is forced displacement?

The Global Program on Forced Displacement defines forced displacement as “the situation of persons who are forced to leave or flee their homes due to conflict, violence and human rights violations” (GPFD 2015). Forced displacement can also occur due to natural disasters and large-scale development projects; this topic guide will focus primarily on conflict-related displacement, and secondarily on that associated with natural disasters, as these are generally recognised as priorities for the international education community. This is not, however, intended to downplay the significance of development-induced displacement.[1]

Table 2.1 provides definitions for the key terms used to describe the populations that are the focus of this topic guide. Note that the application of these terms is often legally and politically contested. For a more comprehensive glossary of key terms, see Appendix B. 

Table 2.1   Definitions of key terms

Term Definition
Refugee

 

According to the 1951 Refugee Convention, a refugee is someone who “owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his or her nationality, and is unable to, or owing to such fear, is unwilling to avail him or herself of the protection of that country.”
Palestinian Refugee A Palestinian refugee is a person whose residence was Palestine for at least two years before losing home and livelihood as a result of the 1948 conflict, or a descendant of such a person. While the definition ‘refugee’ emphasises the legal dimensions of the term, the definition of ‘a Palestinian refugee’ is more operational and exists primarily to identify persons eligible for services from the United Nations Relief and Works Agency (UNRWA), who today reside in Gaza, West Bank, Jordan, Syria, and Lebanon (Feldman 2012). Palestinian women cannot retain or pass on their status to descendants if they marry a non-refugee, though descendants of male UNRWA refugees can (Bocco 2010).
Asylum-Seeker

 

‘Asylum seeker’ refers to an individual seeking international protection, whose claim to refugee status has not been definitively evaluated as yet. Not every asylum seeker will be recognised as a refugee, but every refugee was initially an asylum seeker (UNHCR 2006).
Internally Displaced Person (IDP)

 

The most common definition of IDPs is the one presented by the UN Secretary-General in 1992, which identifies them as “persons who have been forced to flee their homes suddenly or unexpectedly in large numbers, as a result of armed conflict, internal strife, systematic violations of human rights or natural or man-made disasters, and who are within the territory of their own country” (Forced Migration Online 2012).
Returnee

 

A returnee is an individual who was displaced but who has recently returned to her/his country of origin (in the case of refugees) or place of origin (in the case of IDPs) (UNHCR 2006). For the purposes of this topic guide, returnees are discussed in the IDP section, because refugees who have returned to their home country are likely to be displaced within their origin country borders.
Person of Concern

 

“A person whose protection and assistance needs are of interest to UNHCR. This includes refugees, asylum-seekers, stateless people, internally displaced people and returnees” (UNHRC n.d.).
Separated/Unaccompanied Children

 

The Inter-agency Guiding Principles on Unaccompanied and Separated Children defines separated children as “those separated from both parents, or from their previous legal or customary primary care-giver, but not necessarily from other relatives. These may, therefore, include children accompanied by other adult family members.” It defines unaccompanied children/minors as “children who have been separated from both parents and other relatives and are not being cared for by an adult who, by law or custom, is responsible for doing so” (ICRC 2004). Children are entitled to special protection under the UN Convention on the Rights of the Child (CRC), but it has proven difficult to include separated children and adolescents within the protective scope of international refugee law (Bhabha 2014).

The emergencies that lead to displacement are generally complex. They result from a range of factors, including political instability, conflict, violence, inequality, and poverty, and are often exacerbated by natural disasters, health emergencies, and environmental instability (FAO 2016). Many such emergencies are protracted: long-term, and characterised by recurrent conflict and/or natural disaster, weak governance capacity, chronic food crises, etc. (FAO 2016). Crawford et al. (2015) define ‘protracted displacement’ broadly as “a situation in which refugees and/or IDPs have been in exile for three years or more, and where the process for finding durable solutions, such as repatriation, absorption in host communities or settlement in third locations, has stalled”; they note that it can be difficult to determine a cut-off date for when displacement can be considered protracted, resulting in some disagreements between international agencies and scholars.

2.2   Patterns of forced displacement

For 2015 the total number of forcibly displaced was 65.3 million (21.3 million refugees, 40.8 million IDPs, 3.2 million asylum seekers), the highest figure in history. This year also saw the highest annual increase of forcibly displaced peoples in any single year (UNHCR 2016i). The number of forcedly displaced people has grown by approximately 1.6 million annually between 2000 and 2014 (Crawford et al. 2015) but jumped by 5.8 million in 2014-15 (UNHCR 2016i).

Geographies of displacement are in a constant state of flux. The top ten countries of origin of people displaced by conflict and persecution in 2014 were: Syria (19.4%), Colombia (10.8%), Israel (8.7%),[2] Sudan (6.4%), Iraq (6.3%), Afghanistan (5.9%), DRC (5.6%), Pakistan (3.8%), Somalia (3.8%), and South Sudan (3.6%). Table 2.2 gives the breakdown of IDPs and refugees in countries with large displacement crises in 2014. Most of the ten countries with displacement crises caused by conflict involve both refugees and IDPs in varying numbers. Note that while increasing numbers of refugees are making their way to HICs, the focus of this topic guide is on education for refugees in LMICs, as this is where the majority of refugees are located.

The numbers of IDPs displaced by disasters fluctuates year to year, but the overall trend has been increasing. Models adjusting for population growth show that the probability of being displaced by a disaster is 60% higher today than it was four decades ago. Between 2008 and 2014 there have been on average five disasters per year that have led to the displacement of over a million people. Natural-disaster-induced displacement occurs in countries at all income levels, but middle-income countries tend to be the most impacted by such disasters, and the consequent displacement, due to their high levels of urban growth with limited associated services (IDMC 2015b).

Table 2.2   IDPs and refugees in countries with large displacement crises in 2014 (Source: Crawford et al. 2015, p. 9)

Top ten countries of displacement % of caseload[3] internally displaced % of caseload externally displaced
Syria 66% 34%
Colombia 94% 6%
Israel 0% 100%
Sudan 82% 18%
Iraq 87% 13%
Afghanistan 23% 77%
DRC 83% 17%
Pakistan 83% 17%
Somalia 49% 51%
South Sudan 71% 29%

According to UNHCR data, 50% of refugees in 2014 were female, a slight increase on recent years. The proportion of children under the age of 18 among refugees increased from 41% in 2009 to 51% in 2014 and 2015 (UNHCR 2014c, UNHCR 2016i). The limited data on IDPs disaggregated by sex indicate that the proportion of women to men tends to match that of the general population, but with slightly more women.

2.3  Trajectories and duration of forced displacement

Most displacement crises last for years, if not decades. According to recent studies, once displaced for six months, refugees are highly likely to end up in a state of protracted displacement. Over the past decade, two fifths of all refugees were displaced for three or more years at any one time (Crawford et al. 2015). Further, in two thirds of all countries monitored for conflict-induced displacement in 2014, at least half of all internally displaced persons (IDPs) had been displaced for over three years. It is often assumed that forced displacement due to disasters will be short term; however, although the data is limited, IDMC evidence suggests that disasters can also lead to protracted displacement, such as in Haiti,[4] where conflict and disasters overlap (Hyndman 2011).

Most forcibly displaced people in protracted exile are unlikely to see what is known as a ‘durable’ solution to their displacement (i.e. returning ‘home’, integrating into the place of exile, or resettling elsewhere) (Crawford et al. 2015). It is often difficult for refugees to return to their country of origin;[5] only small numbers of refugees are successful in integrating in the countries that do accept refugees (McCarthy and Vickers 2012), and only 1% of refugees globally are resettled to a third country (UNHCR 2014b). Many refugees and IDPs have experienced multiple displacements, such as the IDPs in Kivu provinces in DRC (IDMC 2015a), and Palestinian refugees living in Syria who have been further displaced by the conflict there.

2.4   Education and forced displacement

Forced displacement inevitably leads to a temporary or permanent halt in a child’s school career. Education opportunities in situations of displacement are often very limited, and refugees and IDPs face numerous additional barriers to accessing education (see Sects. 3 and 4). In general, forcibly displaced persons are less likely to access education than their non-migrant peers (Dryden-Peterson 2011).  However, forced displacement does not universally lead to a reduction in access to education;  where families are forced to flee from areas with very few schools to urban areas or organised camps with more schools, displacement can in fact increase access to education (Ferris and Winthrop 2010).

Research suggests that non-formal and formal education opportunities of a reasonably high standard can provide a certain level of psychosocial protection and support for forcibly displaced peoples, as regular education activities can help to restore a sense of stability and hope among affected populations (Dryden-Peterson 2015, Shah 2015a). High-quality education that emphasises learning and pays particular attention to the varied needs of forcibly displaced peoples has the potential for societal benefits, including community cohesion, in addition to individual benefits (Dryden-Peterson 2015, McCorriston 2012). The EiE community of practice emphasises that education has lifesaving (short-term) and life-sustaining (longer-term) aims (INEE 2016). However, research also indicates that the education generally available for forcibly displaced persons is of such low quality that it commonly fails to exercise this protective dimension (Dryden-Peterson 2011). 

Table 2.3   Comparing education for IDPs and Refugees (Sources: UNHCR 2015a, UNHCR 2016i, IDMC 2015a, IDMC 2015b, Ferris and Winthrop 2010)

  Refugees IDPs
Causes of displacement (according to UN definition)

 

Persecution

 

Armed conflict, internal strife, systematic violations of human rights, or natural or man-made disasters

 

Place of refuge

 

Outside their own country

 

Within their own country

 

Global numbers (2015)

 

21.3 million refugees
3.2 million asylum seekers
40.8 million displaced by conflict, persecution, generalised violence, or human rights violations (including 8.6 million newly displaced in 2015). This figure does not include those displaced by natural disasters.
Bodies responsible for ensuring the right to education

 

UNHCR, host governments, UNRWA for Palestinian refugees

 

National governments
UNICEF for returnees (UNHCR 1997)
Global legal frameworks and conventions

 

1951 Convention and 1967 Protocol Relating to the Status of Refugees

 

1998 UN Guiding Principles on IDPs (not legally binding)

 

Regional Instruments

 

1969 OAU convention governing the specific aspects of refugee problems in Africa

1984 Cartagena Declaration on Refugees

2009 African Union Convention for the Protection and Assistance of Internally Displaced Persons in Africa (Kampala Convention)[6]

 

Durable solutions

 

  • voluntary repatriation
  • integration into the asylum country,
  • resettlement to a third country

 

  • return and reintegration in place of origin
  • integration in the area of displacement
  • integration in another part of the country

 

Monitoring

 

UNHCR/UNRWA Responsibility of national governments, collected by national governments and humanitarian organisations (e.g. UNICEF), collated by IDMC

 

Implementing bodies

 

UNHCR, host governments, UNICEF, INGOs, NGOs, FBOs, UNRWA

 

National governments, FBOs, UNICEF, UNHCR, INGOs

 

Coordinating bodies

 

UNHCR

UNRWA

Cluster (global and national), UN OCHA

 

The educational trajectories experienced by displaced people are generally interrupted, diverted, and/or stalled (Dryden-Peterson 2015). Education is often planned as a temporary stop-gap measure in camps or urban settlements; yet the reality is that many individuals will remain displaced for a period equivalent to a complete schooling cycle. The likelihood that forcibly displaced peoples are able to develop key literacy, numeracy, socio-emotional, and vocational skills in makeshift learning environments is low. Individuals who do return ‘home’, or resettle in a new place, are often not prepared to (re)integrate into the formal schooling system, or do not have relevant or recognised education credentials, or face barriers to school participation, including the language of the curriculum, discrimination, past trauma, bullying, and exclusion (Dryden-Peterson 2015).

Table 2.3 compares refugees and IDPs according to global numbers, legal frameworks and bodies involved with the monitoring and provision of education. While there is a strong international legal framework for the protection of refugees’ right to education, and two UN bodies mandated to ensure that these rights are upheld, there is no equivalent legally binding agreement or set of UN structures dedicated to upholding the rights of IDPs.

2.5   Problems with data collection and monitoring in the field of forced displacement

The UNHCR was mandated in 1951 to collect and disseminate global statistics on refugees (UNHCR 2014c). Most countries (164 in 2014) report sex-disaggregated data on refugees. The availability of age-disaggregated data is more limited, with less than a third of UNHCR’s data disaggregated by age in 2014 (UNHCR 2014c).

The collection of data on IDPs is much more problematic. There is no single accepted definition of who counts as an IDP, nor any clear point at which they can be classed as having reached a durable solution. Because IDPs remain within their country, there may be no legal requirement to register as an IDP. Distribution of assistance may be an incentive to register, but this is often offset by a fear of misuse of data and of being associated with a party to the conflict. Political issues around the official acknowledgement of IDPs can also impact on national datasets. In general, comprehensive data sets do not exist (IDMC 2015a; 2015b). There is no equivalent body to the UNHCR in charge of supervising and maintaining data at field level. IDPs displaced by conflict are sometimes in areas of high insecurity that are inaccessible to humanitarian organisations.

The Norwegian Refugee Council’s (NRC’s) Internal Displacement Monitoring Centre (IDMC) compiles data on IDPs (and refugees) collected by governments, international humanitarian and development organisations, NGOs and research institutes. The data are triangulated and validated with field visits and research by the IDMC, but ultimately they remain estimates and are not directly comparable country to country. In the early stages of an emergency, data on newly displaced people are reasonably well tracked, but as crises become protracted, and situations of displacement become complicated by returns and new rounds of displacement, the data collected often drops off and estimates on the number of IDPs become less accurate. Data disaggregated by age and sex are only available to IDMC in a minority (17 out of 60) of the countries that they monitor.

Table 2.4 shows the advantages and disadvantages of various data collection methods for measuring access to education for forcibly displaced people (see Appendix A for a broader discussion of the quality of the evidence in the studies used in this report).

Collecting data on refugees and IDPs in organised camps can be relatively straightforward, as the displaced people and the service providers are gathered together in one site. Surveys can be conducted amongst camp residents and data can be collected on the quantity and quality of education services provided. Nonetheless, in some situations, particularly in spontaneous camps and cases of IDP camps where the government may be implicated in the displacement, negotiating access to camps by outsiders can be difficult.

Table 2.4   Advantages and disadvantages of various data collection methods on access to education

Data collection method Advantages Disadvantages
School administrative data

(used for Education Management Information Systems)

  • Relatively cheap
  • Collected routinely
  • Comprehensive data for children enrolled in public schools

 

  • Prone to over-reporting of enrolment by schools
  • May omit some education providers (e.g. non-formal schools)
  • Reliant on good census data to calculate enrolment rates
Large scale census / household survey

(e.g. UNICEF’s Multiple Indicator Cluster Survey)

  • Reliable source of data on school participation rates (more reliable than administrative data)
  • Can disaggregate data by wealth, ethnicity, age and other markers
  • Expensive
  • Long time lag between data collection and publication
  • Omit children not living in traditional households
Rapid needs assessments
  • Data available quickly
  • Less reliable
  • Lack detail
  • Education may have low priority in multisector assessments

However, the majority of refugees and IDPs live outside camps (UNHCR 2014c, IDMC 2015a). Collecting data on displaced people in private accommodation is difficult, as the displaced populations are often dispersed among the host populations. While refugees generally need to register to access local services, this is not always the case with IDPs, who may not be registered and may not wish to be identified as coming from conflict areas. It may be difficult to identify which, if any, education service providers are being accessed by displaced populations. Therefore much less is known about the numbers of displaced people living outside camps and their levels of access to and quality of education. In many cases, IDPs living outside camps are effectively ‘invisible’ from a data perspective (IDMC 2015a).

Many key international indicators are defined based on the children’s ages and official school ages.[7] For example, net enrolment ratios (NER) refer to the enrolments of the official age group for any given level of education, expressed as a percentage of the population in that age group. However, age-disaggregated data are not available in the majority of cases of forced displacement, though for refugees the level of detail of age-disaggregated data available is increasing. When age data are not available, gross enrolment ratios (GER) are used instead, although these tend to overestimate enrolment, especially in the presence of overage children who have had their educational journeys disrupted by forced displacement (Dryden-Peterson 2015). These enrolment estimates may be further skewed because unregistered refugees and IDPs are often missing from the data. Thus, systematic data on education for refugees is very limited, and for IDPs even more so. Innovative approaches to data collection and monitoring are noted in section 5.10.

2.6   Coordination of education in emergencies and forced displacement

It can be challenging for national governments to interact with and coordinate the wide variety of actors offering support in situations of forced displacement. Lack of coordination can lead to duplication in some areas and gaps of provision elsewhere. Inconsistencies in implementation can become a source of tension (for example with different approaches to teacher incentives). However, there are a number of initiatives designed to overcome the challenge of coordination.

Founded in 2000, the Inter-Agency Network for Education in Emergencies (INEE) has over 12,000 individual members and 130 partner organisations in 170 countries. The network has developed multiple tools for working in education in emergency situations, and provides platforms for knowledge sharing, policy influence, and advocacy work. Tools include the INEE Minimum Standards for Education: Preparedness, Response and Recovery, and the INEE Conflict Sensitive Education Pack. The INEE has commissioned a range of assessments and evaluations of the use, awareness, and impact of its Minimum Standards, including a number of country evaluations, and these are published on its website.

The Global Education Cluster was established in 2007 as a central coordination mechanism for the international community during humanitarian crises. It is co-led by UNICEF and Save the Children. In 2016 there were 21 active country-level clusters. The Cluster does not have a specific mandate to address refugee situations, but is actively involved in many IDP situations (see also Sect. 4.3).

No Lost Generation is a coordinated global response to the Syria conflict. It is a multi-agency initiative designed to put education and child protection at the centre of the international response. It supports education initiatives and protection initiatives for refugees in the region and conflict-affected groups inside Syria, including IDPs. Partners include UN agencies, bilateral donors, and international NGOs.

2.7   Funding for education in emergencies and forced displacement

Figure 2.1 shows the percentage of humanitarian funds allocated to education between 2000 and 2014. As can be seen, the percentage of humanitarian aid allocated to education is erratic and has never gone above 5% as a global average. Support to refugee and IDP education constitutes only a portion of this funding. Education in situations of protracted displacement faces particular funding shortages due to the problem of donor fatigue (Oh 2012).

Recent years have seen the emergence of new global partnerships in education which have the potential to address at least part of the financing gap. Examples include the Global Business Coalition for Education, which has recently pledged to support Syrian refugees. The Global Partnership for Education (GPE)[8] has developed new mechanisms through which national governments can apply for funds to support education in emergencies, including education for IDPs and refugees.

Case File: Chad

Chad joined the Global Partnership for Education (GPE) in 2012. The GPE has shown a strong commitment to supporting education for refugees in Chad, in addition to education for national populations (GPE 2016a). The government applied to the GPE and received emergency funding of 6.95 million USD to address urgent education needs for refugee and returnee children in the Lake Chad region for 2016-2017. The funding will be used to support the construction of over 100 classrooms (permanent and temporary), wells and latrines, and to provide more than 60,000 textbooks and other school supplies, as well as school feeding for more than 8,500 children. More than 800 teachers will receive training. Micronutrients and parasite treatment will also be provided to students in the entire Lake Chad region. Finally, youth training programmes for more than 1,000 youth are currently being planned (GPE 2016b).

Figure 2.1   Percentage of humanitarian aid allocated to education (based on data from the OCHA Financial Tracking Service, available at: https://fts.unocha.org/pageloader.aspx?page=home)

figure-2-1

In mid-2016 the Education Cannot Wait fund was launched,[9] designed to generate political and financial commitment to meeting the education needs of children and young people affected by crisis. This is intended to be achieved through a high-level global partnership focused on improving the timeliness and sustainability of education responses in crisis settings. It will be initially hosted by UNICEF until a permanent host is identified. The initial framing paper for the fund was based on a thorough review of evidence (Nicolai et al. 2015) and it has been backed by strong political will so far.[10]

 

[1] Research suggests that development-induced displacement (which tends to occur within national borders) affects more people than conflict-induced displacement and disproportionately affects indigenous peoples and ethnic minorities, and the poor (Forced Migration Online 2012).

[2] Palestinian refugees who make up UNRWA’s entire caseload. See the definition of Palestinian refugee in table 2.1.

[3] ‘Caseload’ refers to the number of individuals/cases of concern to UNHCR and other partners working with forcibly displaced persons.

[4] For example, five years after the earthquake in Haiti, around 65,000 IDPs were still living in temporary or transitional camps (IDMC 2015b).

[5] ‘Returnees’ are discussed in the section on IDP education (Sect. 4.2.3).

[6] There is no universal legal instrument protecting the rights of IDPs. The Kampala Convention is a rare example of a regional instrument protecting IDP rights.

[7] UNESCO uses the International Standard Classification of Education (ISCED) age ranges for levels of schooling. These differ from country to country and in some cases differ from national definitions of ‘primary’ and ‘secondary’ school ages.

[8] The Global Partnership for Education was founded in 2002. It comprises 65 developing countries and more than 20 donor governments, as well as international organisations, the private sector, and foundations, teachers, and civil society/NGOs. The GPE works to develop effective and sustainable education systems, mobilise technical and financial resources, and ensure that those resources are coordinated and used efficiently.

[9] See website at http://www.educationcannotwait.org/.

[10] This work was underpinned by a two-phase international consultation exercise faciliated by INEE. Documentation can be found on the INEE website, http://www.ineesite.org/en/eie-global-consultation-phase-i and http://www.ineesite.org/en/eie-global-consultation-phase-ii.

 

Section 3: State of Research, Policy, and Practice in Refugee Education

section-3-summary-box

3.1   Introduction

The Refugee Crisis: At A Glance

  • 21.3 million refugees and 3.2 asylum-seekers worldwide in 2015 (UNHCR 2015i)
  • 14.4 million refugees under UNHCR’s mandate
  • 5.1 million Palestinian refugees under UNRWA’s mandate
  • Over 85% of refugees are in Low- and Middle-Income Countries (LMICs)
  • Increasing numbers are seeking asylum in High Income Countries (HICs)
  • In 2011, average time spent by refugees in displacement due to the 30 major protracted crises was 20 years (up from 9 years in the early 1990s) (Milner and Loescher 2011)
  • In 2012, 75% of the international refugee caseload had been displaced for more than 5 years (UNHCR 2012)

The 2011 Global Review on Refugee Education found that access to education for refugees is “limited and uneven across regions and settings of displacement, and particularly at secondary levels and for girls.” According UNHCR’s Age, Gender, and Diversity: Accountability Report (UNHCR 2015b), approximately 3.2 million school-aged refugee children and adolescents are out of school. Refugee children and youth are often excluded from educational opportunities due to restrictive legal/policy frameworks, lack of necessary documentation, language barriers, limited educational institutions, discrimination, poverty and child labour (UNHCR 2015a). Access issues are often magnified for refugee children and youth who are female, have disabilities, have experienced trauma (including school-related gender-based violence), are separated, unaccompanied, or orphans, are associated with armed groups, are married or pregnant, are over-age, and/or belong to minority groups (UNHCR 2015c; see also UNHCR 2016h).

The quality of refugee education is generally low and uneven at all levels. Student–teacher ratios are on average quite high, leading to overcrowding and a disruptive learning environment (Dryden-Peterson 2015). Teaching capacity and support for educators is limited, leading to protection risks in schools (UNHCR 2015e). While the number of trained teachers is rising, it is still well below the UNHCR goal of 80% (Dryden-Peterson 2015). Inadequate teacher compensation also emerges as a significant problem in refugee education, and in education in emergencies more generally. Salaries have a dramatic impact on recruitment and retention of teachers, job satisfaction, teacher morale, and class size, all factors which ultimately impact the quality of educational provision (Dolan et al. 2012). As refugees often do not have the right to work, they may be compensated through a stipend rather than a salary proper, but such stipends are often inadequate.

Finally, protection and wellbeing concerns can limit refugee education. In many contexts community engagement and efforts to improve social cohesion are lacking, distances between home and school are large (which poses risks for children, especially girls, and female teachers), Water, Sanitation, and Hygiene (WASH) facilities are of poor quality and non-inclusive, and there is limited cultural understanding: these are further barriers to ensuring quality education for refugees (UNHCR 2015c).

These issues are explored in more depth below in terms of coordination, funding, access, quality, and protection and wellbeing. As noted by Thompson (2013), for many of the issues raised in this topic guide, the evidence base is quite limited. As a result, a range of literature has been reviewed, from formal scholarships to so-called ‘grey’ literature (such as reports, policy documents and briefs, evaluations, etc.). Appendix A provides a full discussion of the quality of evidence found in the sources used for this topic guide.

3.2   Coordination of refugee education

Education for refugees and asylum seekers in LMICs is the responsibility of the governments that have signed the 1951 Refugee Convention and/or 1967 Protocol,[1] the UNHCR, and any organisations with a mandate to protect the rights of refugees to education. Education services for refugees are implemented through a range of Implementing Partners (IPs) and, where possible, in coordination with national ministries of education. In addition, refugee communities frequently initiate education programmes and interventions themselves, though often they are limited in their abilities to coordinate activities. Recent research suggests that networks of resettled refugee diaspora also support education for other refugees through remittances, advice, etc. (Lindley 2007, Dryden-Peterson and Dahya 2016).

Palestinian refugees are not included in the 1951 Convention and the 1967 Protocol, and do not come under UNHCR’s mandate. Education for Palestinian refugees is technically the shared responsibility of UNRWA,[2] host governments (Lebanon, Syria, Jordan, Gaza, and West Bank), and a range of NGOs operating in the area, though the degree of coordination and provision varies significantly depending on the particular context.[3]

Case File: Coordination of education response for Palestinian refugees

UNRWA’s education programme is its most significant programme, having been identified as a priority shortly after UNRWA’s inception and then set up through a partnership with UNESCO (World Bank 2014). The importance of schools and education for UNRWA and Palestinian refugees themselves is highlighted in a recent qualitative study: “Schools formed the nucleus of each and every refugee camp, the centre around which all other activities revolved. Education, vocational training, self-support, health care, and continued relief for the needy became the primary blueprint for UNRWA’s operations” (Shabaneh 2012). In addition, education makes up the largest budget item for UNRWA, at 59% of the budget in 2008, compared to 4% of the UNHCR budget in 2010 (Dryden-Peterson 2011).

UNRWA’s Education Programme is managed by the Unit for Administration and Governance at UNRWA Headquarters. UNRWA’s Department of Education provides guidance, policies, and support to its Education Officers, who traditionally have mostly been Palestinian (Shabaneh 2012). UNRWA trains all of its teachers and school administrators (who are mostly drawn from the Palestinian refugee community). It has created Education Development Centres, which act in similar ways to Boards of Education, supporting staff and curriculum development, providing a centralised bureaucracy and coordination mechanism for all academic activities, and creating a sense of cohesion across all of UNRWA’s five fields of operation (Shabaneh 2012). In total, UNRWA employs 21,924 educational staff, including officers, administrators, and teachers (UNRWA n.d.-c). The implementation of education is decentralised, with project/programme planning carried out over a fairly short period of time, and various components linked strategically through a common, harmonised results framework (World Bank 2014).

In 2011, the UNRWA education programme began a major four-year reform to meet the evolving demands of an education system in the twenty-first century (UNRWA 2011). The strategy was developed with consideration for the fluctuating nature of UNRWA’s external operating context, given that the organisation would be impacted by the ever-changing political, social, and economic climate of the region (UNRWA n.d.-b). (See Appendix D for a review of education provision for Palestinian refugees; see Appendix E for a list of key policy and strategy documents written as part of the 2011 Education Reform.)

In a recent World Bank study examining education in the West Bank, Gaza, and Jordan, it was found that UNRWA and public schools in these areas share a number of similarities as regards management: both have limited autonomy when it comes to budget, financing, and staffing (World Bank 2014). However, UNRWA has a world-class assessment system, and demonstrates higher levels of accountability than public schools. A number of NGOs and grassroots organisations have emerged in the region which fill gaps left by UNRWA due to lack of resources, notably in the areas of non-formal education, vocational education, disabilities, counselling, etc., but better cooperation is required between NGOs and UNRWA to ensure services are not duplicated (Demirdjian 2012b).

Waters and LeBlanc (2005) have suggested that in certain fragile contexts, international NGOs and multilateral organisations end up acting as ‘pseudo nation-states’, filling the role of the nation state in managing the provision of education services to refugees, with significant implications for coordination between different stakeholders. Coordination with nation-states has increased significantly since the adoption of the UNHCR Education Strategy 2012-2016. (For more detailed information about UNHCR and its Education Strategy, see Appendix C.) This strategy advocates the “integration of refugee learners within national systems where possible and appropriate and as guided by on-going consultation with refugees” (UNHCR 2012). While only 5 of 11 refugee-hosting priority countries integrated refugees in national systems in 2011, 11 of 14 had adopted this approach by 2014 (Dryden-Peterson 2015). Further, in 2011, UNHCR had no formal relationships with national ministries of education; by 2016, it had partnerships with MoEs in almost all the countries in which it works (Scowcroft 2016) – exceptions include Bangladesh, Burundi, Djibouti, Malaysia, and Tanzania.

Signatories to the 1951 Convention and the 1967 Protocol have the mandate to uphold the right to education for refugees, which means that the ministries of education in these countries are responsible for the coordination of refugee education in collaboration with other partners, as is the case in Kenya under the 2014 directive (Comprehensive Refugee Programme in Kenya Ad Hoc Group 2014). Yet education for refugees is dependent on the laws, policies, and practices in place in each national context. In many cases, the provision of refugee education aligns with Convention ratification, for example in Sudan, Ethiopia, and Pakistan, where MoEs manage refugee education in collaboration with other stakeholders; and Rwanda, Cameroon, and Uganda, where MoEs are strongly engaged. In some cases countries that are not signatories do provide protection and education for refugees. A case in point is Jordan, which is not a signatory, but the Jordanian Government still chooses to refer to Syrians as refugees. UNHCR describes the Jordanian protection space as “generally favourable, although fragile owing to the country’s own socio-economic challenges,” and has drawn up a Memorandum of Understanding with the government (UNHCR 2016a). Further, there are other strategies employed by UNHCR and its implementing partners in negotiating work with refugees in countries that are not subject to the terms of the Convention, for example, by using the term ‘person of concern’ to refer to “A person whose protection and assistance needs are of interest to UNHCR” (UNHCR n.d.), which is both broader and less political than ‘refugee’ and ‘asylum-seeker’.

Case File: Coordination of education response for Syrian refugees

UNESCO reports that numerous education coordination mechanisms have been set up in countries neighbouring Syria which host large numbers of refugees, while in Syria a working group on education focusing on coordination is hosted by Save the Children (UNESCO 2015). High-level regional conferences have been held to discuss education of Syrian refugees; however, there is increasing recognition of the challenge of meeting the education needs of this diverse population, given country capacities and ongoing tensions (ibid.).

UNICEF, in partnership with the UK and others, is leading the development of the No Lost Generation strategy, which aims to address the Syrian education crisis (UNHCR 2016e). The challenge is compounded by the fact that refugee populations are constantly in flux and that host countries can become countries of origin and vice versa (and sometimes exist as both). Syria, for example, which hosts/hosted large numbers of refugees, including Palestinians, is now the largest source of refugees worldwide (Pecanha and Wallace 2015). In its 2011 Education Reform Strategy, UNRWA described Syria and Jordan as relatively stable, and as a place “where the Palestinian refugees enjoy a wide range of rights and opportunities”, compared with the “progressively more complex environments of Lebanon, the West Bank and Gaza” (UNRWA 2011). This conflict in Syria serves as an important reminder that work with refugees requires both rigour and flexibility. Education remains under-financed despite pledges by many donors (UNESCO 2015). The table below summarises projected education financing needs for Syrian refugees of 2014.

 

 
Country Key figures Projected education requirements
Iraq
  •  Projected access provided to Syrian refugee children aged 6-15 years to basic education through formal and alternative approaches in camp and non-camp settings (by Dec. 2014): 91,441[4]
25 million USD (January to June 2014)[5]
Lebanon
  • Total registered refugee children: 476,173[6]
  • School-aged Syrian refugee children: 302,000[7]
  • Syrian refugee children enrolled in public schools in 2013-14 (5-17 years old), in both first and second shifts: 90,000[8]
91 million USD (January to June 2014)[9]
Jordan
  • Proportion of Syrian population in Jordan that will be of school-going age (5-17 years old) in 2014: 36 percent (Boys: 147,000 + Girls: 131,000)[10]
  • Number of school-aged Syrian boys and girls benefitting from formal education: 110,880[11]
52 million USD (January to June 2014)[12]
Turkey
  • Percent of Syrian population in Turkey that will be of school-going age (6-17 years old) in 2014: 65%[13]
  • Number of Syrian children enrolled in primary, secondary, and high school in camps and non-camp settings: 93,085[14]
29 million USD (January to June 2014)[15]

3.3   Funding of refugee education

Refugee education faces a significant financing gap, as part of wider global shortfalls for education in humanitarian response (see Sect. 2.7, Fig. 2.1).  Figure 3.1 indicates the impact of these trends on UNHCR’s budgets, listing some of UNHCR’s most critical areas of unmet education in 2015; these are forecast to continue if budgetary shortfalls extend into 2016 (UNHCR 2016f). The ‘Prioritized’ column shows what UNHCR planned to achieve in 2015 with projected funding; the ‘Unmet’ column shows the needs UNHCR considers it has the capacity to address within the year, if the budget is fully funded. However, there is a strong risk that UNHCR – and other organisations working in refugee education – will fail to raise the required education budgets, without a reversal in current funding trends for refugee education.

Figure 3.1    Impact of funding shortfalls on education in 2015 (as of October 2015) (UNHCR 2016f, p. 20)

figure-3-1-impact-of-funding-shortfalls-on-education-in-2015

3.4   Access to education for refugees

Enrolment rates for refugee children are well below rates for children globally at all levels of education. Given the disruptions they face, refugees who do enrol are generally behind their age-appropriate grade level. Data on access is difficult to collect, but, according to UNHCR (2015b):

  • Only 1 in every 2 refugees accesses primary education
  • Only 1 in every 4 refugees accesses secondary education
  • Only 1 in every 100 refugees accesses higher education or skills-based education

There is wide variation in enrolment rates across LMICs, and access depends on refugee governance structures and asylum policies, which vary according to location and time (Dryden-Peterson 2011). For example, secondary school enrolment rates for refugees are notably low in Kenya and Pakistan at about 10%, and in Malaysia at less than 2% (Dryden-Peterson 2015).

Common barriers to access at all levels of education include shortage of school space, language barriers, curriculum, transport, parental (and learner) documentation, child labour, school fees, and security concerns (Culbertson and Constant 2015). Particular challenges for girls include pregnancy and/or marriage, and a lack of access to sanitation facilities. In camps where refugee-led educational interventions have emerged, there can be problems for incoming refugees who are from a different ethnic group and/or do not share a language with the refugees who initiated the interventions – for example in Thailand, where non-Karen speaking refugee learners (Karenni, Shan, Mon, Burman, Rakhine, Chin, etc.) were excluded from the Karen-dominated schools in the refugee camps (Oh 2012). In protracted crises there is a definite risk that a majority of children will not be able to access any form of education during their childhoods. In the Syrian case, for example, neighbouring countries felt unable to accept any more refugees into their already taxed education systems, and not in a position to support the displaced learners from Syria without additional resources. Finally, access to education for refugees and IDPs at all levels is under threat due to deliberate targeting of education institutions; many schools in Syria have ceased running, or have been turned into detention and torture centres or barracks (UNESCO 2015).[16]

3.4.1   Primary and secondary education

Access tends to be better for refugees at the primary level than at other levels of education, but significant barriers still remain. One key problem is a lack of availability of documentation. UNHCR (2015b) has found that many refugee children have problems obtaining a birth registration certificate, which hinders access to primary education and can also lead to statelessness.

A number of barriers have been identified that are specific to secondary education, including costs, distance, language, documentation (primary school leaving certificates and birth certificates), teaching and administrative capacity, low primary completion rates, cultural norms, and low priority given to secondary education on the international agenda (UNHCR 2015d).

There is a lack of rigorous research on the delivery of primary and secondary education at scale to refugee populations (Thompson 2013, Burde et al. 2015). Education access for refugees at these levels is usually attempted in one of three ways: (1) the opening of schools specifically for refugees (in refugee camps and increasingly in urban settlements); (2) mainstreaming into the host country’s public education system; or (3) community-based schools, initiated and supported by refugees themselves. Evidence of the effectiveness of opening schools for refugees in camps or tent settlements is mixed and mostly limited to observational studies (Burde et al. 2015). A 2004 UNESCO observational study involving qualitative interviews with nearly 100 individuals in Timor Leste found that schools in camp could accommodate a relatively large number of refugees, but because classes were unstructured and there was no assessment or grade progression, attendance was sporadic (and there was no certification of attendance) (Nicolai 2004). However, the same study revealed a number of barriers faced by refugees when instead attempting to access public schools in West Timor, including complicated enrolment processes, language barriers, and prohibitive school fees (ibid.). There has been a global shift towards the second of the three options – mainstreaming into national systems – and the limited available research suggests this approach has several major advantages compared with attempting to sustain parallel, informal, and/or alternative education over time. Advantages include accountability, standardisation, and recognised certification of educational opportunities.

Case File: Mainstreaming primary and secondary education for Syrian refugees in Lebanon and Turkey

The reality for many LMICs is that their public institutions, including schools, are not equipped to deal with large influxes of people. A case in point is Lebanon, which has recently received more than 1.2 million Syrians (Abla et al. 2015). Other countries in the region, including Jordan and Turkey, have also found their public service sectors overstretched, and despite what has been described as “remarkable generosity” on the part of the governments and citizens of these countries, tensions are on the rise in areas with high concentrations of refugees, bringing concerns for security and social cohesion (Culbertson and Constant 2015). Pressure on existing systems and institutions and dwindling resources in both camps and mainstream schools have meant the introduction of double shifting. Burde et al. (2015) remark that the evidence on the effectiveness of this strategy is limited and mixed. One recent (unpublished) ethnographic study on education for Syrian refugees in Turkey revealed that while double shifting in public schools may increase access from a purely numerical point of view, issues around quality, instability, teacher turnover, and conflict with students and staff from regular school hours persist, which may lead to a decrease in attendance and an increase in drop out among refugees (Burde et al. 2015).

According to another recent study, fewer than 107,000 Syrian children in Lebanon (25% of the school-aged Syrian refugee population currently hosted there) have been able to access formal public education (Abla et al. 2015). The Lebanese Ministry of Education and Higher Education works with the UNHCR to integrate Syrians into public schools. Double shifting has been an increasingly popular strategy in Lebanon, with 62,000 students attending second-shift schools across 156 Lebanese schools in 2014-2015, compared with fewer than 43,000 in the regular first shift (ibid.). In 2016, 160 of Lebanon’s 1350 public schools are operating a morning shift (majority Lebanese) and an afternoon shift (mostly Syrian refugees), taught by Lebanese teachers (who often teach both shifts) (Dryden-Peterson and Adelman 2016). While the introduction of second shifts at schools may have allowed more students to enrol, this strategy can have a negative impact on quality, particularly if it involves the same teachers and/or a lack of adequate resources (Burde et al. 2015). Ongoing research suggests that refugees who participate in second shifts can feel alienated, which may contribute to low attendance and eventual drop-out (Dryden-Peterson and Adelman 2016). Education quality is discussed in more detail in section 3.5.

Case File: Primary and secondary education access for Palestinian refugees

School enrolment among Palestinians living in the Occupied Palestinian Territory (OPT) is generally quite high. By the end of 2013, 1,151,702 students were enrolled, including 1,009,639 at the basic level (grades 1-10) and 142,063 at the secondary level (grades 11-12), representing a majority of the basic and secondary school-age population (UNDP 2014). Further, gender parity is relatively high, with comparable proportions of girls and boys enrolled at the basic level (though more boys attend secondary school) (ibid.). UNRWA is a key education provider for Palestinian refugees in Gaza, West Bank, Syria, Jordan, and Lebanon, operating 677 elementary and preparatory schools in its five areas of operation, and eight secondary schools in Lebanon, accounting for free education access for around 500,000 of the total Palestinian students currently enrolled in formal education (UNRWA n.d.-c). It maintains gender parity, a benchmark first achieved in the 1960s.

UNRWA has traditionally focused on the provision of primary education, with secondary school age students accessing local host government schools with the exception of Lebanon. As a result, educational access at the secondary level is therefore more limited than at the primary level for all Palestinian refugees.

The Lebanon Office has taken a special interest in inclusive education and is currently piloting the Special People Special Focus project, with other UNRWA departments and NGOs. Further, EU support has allowed UNRWA to offer two other projects in Lebanon with inclusive education components:

  1. Adapting schools to be accessible for students with disabilities (implementing American University of Beirut survey recommendations)
  2. Recruiting a group of psychologists and psychiatrists to support schools in identifying and responding to the diverse psychosocial needs of students

While Palestinian refugees’ literacy and levels of educational attainment are among the highest in the Middle East region, there are problems related to access. One major problem is space. In 2010 in Lebanon, there were only 75 UNRWA schools supporting 32,892 students, resulting in overcrowded classrooms and a multiple-shift system with shortened teaching sessions (Demirdjian 2012b). Meanwhile, “Years of underfunding have left the education system in Gaza overstretched, with 94 per cent of schools operating on a double-shift basis, hosting one ‘school’ of students in the morning and a different group in the afternoon. As a result, children’s education is severely truncated. In 2006 examinations, nearly 80 per cent of students failed mathematics, and more than 40 per cent failed Arabic” (UNRWA n.d.-a). Finally, due to the increasing instability in the MENA region as a whole (particularly Syria), and the ongoing tensions and conflict between Israel and the OPT, it is challenging for schools to remain open and/or for children to safely access education (Shapland 2016). A recent report documents how Palestinian schools have been targeted for attacks (GCPEA 2014). (See also Appendix D on UNRWA and education for Palestinian refugees.)

3.4.2   Higher education

Crea and McFarland (2015) found that while access to education for refugees is limited at all levels, opportunities for higher education are particularly lacking. Higher education has subsequently become an emerging priority for the international community.[17]

One established strategy for increasing access to higher education for refugees is through the provision of  scholarships.[18] This strategy has been in place since 1992 through the Albert Einstein German Academic Refugee Initiative Fund (DAFI) programme, which is run by UNHCR (UNHCR 2016b).[19] In 2014, over 2,240 DAFI scholarship students were enrolled in universities and colleges in 41 countries of asylum (ibid.). A 2007 evaluation of DAFI found it to be successful in improving enrolment, including female enrolment, which stabilised in recent years at over 40% from a low of 23% in 1992 (Morlang and Watson 2007). Further, 75% of the DAFI graduates who replied to a questionnaire had received a bachelor’s degree, and 8% were continuing studies with other funding. Research suggests that most DAFI scholars return to their country of origin, finding employment in NGOs and other UN agencies (Demirdjian 2012a). However, scholarship-winners tend to form a relatively small group; in addition, some research has pointed to the relationship between increased inequality of educational opportunity and the increased likelihood of renewed conflict (Milton and Barakat forthcoming).

Other more recent strategies include the use of ICT to bring higher education to refugee camps. Two examples include the InZone Higher Education initiative, and the Borderless Higher Education for Refugees (BHER) initiative, which both currently run out of camps in Kenya.

Case File: Higher education access for Palestinian refugees

UNRWA serves 2,100 students in two educational science and arts faculties and teacher training institutes (one in the West Bank and one in Jordan). However, as there is an emphasis on teaching as a profession, it is difficult for Palestinians to access higher education opportunities leading to other career paths.[1] Jordan provides university education in teaching, Arabic, and English to about 1,200 students through the Faculty of Educational Sciences and Arts, and was planning to introduce geography as a fourth subject in 2013/2014 (UNRWA website).[2] Further, UNRWA is developing a scholarship and stipend programme. To ensure sustainability, upon completing their studies, study fellows serve at UNRWA schools for twice the period of their study, helping students to access further education and supporting UNRWA by filling vacant posts in high-demand subjects. They are also planning to start a postgraduate scholarship programme to ensure sustainability of faculty teaching staff. Higher education is viewed as a priority by households in the OPT, with enrolment of students in higher education increasing by 940% between 1993 and 2011 (UNDP 2014). There are 53 accredited post-secondary institutions (34 in the West Bank, 18 in Gaza, and one open university), which include 14 traditional universities, 18 university colleges, and 27 community colleges, offering over 300 fields of study (ibid.). Over half the students are women. In refugee camps and rural areas, higher degrees (Masters and PhDs) are less common. There are also eight vocational training centres (in West Bank, Gaza, and Lebanon), serving 7,000 Palestinian refugees.

[1] Of course, many other careers remain out of reach for Palestinians, who still face enormous barriers to their integration in host countries, and no real prospects to ‘return home’.

[2] It is not clear from the website whether or not this discipline was introduced at that time.

3.4.3   Early Childhood Care and Education (ECCE)

There is very little research on Early Childhood Development (ECD) or Early Childhood Care and Education (ECCE) in refugee education. The 2011 Global Review specifically mentions that it does not look at ECD. This problem is not limited to refugee contexts: the international community as a whole has been slow to draft national strategies for ECD. The UNHCR Education Strategy 2012-2016 set a goal for itself and its partners to “Enable early childhood education for 500,000 children aged 3 to 5” (UNHCR 2012, p. 8), though research suggests that even where there is a strong national commitment to ECCE, correlative gains for refugees are limited. For example, in Thailand, a study found that only 55% of non-Thai migrant and refugee children attend ECCE programmes, compared with 93% of Thai children (Shaeffer 2015, in UNESCO 2015). Similarly, few Palestinian families can afford quality preschool, and in 2010-11 only 85,200 children (38%) were enrolled in preschool in the OPT (ANERA 2014), though this is higher than the rate for the MENA region as a whole (20%) (UNDP 2014). However, according to UNRWA (2011), Jordan is currently developing its ECD sector as a result of international investment, which has potential to increase access to ECD for Palestinian refugees living in Jordan.

3.5   Quality of refugee education and learning outcomes

The issue of education quality has increasingly become a global priority. While access significantly improved between 1990 and 2015, many students who had been in school for four to five years had still not acquired basic literacy (UNESCO 2015). Subsequently, the international community has adopted a goal to “ensure inclusive and equitable quality education and promote lifelong learning opportunities for all” as SDG 4 in the sustainable development agenda (UN 2016).

Increase in education access for refugees often comes at the cost of quality (Dryden-Peterson 2011). This is particularly evident where there is a choice between educating refugees in camp schools versus national mainstream schools: refugee camp schools may have spaces available, but they often lack a qualified teaching force; national schools, on the other hand, present access challenges associated with high costs and non-mother-tongue instruction leading to grade repetition (Dryden-Peterson 2003). Such is the importance of quality that UNHCR focused on learning in its latest Education Strategy 2012-2016.

Case File: UNRWA schools outperform public schools

The World Bank found that in 2007, UNRWA students outperformed students attending public schools by over a year’s worth of learning in the Trends in International Mathematics and Science Study (TIMSS) assessment, a finding which held for Jordan as well. In 2011, there were declines in TIMSS scores in both UNRWA and public schools; however, UNRWA schools showed a significant student performance advantage (World Bank 2014). Consequently, the World Bank carried out a mixed-methods study to determine how UNRWA schools in West Bank, Gaza, and Jordan continually and consistently outperform public schools. The report revealed a counterintuitive finding: While the education literature has demonstrated that socioeconomic status (SES) and parental education are highly associated with performance, UNRWA students outperform public school peers in spite of their SES disadvantages. Key factors that help to explain this finding include higher student self-confidence, and higher levels of parental support and involvement in educational activities. The report also found that a number of teacher factors contributed to the overall quality of education in UNRWA schools. Given the increasing instability in Syria, and the difficult conditions in Lebanon, it is likely that UNRWA schools will struggle to maintain educational quality in these contexts. Further, the World Bank has acknowledged that standards have been falling over the past few years. In other words, it is important to try to isolate the key factors that have contributed to educational quality and to determine pathways through which quality can be maximised. This is particularly important given the findings from a recent UNDP finding that overall academic achievement in the Arab region is lower than expected (given its average GDP), and that the achievement of UNRWA students should in fact be higher, given the relatively consistent support of the system over decades (UNDP 2014). Finally, UNRWA’s focus is on primary schooling (Demirdjian 2012b), so lessons learned have to be contextualised for early years and secondary school settings. (See Appendix D on education for Palestinian refugees.)

Education quality can be considered across three key interrelated dimensions of education: (1) curriculum (what is taught), (2) pedagogy (how it is taught), and (3) assessment (how teaching and learning is measured) (Wyse, Hayward and Pandya 2015). These dimensions are discussed below in more detail, in relation to refugee education.

3.5.1   Curriculum issues

A key question concerns whether refugees should follow the curriculum of the host country or their country of origin. On the one hand, voluntarily returning to the country of origin is generally considered to be the preferred durable solution (as set out by the UNHCR), which would suggest that the country of origin curriculum should be taught. On the other hand, the reality is that the average time refugees spend in displacement is longer than a completed cycle of schooling (primary and secondary), which would suggest that it is better to teach the host country curriculum. At the heart of this curriculum paradox is a complex problem: how to ensure that what refugees learn is meaningful, and linked to officially recognised forms of accreditation and certification. A recent trend has been towards integration/mainstreaming into stable national systems (and consequently use of the host country curriculum), as the education is perceived to be of higher quality there than in camp schools. Further, an increasing number of educators and organisations are attempting to “enrich” the curriculum, by bringing in elements from the country of origin curricula to teach alongside host country curricula (and vice versa), and including supplementary curricula on human rights, life skills, conflict resolution, peacebuilding, etc. (INEE 2010).

Curriculum is a contested term in educational research. Some define it narrowly, as the plan or syllabus followed by teachers for a given course of study; others define it broadly, as everything that is learned in an educational context, be it intentional or unintentional, explicit or implicit (Moore 2014). Questions around selection of content can be politically charged, and have important implications for what refugees learn. For example, if no mother tongue curriculum materials are available, young refugee learners find it difficult to learn basic literacy and numeracy, and also come to believe that their language is not as valued as the language of instruction. In other words, alongside academic knowledge and skills, the curriculum also transmits to children lessons about social structures and power relations (Dryden-Peterson 2015, p. 12). For this reason, the INEE Guidance Notes on Teaching and Learning and additional materials on conflict-sensitive education highlight the importance of “context-specific curriculum choices” (INEE 2010, p. 1).

Dryden-Peterson (2015) traces the educational histories of learners from the DRC in Uganda and Burundi, Somali refugees in Kenya, Rohingya refugees in Bangladesh and Malaysia, and Syrian refugees in Egypt before their resettlement to the United States. One major barrier faced by many refugees is curriculum language and language learning. There will rarely been a single language in common within a class of refugees, meaning that instructional content has to be translated multiple times, impeding educational progress. As an added complication, both the UNHCR’s and host countries’ policies on whether to teach children in host country or origin country language have changed over time. At the local level, this has meant that many students are exposed to different languages but are not supported to attain mastery of any of them. In some situations, language is not as much of a problem, for example for Congolese refugees in Rwanda, and Somali refugees in the Somali region of Ethiopia. There are also examples of attempts to address language of instruction problems, for example in Turkey, where informal Turkish language courses are held for refugees at Public Training Centres (Bircan and Sunata 2015). Another example is described by UNHCR Chad (2015) which carried out a participatory assessment among Sudanese refugees in 12 camps in 2012 on transitioning to the Chadian system, and as a result worked with the Government of Chad to adopt the bilingual national curriculum (French and Arabic) for use with Sudanese refugees, without compromising the language of instruction the refugees were used to, and to train teachers. Finally, it is worth recalling that barriers to language acquisition vary from individual to individual, depending on age, academic level, opportunities for practice, etc.

3.5.2   Pedagogy issues

Regardless of the quality of the curriculum, if teachers lack the pedagogical capacity to implement that curriculum, the quality of the learning experience will suffer.

Dryden-Peterson (2015) found that national resources for teaching in LMICs are limited, as reflected in high student–teacher ratios and low-level teaching qualifications. This means that national systems are often below current UNHCR standards. However, these trends vary strongly according to context; for example, student–teacher ratios ranged from 18:1 in Ghana to 70:1 in Pakistan according to 2009 data (Dryden-Peterson 2015), while the proportion of trained teachers ranged from 0% in Djibouti to 100% in Eritrea (ibid.).

There is limited research on teachers of refugees specifically in LMICs. According to the Commonwealth Secretariat (2013), in Kenya, South Africa, South Sudan, and Uganda, teachers of refugees were under-qualified and did not have sufficient experience. While there has been a global rise in the percentage of professionally qualified teachers overall, according to UNHCR data this trend is uneven for teachers of refugees, with some areas showing no or little progress.

Case File: Teachers’ self-image in Ethiopia and Afghanistan

As early as 2002, as part of an internal evaluation, the International Rescue Committee (IRC) identified teacher training as the highest priority for improving the quality of its education programme (Winthrop and Kirk 2005). Their research from Ethiopia and Afghanistan revealed that 92% of teachers in Ethiopia and 75% of teachers in Afghanistan did not see themselves as real teachers, which had major impacts on their confidence levels. While in-service training in Ethiopia helped teachers to function fairly effectively, teachers felt that they could not be good teachers until they had completed their own education (even if they had received in-service training). Women, in particular, were very aware of their own limitations and lacked confidence in their own abilities. Teachers’ self-image plays a key role in productive pedagogies, and hence quality education, and must therefore be taken into account in designing teacher education.

This lack of trained teachers is reflected in poor learning outcomes for refugees. For example, in NGO-run and community-based secondary schools for Chin and Afghan refugees in Malaysia, refugee teachers were unable to effectively teach the Malaysian curriculum, because of issues with training and inadequate support (Rahman 2011 in Dryden-Peterson 2011). Research shows that teachers of refugees commonly find it difficult to implement instruction and to build inclusive classroom environments, and end up using teacher-centred rather than learner-centred methodologies; quality pedagogy is constrained by factors including limited resources (low funding, overcrowding, and lack of educational materials), a lack of pedagogical training and content knowledge, and curriculum and language policies (Mendenhall et al. 2015).

Case File: Quality teaching in UNRWA Schools

UNRWA began working on a Teacher Policy in 2011, and it was released in 2013 (UNRWA 2013). The policy recognises the key role of teachers in ensuring quality education, and attempts to support teachers in the classroom, as well as through ongoing professional development and motivating career opportunities. This policy is supported by the School Based Teacher Development (SBTD) programme[1] of continuous professional development, launched in 2012.

The World Bank (2014) found that UNRWA students outperformed students educated in public schools by teachers with the same years of service and degrees, and that this was due to the following factors:  

  • UNRWA is able to attract and recruit high quality teachers, through their own (free) teachers’ colleges which guarantee employment upon successful completion
  • UNRWA teachers are given clear expectations and guidance on how to use time effectively in classrooms and waste less time in schools. For example, in Jordan, UNRWA teachers spent 90% of their working time teaching, compared with less than 60% at public schools
  • UNRWA schools have more mandated opportunities for CPD and orientation for teachers than their public counterparts
  • UNRWA teachers are supported by qualified and experienced principals/head teachers
  • UNRWA teachers exhibit more confidence, are able to use a more diverse range of teaching methods, and rely more on interactive learning activities, discussions, and assignments than their public school counterparts
  • As UNRWA teachers come from the same at-risk population as the students themselves, they have shared experiences with the students that allow them to serve as role models and more effectively provide psychosocial support and address learning needs.

However, as successful as UNRWA has been in teacher professional development and ongoing support, overcrowding and multiple shifts have had significant impacts on teachers’ ability to do their jobs well. Working double shifts can be exhausting, and with more students in their classes, teachers find themselves paying attention to the highest-achieving students, with insufficient time to help students prepare for key exams (Demirdjian 2012a). (See Appendix D on education for Palestinian refugees.)

[1] The programme focuses on developing active pedagogies, learning focused classroom practices, assessment for quality learning, the teacher’s role in promoting literacy and numeracy, the inclusive approach to teaching and learning, and engaging parents in raising achievement (UNRWA 2012). Currently, there are no scholarly studies on the effectiveness of the SBTD programme.

Teacher retention and motivation is difficult to maintain in these types of contexts. A number of initiatives, guidelines and toolkits have been developed as a response, including:

Section 4.6 provides an extended discussion of IDP teacher recruitment, training, compensation, and wellbeing, which is also relevant to refugee teachers; section 5.7 provides examples of current innovations and innovations on building teacher capacity and wellbeing.

3.5.3   Assessment issues

In addition to problems of weakness in ongoing informal assessment (i.e. assessment carried out by the teacher day-to-day to ensure learning is taking place), refugees face a number of challenges concerning assessment. These include a lack of access to formal assessment opportunities such as national examinations, a lack of recognition of certain credentials and qualifications, and no recognition of prior learning (Kirk 2009). Refugees themselves prioritise the need for official recognition of their qualifications (Dippo 2016). A recent study of refugees in Thailand shows that while the education provided through refugee camps in Thailand was perceived to be higher quality than in Myanmar, it was only seen to hold currency within the refugee context, and the education was not accredited (Oh 2012).

Case File: Accreditation and certification for Syrian children in Lebanon, Jordan, Iraq, and Turkey

Lebanon allows Syrian students to sit for both end-of-year and official leaving examinations if they can provide proof of identity (UNICEF 2015b). However, problems with documentation, including equivalence of transcripts, etc., and a reluctance to allow school standards to slip has led to some barriers for Syrian refugees in accessing Lebanese assessment systems.

According to the same UNICEF study, in Jordan, any students who pass the Grade 12 examination are entitled to receive a diploma that is officially recognised and accredited, regardless of the child’s nationality (and therefore refugee status), and can use that diploma to apply for university. However, there was no Grade 12 open for Syrian children in Za’atari camp during 2012-13, and no Syrians could enrol in Grade 12 in host communities. Syrian students sat the Grade 12 examination for the first time in 2014.

In Iraq, Syrian refugees who submit school records on time and have reached their final year are allowed to sit the national examination and receive the same certificates as Iraqi students. In 2013, in parts of Iraq with a high concentration of Syrian students, there was a very low success rate in examinations among both boys and girls. The Kurdistan Regional Government faces an issue with certification of the revised Syrian curriculum, but the MoE noted in 2014 that they would provide all Syrian children with official certificates, regardless of the curriculum followed.

In public schools in Turkey, Syrian refugees follow the Turkish learning assessment system. At the end of Grade 8, students sit an examination and are awarded a primary education diploma, which allows them to progress to secondary school. At the end of Grade 12, students sit a school-leaving examination, which leads to a secondary school certificate, allowing them to leave the system or progress to higher and further education opportunities in Turkey or other countries. However, as there are only limited numbers of Syrian students enrolled in Turkish schools, and therefore eligible to receive a national diploma/certificate, the issue of certification is an urgent priority. The Turkish MoE started providing attendance certificates to Syrian students (Grade 1 through 12) beginning in 2012/2013, and at the end of 2014 Syrian students attending temporary education centres received school reports from the MoE. To further complicate matters, there are many unregistered schools in host communities in Turkey, and while several of these provide their own certificates, these are not recognised by the MoE.

UNRWA’s “world class” assessment system has been identified as a key factor in their strong performance. As part of their orientation, new UNRWA teachers are trained to assess student achievement. All major examinations are prepared at the central UNRWA level and implemented in common across all UNRWA schools, and overall assessment data is monitored by UNRWA policymakers. UNRWA schools take part in national and international assessments, and results are usually shared with families of students. There is a high degree of accountability in the assessment mechanism, with parents, local governments, and society held accountable for education outcomes.

3.6   Protection and wellbeing of refugees in and through education

Much research has been undertaken on the protective dimension of education in itself, as well as its ability to act as a delivery platform for medical attention, mental health interventions and psychosocial support. Notably, education can equip children with specific skills and knowledge to protect themselves from the risks associated with displacement (including health risks, gender-based violence, land mines; see for example No Lost Generation 2016), and literacy itself can entail improved health outcomes (Winthrop and Matsui 2013). However, it has also been argued that education of low quality (i.e. where high-quality teaching and learning is not prioritised) loses its protective quality (Dryden-Peterson 2011).

Case File: IRC Healing Classrooms Initiative

As a result of an internal evaluation of its education programmes in 2002, the IRC launched an initiative called Healing Classrooms, which aimed to research teachers’ and students’ experiences in school and their perceptions of teaching and learning in order to inform teacher development for student wellbeing (Winthrop and Kirk 2005). While the IRC includes psychosocial teacher training as a separate module in in-service pedagogy and classroom management training, and individual interviews with teachers in Ethiopia revealed that they had understood and retained lessons from the training, classroom observations revealed little evidence of teachers being able to integrate their learning into their day-to-day pedagogy. This research suggests that stand-alone models of psychosocial training may not be an effective approach, and that it may be better to integrate psychosocial concepts (without naming them psychosocial) into teacher education programmes as a whole.

The IRC also introduced a programme of training and deploying female classroom assistants (CAs) in refugee schools in Guinea and Sierra Leone, who were initially active in Grade 3 to 6 classrooms (Winthrop and Kirk 2005). Their mandate was to support a girl-friendly school environment, and they were charged with monitoring attendance, helping girls with studies, supporting health education and social club activities, and minimising situations where teachers were able to exploit girls for sex.

However, education can also carry a risk of negatively impacting on a child’s well-being or safety. Although being in education can in itself protect children (Winthrop and Matsui 2013), schools and other educational interventions can themselves be sites of violence or targets for attack.[23] Attacks on Palestinian schools are increasing, with corresponding exposure of children, their families, and educators to violence (GCPEA 2014). At the same time, teachers who lack adequate training may resort to corporal punishment to maintain classroom discipline, and can contribute to a culture of violence at schools, including exploitation, abuse and bullying.

Given the levels of potential or actual violence to which refugee children are exposed, it is important to consider psychosocial factors when addressing their education needs. There is a recognised need for more research exploring the differences between girls and boys as regards their psychosocial responses in emergency settings and the impact this has on education (Burde et al. 2015). For example, an observational study examining a Serbian community-based Youth Clubs programme found higher levels of trauma reported by both refugee and non-refugee girls than their male counterparts (Ispanovic-Radojkovic 2003). However, in an epidemiological study aiming to establish the prevalence of posttraumatic stress disorder (PTSD) and depression among 1425 Somali and Rwandese refugees in the Nakivale refugee settlement in Uganda in 2003, it was found that gender was not a uniform factor across cultures in terms of prevalence of PTSD and depression (Onyut et al. 2009).

After the 2014 conflict in Gaza, UNRWA attempted to restore a basic level of normalcy through a ‘Back to School’ approach (UNRWA Education Department 2015). ‘Return to school’ is often prioritised by communities and practitioners because schooling is believed to have a positive impact on the mental health and wellbeing of children and young people. Shah (2015a), however, reports that educational quality is being undermined for Palestinian refugees: most schools in Gaza operate on double or triple shifts, with high student–teacher ratios and reduced class hours; in East Jerusalem and the West Bank, teaching is under-remunerated and under-resourced, leading to low motivation among educators. Under such circumstances, the benefits of a return to school may be minimal.

A number of studies suggest that consistent exposure to structural violence, inequality, and injustice may undermine any psychosocial benefits, particularly in the long term, even where educational and psychosocial interventions are of a reasonable quality. A recent study by the Better Learning Programme (BLP), supported by the NRC, and the Eye to the Future Programme (E2F), administered by CARE International, found that while education programmes may deliver short-term benefits, including a new state of normalcy and some resilience, this may be ineffective or even counter-productive in the long-term. Appendix A provides a discussion of the quality of evidence available on the effectiveness of psychological interventions for children with posttraumatic stress disorder.

Research on psychosocial interventions in Gaza

A controlled clinical trial (CCT) evaluated the short-term impact of a group crisis intervention for children aged 9-15 years from five refugee camps in Gaza (Thabet, Vostanis and Karim 2005). 47 children were allocated to the group intervention, encouraging expression of emotions and experiences through numerous activities, including storytelling, drawing, and free play; 22 children were allocated to education about symptoms; and 42 children were allocated to a control group. No significant impact of the intervention on children’s posttraumatic or depressive symptoms was established. One explanation suggested by the authors is that children’s exposure to continuous direct violence and indirect trauma may sustain stress reactions despite treatment.

A recent rigorous randomised evaluation conducted with Palestinian children aged 10-13 suggests there may be a gendered dimension to the impact of psychosocial interventions. Punamäki et al. (2014) explored the effects of a “Teaching Recovery Techniques” psychosocial intervention on emotional regulation and found that while post-traumatic stress symptoms were reduced for boys in the study, they were reduced in only a subset of girls (girls who demonstrated lower levels of trauma at the baseline).

3.7   Current gaps and challenges

This review of the state of research, policy, and practice in refugee education has uncovered a number of gaps and challenges.

First, there is a gap in the research when it comes to understanding and responding to the protracted nature of refugee crises and to the individual and community educational trajectories and experiences of refugees. Robust longitudinal data on these trajectories and experiences are lacking. On a related note, there is a need for a strengthening of pathways for research to inform policy and practice by building partnerships and improving coordination between researchers, governments, IPs (Implementing Partners), NGOs, and affected communities.

Second, there is a gap in the evidence about increasing access to and beyond primary school and addressing lack of space. Since mainstreaming of refugees into national education systems has become a preferred option among key stakeholders, there is an urgent need for relevant and meaningful curriculum and assessment systems and a better understanding of how to meet specific learning needs, including those to do with language of instruction and assessment, disabilities, gender, and ethnicity.

Third, since education is thought to lose its protective dimension if it is of low quality, more research is required on how best to build teacher capacity, support teacher wellbeing, and facilitate compensation for teachers of refugees. The quality of UNRWA schools relative to other schools in the region has been attributed in part to UNRWA’s teacher training programmes and ongoing support mechanisms. However, standards in these schools are falling, thus there is an urgent need to determine how to recover and maintain the previous standards and how to transfer lessons learned from the Palestinian context to LMICs in general.

Fourth, since an increasing number of refugees go to urban settlements rather than camps, there is a need for more effective data collection with these urban populations, who are often not documented and/or are dispersed across contexts rather than grouped together in a camp setting.

Finally, given the increasingly protracted nature of refugee crises, more sophisticated funding mechanisms are required to respond to more immediate short-term educational needs and longer-term educational needs.

 

 

[1] LMICs that have not signed the 1951 Convention and the 1967 Protocol include Guyana, Cuba, Western Sahara, Libya, Eritrea, Lebanon, Syria, Jordan, Iraq, Saudi Arabia, Kuwait, U.A.E., Oman, Pakistan, Uzbekistan, India, Nepal, Sri Lanka, Bangladesh, Bhutan, Burma/Myanmar, Laos, Thailand, Vietnam, Malaysia, Indonesia, Taiwan, North Korea, Mongolia, and the Solomon Islands. Madagascar is only party to the 1951 Convention. Venezuela is only party to the 1967 Protocol.

[2] Palestinian refugees living inside areas where UNRWA operates are excluded from the UNHCR Statute and protection according to the 1951 Refugee Convention, which excludes persons receiving protection or assistance from other UN organs or agencies.

[3] While UNHCR does not have a mandate to protect Palestinian refugees, the 1951 Refugee Convention does mandate the ipso facto inclusion of Palestinians, should the protection or assistance from UNRWA cease for any reason.

[4] Statistic retrieved from http://www.unhcr.org/syriarrp6/

[5] Statistics 1a, 1b, 2d, 3c, 4a–4c retrieved from http://www.unhcr.org/syriarrp6/

[6] Statistic retrieved from http://data.unhcr.org/syrianrefugees/download.php?id=5104

[7] Statistic retrieved from http://data.unhcr.org/syrianrefugees/download.php?id=5112

[8] Statistic retrieved from http://data.unhcr.org/syrianrefugees/download.php?id=5112

[9] Statistic retrieved from http://www.unhcr.org/syriarrp6/

[10] Statistics retrieved from http://data.unhcr.org/syrianrefugees/download.php?id=5001

[11] Statistics retrieved from http://data.unhcr.org/syrianrefugees/download.php?id=5001

[12] Statistic retrieved from http://www.unhcr.org/syriarrp6/

[13] Statistic retrieved from http://www.unhcr.org/syriarrp6/

[14] Statistic retrieved from http://www.unhcr.org/syriarrp6/

[15] Statistic retrieved from http://www.unhcr.org/syriarrp6/

[16] See the website of the Global Coalition to Protect Education from Attack, www.protectingeducation.org/.

[17] See, for example, the recent HEART Topic Guide on Building Capacity in Higher Education (2015).

[18] This mirrors target 4.b of the SDGs, which calls for the international community to “By 2020, substantially expand globally the number of scholarships available to developing countries, in particular least developed countries, small island developing States and African countries, for enrolment in higher education, including vocational training and information and communications technology, technical, engineering and scientific programmes, in developed countries and other developing countries.” Available at: https://sustainabledevelopment.un.org/topics/sustainabledevelopmentgoals

[19] Another scholarship programme for refugee higher education is the World University Service of Canada.

[20] Of course, many other careers remain out of reach for Palestinians, who still face enormous barriers to their integration in host countries, and no real prospects to ‘return home’.

[21] It is not clear from the website whether or not this discipline was introduced at that time.

[22] The programme focuses on developing active pedagogies, learning focused classroom practices, assessment for quality learning, the teacher’s role in promoting literacy and numeracy, the inclusive approach to teaching and learning, and engaging parents in raising achievement (UNRWA 2012). Currently, there are no scholarly studies on the effectiveness of the SBTD programme.

[23] The Global Coalition to Protect Education from Attack, an inter-agency coalition formed in 2010 to address the problem of targeted attacks on education during armed conflict, provides regular updates on the multiple threats to education (including refugee education).

 

Section 4: The State of Research, Policy, and Practice in IDP Education

section-4-summar-box

4.1   Introduction

Most forcibly displaced people remain within their national borders as IDPs. Their situation is often less visible to the international community than that of refugees. They legally remain under national laws, and do not come under the protection of international agreements covering refugees. Where the national government is unable or unwilling to provide social services, it can be difficult for IDPs to participate in education.

Global IDPs in 2014/15: At A Glance

  • 40.8 million IDPs displaced by persecution, conflict, generalised violence, or human rights violations in 2015 (UNHCR 2016i)
  • 19.3 million IDPs newly displaced by disasters in 2014 (IDMC 2015a)
  • Forced displacement often lasts for many years, with IDPs living in displacement for 10 years or more in the majority of countries monitored by IDMC (IDMC 2015a)

Evidence from IDPs themselves indicates that education is often a high priority (Cohen 2008). However, it has tended to be a low priority for humanitarian actors, as demonstrated by the initial omission of education from the SPHERE handbook on the humanitarian charter and minimum standards in humanitarian response, and the very low share of humanitarian aid to education (see Sect. 2.7, Fig. 2.1). Nonetheless, the structures for improving humanitarian aid to education have improved, notably with the creation of an Education Cluster in 2007 and adoption of the INEE Minimum Standards for Education as a companion to the SPHERE guidelines in 2008 (Sphere Project and INEE 2009).

Education programmes in emergencies sometimes fail to take the specific needs of IDPs into account. An evaluation of UNICEF’s education programming in the Maldives following the tsunami found that no thorough situational analysis of IDPs had been undertaken and that they had some of the highest rates of dropout and absenteeism (UNICEF 2009). As noted in section 2.5, there is a lack of data on education for IDPs, especially for the vast majority of IDPs who do not live in camps. This lack of data is symptomatic of, and at the same time contributes to, the low priority accorded to the education of IDPs by national and international actors.

4.2   IDP contexts

In 2014, five countries accounted for 60% of the global population of IDPs displaced by conflict: Syria (7.6 million), Colombia (6 million), Iraq (3.4 million), Sudan (3.1 million) and DRC (2.8 million). At least 35% of Syria’s population was living in displacement. Other countries with very large IDP populations relative to their size included South Sudan (1.5 million, equivalent to 12.5% of the population) and Somalia (1.1 million, equivalent to 10.5% of the population) (IDMC 2015a).

The sections below concern three groups of IDPs:

  • IDPs living in camps (a minority, but the subject of the majority of the IDP literature)
  • IDPs not living in camps (a majority, but the subject of a minority of the IDP literature)
  • Returning populations, including returning former refugees, IDPs, and children associated with fighting forces

4.2.1   IDPs in camp-like contexts

IDP camps or settlements may be planned by the authorities or may be self-settled. Self-settled camps tend to form around places that people associate with protection and assistance. For example, during an outbreak of violence in East Timor, many IDPs settled near international armed forces or around churches (Penson and Tomlinson 2009).

As with refugee camps, IDP camp residents are often provided with food rations; however, the distribution of these rations can inadvertently act as a barrier to education as collecting and transporting them is a common cause of absenteeism (Ferris and Winthrop 2010).

Education provision in camps may be limited to a few non-formal emergency education programmes such as Child Friendly Spaces (see Sect. 4.4.1). Primary and non-formal basic education may become established in longer-term camps, but camps often lack secondary schools. In an analysis of education for IDPs in camps in Darfur, it was noted that there were no secondary schools within camps, and it was almost impossible for camp residents to access secondary schools in towns due to the distance, insecurity, and school fees charged (WCWRC 2008). Another survey in Darfur found that only a minority of primary schools in IDP camps provided education up to grade 8, the last grade of primary. None of the camps had accelerated learning programmes (Lloyd et al. 2010).

4.2.2   IDPs integrated into host communities

The vast majority of IDPs live outside camps. Many live in private accommodation, either hosted by, or sited within local communities, or in some cases (for example in DRC and CAR) hiding in the bush (IDMC 2015a). In many cases, IDPs will go to live with friends, relatives, or clan members in safer parts of the country. For example, between 2008 and 2010, an estimated 3.3 million people were displaced by conflict in northwest Pakistan. Of these, 85 to 90% were accommodated in host communities (Ferris and Stark 2012).

IDPs living outside camp situations tend to remain an invisible group, even though they constitute the largest proportion of all forcibly displaced populations (IDMC 2015a). In contexts like Somalia, where groups are traditionally nomadic and have experienced protracted crises, distinguishing whether people are living in their current homes due to forced displacement, nomadic displacement, or urban migration becomes difficult, and is further complicated by the fact that targeting of humanitarian aid to IDPs may encourage self-identification as IDPs (Skeie 2012).

IDP families living outside camps often lack access to assistance to cover their basic needs, so may be reliant on child labour to generate income. They may experience discrimination, as reported by IDPs in Colombia, Azerbaijan, and Sudan (Cohen 2008), and may have concerns about their children attending schools in unfamiliar settings (Ferris and Winthrop 2010). However, it is not always the case that IDPs outside camps have less access to education than those within them. While they may receive less access and support from international humanitarian organisations, they may have better access to government schools or low-cost private schools. In Kurdistan, for example, the out-of-school rate in 2015 was higher in camps than for IDP children outside camps (UNICEF 2015a).

4.2.3   Returning populations

Returning populations can include refugees returning from exile, IDPs returning to their regions of origin, and demobilised children and adolescents formerly associated with fighting forces returning to their communities. Again, definitions and identification are complicated. In cases of secession, as with the independence of South Sudan in 2011, there may be an influx of former IDPs and other diaspora from other parts of the original country. When refugees return from protracted displacement they may not be able to return to and settle in their places of origin, and so become IDPs.

IDPs who return to their places of origin but fail to reintegrate or to access their basic rights have not achieved a durable solution as defined by the IASC’s Framework on Durable Solutions for Internally Displaced Persons. Reintegration can be particularly difficult for ethnic minorities returning to their original ethnically heterogeneous places of origin following an ethnic conflict. 

Case File: Curriculum exclusion in Bosnia and Herzegovina

In Bosnia and Herzegovina, families who would face becoming minorities in their places of origin were much slower to return than those from the majority ethnic group. Following the war, the education system became highly fragmented, lacking any state-level central coordinating office. This contributed to an education system divided along ethnic lines, with local education systems operating distinct Bosniak, Croat, or Serb curricula. As a result, minority returnees found themselves culturally excluded from the curriculum of the majority in their places of origin (Bowder and Perry 2012).

The availability of education in the region of origin is often central to decisions by IDPs and refugees to return (Ferris and Winthrop 2010). In Peru, for example, IDPs were reluctant to return due to lack of education opportunities (Cohen 2008).

One common challenge faced by returnees, whether from outside the country or from IDP camps, is obtaining certification for learning during displacement (Kirk 2009). For example, returnees after the war in Sierra Leone were often required to repeat years of schooling because the courses that they had studied while in displacement were not recognised (Ferris and Winthrop 2010). Further, returnee teachers trained by NGOs in IDP camps (or those trained in exile while refugees) may also face a major barrier to employment on their return because their training and experience is often not recognised. The issue of teacher qualifications is discussed in more detail in section 3.5.2, and strategies to address certification issues are discussed in section 5.9.

For demobilised child soldiers, education is an important part of the reintegration process, as it provides social and emotional development as well as academic learning (Song and de Jong 2015).

4.3 Coordination and funding of IDP education

The legal responsibility for provision of education to IDPs remains with the national government. Some countries have adopted legal frameworks to protect the rights of IDPs, but only a minority, and of these only a handful have laws or policies specifically addressing the needs of IDP children and youth. In some cases little progress has been made in putting these policies into practice (Smith Ellison and Smith 2012). Colombia is a rare example of a country with a large IDP population that has made significant progress in developing and implementing laws protecting IDPs’ rights, including the right to education. The state is bound by law to provide access to education for all IDP children between the ages of five and fifteen (Espinosa 2013). While the enrolment rate of IDP children in Colombia in 2007 was slightly below that of the general population, analysis of the pre-displacement data indicate that the IDP population had better access to education than they had previously had in their places of origin (Ferris and Winthrop 2011).

Ministries of Education have a central role in providing and coordinating support to education for IDPs.[1] Although the capacity and political will to provide education for IDPs varies greatly from context to context, state-run schools are generally the primary provider of education for IDPs. Ministries of Education can support schools in host areas to accommodate IDP children through multi-shift schooling and building additional learning spaces, with support from the international community where necessary. States eligible for funding from the Global Partnership for Education can apply for accelerated funding to respond to crises, which can include support to IDP education.[2] Ministries of Education can also facilitate access by relaxing requirements for IDP children to have the correct uniforms or documentation for enrolment, and through fee waivers. Reliance on or coordination with national governments can be problematic, however, especially where the government is the agent of displacement, or in areas outside of government control.

In the absence of education provision by the state, IDP communities often set up their own schools, sometimes supported by local faith-based organisations. Examples include southern Sudanese IDPs living in and around Khartoum (Sesnan 2012), IDP communities in the DRC and Pakistan (Watkins 2012), and schools set up by IDPs in camps in Liberia (Mooney and French 2005).

Despite the fact that many IDPs live in conditions of protracted displacement, international support for education for IDPs is generally treated as a short-term humanitarian response. Indeed, in Darfur in 2007 many international development donors said they were unable to support education at all, since this was a humanitarian situation (Penson and Tomlinson 2009). Within humanitarian funding, education tends to be a low priority and is difficult to procure funding for. In 2013, appeals for education made up only 3.2% of the total of humanitarian appeals, and less than 2% of actual funds received (Nicolai et al. 2015; see Fig. 2.1 in Sect. 2.7).

Since 1999 there has been increased coordination of support for education in emergencies (Winthrop and Matsui 2013). The Global Education Cluster was established in 2007 by the IASC to uphold education as a basic human right and a core component of humanitarian aid. In early 2016 there were active country education clusters in 21 countries (see Sect. 2.6). The cluster system has contributed to a greater inclusion of education in humanitarian response,[3] and can facilitate better coordination with national governments.[4] The Education Cluster Handbook[5] recommends that where possible the national Ministry of Education act as co-lead for the country-level cluster.

A lessons-learned analysis of the education cluster response to the 2010 floods in Pakistan found that the cluster was widely recognised as a strong mechanism for coordination and created an effective “platform for partnership”. However, integration between the education cluster and other clusters was weak. This resulted in cases of duplication and missed opportunities for integrated programming with other sectors. The analysis also noted that there was scope for the education cluster to be more aggressive about fundraising (Alexander 2011). The cluster mechanism is designed around short-term humanitarian funding cycles and not well suited to addressing the longer-term education needs of protracted displacement situations (Mundy and Dryden-Peterson 2015).

UNICEF is the co-lead of the Global Education Cluster, alongside Save the Children, and has a long history of supporting education in humanitarian situations. It has also been chosen as the initial host of the Education Cannot Wait fund,  a high-level global partnership formed to improve the education response in crisis settings (see Sect. 2.7). UNHCR does not have a mandate for supporting education of IDPs, but is increasingly active in this role. UNESCO’s role in providing operational support to IDP education is more limited, but it makes significant contributions to the global knowledge base and provides technical assistance to MoEs dealing with IDP issues (Ferris and Winthrop 2010). The Internal Displacement Monitoring Centre (IDMC), established by the Norwegian Refugee Council in 1998, as well as providing the most comprehensive data set on IDPs, plays a strong advocacy and training role regarding the rights of IDPs (Smith Ellison and Smith 2012).

UNHCR has signed an MoU with UNICEF which has implications for returnees (UNHCR 1997). According to the MoU, UNICEF is given specific responsibilities and roles with regard to returnees in countries of origin, encapsulated in the statement of “a strong UNICEF commitment to facilitate the reintegration of returnee children and families into national programmes, in particular educational programmes and those related to the monitoring of unaccompanied returnee children.”

Case File: Coordination of education response for IDPs in Syria

In Syria there has been a relatively high level of coordination of efforts by humanitarian and development partners in service provision for IDPs, through the government-led Humanitarian Response Plan (No Lost Generation 2016). In order to facilitate the continued access to education for IDPs, the Ministry of Education has allowed students without documentation to register at any school (using placement tests to identify the appropriate grade of entry), suspended compulsory uniform policy, and organised an extra round of public examinations for children who missed the previous round. Children who have missed out on schooling can apply for accelerated or remedial courses. However, there is evidence that some overcrowded schools have refused admission to IDPs (UNICEF 2015b).

The Syria response illustrates how IDP communities and communities who have stayed put during a conflict often receive less international support than refugees. No Lost Generation is a multi-agency initiative designed to put education and child protection at the centre of the international response to the conflict in Syria and the resulting refugee crisis. In its 2015 update (No Lost Generation 2016), it estimates that there were 2.8 million internally displaced children and 2.1 million out-of-school children (aged 5-17) in Syria. By comparison, among the Syrian refugee population in neighbouring countries there were 2.3 million children and 700,000 out-of-school children (5-17). However, only a third of the No Lost Generation budget was assigned to programmes within the country, due to problems with delivering education support in a conflict zone. It has also been more difficult to raise funds for programmes within Syria.

4.4   Access to education for IDPs

It has been estimated that a substantial proportion of out-of-school children in emergency situations are IDPs (Mooney and French 2005), but the exact numbers remain unknown. In 2008 the IDMC identified 12 countries in which the majority of IDP children had no access to schooling (IDMC 2009). Access to education for IDPs is highly context-dependent.

Case File: Varied level of access to schools for IDPs in Nigeria

In Nigeria, IDPs’ access to education has varied from state to state. In Gombe state some IDP children were refused admission to schools. In Taraba state, schools were attacked and forced to close but others were open to IDPs. In Bauchi, IDPs were able to enrol in host schools but this has led to overcrowding. The timing of the displacement also impacts on access to education: IDPs arriving after the school year began were not able to enrol, so would miss, at minimum, a year of education (IDMC 2014).

IDPs face numerous barriers to accessing education. Mooney and French (2005), Smith Ellison and Smith (2012), Watkins (2012), and Cohen (2008) list the main barriers to accessing education experienced by IDPs. Some of the barriers experienced by IDPs are similar to those experienced by other conflict and crisis-affected populations, including refugees and those not displaced within the country of origin. These include barriers associated with the limited or poor quality supply of education, including:

  • lack of infrastructure due to damage inflicted by the crisis, or stagnated educational development exacerbated by the crisis
  • shortage of trained and qualified teachers
  • unsafe journeys to and from school
  • unsafe schools

Some barriers apply to non-displaced, conflict-affected groups in general, but are especially common as barriers for IDPs. These include factors relating to poverty and ill-health associated with crises. IDPs are more vulnerable to these barriers due to the loss of livelihood, home and possessions associated with forced displacement. These barriers include:

  • school fees
  • material requirements (pens, books, uniforms, transportation costs, etc.)
  • economic responsibilities and the need for child labour
  • psychosocial stress and trauma, malnourishment and ill health (including disabilities) limiting children’s capacity to learn

School fees are one of the most significant barriers for IDPs, whose circumstances often make them doubly vulnerable. Due to the general lack of public schooling available for IDPs, frequently their only option is schools run by non-state providers, i.e. communities, faith-based organisations, and NGOs. These schools often need to charge fees to cover recurrent costs (mainly teacher salaries/incentives), but IDPs are generally the least able to pay these fees. This situation has been noted in DRC, Chad, Yemen, Somalia, South Sudan, and Afghanistan (Watkins 2012). In contexts where IDPs access local public schools, there may often also be fees, or other charges including for uniforms and teacher salary top-ups. Transportation costs can also be a barrier.

Some barriers arise as a direct result of sudden and forced relocation to a new, unfamiliar area, and are particular to IDPs:

  • lack of education providers within or near camps and other IDP settlements
  • loss of documentation
  • inability to meet residency requirements for school enrolment
  • language barriers (e.g. for IDPs from minority language groups displaced to majority language host communities or refugee returnees from protracted displacement, where schooling had been in the language of the country of exile)
  • discrimination

Female IDPs are often more affected by the barriers listed above, and face additional barriers to accessing education (Skeie 2012). These include:

  • fear of gender-based violence in and on the way to schools
  • cultural restrictions on girls’ freedom of movement
  • lack of female teachers and girls’ toilets in schools
  • early marriage and childbearing
  • lack of access to sanitary supplies for menstrual management

Mooney and French (2005) list a number of strategies for bridging the education gap for IDP children, including:

  • rapid response education interventions such as “school in a box” for providing education at the early stages of an emergency
  • hiring IDP teachers, especially female teachers, to teach in IDP camps
  • issuing IDPs with temporary documentation
  • school feeding programmes
  • providing alternative education classes
  • improved monitoring and reporting of the availability of fee-free education and of national and international funds supporting IDP education

From their extensive systematic review of the literature, Burde et al. (2015) concluded that more research was needed on the best way to rapidly expand access to large numbers of displaced children. Evidence on camp schools was mixed and mainly from observational studies.[6]

4.4.1   Primary education

Two very common approaches to providing basic education in emergency situations where children cannot access national schools are Child Friendly Spaces (CFS) and School in a Box. Penson and Tomlinson (2009) researched these interventions in a range of conflict contexts with large numbers of IDPs, including Darfur and Timor Leste.

There are a variety of conceptions and models of Child Friendly Spaces used by different agencies, but in general they are spaces that are developed, with community participation, with activities to help protect children through structured learning, play, psychosocial support, and access to basic services. In some cases they have been implemented as an education intervention in coordination with child protection. In other cases they are implemented primarily for child protection with limited, if any, explicit education elements (Penson and Tomlinson 2009, Metzler et al. 2015). They often target younger children, and while some are open to a wide range of age groups, they are generally more effective for younger children (Metzler et al. 2015).

In a wide range of IDP contexts it has been noted that while humanitarian agencies have concentrated resources on supporting Child Friendly Spaces, IDP children and families have voiced that they would prefer opportunities to study, and prefer formal education activities over structured play and non-formal education. This preference was noted by Penson and Tomlinson (2009) in Darfur and Timor Leste, by Kirk (2009) among Chechen IDPs in Ingushetia, and by Cohen (2008) in Sri Lanka. In Darfur, the Child Friendly Spaces were so unpopular with children that staff spoke about the need to give them treats to attract them and to “encourage the children not to escape”. One of the reasons why Child Friendly Spaces have continued to be such a common response is that child protection is seen as easier to raise funding for than education (Penson and Tomlinson 2009). Also, they can be quicker to establish than learning spaces and formal schooling.

Another common strategy for supporting basic education in emergencies, including in IDP camps, has been the “school in a box” approach. One of the earliest uses of this approach was in the late 1980s by the Sudan Open Learning Organisation, supporting schools set up in informal IDP camps around Khartoum (Sudan Open Learning Organisation 2005). These informal schools were not recognised by the Khartoum administration, and faced the constant risk of being bulldozed and destroyed. This risk generated the need for a portable school that could be picked up and moved to a new site (Penson and Tomlinson 2009, Sesnan 2012). The concept has since been adopted and adapted by various UN agencies and NGOs as a strategy for supporting education in a wide range of emergency contexts. UNICEF uses kits that are designed to be culturally neutral and maintains a stockpile in various supply hubs around the world, which can be rapidly deployed in emergencies. This is helpful in the case of sudden-onset emergencies and displacements such as the 2004 tsunami. However, one problem with the scaling up of the strategy, combined with the centralised procurement system, is that the stockpiled kits are not adapted to local situations and do not draw on local materials or resources (Penson and Tomlinson 2009). In cases of prolonged displacement, locally developed and procured kits provide a more culturally appropriate and value-for-money approach.

Other examples of material support to improve access include:

  • construction of temporary learning spaces
  • rehabilitation of schools, including schools damaged through use as IDP shelters
  • provision of learning materials including school bags, textbooks, and stationery
  • provision of sanitary kits for girls

Strategies that have been used to cover the costs of schooling, including the direct and opportunity costs, include:

4.4.2   Alternative basic education

National governments, NGOs, and civil society organisations often run non-formal education courses, providing an alternative basic education for children unable to attend primary schools. These courses may include accelerated learning courses which offer a condensed version of the primary curriculum aimed at children and youth who have missed out on some or all of their primary education but are too old to return to primary schools. In Syria, the Ministry of Social Affairs, NGOs, and civil society organisations have been providing remedial classes and accelerated learning classes for IDPs. These courses follow the national curriculum but are not formally recognised by the Ministry of Education. In order for the learning to be recognised, students need to take the national official examinations (UNICEF 2015b).

Case File: The Norwegian Refugee Council’s alternative basic education programmes

The NRC has delivered a range of alternative basic education programmes in a wide range of IDP contexts, mainly targeting children between the ages of 9 and 14. A meta-evaluation of these programmes (Shah 2015b) distinguishes between three types of courses:

  1. Bridging programmes: short-term targeted courses designed to help out-of-school children re-join formal education, for example language courses
  2. Catch-up programmes: short-to-medium-term courses to enable children to catch up on missed education and re-enter the formal education system
  3. Alternative basic education: longer-term programmes that enable learners to complete a full course of basic education

The meta-evaluation found that most programmes either met or exceeded the expected number of out-of-school beneficiaries served, and that many had shown particular success in achieving gender parity in enrolment. The programmes paid particular attention to the specific needs of certain groups such as young mothers and ethnic minorities. The programmes have had varying success in ensuring the transition of learners into formal schools, with transition rates varying from below 30% up to 100%. Inefficiencies appeared to be greater in multi-year programmes. The meta-evaluation notes that there were significant knowledge gaps regarding the longer-term reintegration trajectories of alternative education students. Where tracer studies had been carried out (Angola, Somalia and DRC) it noted that many graduates did not transition into formal school, despite qualifying to do so.

Costs of the formal education system and opportunity costs were found to be major barriers to transition from NRC’s alternative basic education courses into formal education. In Somalia, the NRC addressed this by supporting partner schools so that they could waive tuition fees for IDPs and issuing vouchers to beneficiary households to help cover the opportunity costs. Vouchers were issued conditional on their children’s attendance of upper primary school, and could be redeemed for goods and services from local merchants. Dropout rates among beneficiaries over the two years for which the programme was run was only 1%. However, the upper primary cycle was four years and it was unclear whether attendance would be sustained once the supply of school subsidy and vouchers ended (Lodi 2011).

The NRC has supported alternative basic education over relatively long terms in situation of protracted displacement. For example, it ran one-year basic education courses (using the Teacher Emergency Programme) for over a decade in Angola, Burundi and DRC (Shah 2015b). NRC has attempted to ensure that the pedagogical approaches used in its programmes are sustained and transitioned into the formal education system. There have been challenges with getting Ministries of Education to meet earlier commitments to absorb NRC-trained teachers into the formal system, but NRC has increasingly extended its training programmes to teachers working in the formal system.

4.4.3   Post-basic education

There are often very few opportunities for IDPs to continue studying post-primary. Education programming for “youth” (generally 15 years and older) in IDP situations often focuses on providing technical and vocational skills. For example, in 2008 in Darfur there were no secondary schools in IDP camps. Technical and Vocational Education and Training (TVET) was available in some cases, although these generally focused on adults. In a few cases, TVET was available for 15-19 year olds, but with Child Friendly Spaces only catering for children up to 12 years old, this left a gap in provision for 13 and 14 year olds, an age at which children are vulnerable to exploitation, early marriage or recruitment into armed forces (WCWRC 2008, Penson and Tomlinson 2009). In IDP camps in Pakistan in 2009, the education cluster estimated that while 54% of children aged 5 to 11 had access to education services, only 8% of children aged 12-17 had access (Ferris and Winthrop 2010). The annual review of the No Lost Generation initiative notes that adult and youth programming was a challenge in Syria due to the limited number of implementing partners, and human resource constraints (No Lost Generation 2016).

One of the few examples of an intervention by international donors supporting youth education for IDPs is NRC’s Youth Education Pack, which has been implemented in over 13 countries including Afghanistan, DRC, Georgia, Somalia, Sudan, Timor Leste and Uganda. The pack comprises a one-year training programme for youth with three strands to its curriculum: literacy and numeracy, livelihood skills training, and life-skills (including health and micro-business management). After completing the course, beneficiaries receive toolkits to help them set up in the trades in which they have been trained. A global evaluation of the pack found that the programmes were highly regarded by IDP youth and host communities. It identified a number of common challenges including lack of capacity of trainers, market saturation of newly learned trades, and high levels of dropout among female participants. The analysis noted the high cost-per-beneficiary ratio of the pack and suggested options for reducing the costs (Chaffin, Buscher and Ng 2015).

Compared to primary school systems, post-primary education systems tend to be slower to recover following a conflict. Lack of availability of secondary education could impact on refugees’ and IDPs’ decision to return (Ferris and Winthrop 2010).

4.5   Quality of IDP education and learning outcomes

This section considers the very limited evidence on the quality of education available to IDPs, including evidence of the impact of displacement on learning outcomes, evidence of the outcomes of the NRC’s alternative education programmes for IDPs, and evidence of outcomes of training programmes for ex-combatants. Issues of quality regarding teacher supply and training are discussed in more detail in section 4.6.

The quality of education for IDPs varies greatly with context. The INEE’s Minimum Standards for Education (INEE 2010), together with associated tools[7] provide guidance on what international practitioners and experts agree should be the minimum quality of education available to children affected by crises, including IDPs. However, in many cases, the actual quality of education available to IDPs is far below these “minimum” standards. For example, many schools for IDPs in Darfur lacked access to water and sanitation, teacher shortages were common, many schools had student–teacher ratios above 50:1, and half of teachers lacked qualifications (Lloyd et al. 2010).

A learning assessment conducted by UNICEF in Sri Lanka (UNICEF 2010) found that there was a significant learning achievement deficit associated with any form of displacement. Children still living in IDP camps, or those in schools that had been evacuated and subsequently restarted, showed a learning deficit equivalent to three years’ education compared to non-displaced children living in conflict-affected areas. The learning deficit was lower but still significant (approximately 1.5 years) for children who had found places in schools that had continued to function. The impact of displacement on learning was greatest for younger learners.

Relatively few evaluations of the NRC’s alternative education programmes for IDPs included comparisons of retention and learning outcomes with those of the formal system. But data from Liberia, Sierra Leone, Mali, and Colombia indicate that completion rates and learning outcomes for children in these programmes were similar to or better than those of children in mainstream schools (Shah 2015b).

In their review of youth agency and peace building, Lopes Cardozo et al. (2015) identify a number of positive outcomes of training programmes for ex-combatants:

  • Skills training for ex-combatant youth in Sierra Leone led to real work opportunities and enabled them to participate in community rebuilding, thus facilitating their reintegration.
  • Technical and vocational training courses in Liberia included agricultural vocational training, apprenticeship programmes, and public works. Many youth who had missed out on education chose vocational training rather than formal education. Programmes targeting ex-combatants provided them with skills to participate in Disaster Risk Reduction and to generate new livelihoods. This helped to facilitate their assimilation into communities.

However, the review notes the lack of rigorous evaluation of the peacebuilding outcomes of technical and vocational training programmes.

4.6   Teacher recruitment, training, compensation, and wellbeing

4.6.1   Remuneration for IDP teachers

Teacher migration, like migration more broadly, is impacted by economic opportunities. In cases of civil war, teachers on the civil service payroll may need to move to areas of the country within government control in order to be paid. For example, during the civil war with the Khartoum administration in southern Sudan, many teachers migrated to the garrison towns such as Juba, leading to an overabundance of teachers in these locations. During the conflict in Cote D’Ivoire, the government announced that civil servant salaries would only be paid in government-held areas, resulting in an exodus of teachers from the rebel-held areas (Sesnan 2012). In these ways, teacher payment practices may exacerbate conflict and displacement dynamics.

In cases of forced displacement, teachers may have limited options, but given the poor levels of teacher remuneration available in many IDP camps, it is not unsurprising that teachers are often underrepresented and in short supply there. Compared to other IDPs, qualified teachers are more likely to get employment with NGOs (outside of teaching), get scholarships or find jobs in the wider host community. As a result, organisations supporting education in IDP camps often have to seek out new potential teachers from within the IDP communities, and provide basic training to equip them to teach (Sesnan 2012).

NGOs and UN agencies supporting education for IDPs are more likely to support capital (e.g. building) costs rather than teachers’ salaries. A survey of primary schools providing education for IDPs in Darfur (Lloyd et al. 2010) found that while 84% of schools had received NGO funding for school buildings, and 28% for annual costs, only 19% had received support for teachers’ salaries. NGOs and UN agencies face a dilemma of whether to pay teachers or face a teacher shortage. If NGOs/UN agencies pay teachers a salary as an interim strategy, for example, while a government establishes its response to a sudden population displacement, it enables many children to gain quick access to education. However, it could undermine government authority and create disincentives for governments to start/resume paying teachers and for teachers to continue teaching after the donor funding ends (INEE 2009). Due to these concerns, along with funding constraints, teachers in IDP camps are often given food for work and top-up incentives rather than a formal salary.

The INEE Guidance Notes on Teacher Compensation (INEE 2009) recommend that the government, together with NGOs and UN agencies, play a key role in teacher compensation in IDP schools, and that teachers be provided with standardised incentives as an interim arrangement. Where possible, arrangements should be made for teachers on the government payroll to have their place of work and payment officially transferred to the location of displacement. One problem faced by displaced teachers is that, although they may officially remain on the payroll at their school of origin, they may be unable to access their salary and/or their bank account. The INEE recommends a phased handover of the management of teacher payment back to local education offices, with teachers registered on the government teacher payroll, with support from donor funding through multi-donor trust funds in protracted situations.

In practice, teachers in IDP camps can remain reliant on NGO incentives for a long time. This is partly because the incentives are often insufficient to attract qualified teachers, so NGOs recruit and train unqualified teachers, often with only secondary education or less. Governments are generally unwilling to add unqualified teachers to their payrolls, and rarely recognise NGO teacher training (see below), so it then becomes difficult to get the government to pay their salaries. For example, in Zam Zam camp in Darfur, UNICEF set up schools in partnership with the MoE and used volunteer teachers recruited by Parent Teacher Committees. But there were no qualified teachers available in the camp and the MoE did not recognise or pay the volunteer teachers, so they went on strike and the schools closed (INEE 2009). Sesnan (2012) speculates that paying teachers in camps a decent wage, thus attracting qualified teachers, could prove a more cost-effective strategy to the standard approach of limiting teacher payment to small incentives and having to recruit and train unqualified teachers.

Alternative strategies for raising funds for teacher compensation in situations of protracted displacement include school fees (sometimes referred to as “community contributions” in situations where school fees are politically unacceptable) and school income generation projects. The problem with fees, or any obligatory household financial contribution, is that it excludes the poorest families from accessing education. School income generation projects are often ineffectual and can divert teacher and pupil time from teaching and learning. These strategies may not provide adequate income for teachers (INEE 2009).

The INEE recommends that the level of teacher compensation should be comparable to host communities and communities of origin, but that the base wage should not be below that of other skilled workers. In some cases it may be justified to provide additional incentives for teachers in order to promote equity. For example, recruiting female teachers can often be a particular challenge. In Pakistan, UNICEF attracted female teachers to teach in IDP schools by paying them higher salaries than men and hiring their male relatives for other school jobs so that it was culturally acceptable for the women to work in the schools (INEE 2009).

4.6.2   Teacher recruitment and training

Guidelines for the recruitment and selection of teachers are given in the INEE Minimum Standards for Education. Given the shortage of qualified teachers often found in IDP situations, many NGOs develop and deliver their own training courses for volunteer teachers and teachers for working in NGO-supported non-formal education courses, such as accelerated learning programmes. Even where teachers are qualified, further professional development is important to support the quality of education, help teachers adapt to new challenges (e.g. large class sizes, accelerated learning, multi-grade teaching) and curricular content (e.g. peace education), and contribute to teacher motivation.

Examples of courses developed for unqualified teachers include the following:

  • Sudan Open Learning Organisation’s Teacher Assistance Course. This course involved self-study and group study materials on specific, practical themes, for new teachers to study with support from experienced teachers. In the decade from 1996 to 2005, SOLO trained over 31,000 teachers, many of whom were IDPs.
  • Be a Better Teacher. An adaptation of the SOLO materials for the Somalia context.
  • The Teacher Emergency Package. Developed by UNESCO Programme for Education in Emergencies and Reconstruction (PEER), Norwegian Refugee Council and UNICEF, this consisted of a teacher’s guide, training of teachers, ongoing teacher supervision combined with a “school in a box” kit.

In line with evidence of best practice in teacher training in non-emergency situations, a meta-evaluation of the NRC’s accelerated learning programmes noted that: “Programmes that were most effective … were ones that placed heavy emphasis on ongoing classroom-based support through microteaching opportunities, classroom observations, regular supervision, and a schedule of ongoing workshops and refresher courses” (Shah 2015b, p. 9).

4.6.3   Returnee teachers

Many refugee and IDP teachers receive their training and experience in camps, delivered by NGOs or UN agencies. However, when these populations return home this training is rarely recognised by the state (Baxter and Bethke 2009). Refugees who qualify as teachers under a host country system may also find that their home country does not recognise their qualifications on their return. An exception to these persistent challenges was the IRC’s refugee education programme in Guinea from 1990 to 2007, which emphasised the training and regional certification of teachers. These credentials were recognised in Sierra Leone and Liberia upon return, which had a long-term impact on the livelihoods of these teachers; two thirds of them were employed upon return as teachers, often at their old schools (Shepler 2011).

The lack of transferability of teacher certification creates problems, both at the personal level of the returnee teacher who is unable to find salaried work, and at the system level, with the high costs and inefficiency associated with training new teachers. Penson et al. (2012) argue for developing an internationally transferable competency-based framework for teacher professional standards that would cover both formal and non-formal teacher training.

When administrative record-keeping regarding teacher certification is poor, or destroyed by conflict, qualified IDP teachers who have lost their training certificates can face difficulties in convincing the authorities of their qualifications and may find it hard to be included on the teacher payroll (Dolan et al. 2012, Mooney and French 2005).

Teachers who have found employment in their place of refuge may be reluctant to return once a crisis is over, contributing to teacher shortages in post-crisis situations. One strategy to support teachers to return to teaching is to provide housing for returning teachers. This can enhance the school’s permanent capital (if built on the compound), but may be seen to create a precedent for returning professionals and may disadvantage teachers who stayed during the crisis (INEE 2009).

4.7   Protection and wellbeing of IDPs in and through education

IDPs often remain highly vulnerable to risks associated with conflict and insecurity. Children in IDP settlements and IDP schools have been targeted for recruitment into armed forces, for example in Sudan (Cohen 2008), DRC (Watkins 2012), and Sri Lanka (Davies 2013). IDP schools can become targets for attack, as in the case of northern Nigeria (IDMC 2014). There is some evidence that schools that meet in non-traditional settings and those constructed from non-traditional structures are at reduced risk of attack (Burde et al. 2015).

Good quality education can help to protect IDP children. Being in education can protect children from exploitation, sexual violence, kidnapping, and separation from family members (Winthrop and Matsui 2013). Curricula can equip children with skills and knowledge to protect themselves from exploitation, health risks, gender-based violence, land mines, and other risks (see for example No Lost Generation 2016). Cahill et al. (2010) point out that education for children associated with fighting forces should include drug education and sexual health education due to their increased exposure to these risks.

Literacy skills can translate into improved health outcomes, and schooling (formal or non-formal) has been shown to play an essential role in supporting children’s psychosocial well-being across a wide range of contexts (Winthrop and Matsui 2013). Schools provide sites where children can receive other support such as vaccinations, deworming, food and nutritional supplements, and counselling.

For demobilised child soldiers, education provides social and emotional development. Children who are incorporated into armed forces lack opportunities for individual expression and friendships are often discouraged. There is evidence that schooling supports the psychosocial healing process for child soldiers, and leads to more prosocial behaviours and fewer mental health issues (Song and de Jong 2015).

4.8   Integration versus segregation of IDP education

UNHCR and other international bodies (see IDMC 2014, note 17) advise that displaced children, where possible, should be educated in local schools alongside children from host communities. However, this is not always practicable in situations where there is a large sudden influx of IDPs and where local schools lack the capacity to accommodate them. New schools/learning spaces may need to be established to accommodate IDPs, at least in the short term. It is also difficult in cases where the displaced children are unfamiliar with the language of instruction of the host community schools. However, once segregated IDP schools have become established, it can be difficult to transition into an integrated system where IDP children study alongside those from the host community. In the DRC it is difficult for IDP children in camps to join local schools as they are either too far away, too full, or charge unaffordable school fees (IDMC 2014). In Azerbaijan and Georgia, IDP parents often choose to send their children to segregated IDP schools, and the governments have supported their choice to remain segregated on the basis that it helps to keep the memory of their homeland alive, and could facilitate return (IDMC 2014).

Kurdish IDPs in Turkey have experienced compounded difficulties of displacement-induced poverty and discrimination. Under Turkish law, recognised minority groups can set up schools and adapt the curriculum to their own language and culture. However, Turkish law does not recognise Kurds as a minority group, so they are not permitted to adapt the curriculum to their own culture and language (IDMC and RC 2010).

4.9   Impacts on host communities and education systems

In many emergencies, schools are used to provide temporary accommodation for IDPs. This impacts on the access to education of host communities. In Pakistan, around 5,000 schools were used to provide shelter for IDPs fleeing from conflict in 2009 (Ferris and Winthrop 2011), and 5,600 were used as IDP shelters following the 2010 floods (Alexander 2011). In Nigeria, IDPs fleeing from the conflict with Boko Haram sought refuge in schools in the North East of the country. Many schools in Adamawa state were unable to open at the start of the 2014 academic year because they were hosting IDPs. IDPs in Nigeria have in some cases damaged or even destroyed school infrastructure, meaning that schools are unable to function properly, even once alternative accommodation for the IDPs has been found (IDMC 2014). Similarly, many schools in Syria have been used as shelters, with 320 schools being used as shelters in March 2014, according to the Ministry of Education (UNICEF 2015a). Damage and destruction of schools as a direct result of the conflict can further reduce school capacity.

In some cases local integration of the displaced population may be resented and resisted, and education access has been restricted in order to incite IDPs to return to their place of origin (Penson et. al. 2012). In Syria, the influx of internally displaced persons has created tension with host communities over the limited resources available (No Lost Generation 2016). In Sri Lanka, there were concerns among host communities that IDPs would infringe on the local university entrance quota (Davies 2012).

The NRC found that in their alternative basic education programmes in Angola and DRC, parents had hidden their actual status from the NRC in order to enrol their children in the alternative education programmes designed for IDPs. These courses were seen as preferable to formal schools as they were considered to be higher quality and free of cost. In order to alleviate tensions, and to support integration, many programmes allowed for a small proportion of host community children to enrol and included staff from local formal schools in capacity building and training activities (Shah 2015b).

Tensions can arise in the home country when returnees are seen as receiving preferential treatment. Funding allocations from central governments to districts receiving large returns may not increase sufficiently to cover the increased demand for services (Ferris and Winthrop 2010).

The INEE guidance note on Conflict Sensitive Education (INEE 2013) gives strategies for mitigating tensions between displaced and host communities, including supporting programmes that make education accessible to all, and fostering links between host and displaced communities through participation mechanisms.

4.10   Current gaps and challenges

This review of the state of research, policy, and practice in refugee education has uncovered a number of gaps and challenges.

First, the most pressing current challenge is the need for more robust data, analysis, and research, including data on availability, quality, and outcomes of education for IDPs. Only once this becomes available will it be possible to give an informed prioritisation of the most urgent operational gaps and challenges in the field.

Second, given that national governments have primary responsibility for education of IDPs, enhancing national capacity to address IDP education needs should be a priority for the international community. This should cover inclusion of current IDPs in national and local education sector plans, EMIS, and budgets, and contingency planning to reduce the disruption of education in the event of unforeseen future displacement crises. National governments’ legal responsibility to protect IDPs’ right to education needs to be strengthened through the development of legal frameworks at the global, regional, and national level.

Third, despite progress made by the GPE, education provision for IDPs remains impeded by the perception of a humanitarian/development divide within the international donor community. The international donor community needs to develop medium- to long-term flexible funding and implementation mechanisms to support IDP education in situations of protracted displacement (for a full analysis, see the ODI paper on education in emergencies and protracted crises (ODI 2015).

Fourth, improved national-level planning and longer-term, more flexible funding from the international community is needed in order to improve teacher recruitment and compensation strategies in IDP situations, including consideration of strategies to attract and retain qualified teachers (especially female teachers).

Lastly, provision of post-primary education and training opportunities for adolescent and youth IDPs remains a major gap, requiring increased support from national and international actors, and exploration of innovative means of providing cost-effective access to education for this group.

 

[1] See for example the role of the Ministry of Education in Syria in the provision of education for IDPs in UNICEF’s 2015 report Curriculum, Accreditation and Certification for Syrian Children in Syria, Turkey, Lebanon, Jordan, Iraq and Egypt, Regional Study: UNICEF 2015b.

[2] See the website of the Global Partnership for Education

[3] See for example the role of the cluster in supporting early childhood education in IDP camps in Sri Lanka (Smith Ellison and Smith 2012).

[4] For example, the Nepal Earthquake Assessment Unit identified the Education Cluster School Structural Assessment as a notable example of close cooperation between a cluster and the government (Nepal Earthquake Assessment Unit 2015).

[5] Global Education Cluster (2010) “Education Cluster Coordinator Handbook,” Save the Children, Geneva, https://www.savethechildren.org.uk/sites/default/files/docs/Education_Cluster_Handbook_1.pdf

[6] The Camp Management Toolkit provides resources for practitioners working with displaced communities. Chapter 17 of the Toolkit is dedicated to education, and has extensive links to relevant guides and documents: http://cmtoolkit.org/chapters/view/education.

[7] See toolkit on the website of the INEE, http://toolkit.ineesite.org/inee_minimum_standards

 

Section 5: Opportunities, Innovations, and Best Practice in Education for Forcibly Displaced People

section-5-summary-box

5.1   Introduction

This section sets out some of the opportunities, innovations, and examples of best practice in education for forcibly displaced people. Many of the approaches presented could be used for both refugees and IDPs, and indeed some have been so used. Given the limited evidence base (see section 5.2, and discussion in Appendix A), the range of approaches described here represents a menu of potentially productive strategies, rather than a definitive list of “what works”.

5.2   Note on the evidence base

As noted passim in this report, there is limited generalisable evidence on what works in education for forcibly displaced people. One reason for this is that situations of forced displacement tend to be in flux with very unpredictable futures, which makes it difficult to implement the sorts of structured research exercises which generate robust results. The sections on innovations and interventions should be read in the light of the important caveats contained in Appendix A.

5.3   Supporting impacted communities

Issue: Refugees and IDPs are often displaced with other members of their family and community, or form new communities where they end up. Refugee and IDP education interventions that only look at the needs of individuals are unlikely to have as much success as those attempting to reach individuals as part of a community.

Innovations and Interventions: Often, forcibly displaced people themselves initiate schools and other education programmes to directly respond to the needs of their own communities. Examples include the educational work of Karen refugees along the Thai-Burma border (Oh 2012), and the school set up by the Sudanese community in the Jungle in Calais (Bengtsson, McAllister and Abrahams 2016). While education initiatives by refugees and IDPs themselves usually already have community ‘buy-in’, research has shown that it can be difficult for the forcibly displaced to have a voice in negotiations with other stakeholders, and that often the education delivered through these programmes is not officially recognised (Oh 2012). In other words, such initiatives have a greater chance of success if supported by national and international stakeholders.

Increasingly, researchers in EiE are recognising the importance of taking what is known as an “ecological approach” to education. This concept draws on the work of child development expert Urie Bronfenbrenner and involves understanding each individual learner as part of an ecosystem, involving peers, families, schools, services, governance, etc. Once such an understanding has been built, researchers are in a better position to analyse strengths and weaknesses in the “ecosystem”. Two recent studies have shown the value of such an approach. The first has used it to understand how to connect local and global resources to support educational success for Somali refugees in Kenya (Dryden-Peterson and Dahya 2016), and the second has explored how community-based NFE can support wellbeing of refugees in Denver, Colorado (Shriberg, Downs-Karkos and Wisberg 2012).

In order to support forcibly displaced people in accessing education, some interventions have involved cash transfers to ensure that they can afford the opportunity costs of sending children to school. A quasi-experimental study by Lehman and Masterson (2014) found that providing unconditional cash assistance to Syrian refugees in Lebanon increased access to school and decreased child labour.

5.4   Ensuring protection, psychosocial support, and safe spaces, and building resilience

Issue: Forcibly displaced people have often experienced high levels of stress and trauma that can make it difficult for them to cope with day-to-day life and can negatively impact their overall health and wellbeing.

Innovations and Interventions: The Better Learning Programme (BLP) is a classroom/school-based intervention designed as a partly manualised, multi-level approach to help teachers, educational psychologists, and parents cope with behavioural difficulties of children who have experienced trauma, while at the same time empowering schoolchildren through strategies for calming and self-regulation. The goal is to promote behavioural change in the classroom, to regain lost learning capacity, and strengthen resilience, concentration, and learning in the school community.

The E2F programme was initiated by CARE International in response to a perceived need to provide children with psychosocial support in the Gaza Strip following Operation Cast Lead (Shah 2015a). The after/before school programme provided (1) regular academic enrichment in English, Arabic, Science, and Maths, (2) key study, problem-solving, and conflict-resolution skills, and (3) positive peer relationships.

Shah (2015a) reviews both the BLP and E2F Programme and finds they had positive impacts on Palestinian communities, building resilience, communication skills, and counselling skills, in light of increasing instability. However, he questions the depth of the resilience built by these programmes in light of recent increases in violence and instability, and asks whether it is appropriate to restore a sense of normalcy in a site of cyclical violence. He suggests that such programmes may play a key role in supporting immediate psychosocial needs at the onset of conflict, but that longer-term solutions are needed in contexts where conflict is constantly reoccurring, such as Gaza.

In recent years, there has been an increasing recognition that schools can act as a key site for the delivery of mental health interventions in a number of ways, including cognitive behavioural therapy (CBT), creative arts, play, life skills, and sports. According to a systematic review by Tyrer and Fazel (2014), mental health interventions delivered within a school setting can help children overcome difficulties associated with forced displacement. The authors found that achievement in school (in terms of both education and peer relationships) is a key determinant of future success and mental health, echoing Dryden-Peterson’s (2011) finding that education must be of high quality for it to maintain its protective dimension. Ager et al. (2011) conducted a quasi-experimental study centred on creative arts activities in northern Uganda to analyse the effects of a psychosocial structured activities programme on child wellbeing in 21 schools for children ages 7 to 12 (n=203 intervention, n=200 in comparison group). The authors found that there were statistically greater improvements in the wellbeing of participants from the intervention group. Garfin et al. (2014) conducted an observational study on a school-based psychosocial intervention involving life skills for 117 children ages 7 to 9 in Chile following the 2010 earthquake. They found that levels of post-traumatic stress and earthquake anxiety were significantly reduced for the majority of participants. Finally, Lange and Haugsja (2006) conducted an observational evaluation of ‘Right To Play’ programmes in refugee camps in Tanzania and Pakistan and found that programme participation generally supported wellbeing through building of peer relationships, student and teacher relationships, and inclusion of young girls.

When the EU was awarded the Nobel Peace Prize in 2012, it set up the EU Children of Peace initiative. This initiative funds projects for children in conflict-affected regions. It facilitates access to schools, where they can participate in learning in a safe environment and receive psychosocial support to deal with traumatic experiences of conflict. While there are no readily available academic studies or evaluations of the EU Children of Peace initiative, according to the website over 1.5 million children in 26 countries have benefitted from the initiative so far, though how many of these are refugees or IDPs is not mentioned.

5.5   Addressing disruptions in learning

Issue: Displaced children and youth have often missed out part or all of their basic education, may have had learning interrupted, and may be too old to return to formal primary school.

Innovations and Interventions: Accelerated learning programmes (ALPs) deliver a condensed version of the school curriculum for out-of-school children and youth, with the aim of providing them with the basic learning foundations and enabling them to re-enter the formal school system. The Norwegian Refugee Council has delivered a range of accelerated learning programmes in IDP and refugee contexts (Shah 2015b). Evidence from evaluations indicate that ALPs have been effective at enrolling over-age and out-of-school youth, particularly populations that have been marginalised or stigmatised (for example, girls, and former child combatants). A rigorous review (Burde et al. 2015) found that while there was a great deal of grey literature and project evaluations of ALPs, there were no experimental or quasi-experimental studies and no longitudinal studies.

A meta-evaluation by Shah (2015b) of NRC’s accelerated education (AE) programmes around the world identifies both positive and negative patterns in terms of the design, delivery, and assessment of impact of AE provision across a range of contexts and phases of the humanitarian responses. According to the evaluation, NRC’s AE programmes have made a clear contribution in providing access to education for populations who may otherwise not have such an opportunity. A success of many of NRC’s AEPs has been ensuring that close to 50% of direct beneficiaries are females, often in contexts where achievement of this gender equity target is challenging. NRC has recognised that for students who complete the AE programme, the hidden and actual costs of schooling can preclude them from continuing in formal education. Country programmes vary in how they have responded to this challenge, with some working extensively with schools, others advocating directly with the MoE, and still others including AE beneficiaries’ caregivers in income generation and/or livelihood opportunities to enable them to send their children to school. A strength of NRC’s approach has been the active mobilisation of the wider community, who have gone on to play an important role in reducing issues of stigmatisation, operation and oversight of programming, and the recruitment, selection, and retention of learners and teachers.

The Youth Education Pack, developed by the NRC, is a one-year full-time education package which provides training in literacy and numeracy, livelihood skills training, and life-skills for youth aged 15-24, who have missed out on schooling and skills development due to displacement and lack of opportunities. YEP targets the most vulnerable, with priority being given to young single mothers, youth heads of households, and those with the poorest educational background (see Chaffin, Buscher and Ng 2015 for an external global evaluation of YEP).

An Accelerated Education Working Group has brought together a number of NGOs, donors, and UN agencies to document best practice, standardise terminology and definitions, develop tools for field practitioners, and develop indicators and evidence on Accelerated Education.

5.6   Addressing problems of space

Issue: Forcibly displaced people often face problems of access, insecurity, and constant movement, which prevent them from participating in quality education.

Innovations and Interventions: According to a recent landscape review, ICT can play a key role in strengthening education systems in conflict and crisis; for example, by using mobile money transfers to ensure teachers receive regular salaries, text messaging warning systems, and data collection about students and schools (Dahya 2016). ICT is also used to enhance basic education, teacher training, higher education, and vocational training, which often incorporate blended learning approaches that include locally existing technologies such as mobile phones. Radio and tablets are often used to reach out-of-school children. Mobile phones can be used to distribute audio-recorded or SMS-based information and conduct quizzes. Life skills training through digital video is an increasingly important form of community education. According to the review, much work is being undertaken to develop Open Educational Resources (OER). Finally, social media and networks are increasingly recognised as a crucial education information source for displaced people.

Examples of ICT education interventions include: Can’t Wait To Learn (an innovation developed by War Child Holland to support out-of-school children in Sudan, using tablets to teach mathematics through games); Funzi (mobile phone app for teaching of key skills); RACHEL (Remote Area Community Hotspot for Education and Learning) (a collection of popular educational resources made available offline); TIGER (These Inspiring Girls Enjoy Reading) (a tablet-based learning programme for adolescent Syrian girls in the UNHCR Za’atari camp in Jordan); Open Learning Exchange (a collaborative educational resource for people affected by conflict); and Vodafone’s Instant Classroom (a ‘school in a box’ for tablet-based teaching in refugee camps).

According to the landscape review, most projects it has identified are still in pilot phase, and thus formal research on the use of ICTs for education for displaced people is still limited (Dahya 2016). The authors point out that there is no single, simple model for sustainability or scale, given the complexity and diversity of contexts, so ICT for education interventions should seek to be iterative and adaptable. Further, they argue that human resources/educators are still the crucial component in the success of education interventions. A working paper by the Global Business Coalition for Education explores whether and how technology can support education and skills training for Syrian refugee youth (Global Business Coalition for Education 2015). A number of key lessons emerged from the review, including the importance of viewing technology as a tool, not the solution; increasing coordination and M&E of programmes; ensuring credibility through accreditation; and prioritising open source development and user-generated content.

The UNHCR is working with organisations to prototype and test innovations with the potential to expand educational opportunities for refugees and IDPs through its Innovation Learn Lab. Learn Lab partners include

Some recent interventions involve bringing educators and educational resources to vulnerable populations through travelling or mobile schools. One example is a collaboration between EAC and BRAC using boat schools to reach children in disaster-prone and remote rural areas.[1] This pilot programme aims to reach 13,000 children through the training of local boat manufacturers, construction and equipping of 400 boats with mobile classrooms, selection and training of 500 teachers, and the creation of 400 School Management Committees with representatives from the community, schools, and local government.

5.7   Building teaching capacity and wellbeing

Issue: Refugee and IDP education faces major challenges regarding teaching quality, because of lack of trained teachers, problems with teacher motivation and compensation, etc.

Innovations and Interventions: The NRC has a long history of working with teachers and school authorities on capacity building in pursuit of durable solutions, for example through the Teacher Emergency Package (TEP) programme. This programme was a collaboration with UNICEF and the MoE in Angola, and involved the training of teachers to deliver catch-up education and other learning opportunities for marginalised children, including displaced and returned children. The teacher guide was based on a participatory and child-centred methodologies and linked to the provision of school supplies. According to Midttun (2009), over 12 years, through the TEP programme 3,188 teachers were trained and 212,000 children enrolled in the one-year catch-up programme, including 104,250 girls. Most of these children would not have benefited from basic education without the TEP and many would not have been able to transfer to the mainstream system, though exact numbers of how many children transferred and completed basic education are not known.

As described in the case file in section 3.6, the IRC launched the Healing Classrooms initiative in 2002, a research-based approach to informing teacher development for student wellbeing.[2] They also worked on a programme of training and deploying female classroom assistants (CAs) in refugee schools in Guinea and Sierra Leone, who were there to support a girl-friendly school environment. While a number of studies have looked at the Healing Classrooms Initiative and found it to be an effective intervention, many of these are observational and/or interview-based and therefore the findings are transferrable rather than generalisable (Burde et al. 2015; see review of evidence base in Appendix A).

Teacher training in the Palestinian refugee education context is discussed in section 3.5.2. Worth mentioning here are the provisions UNRWA makes for further career development, pre-service and in-service training, and learner-centred pedagogies and assessment techniques. As mentioned earlier, there is limited research available on the effectiveness of UNRWA’s latest teacher training initiatives, though the World Bank (2014) did report that the quality of teaching was better at UNRWA schools than in public schools in Gaza, West Bank, and Jordan.

The INEE Guidance Notes on Teacher Compensation in Fragile States, Situations of Displacement and Post-Crisis Recovery and the UNHCR Brief on Refugee Teacher Management provide guidance on key areas of teacher management and support. INEE has also conducted a literature review of Teacher Professional Development in Crisis and produced an Annotated Bibliography, which includes key resources on teachers and their professional development. Finally, a new inter-agency training pack, Introduction to Training for Primary School Teachers in Crisis Contexts, was launched in March 2016 as part of an effort to improve teacher training for unqualified or under-qualified teachers often recruited to teach in refugee camps and in a range of other emergency settings. It responds to a critical gap in open source, competency-based teacher training materials that provide coverage of foundational knowledge and skills required by teachers in crisis contexts, where teacher training is often limited to ad hoc workshops. The pack was developed by the Teachers in Crisis Contexts Working Group (TCCWG) which is comprised of seven partner agencies: Finn Church Aid, International Rescue Committee, Norwegian Refugee Council, Save the Children, Teachers College-Columbia University, UNHCR, and UNICEF, working in close association with the Inter-Agency Network for Education in Emergencies. It has undergone systematic review and was field-tested in Iraq and Kenya and externally reviewed by a range of EiE specialists.

5.8   Improving higher education

Issue: According to UNHCR, only 1% of refugees have access to higher education opportunities. When it comes to IDPs, the figures are not known. There tends to be a reliance on scholarships as a strategy to improve higher education access, but for most forcibly displaced peoples these are unrealistic.

Innovations and Interventions: As mentioned in section 3.4.2, the Albert Einstein German Academic Refugee Initiative Fund (DAFI) scholarship programme has been functioning since 1992 and is considered an integral part of UNHCR’s mandate (UNHCR 2016b). In 2014, over 2,240 DAFI scholarship students were enrolled in universities and colleges in 41 countries of asylum (ibid.). Another scholarship programme for refugee higher education is the World University Service of Canada (WUCS), which has been supporting refugee scholarships for 35 years. See Appendix F for a figure showing the response of WUCS and other international stakeholders to the Syrian higher education crisis.

DAFI was evaluated in 2007, and was found to be successful in improving enrolment, including female enrolment, which stabilised in recent years at over 40% from a low of 23% in 1992 (Morlang and Watson 2007). Further, 75% of the DAFI graduates who submitted questionnaires had received a bachelor’s degree, and 8% were continuing studies with other funding. Research suggests that most DAFI scholars return to their country of origin, finding employment in NGOs and other UN agencies (Demirdjian 2012a). But they form a relatively small group, and thus questions arise about how much of an impact these scholars can have on overall development in the countries of origin. Studies have also pointed to a relationship between inequality of educational opportunity and the likelihood of renewed conflict (Milton and Barakat forthcoming).

In 2015, InZone launched locally designed learning hubs in Kenyan refugee camps, offering blended higher education courses including humanitarian interpreter training and a MOOC on humanitarian communication to try to provide access to higher education for the 180,000 French-speakers in Kakuma refugee camp. They are currently working to get the courses accredited, so that they are internationally recognised and can facilitate access to the job market for refugee graduates (Moser-Mercer 2016). The InZone higher education initiative is relatively new, but is based on an extensive review of the state of higher education and refugees, and also builds on InZone’s extensive experience in providing humanitarian interpreting education to refugees (Moser-Mercer 2016). As it is relatively new, there is not much scholarly evidence on the effectiveness of the programme as yet.

The Borderless Higher Education for Refugees (BHER) aims to make higher education opportunities available where refugees need them, as an alternative to scholarships, which are few and only benefit 1% of refugees who are able to take them based on age, availability, and merit. BHER is currently operational in Dadaab refugee camp and has focused to begin with on teacher training, aiming to provide gender-equitable teacher training and mentoring programmes which pair young women with international scholars and students. BHER describes its course offerings as “stackable”, i.e. students can earn certificates or diplomas at each level to build incrementally towards earning a degree. BHER has only been operational for a relatively short amount of time, so not much evidence is available as yet. However, a number of presentations at the 2016 Annual Comparative International Education Society (CIES) Conference in Vancouver, Canada, focused on BHER and reported initial successes (Dryden-Peterson and Dahya 2016).

5.9   Strengthening capacity for accreditation and certification

Issue: Without a certificate of learning that is recognised by the authorities, it is difficult for individuals to use their learning to access further education, training, and employment. Certification can be particularly problematic for displaced teachers and students, as documentation may get lost during displacement; qualifications gained in one country may not be recognised in another; and alternative and informal education programmes, particularly those delivered by non-state providers, may not result in official qualifications. Certification is also a challenge with distance-learning courses.

Innovations and Interventions: Kirk (2009) presents a range of strategies for addressing certification challenges for refugee and IDP learners. These include cross-border and regional examinations, enabling refugees to study in host schools and sit the national examinations of the host country; accreditation of distance-learning initiatives by universities in the country of origin; development of recognition agreements between governments of the countries of origin and host country governments; and support for development of international conventions such as the “Lisbon Convention” on the Recognition of Qualifications concerning Higher Education in the European Region. 

UNICEF’s report on Curriculum, Accreditation, and Certification for Syrian Children in Syria, Turkey, Lebanon, Jordan, Iraq, and Egypt (UNICEF 2015b) describes some of the initiatives of the Government of Syria, including the use of placement tests to enable IDP students lacking documentation to enrol in the most appropriate grade, and reissuing certificates based on certification records held within the national education database.

UNICEF and partners in Sudan have worked with State Ministries of Education to support IDP children to attend examination centres by providing toilets, logistical support, school supplies, sanitary supplies, and meals, enabling around 8,000 IDP children to sit their grade 8 examinations, and advocated for changing examination dates to accommodate displaced learners (UNICEF 2016).

Evidence of the successes and challenges of initiatives to support certification for refugees and IDP learners is presented in Kirk (2009). Evidence and implications of certification procedures for returnee teachers are discussed in section 4.6.3.

5.10   Improving data and monitoring

Issue: There is a serious shortage of good data on education for refugees and IDPs (see Sect. 2.5)

Innovations and Interventions: This problem has been recognised by the international community (see Dryden-Peterson 2011), and a number of agencies have attempted to remedy it through increased investments in data and monitoring. One noteworthy development in education data monitoring is OpenEMIS (Education Management Information System), a system initially conceived by UNESCO to be easily customised to meet specific country needs, and which is intended to help education leaders at all levels to efficiently monitor data about schools (UNHCR Malaysia 2016). Other examples include UNRWA, UNICEF’s monitoring and evaluation of the Peacebuilding, Education, and Advocacy Programme (PBEA 2012-2015) (UNICEF 2014), and Adam Smith International’s use of GPS technology to access school data in remote areas (Adam Smith International 2014). Humanitarian agencies are beginning to use satellite and drone imagery to identify IDP settlements and shelters in hard-to access areas.

 

 

[1] See Educate a Child website, http://educateachild.org/our-partners-projects/projects/boat-schools-rural-children

[2] Two recent initiatives from ICR are also relevant here. The Interactive Outcomes and Evidence Framework supports humanitarian and development professionals to design effective programs, http://oef.rescue.org/#/home?_k=um8w1r; and the IRC Toolkit for Safe Healing and Learning Spaces (SHLS) provides child protection and education practitioners with content needed to initiate an SHLS program: http://shls.rescue.org/.

 

 

Appendix

Appendix A: Assessing the Strength of Evidence

General note

This topic guide is based on an extensive (though not systematic) review of scholarly and grey literature (e.g. agency reports, evaluations, guidance documents, etc.). In general, however, the evidence base on the effectiveness of educational interventions for refugees and IDPs is limited. According to a recent rigorous literature review by Burde et al. (2015) entitled What Works to Promote Children’s Educational Access, Quality of Learning, and Wellbeing in Crisis-Affected Contexts, there is very little robust, rigorous, longitudinal and generalisable research in the field of Education in Emergencies. For this reason, while the authors have drawn from a number of quality scholarly sources for this guide, most of those are qualitative, small-scale and/or context-specific in nature, as there are very few experimental or quasi-experimental, large-scale and/or generalisable studies available. The review of the scholarly sources has been supplemented by consultation of grey literature. While these documents and studies are not as rigorous or robust as scholarly sources, much of the work is of a relatively high standard and contains potentially useful lessons for practice and policy.

Literature on IDPs

The body of literature specifically addressing issues of education for IDPs is more limited than that for refugees. This is partly because the concept of IDPs as a distinct group of people with particular needs has only gained international recognition since the 1990s (Mooney 2005). Also, due to significant gaps in monitoring data (see Sect. 2.5), IDPs are relatively invisible to international humanitarian and development actors.

There is a growing literature on education responses in emergencies (see Winthrop and Matsui 2013, Burde et al. 2015) and growing attention to the educational needs of children living in conflict-affected countries (see UNESCO 2011, Menashy and Dryden-Peterson 2015). But while many of the beneficiaries of these education responses are IDPs, the literature rarely distinguishes between education for IDPs and education for other conflict or disaster-affected people. Education and Internally Displaced Persons, a collection of studies edited by Smith Ellison and Smith (2012), is one of the few volumes of empirical studies dedicated to the topic. Other papers that provide a global overview on the issues include Mooney and French 2005, Ferris and Winthrop 2011. There are a small number of papers that focus on education for IDPs in specific situations, for example: Georgia (IDMC and NRC 2011), Darfur (WCWRC 2008, Lloyd et al. 2010) and Angola (Midttun 2009). The IDMC’s Learning in Displacement (IDMC 2010) reviews the international legal frameworks around IDPs’ right to education. There is very little rigorous, peer-reviewed research specifically addressing the education needs of IDPs and the effectiveness of specific interventions. In particular, section 4 has had to draw largely on observational studies and agency reports and evaluations.

Literature on the role of education in protection and wellbeing

Section 3.6 of the review addresses the role of education in the protection and wellbeing of refugees. There is little research on the effectiveness of psychological interventions for children with posttraumatic stress disorder (PTSD) resulting from exposure to conflict/war, especially in LMICs (Onyut et al. 2005) – in fact, in a recent systematic review of school and community-based interventions for refugee children, 14 of the 21 studies reviewed were carried out in HICs (11 in school settings) (Tyrer and Fazel 2014); the remaining seven were carried out in camps for forcibly displaced persons in LMICs, but only two looked at refugees (one worked with six Somali refugees aged 13-17 in Uganda, and one with Palestinian children in Gaza). The former study (Onyut et al. 2005) was found by Tyrer and Fazel (2014) to partially fulfil the standards of quality design and methods and to fulfil the standards of treatment quality. Onyut et al. (2005) created and evaluated the efficacy of a child-friendly version of Narrative Exposure Therapy (NET) known as KIDNET as a short-term treatment for children. Symptoms of PTSD and depression were assessed at three intervals – pre-treatment, post-treatment, and nine-month follow-up – and were found to be sustainably reduced as a result of the treatment. One observational study examining a Serbian community-based Youth Clubs programme and involving pre- and post-surveys with 1,106 boarding school students (aged 15 to 18) found that while traumatic stress was reduced for non-refugee participants, it increased for refugee participants, indicating that the protection and wellbeing needs of refugees are often different from their non-refugee counterparts (Ispanovic-Radojkovic 2003).

Literature on Effective Interventions

The evidence base reviewed for section 5, on Opportunities, Innovations and Best Practice in Education for Forcibly Displaced People, is notably weak. Burde et al. (2015) call for more research to determine how best to expand access to forcibly displaced populations, and point out that while there are approaches that are often implemented (such as offering double shifts at schools, or opening schools in camps or settlements), there is mixed evidence about the effectiveness of these approaches, and that it is often limited to observational studies. There has been a trend among aid organisations towards mainstreaming displaced people into local schools. This decision stems from alternative education programmes facing problems with sustainability, accreditation, and quality, and these organisations have been attempting to strengthen infrastructure and support administration in conflict-affected contexts and countries receiving a large number of refugees. There is, of yet, little evidence on the long-term effectiveness of this approach.

Conclusion: Generalisation vs. Transferability

Why is there limited generalisable evidence on what is effective? To begin with, as was mentioned with respect to section 2, the field of forced displacement as a whole is plagued by poor data and monitoring systems, which makes it difficult to determine the impact, if any, of interventions. Another reason is that situations of forced displacement tend to be in situations of flux with very unpredictable futures. For this reason, it becomes difficult to plan interventions that have long-term, quantifiable, achievable goals and follow a logical, linear pattern, and that can be monitored and evaluated effectively using experimental and quasi-experimental methods – such as the randomised control trial (RCT), which is seen by many donors and other agencies as the ‘gold standard’ of research to inform policy and practice.

There has been an increasing recognition among members of the international education academic community that high-quality qualitative research can help to inform policy and practice, depending on the nature of the research problem, and that while results from qualitative studies cannot be generalised, lessons learned can be transferred to inform practice and policy (Lincoln and Guba 1985). In fact, when it comes to education and forcible displacement, Demirdjian (2012a) notes that each situation is unique in its own way and that therefore it is impossible to come up with a set of specific guidelines that will work universally, even with evidence from RCTs. What can be done through qualitative research is to answer important questions about the ‘how’ and ‘why’ of education and forced displacement.

Further, it is often difficult to conduct field-based academic research on education and forced displacement. It can be tricky to negotiate access to forcibly displaced populations – not only do some academic institutions restrict travel for their staff to regions that are perceived to be unsafe, but researchers also often find it difficult to find so-called gatekeepers who can help to facilitate access to vulnerable communities. On a related note, there are many ethical considerations (protection of vulnerable populations, etc.) that need to be addressed by researchers, both individually and officially.[1] In terms of methodology, as has been previously mentioned, there is sometimes a bias among donors and other agencies towards using findings from academic studies based on RCTs. On the one hand, this is problematic because many researchers lack the resources, time, and institutional support to set up rigorous RCTs, and the limited applicability make the costs less appropriate.[2] On the other hand, it means that studies which meet the naturalistic inquiry standards of trustworthiness and quality – i.e. credibility, transferability, dependability, and confirmability – will be overlooked upon completion or will not attract sufficient funding to get off the ground to begin with (Demirdjian 2012a).

Appendix B: Glossary of Key Concepts

  • Forced displacement/migration
    The Global Program on Forced Displacement (GPFD 2015) defines forced displacement as “the situation of persons who are forced to leave or flee their homes due to conflict, violence and human rights violations.” “Forced migration” tends to refer to the actual movements of those who are forced to flee.
    • Conflict-induced migration/displacement
      Conflict-induced displacement can happen within or across national borders and occurs when people are forced to flee from their homes because of armed conflict (including civil war), generalised violence, and/or persecution due to political opinion, social group, race, religion, or nationality, and their state is unwilling or unable to protect them (Forced Migration Online 2012).
    • Disaster-induced migration/displacement
      Disaster-induced displacement can happen within or across national borders and occurs when people are displaced as a result of natural disasters, environmental change, and human-made disasters. These are overlapping categories of disaster, and it is sometimes difficult to draw clear distinctions between them (Forced Migration Online 2012).
    • Development-induced migration/displacement
      Development-induced displacement occurs when people have to leave their homes due to development-related projects and policies, for example, infrastructure projects such as roads and dams, mining, etc. This type of displacement tends to happen within national borders. Research suggests that this type of displacement (which impacts more people than conflict-induced displacement) disproportionately affects indigenous peoples and ethnic minorities, and the poor (Forced Migration Online 2012).
    • Complex emergencies
      Complex emergencies refer to major humanitarian crises that are the result of a combination of factors, including political instability, conflict, violence, social inequality, and poverty, and are often exacerbated by natural disasters, diseases, and environmental instability (FAO 2016).
    • Protracted emergencies/crises and protracted displacement
      Protracted crisis/emergency refers to a long-term humanitarian crisis, characterised by recurrent conflict and/or natural disasters, weak governance and institutional capacity, chronic food crises, etc. (FAO 2016). Crawford et al. (2015, p. 9) define protracted displacement broadly as “a situation in which refugees and/or IDPs have been in exile for three years or more, and where the process for finding durable solutions, such as repatriation, absorption in host communities or settlement in third locations, has stalled. This definition includes refugees and IDPs forced to leave their homes to avoid armed conflict, violence, violations of human rights or natural or human-made disasters. It also includes those living in camps or dispersed among host populations.” However, when it comes to displacement, it can be difficult to determine a cut-off date for when it can be considered ‘protracted’ because displacement is a dynamic, fluid phenomenon, resulting in some disagreements between international agencies and scholars (Crawford et al. 2015).
  • Refugee
    According to the 1951 Refugee Convention, a refugee is someone who “owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his or her nationality, and is unable to, or owing to such fear, is unwilling to avail him or herself of the protection of that country.”
    • Refugee Status Determination (RSD)
      RSD is a crucial part of an individual being recognised officially as a refugee. It refers to the administrative (or legal) process by which states (or UNHCR where governments are unable/unwilling) determine whether a person seeking international protection is a refugee (under international, regional, or national law) (UNHCR 2016g).
    • Prima facie status
      According to UNHCR’s Handbook on Procedures and Criteria for Determining Refugee Status, “[s]ituations have […] arisen in which entire groups have been displaced under circumstances indicating that members of the group could be considered individually as refugees. In such situations the need to provide assistance is often extremely urgent and it may not be possible for purely practical reasons to carry out an individual determination of refugee status for each member of the group. Recourse has therefore been had to so-called ‘group determination’ of refugee status, whereby each member of the group is regarded prima facie (i.e. in the absence of evidence to the contrary) as a refugee” (UNHCR 2011).
  • Asylum seeker
    The terms asylum seeker and refugee are often confused (and used interchangeably). Asylum seeker refers to an individual seeking international protection but whose claim to refugee status has not been definitively evaluated as yet. While not every asylum seeker will be recognised as a refugee, every refugee was initially an asylum seeker (UNHCR 2006).
  • Internally Displaced Person (IDP)
    The most common definition of IDPs is the one presented by the Secretary-General of the United Nations in a 1992 report, which identifies them as “persons who have been forced to flee their homes suddenly or unexpectedly in large numbers, as a result of armed conflict, internal strife, systematic violations of human rights or natural or man-made disasters, and who are within the territory of their own country” (Forced Migration Online 2012).
  • Migrant
    There is no consensus on what the term ‘migrant’ means, with definitions ranging from an individual of foreign birth and/or foreign citizenship to an individual moving to a new country to stay temporarily, or to settle in the long-term. Some use the terms ‘immigrant’ and ‘migrant’ interchangeably, while others distinguish the two, using the former to denote an individual who intends to be settled in the new country and the latter to denote an individual who is temporarily resident. ‘Migrant’ can be defined as an individual who is subject to immigration controls (Anderson and Blinder 2012).
    • Economic migrant
      An economic migrant is an individual who leaves his/her country of origin for economic reasons not related to the refugee definition. Such individuals are not entitled to international protection as refugees because they do not fall within refugee status criteria (UNHCR 2006).
  • Returnee
    A returnee is an individual who was a refugee but who has recently returned to her/his country of origin (UNHCR 2006).
  • Stateless person
    A stateless person is defined in Article 1 of the 1954 Convention relating to the Status of Stateless Persons as “a person who is not considered as a national by any State under the operation of its law.” In other words, a stateless person is someone who does not have a nationality of any country. Some individuals are born stateless, others become stateless (UNHCR 2016d).
  • Refoulement
    Refoulement refers to the expulsion of persons who have the right to be recognised as refugees. According to the UN Convention relating to the Status of Refugees, the principle of non-refoulement holds that: “No Contracting State shall expel or return (‘refouler’) a refugee in any manner whatsoever to the frontiers of territories where his life or freedom would be threatened on account of his race, religion, nationality, membership of a particular social group or political opinion.” The principle of non-refoulement does not just forbid expulsion of a refugee to his/her country of origin, but to any country in which she/he might be subject to persecution (UNESCO 2016).
  • Unaccompanied/separated children
    When an emergency happens, many children are separated from their parents/care-givers. As the status of these children is not immediately clear, they are referred to as ‘separated’ or ‘unaccompanied’, rather than orphans. The Inter-agency Guiding Principles on Unaccompanied and Separated Children defines separated children as “those separated from both parents, or from their previous legal or customary primary care-giver, but not necessarily from other relatives. These may, therefore, include children accompanied by other adult family members.” Further, it defines unaccompanied children/minors as “children who have been separated from both parents and other relatives and are not being cared for by an adult who, by law or custom, is responsible for doing so” (ICRC 2004).
  • Child soldiers and children associated with fighting forces (CAFF)
    According to the 2007 Paris Principles and Guidelines on Children Associated with Armed Forces or Armed Groups, “The internationally agreed definition for a child associated with an armed force or armed group (child soldier) is any person below 18 years of age who is, or who has been, recruited or used by an armed force or armed group in any capacity, including but not limited to children, boys and girls, used as fighters, cooks, porters, messengers, spies or for sexual purposes. It does not only refer to a child who is taking or has taken a direct part in hostilities” (Child Soldiers International 2016). Many people working in child protection use the term ‘children associated with fighting forces (CAFF)’ rather than ‘child soldier’ in order to capture the diversity of the children who are involved with fighting forces.
  • Home country/country of origin, host country, third country, country of first asylum
    These terms are commonly used in discussions around refugees and asylum seekers.
    • Home country/Country of origin
      Home country or country of origin refers to the country from which a refugee (or asylum-seeker has fled). It generally refers to the nationality or country of citizenship of the refugee.
    • Host country
      Host country refers to the country to which the refugees have fled.
    • Third country
      Third country refers to the country refugees are resettled to if they are unable to go home because of continued persecution/conflict or if they live in dangerous situations or have specific needs that cannot be addressed in the country where they have sought protection.
    • Country of first asylum
      According to the Asylum Procedures Directive, “A country can be considered to be a first country of asylum for a particular applicant for asylum if: (a) s/he has been recognised in that country as a refugee and s/he can still avail him/herself of that protection; or (b) s/he otherwise enjoys sufficient protection in that country, including benefiting from the principle of non-refoulement; and provided that s/he will be re-admitted to that country” (UNHCR 2010).

Appendix C: UNHCR Structural Information

The UNHCR has a staff of over 9,300 people working in 123 countries worldwide. In the field, UNHCR’s core work is managed from a series of regional offices, branch offices, sub-offices and field offices. The High Commissioner’s representatives head operations in the countries where the agency works, while there are also a number of regional representatives (UNHCR 2016c). Education is not such a priority within UNHCR as it is in UNRWA (Dryden-Peterson 2011). UNHCR has tended to rely on external expertise and experience when implementing education interventions, though the agency has recently begun to build its own internal capacity in education, and education has been prioritised to a greater extent over the past five years. It is currently one of six key areas of UNHCR Assistance, along with Public Health, Food and Nutrition, Water, Sanitation and Hygiene, HIV and Reproductive Health, and Public Health Data.

Dryden-Peterson (2011) remarks on the small size of the UNHCR Headquarters Education Unit as of 2011, in contrast to the overall size of the organisation. At the time there was only one Senior Education Officer for overall coordination, policy advice, and technical support for Field Offices, one Tertiary Education Officer and one Education Assistant for management of the UNHCR’s higher education scholarship scheme, DAFI (supported by external funding), and, frequently (though not always) an Associate Education Officer. At the regional and country level, UNHCR relied on education ‘focal points’ (usually Community Service Officers, Protection Officers, or Programme Assistants, and at times UN volunteers, rather than education experts) and Education Officers seconded from organisations such as the Norwegian Refugee Council, Irish Aid, and Save the Children. Since the Global Review in 2011, there have been a number of structural changes to the UNHCR Education Programme, which is now set up at the country level as a part of broader programming on protection and durable solutions. By 2014, there were 44 dedicated education officers: 15 on the global team, working at headquarters and regionally; and 29 in field-based positions. There has also been a significant increase in long-term contractual staff for education, particularly in emergency contexts (Tamer 2015). In addition to its own staff, UNHCR contracts over 200 national and international IPs to deliver education programmes at the field level, though there is wide discrepancy in the quality of services provided by these IPs (Dryden-Peterson 2011). Further, UNHCR has a number of Memoranda of Understanding (MoUs) with key partners, including, for example, with UNICEF (global and national level) (UNHCR 1997). A number of UNICEF’s responsibilities according to the MoU are to do with reintegration of returning populations. Recently, UNHCR has launched the Learn Lab as a collaboration between UNHCR Innovation and UNHCR’s Division of International Protection, which aims to expand educational opportunities for refugees and the forcibly displaced through new approaches to learning (UNHCR Innovation 2015). Table C.1 provides a list of the key UNHCR policies, guidelines, and documents for refugee education in chronological order. 

Table C.1   Key UNHCR policies

UNHCR Document Year
Organising primary education for refugee children in emergency situations: Guidelines for field managers 1988
Guidelines for educational assistance to refugees 1992
Revised guidelines for educational assistance to refugees 1992
UNHCR Education Field Guidelines 2003
UNHCR Safe School and Learning Environment Guide 2007
Ensuring Access to Quality Education: Operational Guidance on Refugee Protection and Solutions in Urban Areas 2011
Refugee Education: A Global Review 2011
2012-2016 Education Strategy 2012
Education Briefs:

1.       Education and Protection

2.       Out-of-School Children in Refugee Settings

3.       Curriculum Choices in Refugee Settings

4.       Mainstreaming Refugees in National Education Systems

5.       Refugee Teacher Management

6.       Secondary Education for Refugee Adolescents

2015

In addition to structural changes, UNHCR’s Global Strategy for Education underwent significant strategic changes following the 2011 Global Review (Dryden-Peterson 2011). The new strategy (2012-2016) revealed a much bigger emphasis on learning and on quality of education (see box below). This shift reflected global shifts toward quality education and findings of the 2011 review, which found that “Refugee education is not serving its protective function due to a lack of focus on learning” and “UNHCR cannot meet its mandate to provide high quality and protective refugee education with the current level of human and financial resources” (Dryden-Peterson 2011, p. 7).

This education strategy is anchored in a renewed focus on ensuring the provision of refugee education, not as a peripheral stand-alone service but as a core component of UNHCR’s protection and durable solutions mandate. Quality education that builds relevant skills and knowledge enables refugees to live healthy, productive lives and build skills for self-reliance. (UNHCR, 2012, p. 7).
Listed as a priority in the UNHCR Education Strategy 2012-2016, better data and monitoring systems, systems for accountability, and quality assessments are fundamental to the success of refugee education interventions. In an attempt to help countries and other organisations monitor their own progress, in addition to proposed activities, the Education Strategy includes a number of proposed indicators on a range of topics (e.g. enrolment rates, % of teachers trained, % of Education Partners applying the Safe Schools e-learning course in their work, % of persons regularly attending accelerated learning programmes, etc.). Currently, chosen indicators vary from operation to operation, and country to country, and there are very limited central data storage systems.

The following map from UNHCR shows a composite ‘criticality’ score for each of 55 educational operations around the world based on current baseline data on a range of access indicators, including % primary school-aged children enrolled in primary education, % of secondary school-aged young people enrolled in secondary education, and % of children aged 3-5 years enrolled in early childhood education. Further, it considers % of teachers who are female, and % of teachers with professional teaching qualifications, teacher-related indicators which have proven to have an impact on both educational access and educational quality, particularly for vulnerable groups.

Figure C.1   Situation overview for UNHCR education operations (Baseline for 2016 data) (UNHCR 2016b)

figure-c-1-situation-overview-for-unhcr-education-operations-baseline-for-2016-data-unhcr-2016b

The map below shows UNHCR’s target criticality scores for each of the 55 educational operations for 2016:

Figure C.2   Situation overview for UNHCR education operations (Target for 2016 data) (UNHCR 2016b)

figure-c-2-situation-overview-for-unhcr-education-operations-target-for-2016-data-unhcr-2016b

It should be noted that for operations that remain in the critical range on the target map, significant improvements are aimed for, but because the baseline is so low, the operation will remain in the critical range even after great improvements. It should also be noted that not all indicators are available for all 55 operations. In fact, data on % secondary school enrolment are only available for 37 countries, on % teachers who are female are only available for 8 countries, on % of teachers with professional teaching qualifications are only available for 6 countries, and on children enrolled in ECE are only available for 18 countries. This information about indicators points to a well-established problem that has already been mentioned: data management and analysis systems on refugees (and their access to education) are in dire need of expansion and improvement.

Appendix D: Education for Palestinian Refugees

The education situation for Palestinian refugees differs from most refugees worldwide. Palestinian refugees’ literacy and levels of educational attainment are among the highest in the Middle East region. UNRWA is responsible for their education. Education is its most significant programme, making up over 50% of its budget. UNWRA focuses mainly on primary education, and schools follow host country curricula.

A recent World Bank study in West Bank, Gaza, and Jordan, found that UNRWA has a world-class assessment system, and demonstrated higher levels of accountability than public schools. UNRWA students outperformed students attending public schools by over a year in the Trends in International Mathematics and Science Study (TIMSS) assessment.

UNRWA’s education system has been highly resilient to shocks and new rounds of migration. It managed to implement a major reform despite escalating conflict in Syria.

A number of teacher factors have contributed to the quality of education in UNRWA schools:

  • UNRWA is able to attract and recruit high quality teachers, through their own (free) teachers’ colleges which guarantee employment upon successful completion
  • UNRWA teachers spend more of their working time teaching than teachers in public schools
  • UNRWA schools have more mandated opportunities for CPD
  • UNRWA teachers are supported by qualified and experienced principals/head teachers
  • UNRWA teachers exhibit more confidence, are able to use a more diverse range of teaching methods, and rely more on interactive learning activities, discussions, and assignments than their public school counterparts

As UNRWA teachers come from the same at-risk population as the students themselves, they have shared experiences with the students that allow them to serve as role models and more effectively provide psychosocial support and address learning needs.

UNRWA is seen as a leader in providing education for refugees: in a 2014 report the World Bank referred to the UNWRA education programme as particularly resilient, noting that “it has maintained effective student and teacher performance despite the ongoing shocks it faces” (Shah 2015a, p. 181), and UNRWA has managed to make significant progress on its Education Reform, as described in a recent update (UNRWA Education Department 2015). The update highlighted the full implementation of a holistic, enabling Teacher Policy; the creation of a curriculum framework and progress on embedding inclusive education, human rights, and conflict resolution into education programmes; the resilience of the reform process, despite escalating conflict; and the development of an UNRWA-wide Education Management Information System (EMIS).

UNRWA’s official policy is one of assimilation and integration into host societies. Therefore, UNRWA schools follow host country curricula (Shabaneh 2012), based on an agreement between UNRWA, UNESCO, and host countries in 1954 (UNRWA 2012). This agreement was intended to facilitate access for Palestinian refugees to host country secondary schools, as UNRWA mainly focuses on primary schools (ibid.). However, host country education policies often undermine assimilation efforts by keeping Palestinians separate from their own populations, and Palestinians themselves often resist these efforts as a result of their desire to be recognised as Palestinians with a homeland (Shabaneh 2012). Paulson’s (2015) qualitative analysis of history education in 11 conflict-affected countries, including Israel/Palestine, highlights the potential problems of segregated learning, even where a common curriculum is used: “the lived experience of young learners is likely to trump the intended educational experience when these two are mismatched.”

Not all curriculum materials come from the host countries: UNESCO has supported UNRWA to create its own textbooks on human rights and conflict resolution. Further, as mentioned earlier, the EDCs allow for some cohesiveness across all of UNRWA’s schools, as does the presence of an almost exclusive Palestinian staff (Shabaneh 2012). 

Appendix E: Key UNRWA Education Policy and Strategy Documents

Table D.1   Key UNRWA education policy and strategy documents

UNRWA Document Year
UNRWA Education: Learning Together 2012
Policy Education for Human Rights, Conflict Resolution and Tolerance (also available in Arabic) 2012
Planning and Monitoring for Success 2012
UNRWA Technical and Vocational Education and Training (TVET) programme 2012
Leading for the Future: Professional Development for Head Teachers/Principals 2012
UNRWA School Based Teacher Development (SBTD): Transforming Classroom Practices 2012
Assuring Quality Curriculum in UNRWA Schools 2012
UNRWA Teacher Policy 2013
UNRWA Human Rights, Conflict Resolution and Tolerance (HRCRT) Education (also available in Arabic) 2013
School Health Strategy 2013
UNRWA Inclusive Education Policy (also available in Arabic) 2013

Appendix F: The International Response to the Syrian Crisis in Higher Education

The following figure shows the current international response to the Syrian Higher Education crisis, which involves the World University Service of Canada.

Figure F.1   The international response to the Syrian higher education crisis (WES 2015).

figure-f1

Appendix G: Principles of Learner-centred Education

Mendenhall et al. (2015) have drawn from the best practice international education literature to come up with a framework for quality learner-centred education, set out in figure G.1 below.

Figure G.1   Core elements of learner-centred education (Source: Mendenhall et al. 2015)

figure-g1

It can be helpful to consider quality across the three key interrelated dimensions of education identified by education scholars, namely: (1) curriculum (what is taught), (2) pedagogy (how it is taught), and (3) assessment (how teaching and learning is measured) (Wyse, Hayward and Pandya 2015). Table G.1 demonstrates how each core element from the figure above links to the dimensions of curriculum, pedagogy, and assessment:

Table G.1    Linking core elements of learner-centred refugee education to the dimensions of curriculum, assessment, and pedagogy

Element Dimension Link to Dimension
Meaningful and active pupil engagement Pedagogy

 

Teachers do not just transfer knowledge and rely on rote learning, but work with pupils to ensure that they are active participants in the learning process.
Inclusive and respectful learning environment Pedagogy

 

Teachers work to create a classroom climate that is welcoming to and safe for all learners, and thus conducive to learning. (This includes the use of non-violent discipline and classroom management strategies).

 

Differentiated instruction

 

Curriculum/ Pedagogy/ Assessment

 

Differentiated instruction refers to the process by which different entry points are available to learners according to differences in knowledge, abilities, skills, etc. It happens at the level of curriculum (what all students learn, what most students learn, what some students learn), at the level of pedagogy (the variety of teaching methods employed by teachers to ensure all students are learning), and assessment (a range of opportunities for students to demonstrate what they have learned). Differentiated instruction is particularly important for ensuring a quality learning experience for refugee learners, because often they come to the classroom with a broad range of learning needs.
Constructive classroom discourse Pedagogy

 

Teachers enable students to engage in the active co-construction of knowledge, and work on building positive classroom discourse.
Relevant curriculum and language(s) of instruction Curriculum

 

For quality learning experiences to happen, what is taught in classrooms needs to be relevant to learners, not only in terms of building on knowledge and experience they already have, but in ensuring that lessons learned are applicable for their current and future lives and contexts. For refugees, the curriculum question involves decisions around using the host curriculum or the curriculum from the country of origin (or a combination), etc. Often these choices are determined based on availability of officially recognised assessment opportunities. When it comes to language of instruction, research has demonstrated that mother tongue instruction tends to be more effective, particularly for younger learners. The UNICEF EAPRO Language, Education and Social Cohesion (LESC) initiative provides some key ideas about multilingual and mother tongue learning and research (UNICEF EAPRO 2016).
Conceptual learning and critical thinking

 

Curriculum

 

According to the proposed model, curriculum should not just contain key facts and figures for students to memorise, but should provide ample opportunities for learners to engage in more abstract and conceptual learning and to develop critical thinking skills that will serve them in real life beyond the classroom.
Varied comprehension checks and assessments

 

Assessment

 

According to the proposed model, learners should have the opportunity to demonstrate what they have learned in a number of meaningful ways. Where possible, assessment should be formative – i.e. contributing to the overall learning process. Further, while ‘teaching to the test’ should be discouraged, key national and international assessments should be considered to ensure that refugees’ educational achievements are officially recognised through formative, summative, and inclusive processes.

 

 

[1] Academic institutions generally have Institutional Review Boards which evaluate the proposed research methodology to ensure that the research to be undertaken meets the relevant ethical standards. When working with vulnerable populations, it is usually not possible to expedite the review process, and the proposal has to go in front of a committee. This is a necessary but time-consuming process.

[2] See Dana Burde’s work in Afghanistan for a rare example of quality RCTs on education in conflict-affected settings: http://www.danaburde.com/publications.html

 

 

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Skills /topic/skills/ Thu, 28 Jan 2016 15:10:47 +0000 http://www.heart-resources.org/?post_type=topic&p=27128 Read more]]>
1. Executive Summary2. General introduction and overview3. Skills and development4. Market failures and skills shortages5. Existing systems for skills training in partner countries6. Skills for employment, employability and higher earnings7. The geopolitical landscape - international players and skills training systems in developing countries8. Conclusion9. Annotated bibliography

By expert advisor Prof Simon McGrath, University of Nottingham.

A focus on skills and technical and vocational education and training (TVET) almost slipped off the development agenda after 2000. Excluded from the Millennium Development Goals (MDGs) and marginalised in the Education for All (EFA) debate, the dominant policy and research view was that specific vocational skills were less important than general education and that public provision of vocational skills was particularly ineffective. This orthodox position had largely been developed by the World Bank in the 1980s and early 1990s (e.g., Psacharopoulos 1981 and 1985; Psacharopoulos and Loxley 1985; Middleton, Ziderman and Adams 1993), drawing strongly on human capital approaches.

Yet, the current decade has seen skills and TVET return to the development agenda. TVET is clearly present in the new language of the Sustainable Development Goals (SDGs); UNESCO convened a world conference on the subject in 2012 and is working on a new revised recommendation – its key standard-setting tool; whilst a range of international reports have emerged on skills from organisations such as McKinsey and the Organisation for Economic Co-operation and Development (OECD), as well as the Global Monitoring Report on Youth and Skills. These global policies can be placed against a backdrop of national commitments in developed and developing contexts to diversify and expand skills provision in terms of its supply and demand.

However, the policy of neglect of skills has contributed to a paucity of good international research on the topic and there remains more ideological heat than empirical light in the field. This topic guide seeks to review the current state of the debates.

Whilst there is widespread agreement that the skills of young people, nations and enterprises need to be developed, there is disagreement as to the best ways of proceeding. This is partly because skills is researched from different disciplinary traditions, with very little attempt at genuinely transdisciplinary approaches. Much of the literature, particularly from the discipline of economics, has focused on issues of individual and enterprise investment in skills and the question of whether or not there is market failure present. This can be contrasted with literature from sociology and politics that looks more at the institutional arrangements that make national skills systems more or less effective, seeing current skills regimes as arising out of historical contestations and compromises within wider political economies.

There are not simply disciplinary tensions about how to understand skills. The term skills is also a broad one, with there being differing levels of attention from various communities on technical, cognitive and life skills, and largely independent discussions about skills in general education, in vocational education and training providers, and in enterprises.

For the purpose of this topic guide, skills is defined in a broad way to take account of these different usages and multiple disciplinary traditions are considered. However, throughout, there is a strong focus on the skills that help individuals to access decent work, whether through employment or self-employment, and some focus on the positive consequences for enterprises and national economies that arise from such investments.

Seeking to develop one’s skills is an important characteristic of being human. Many individuals invest very significant proportions of their resources in skills development. However, there is evidence that provision and access to skills is unequal in different countries, regions and contexts (EFA GMR 2012). Marginalised groups are less likely to be able to access skills.

Thus, any interventions in the skills field need to be seen as both a process of overcoming market failures and a matter of promoting social justice. Moreover, there is a longstanding political argument that active citizenship requires effective labour market participation. Inclusion of skills development in the SDGs brings with it the need to think more about how skills contribute to sustainable development, and not just in the narrow sense of “green skills”.

The topic guide reports evidence that skills training has resulted in increased self-awareness, empathy, decision making, goal setting, and communication skills for youth pressure (Olenik and Takyi-Laryea 2013). It also points to evidence of training programmes in developing countries have been shown to have a positive impact on future employment and earnings.

Whilst cognitive skills are linked to increases in incomes and employment chances generally, technical skills training is shown to be more effective when focused on skills closely linked to market demand. Women may benefit from skills training more than men because they are often starting from a greater state of disadvantage in the labour market (Adams 2011). Nonetheless, a solid general education is required as a basis for youth development and for future employment opportunities. For the disadvantaged, skills acquisition is more effective when built on a solid foundation of good quality basic education (Adams et al. 2013).

Vocational education systems may benefit from reform in developing countries. However, it is essential to remember that TVET does not guarantee a solution to youth unemployment. Skills and employment are intrinsically related to overall growth, development and innovation pathways. Policies that promote access to general education and business development are likely to support skills training initiatives.

At the level of TVET system reform, there is a consensus that involving all stakeholders, most particularly employers, in the design and delivery of training, contributes to better outcomes for all. There have been many attempts to reform funding regimes, including through levy-grant systems, but there is a lack of conclusive evidence on their efficacy. Indeed, it appears that systems may need to be well-functioning before these reforms are effective (Dunbar 2013). Similarly, national qualifications frameworks (whether education-wide or just vocational) have been introduced in a large number of countries in recent years but there is considerable evidence on their complexity and little on their positive impact (Allais 2010). There is evidence that apprenticeship programmes provide good quality access to training and to new technology, and are a strong route into decent employment. However, such programmes typically prove hard to deliver at scale, due to the limited numbers of medium to large firms in developing economies and market failure (World Bank a. 2013). Overall, there has been more failure than success with TVET policy reform in developing countries (McGrath et al. 2013).

At the system level, the OECD recommends the following as best practices:

  • Prioritise investment of scarce resources
  • Combine short- and long-term considerations
  • Build a case for lifelong learning
  • Foster a whole-of-government approach
  • Align the perspectives of different levels of government
  • Include all relevant stakeholders (OECD 2012).

Overall, there is a degree of consensus that skills development is an important policy area on both efficiency and equity grounds. However, the complexity of the change mechanisms involved and the limitations of the empirical evidence available highlights the major challenges still involved in investing in skills interventions.

Key messages: 

  • Skills are competencies that can be gained from experiences during and after childhood, especially through education.
  • Skills can be regarded as a spectrum. At one end, basic skills are needed to get any job or even for acquiring further skills. At the opposite end, high skills may be referred to as talent.
  • Provision and access to skills is unequal in different countries, regions and contexts. Marginalised groups are less likely to be able to access skills. Gender stereotypes may limit access for women and girls, channelling them into certain jobs, such as sewing and embroidery.
  • TVET skills are concerned with the acquisition of knowledge and skills for the world of work.
  • There is a paucity of data and systematic information on TVET and adult education that must be addressed. In particular, there is a paucity of sex-disaggregated data.
  • Training programmes in developing countries have been shown to have a positive impact on future employment and earnings. The findings were not disaggregated by sex. [1]

2.1 Introduction

Topic guides are user-friendly guides focusing on key education, health and nutrition topics. They provide a synthesis of the key evidence on a particular issue as well as links to essential readings. Current issues and debates are discussed where possible. Topic guides are fundamentally designed to signpost readers to the best original sources of information and summarise very briefly the most important findings and messages from those sources, in order to help readers determine which sources are most relevant to them. A topic guide cannot include all relevant concepts, debates, lessons, and evidence in full detail. Instead, a guide should:

  • Introduce relevant ideas briefly to give the reader a basic overview
  • Help the reader decide which concepts, theories, toolkits, and so on may be relevant to the problem and context that the reader is working with
  • Point the reader to relevant sources for further details.

This topic guide is focused on skills immediately necessary for employment and increased productivity. It focuses on technical and vocational education and training (TVET) skills, which are concerned with the acquisition of knowledge and skills for the world of work. The importance and value of obtaining basic skills is recognised as a pre-requisite for higher order skills development. This document was written between July and December 2015 and includes evidence that was available at this time.

The selection of materials was guided by the principles of the DfID How to Note: Assessing the Strength of Evidence. The topic guide does not include a critical appraisal of individual pieces of evidence used, but provides an assessment of the body of evidence for the main sections of the guide. The topic guide was assessed by a gender reviewer, who provided guidance on whether gender-relevant implications had been adequately covered. The gender reviewer was independently recruited by IDS BRIDGE. Where possible, the evidence presented was disaggregated by sex. Until a time when more robust data is available, case studies offer a good insight into progress in TVET (EFA GMR 2015). This topic guide draws on case studies and country examples, where possible, to illustrate best practices in the delivery of TVET and other skills programmes.

2.2 Definition and description of skills

There is no consensus among social scientists about the definition of the word ‘skill’ (Green 2011). Skills may involve capabilities and competencies. Some capabilities are innate and some competencies are acquired through academic and non-academic experience. In the English language, ‘intelligence’ and ‘talent’ are used to refer to capabilities that are inborn or acquired early in childhood. Under the Dakar Framework for Action ‘skills’ refers to competencies that can be gained from experiences during and after childhood, especially through education. Under the Dakar Framework ‘life skills’ was understood to advocate the capability of generating or adding value to an economic product but also the skills individuals need for a fulfilling and healthy life and full participation in society (EFA GMR 2015).

2.3 Youth bulge

In the world today over 3 billion people are under 25 years of age. This equates to nearly half of the world’s population. Almost 90 per cent of these young people live in developing countries. This demographic trend is referred to as a ‘youth bulge’, as young people constitute a high and peaking proportion of many populations. The youth bulge represents both a challenge and an opportunity for development. The duration of the youth bulge is critical, as it presents a limited window in which to develop a larger and younger workforce who can drive economic development and play a significant role in social development. Young people are a valuable asset to their countries and investing in them brings tremendous social and economic benefits (Huxley 2010). Jobs and opportunities for these youths are an important aspect on the development agenda in many countries. Better data is needed, but the evidence that does exist suggests that unemployment is but one of the main problems facing low-income countries. In the absence of adequate social safety nets, young people are compelled to take low-productivity, low-wage jobs. Better-paying jobs and opportunities are needed to help people escape poverty. A critical part of the policy agenda for youth employment must be to strengthen human capital. Skills influence employment and earning potential (World Bank 2014). It is necessary to address issues such as the shortfall of higher-order cognitive skills, behavioural and socioemotional skills, technical or vocational skills, and business skills to overcome some of the challenges the youth bulge presents.

The need to develop the skills of young people to prepare them for work is urgent. The long-term consequences of the financial crisis and the challenges of increasingly knowledge-based economies have enhanced the need for a skilled workforce. Young people require skills that prepare them for decent jobs so they can thrive and participate fully in society (EFA GMR 2012). People who cannot read, write and do basic arithmetic have fewer opportunities for gainful employment, entrepreneurial activity or civic participation. A global effort is required to build the foundational skills for entering the workforce and actively participating in society. Foundation skills are necessary for employment that pays for daily needs. Access to secondary school can be measured to give an indication of progress made towards opportunities to acquire these foundational skills (EFA GMR 2015). To address the economic strain of the youth bulge present in many low-income settings, workforce development programmes are critical. This is an opportunity to create new growth in areas like technology or sustainable agriculture.[2] Demand-side efforts must be matched by supply-side efforts to ensure that a highly trained youth workforce will have solid, stable employment options that earn them a living wage. Developing an understanding of what services works best for which populations of youth will be crucial to progress. Measuring long term outcomes will be vital. There is a research gap with regards to understanding community and institutional capacity for youth workforce programmes. This may be due to the lack of common indicators for success (Olenik and Fawcett 2013).

2.4 Skills development in context

Skills development does not exist in a vacuum. Other factors may impact skills acquisition. For example, children who are hungry, malnourished or ill are not in a position to gain the skills needed for later learning and employment (EFA GMR 2012). In addition, many young people combine work with schooling to support their families, which may also restrict their acquiring of skills. Girls, in particular, may combine housework with schooling. Many girls drop out from school at the time of puberty, especially if schools don’t have bathrooms. There are usually fewer secondary schools than primary ones, which means that girls entering secondary school sometimes have to walk further, and if it is not considered safe to do so, they simply stop going to school. Primary school completion rates are reaching parity in many developing countries, but the transition to secondary education is much lower for girls. This affects the level of skills development that they can eventually access and the types of jobs they can get. Evidence suggests working students tend to lag behind non-working students in acquiring foundation skills. Good governance and solid policies can mitigate this impact. For example, the negative association between student employment and academic performance is smaller among students in countries that enforce a minimum working age (EFA GMR 2015).

In sub-Saharan Africa, the non-farm informal sector is a major source of employment and earnings, with household enterprises accounting for most non-farm employment in the region. A lack of skills within the workforce may be a constraint that hampers productivity in this sector. Workers in the informal sector have lower education levels than those in the formal sector, but higher education levels than farmers. Education and training is important for both formal and informal employment as it translates into additional investments in skills and higher earnings. Basic education establishes a solid foundation for further skills development. Cognitive and non-cognitive skills developed in primary and lower secondary education provides a foundation for the acquisition of technical skills and the preparation of individuals for employment with secondary and postsecondary education (Adams et al. 2013). Formal secondary schooling is regarded as the most effective way to develop the skills needed for work and life. Enrolment rates at secondary level have improved, but the enrolment ratio is still low in developed countries. An estimated 71 million adolescents of lower secondary school age were out of school in 2010 worldwide, with three quarters of these living in South and West Asia and sub-Saharan Africa (EFA GMR 2012). Unfortunately the data presented here is not disaggregated by sex for comparison.

Education and training are strongly linked to the type of job held. Evidence from Ghana, Kenya, Nigeria, Rwanda, and Tanzania indicate a positive link between education and training and the probability of holding a job that is not farming. Formal education, and particularly higher education, is linked to employment in the formal wage sector. Lower levels of non-formal training are linked to employment in the informal sector. To improve productivity and incomes in small businesses and household enterprises of the informal sector, strategies need to be developed that consider why the shortfall in skills exist. Factors include low levels of education, unequal access to training, the presence of inefficient markets encouraging skills development, lack of engagement from public training providers, and other market constraints. Expanding basic education is a necessary foundation to skills development, but complementary measures must unlock the potential of existing populations (Adams et al. 2013).

Based on evidence from a five country study from sub-Saharan Africa, strategies aimed at improving productivity and incomes in small businesses and household enterprises of the informal sector should consider addressing the following:

  • Increase efforts of public skills providers in the informal sector
  • Encourage investments in skills by small and household enterprises
  • Improve the quality of training offered by master craftspersons in apprenticeships
  • Expand second-chance programmes for education
  • Provide small firms in the informal sector with information about the benefits of training and competitive sources for obtaining it
  • Encourage industry associations to play a larger role in skills development for the informal sector
  • Improve information available on training providers
  • Promote competition and innovation in training for the informal sector
  • Improving understanding of skills and policy effectiveness (Adams et al. 2013).

2.5 Life skills

The World Health Organization (WHO) describes life skills as a group of psychosocial competencies and interpersonal skills that help people make informed decisions, solve problems, think critically and creatively, communicate effectively, build healthy relationships, empathise with others and cope with and manage their lives in a healthy and productive manner. The EFA Interagency Working Group on Life Skills describes life skills as cross-cutting applications of knowledge, values, attitudes and skills that are important in the process of individual development and lifelong learning. Life skills are necessary to promote good health and to maximise societal contributions beyond just earning a livelihood (EFA GMR 2015). Life skills include social or interpersonal skills including communication, negotiation and refusal skills, assertiveness, cooperation, and empathy. Life skills also include cognitive skills such as problem solving, understanding sequences, decision making, critical thinking, self-evaluation and emotional coping skills (Olenik and Takyi-Laryea 2013). The EFA agenda understands skills to originate from deliberate and intentional experiences offered by formal, non-formal, employer-based or other lifelong learning opportunities. Skills are therefore more specific than general knowledge, as they are intended to yield economic, social, developmental or political consequences (EFA GMR 2015).

2.6 Skills and employment

Work readiness skills are those that help youth to find and obtain employment. They include the ability to describe skills and interests, set career goals, write a resume, search for a job, and contact employers (Olenik and Fawcett 2013). Skills for employment are sometimes referred to as livelihood skills. These can be obtained at the foundation level. They may be transferable in nature or described as relating to technical and vocational skills. Transferable skills can be transferred and adapted to different work environments and jobs. They allow people to retain employment. Foundation skills include the literacy and numeracy skills necessary for getting work that can pay enough to meet daily needs. They are a prerequisite for continuing in education and training, and for acquiring transferable and technical and vocational skills that enhance the prospect of getting good jobs. Transferable skills include the ability to solve problems, communicate ideas and information effectively, be creative, show leadership and conscientiousness, and demonstrate entrepreneurial capabilities. These skills allow people to adapt to different work environments and improve employment opportunities (EFA GMR 2012).

2.7 Skills attainment

Different components of competences that contribute to skills development are likely to be acquired in various ways from various contexts. Formal education and training generates scientific knowledge, while work attitudes may be acquired in multiple sites. Skills development may have different levels of complexity. Basic skills may include cognitive skills needed for getting any job, or even for acquiring further skills. At the other end of the spectrum, talent may be used to describe those with especially high skill. Skills under-utilisation refers to the situation where someone has skills that are not being used for their job. This may be linked to over-education, where someone has achieved education at a level higher than needed to get the job they are doing. A skills gap refers to the opposite situation, where workers do not have the competence to do the job required. A skills shortage vacancy occurs where a job vacancy is hard to fill because applicants lack the skills that are required. A skills deficit is when the level of skills supplied and used is below the desirable level. It can be hard to directly measure skills. Using educational achievement as a benchmark can be problematic, as they are not necessarily interchangeable (Green 2011).

2.8 TVET skills attainment

TVET skills can be acquired through work placement programmes linked to secondary schooling and formal technical and vocational education, or through work-based training, including apprenticeships (EFA GMR 2015). The proportion of secondary school pupils enrolled in TVET programmes has remained at 11 per cent since 1999 (EFA GMR 2012). There is currently no single point of information focused on training taking place outside the authority of education ministries. Skill training is increasingly seen to be an integral part of general education, offering foundation and transferable skills at the same time as job and life skills. The exclusive focus on economic production that historically underpinned discourse around skills has now changed. TVET skills are now regarded as not only generating income, but also enhancing workers’ capacity for future growth. Rigorous evidence on TVET programmes remains scarce. Monitoring and evaluation of TVET programmes are yet to be regarded as a priority. It is unclear whether TVET programmes provide skills to workers who are then allocated work, or whether TVET programmes increase the stock of capabilities in the economy, so that new jobs are created (EFA GMR 2015). Creating new jobs will not solve the problem if people do not have the skills needed to do them. Governments must address the skills deficit to improve employability and reduce reliance on subsistence work (EFA GMR 2012).

2.9 Skills within the wider development agenda context

The Open Working Group of the UN General Assembly on Sustainable Development Goals (SDGs) recommended a specific target to measure progress on skills in the post 2015 framework. Goal 4 is to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all (United Nations 2014). Within goal 4, target 4.4 is focused specifically on TVET, aiming to increase the number of youth and adults who have relevant skills, including technical and vocational skills, for employment, decent jobs and entrepreneurship. Target 4.7 is also relevant, although it focuses more generally on skills, aiming to ensure that all learners acquire the knowledge and skills needed to promote sustainable development, including, among others, through education for sustainable development and sustainable lifestyles, human rights, gender equality, promotion of a culture of peace and non-violence, global citizenship and appreciation of cultural diversity and of culture’s contribution to sustainable development (United Nations 2014). The inclusion of skills in the post 2015 development agenda was reaffirmed by the UN Secretary-General in his synthesis report on the SDGs, which argues that it is essential that young people receive the skills they need through quality education and lifelong learning (Ki-Moon 2014).

Lifelong learning provides an organising principle and a process perspective that is focused on learning. Members of the education community can learn from each other, facilitating vertical and horizontal progression. The post-2015 agenda provides an opportunity to build a broader enabling environment, which includes TVET. Visionary leadership will be needed to mobilise collective responsibility and actions. For all countries, regardless of economic or industrial status, it is increasingly clear that development problems are rarely contained within one sector but are best addressed collectively. Broader transformations of public policies and governance are required. The transformation of TVET is dependent on such transformations, but importantly it is also able to contribute to them. Mutual benefits can be realised through the transformation of TVET and the transformation of governance in synchronisation (UNESCO 2015).

2.10 Access to skill provision

Provision and access to skills is unequal in different countries, regions and contexts. Marginalised groups are less likely to be able to access skills. Evidence indicates that those who are poor or female may have limited access to skills, which perpetuates and exacerbates their disadvantage. In lower income settings, girls are less likely than boys to achieve foundation skills. Larger gender gaps appear for richer families. Opportunities are extremely limited for both boys and girls from poor households. Geography also has an influence, with young women living in rural areas least likely to acquire foundation skills. Providing equal education opportunities while improving quality will improve skills acquisition and future job prospects (EFA GMR 2012). Skills programmes need to target people who are most in need. Adult education in the private sector tends to be offered to employees, rather than to unemployed or underemployed, adults. Women are less likely to have received adult education than men. The odds of receiving adult education were also far higher for adults whose parents had attained higher levels of formal schooling. Support must be carefully designed or adult education opportunities may be taken up by adults who have already benefited from formal schooling (EFA GMR 2015). Skills development among migrants is also of major concern. International migrants are often at risk of failing to gain life skills. Systemic factors, including legal status, segregation, school finance and language policy, may affect access to both formal and non-formal education (EFA GMR 2015).

2.11 Quality of evidence

The evidence presented on the current status of skills development is based on a medium number of high-quality systematic reviews, most significantly the recent annual EFA reports compiled by UNESCO. These global reports are based on detailed country level data and case studies, and are regarded as highly reliable sources. Further evidence on skills development in more specific contexts – five populous countries across sub-Saharan Africa; conflict-affected states – is based on systemic studies of available statistical data and proposed frameworks for action presented in reports from the World Bank and USAID. Both reports are substantial and wide-ranging, and are transparent in acknowledging limitations based on the paucity of relevant and up-to-date data in their fields. Evidence on the place of skills development in relation to the emerging SDGs is based on reports delivered by the UN: these documents can be widely considered as key to framing the emerging debates surrounding models for skills development.

 

[1] From experience in Pakistan, women with skills who are earning report more confidence, respect in the community, increased decision making in the household, and their spending priorities are on family’s health and education. Frida Khan, gender reviewer.

[2] There are examples of where women have benefitted from training in these new sectors. For example, call centres in Delhi and Mumbai employ more than 1 million people, most of them women. But even within the ‘new’ old patterns re-emerge with women in the monotonous, lower end jobs, and men in the management one. Frida Khan, gender reviewer.

Key messages: 

  • TVET is shown to be more effective when focused on skills closely linked to market demand. However, TVET does not guarantee a solution to youth unemployment. Other factors may have an influence, including growth, cost of labour, legislation, and unrealistic wage expectations.
  • A solid general education is required as a basis for youth development and for future employment opportunities. For the socially disadvantaged, skills acquisition is more effective when built on a solid foundation of good quality basic education.
  • Women may benefit from skills training more than men because they are often starting from a greater state of disadvantage in the labour market.
  • Considering TVET solely through a productivism lens may not address all the issues and challenges. Other theories and paradigms, including a rights based perspective, are required.
  • Marginalisation in skills has no uniform indicator and is therefore hard to measure.
  • Inefficiencies of the public sector, lack of responsiveness and inability to match demand led to a shift of focus towards the private sector being involved in skills development. The public sector must have the capacity to oversee private sector involvement in skills development, to ensure social objectives are met.
  • Comprehensive approaches to skills development, which combine training with employment or work placements, are the most effective.
  • The following challenges can be experienced when trying to involve the private sector in skills training:
    • Initiatives may fail to attract the participation of private firms.
    • Smaller firms may struggle to participate due to cost and capacity.
    • Private firms may lack an understanding of the benefits of training.
  • The private sector can contribute to the governance of TVET systems through national committees or other institutional arrangements, strengthening the skills training being provided. Industrial associations can work to encourage and support training for small enterprises to broaden skills development. Participation from employers in the design and operation of skills training programmes are likely to increase their effectiveness and acceptance.

3.1 Skills and development theory

The orthodox theory of skills sees vocational education and training improving production. Economic development is regarded as the ultimate goal of society. It is assumed that training leads to productivity, leading to economic growth and that skills lead to employability, leading to jobs. Skills therefore lead to both growth and work. There is an opportunity to re-evaluate the purpose of vocational education and training and how it is understood in the context of development theory. The development lens broadens the TVET debate away from higher income settings and Anglophone developed country contexts. It allows for vocational education and training to be considered from a global perspective (McGrath 2012).

Locating TVET within economic development, and theoretically linking it to productivism may be inadequate to deal with some of the challenges present. Other theories and paradigms can expand on TVET and change how we understand the concept. For example, the human rights perspective stresses the importance of educational access. A rights-based theory of educational access should include vocational learning to posit a new right to vocational learning for all. A transition would be needed and the human rights approach would need to incorporate conceptions of human development and decent work, as are offered by other human-centred development approaches (McGrath 2012).

3.2 Barriers to productivity

Research conducted by the World Bank (a. 2013) gathered data from 45,000 companies in developing countries found that the most significant obstacles to their operations were a poor investment climate due to excessive red tape, high tax rates and competition from the informal sector. Inadequate infrastructure (mainly insufficient or unreliable power supply), lack of access to finance or credit, and workers lacking sufficient skills and training were also stated as obstacles, as shown in the figure below. Different obstacles were found to be present in different contexts. For example, while informal markets were sighted as a major hindrance for small and medium-size enterprises in middle-income countries; inadequate power supply was the most important issue for companies in low-income countries. Small and medium enterprises reported that access to finance was a significant constraint, but larger businesses and businesses in high-income countries reported that a shortage of skilled workers was the key challenge for them (World Bank a. 2013).

First, second, and third ranked constraint by firm size and country income group

Skills TG Figure 1

It is estimated that approximately 45 million job seekers join the labour force every year. Research from 41 countries found that a third of companies report an inability to find the workers they need. There is a mismatch between the supply and demand of skills within countries and in the global economy. The world’s labour force is increasingly concentrated in developing economies. There is currently a shortage of jobs requiring low- and medium-skilled workers in both developed and developing economies. Advanced skills and training are more common among workers in developed economies. Demand for highly skilled workers still outstrips supply. The situation is likely to get worse in both advanced economies and in developing countries.

Skills necessary to manage and grow businesses are also lacking, limiting growth potential and job creation. However, evidence suggests that training to improve managerial skills does not have an impact on either the survival of the business or on the number of employees. Managerial training has however been shown to have a positive effect on business practices, profitability, and investments by the business. Approaches to training must be comprehensive and include collaboration between the private sector and other stakeholders such as educational institutions, training providers, and organisations working with youth. Such collaborations must prioritise the design and implement education and training policies that are tailored to market needs (World Bank a. 2013).

3.3 The role of the private sector in skills development

Historically, in industrial countries, a significant amount of skills training was provided by employers and linked to a job. Despite this context, in the 1950s and 1960s, governments in developing countries were encouraged to invest in skills training to complement investments in physical capital. Institutions were developed to provide people with skills. TVET was linked to fighting youth unemployment and relieving demographic pressure on higher education institutions. Those who entered TVET were generally academically less able. It was thought that skills development must be publically funded to compensate for limited private capacity. Many of these schemes failed as the supply of skills became its own justification (Johanson and Adams 2004). Inefficiencies of the public sector, lack of responsiveness and inability to match demand led to a shift of focus towards the private sector being involved in skills development. There is a distinction between financing and provision of skills.

The role of the private sector in skills development is complex. The motivations of private sector stakeholders may vary significantly. They may be driven by productivity, profit, a desire to secure a skilled workforce, to develop reliable suppliers or for corporate social responsibility factors. Private sector involvement in the development of skills may include private companies training, funding or sharing knowledge with the workforce. Alternatively, the training institute or organisation providing the training may be private. Either of these may involve the development of public-private partnerships (PPPs), which are likely to involve cooperation between the public sector and private sector actors working towards a common goal, while sharing risks, resources, and competencies. Such partnerships often involve nongovernmental organisations and civil society (Glick, Huang and Mejia 2015). The private sector can strengthen TVET systems by contributing to their governance through national committees or other institutional arrangements. The private sector can provide input into the feasibility of public investment in TVET, identifying demand for skills, developing curricula, managing public training institutions and through monitoring and evaluation activities (ETF and World Bank 2005).

With regards to skills development, evidence indicates that comprehensive approaches, which combine training with employment or work placements, are the most effective. At the national level, PPPs that align current and future labour market demands are a key modality for private sector engagement in demand-driven skills development. These partnerships have had some success in East Asia, where national qualifications frameworks have been developed to enhance labour market functioning. There is some evidence that contracting out for private provision of services will lead to improved efficiency and quality, bringing gains in efficiency and competition. However, a degree of capacity from the public sector to provide oversight may be required to ensure social objectives are met, as private service providers tend to focus on youth who are easier to train or easier to place in jobs (Glick, Huang and Mejia 2015).

In many low-income settings, government TVET budgets are regarded as vulnerable and unreliable. TVET may need to be financed by increasing the contribution of beneficiaries, including employers and trainees (UNESCO 2015). The European Training Foundation (ETF) and World Bank (2005) jointly recommended that private sector contributions to TVET will need to be prioritised to sustain diverse, high quality TVET services. TVET financing is often segmented for public and private provision. Private provision is funded through tuition fees. Public provision is funded through direct budget allocations, the collection of modest fees from individuals or from training levies paid by private companies. In the research done by ETF and World Bank (2005), no evidence was found of a successful funding mechanism to open up the training levy to finance private provision.

Private TVET provision over the past decade has become a significant and growing part of TVET in sub-Saharan Africa and in the Middle East and North Africa. Lebanon, for example, now has more people enrolled in private TVET institutions than in public institutions. The Jordanian government is promoting private provision at the community college level (ETF and World Bank 2005). The Morocco Government has produced a legislative framework for private TVET providers. In addition to regulations, governments can support private TVET providers through financial and technical dimensions. Financial support can come in the form of direct subsidies or tuition grants, indirect subsidies or fellowships or bursaries to students, and tax exemptions. The governments of Côte d’Ivoire and Mali gave non-government institutions substantial subsidies and tax incentives. Technical support included the assistance with the training of trainers and curricular design support (UNESCO 2015). The private sector may have a better understanding of the needs of future labour markets, ensuring partnerships aim to overcome failures. The private sector partners, and in particular multinational companies, may have access to substantial resources to inject into skills training (Glick, Huang and Mejia 2015).

In the southern Africa region, a number of countries have revolutionised their attitude to private training providers. Attempts have been made to integrate the private sector into a single national TVET system. Despite this progress, there is still a level of ignorance and disinterest in the potential role of the private sector in skills development. Some countries have chosen to focus more explicitly on non-formal provision. Governance, quality assurance and qualifications frameworks reforms should all assist in better thinking across the range of TVET provision types. There is a need for a deeper understanding of skills provision (McGrath et al. 2013).

Structural change may be needed for economic growth in Africa, including the development of skills. Page (2012) believes the current trend is moving in the wrong direction. He states that official development assistance is in part to blame for this. He argues that not enough has been done to encourage private investment in infrastructure and skills, with the focus instead being on potentially low impact regulatory reforms. Going forward, aid strategies should be focused on creating good jobs and sustaining growth. Workers must be trained in skills allowing them to transition from low productivity to high productivity jobs. In Asia, investment from the private sector has been shown to be a key driver of rapid economic transformation. Such investment in Africa from the private sector has not focused on the expansion of high value added activities. Instead, investment in Africa has focused on the exploitation of natural resources, which does not improve the skills base of the population.

Foreign Direct Investments (FDIs) is an investment made by a company based in one country, into a company or entity based in another. One theory is that FDI increases jobs and can raise skill levels through knowledge transfer and technical skill spill-over. However, a lack of systematic empirical research makes it hard to assess the impact of FDI on skills in Africa. There is no comprehensive evidence on the magnitude and exact nature of these spill-overs. There is limited data on local management practices with most research regarding local firms as being passive recipients of superior western knowledge spill-overs. To overcome the skills shortage in Africa, private companies must invest more in developing, recruiting and retaining talent. Multinational corporations can develop skills at the local level by drawing on their repository of knowledge embedded in their global network of subsidiaries (Kamoche et al. 2012).

The informal economy is both significant and important in sub-Saharan Africa. Public funded TVET programmes have only played a small part in developing skills for the informal sector. Private sector training organisations are filling the gaps left by public sector institutions. The public sector has yet to respond to the changes in demand for skills brought about by the growth of the informal sector. Private institutions (some profit making and some not for profit) have been more responsive to this demand (Jackson 2012; Adams, 2008). Indeed, the limited capacities of public TVET providers and their inability to respond to the demands of enterprises and trainees are factors driving the expansion of private TVET. Private TVET providers can be more responsive to demand as they are traditionally subjected to fewer bureaucratic restrictions than public institutions (UNESCO 2015). However, the quality of such training provided by the private sector has been found to vary dramatically. The promotion of private training associations would lead to cooperation and reduction of costs, while providing a framework for accreditation and quality assurance (Jackson 2012; Adams 2008).

There are some challenges of engaging with the private sector in skills training. If initiatives may fail to attract the participation of many firms, programmes may be less demand driven than desired. Smaller employers may find it harder to participate due to higher costs and lower capacities (Glick, Huang and Mejia 2015). Costs and time needed away from work mean smaller enterprises are less inclined to train their employees. Private firms may also lack an understanding of the benefits of training. Industrial associations, as mentioned above, could encourage and support training for small enterprises to broaden skills development (Adams 2008). Private firms often invest in youth programmes for reputational or corporate social responsibility reasons rather than to increase productivity, meaning resources may not be directed to the areas where skills development is needed in the economy (Glick, Huang and Mejia 2015). Provision of TVET by private proprietary institutions or NGOs is often focused in professional areas that typically do not require large capital investment. This makes entry and exit by private providers from the sector easy (UNESC0 2015).

The effectiveness of private sector skills investment will be influenced by the social, economic and political contexts. For example, although private sector investment in South Africa is higher than that of the government, the impact of the investment is eroded by the HIV/AIDS epidemic. The private sector is encouraged to invest in the health of employees, as well as in their skills development (George, Surgey and Gow 2014).

When designing skills development programmes with the private sector, Glick, Huang and Mejia (2015) recommend that skills training programmes should involve a level of participation from employers in their design and operation. Where possible, skills that have been developed need to be signalled or recognised, for example through diplomas or certifications. For qualification frameworks to be successful, there must be buy-in and engagement from employers. It is hard to encourage the private sector to offer training in soft skills, like cognitive skills, as they are highly transferable across employers. Therefore such skills may need to be provided by the public sector or NGOs. It is recommended that employment services should be improved and expanded, as they are potentially cost-effective. In terms of advice to donor agencies, the level of involvement between the private sector and skills development will depend on the capacity of the country in question. Weak capacity or a lack of existing public-private cooperation may mean intensive public private partnerships are appropriate. It is recommended that donors focus on providing technical advice and capacity-building on PPPs (Glick, Huang and Mejia 2015).

3.4 Country examples

South Africa

In South Africa, the media and policy circles take the view that unemployment is caused by a shortage of skills and an inflexible labour market. Allais (2012) challenges this and argues that the real reason for unemployment is the inadequacy of the South African social security system, high levels of job insecurity, and high levels of inequalities, which make it almost impossible to develop robust and coherent skills development programmes. The South African example shows how education policy can be trapped in a paradigm of ‘self-help’, ‘employability’, and labour market flexibility that works against the possibility of achieving improved levels of education and skills. A better theoretical understanding of the relationships between vocational education and development is required. To make advancements with vocational education policy, it would be better placed in broader social policy, with better regulated labour markets, job security, more egalitarian social welfare, and an expanded vision of citizenship. In addition, for education to meet the long term needs of the economy, there should be less focus on what employers say they need from employees in the short-term, and more focus on strengthening the educational side of vocational education. This includes building a strong curricula based on well-defined areas of knowledge, and developing a better understanding of how to assist students to acquire this knowledge (Allais 2012).

The private sector in South Africa invests more funds than the government on training. The effectiveness of these efforts is being eroded by the HIV and AIDS epidemic. The real costs of HIV and AIDS on the economy is unknown, but is likely to significantly exceed the training investment lost as a result of increasing morbidity and mortality rates due to HIV. In the South African context, it is in the private sector’s best interest to ensure that a sound HIV and AIDS policy is in place. As well as investing in skills, firms must also invest in effective prevention programmes, complete with access to appropriate treatment to employees if they cannot get them through the public system (George, Surgey and Gow 2014).

South Africa’s Department of Higher Education and Training is actively involved in the ‘greening of TVET colleges’ initiative. The initiative was launched in 2013 and aims to establish colleges as green environments based on international best practices in the greening of colleges. The initiative focuses on the development of special green profiles and the integration of green issues in selected TVET colleges. Green issues are integrated into training programmes, college policies and plans. Internal and external stakeholders are involved in the greening process. The colleges are linked through national and international networks. South Africa’s future energy supply will need to have lower greenhouse gas emissions in order to meet the challenges posed by climate change. There is a need for the development of informed and trained human resources in this field. In 2011,  the Industrial Development Corporation and the South African Development Bank estimated that the total employment potential of the green economy would be over 450,000 direct jobs over the long term until 2030, whilst the projections under the category for energy generation, and energy and resource efficiency for the long term would be 130,000 and 68,000 respectively (Merensky-Hartinger 2014).

South Korea, China, and Mozambique

Those who are disadvantaged were badly affected in terms of jobs growth and employment opportunities by the 2008 global recession. For the disadvantaged, skills education is more effective where they build on a foundation of good quality basic education. This emphasises the value of providing second chances for basic education and investing in literacy for adults. In developing countries that have experienced growth and expanded access to post-primary education, like South Korea, China, and Mozambique, the demand for technical and vocational education has increased. In countries with limited job growth, the demand for skills is weaker. Where access exists to TVET and jobs are being created, the socially disadvantaged are likely to benefit. Conditions favourable for growth and sustaining the expansion of access to skills will be essential to improve welfare through employment (Adams 2011).

DfID programme case study

DfID launched a programme in Mozambique called Skills for Employment (S4E) in 2015. The purpose of the £17 million programme is to achieve higher income among targeted youth, especially young women and girls, acquired through increased access to relevant quality non-state vocational training leading to formal or self-employment.

S4E has three main components and two complementary activities:

  • An Employment Fund will be established to reduce skills failures. It will link specific areas of labour force supply with demand. It will catalyse and broker linkages between employers, especially medium-sized enterprises, and non-state training providers to get young people into work. The programme is intended to benefit young people with the potential to undertake technical training to become the future managers of Mozambique’s growth sectors. A second and perhaps larger group will be young people, who, by completing vocational, second chance or entrepreneurial training, can move into formal employment or self-employment. All beneficiaries will receive training combined with wrap around services to optimise their employment prospects. Attention will be given to women and girls and other socio-economic groups that tend to have limited access to skills training and to viable employment opportunities.
  • A National Association of Non-State Providers will be established to facilitate group interaction with the government and the private sector. An important role of the association will be to improve the quality of training, ensure members adopt common accreditation standards, facilitate experience and information-sharing, provide support services to members like improving the commercialisation of products and services, voice the interests of non-state providers vis-à-vis the government, better respond to labour market demand, and collect data on non-state TVET.
  • Capacity Building for the Government of Mozambique to improve working with, and provide direction to, non-state TVET as complementary to public TVET. Capacity building will also capitalise on opportunities like PPPs stemming from the new TVET law and learn from new TVET financing models and approaches including the commercialisation of products and services. In addition, it will capitalise on innovation and new technology in the skills training sector; and help establish the National Employment Observatory.

Mozambique has high growth rates, but poverty persists. Constraints to doing business in Mozambique include the lack of access to finance, corruption, inadequate supply of infrastructure, inefficient government bureaucracy, and an inadequately educated workforce. There is a noticeable shortage of skills development. The cause of the lack of skills is inadequate completion rates in basic education, inadequate access to TVET and inadequate linkages between curricula and market demands. In Mozambique there has been a rise of private sector interest in skills training to fill the gap in public provision. Most private sector involvement involves partnership with the central or local government. The non-state TVET system is currently fragmented with no mechanisms for collaboration, a lack of accreditation and have limited information available. The expected result from the S4E programme is increased quality, labour-market relevance and financial sustainability of non-state training.

Nepal

Nepal is South Asia’s second poorest country. Unemployment and underemployment among 15 to 29 year olds is 19.2 per cent compared to 2.7 per cent for those older than 15 years old. Women face particular challenges due to a number of factors including age, low educational attainment, and norms around their societal role, marriage and childbirth. Young women have lower labour force participation and higher unemployment rates than men. When women do have jobs they tend to have low-income, low-productivity jobs. Nepal has responded to the youth unemployment problem with a combination of job training and placement services programmes. The Employment Fund Project (EF) was founded in 2008 and competitively contracts training and employment service providers. Training courses are market-driven with providers completing a rapid market assessment during the bidding process. The Adolescent Girls Employment Initiative (AGEI) was launched in 2010 with the objective to reach 4,410 Nepali young women aged 16 to 24 over a three-year period. Research into the AGEI has indicated it had positive impacts on labour market outcomes including employment rates, finding employment and earnings (World Bank 2015). Some useful lessons can be taken away from the evaluation of the AGEI programme. The evidence available suggests that, to be successful, training programmes should be designed around employment outcomes. These can be informed by market assessments. Institutes should be encouraged to not only train, but also help those being trained to find a job. Women and girls stand to benefit more from skills training because they are often starting from a greater state of disadvantage in the labour market. Further research is needed to understand the differing impact of skills training on men and women. Also, specialised outreach strategies may be required to engage with young women and get them involved with skills training programmes. This may take more time and money when compared to the recruitment of other trainees (World Bank 2015).

Bangladesh

DfID programme case study

The Skills and Employment Programme of Bangladesh is a programme funded by DfID between 2013 and 2018. £18 million will be provided to improve skills and employment opportunities for the poor, particularly women, in Bangladesh. This will be done through work with private training providers and large employers to deliver more and better quality training programmes. It is estimated that in Bangladesh, 1.8 million new individuals enter the labour force each year, adding to a backlog of 2.7 million unemployed workers, and an estimated 11 million underemployed workers. 83 per cent of the labour force is either illiterate or has had no formal education. Only 60 per cent of children complete primary and only 5 per cent of the labour force has received training. 1 per cent has received TVET. A shortage of skills is preventing quality employment. Growth in Bangladesh is around 5-6 per cent. If Bangladesh can provide the required skills and education training, opportunities exist to absorb workers into the labour force. However, failure to provide skills and education training will constrain growth.

Informal on-the-job training has been shown to increase wastage and reduce the efficiency and productivity of work processes. The skills gap in the labour force is consistently identified by the private sector as one of the critical binding constraints to Bangladesh’s growth. Despite demand to improve skills in workers, the following market failures result in the inability of the labour market to meet this need:

  1. Weak public skills development systems
  2. Weak training markets
  3. Low incentives for employer firms to invest in formal training and/or in hiring poor people
  4. Training and recruitment mechanisms exclude the poor

 This programme will deliver a total of £56 million in higher income for people trained and placed in jobs. 65,000 poor people (60 per cent of whom will be women) will be linked to semi-skilled or skilled jobs in growth sectors in Bangladesh.

3.5 Quality of evidence

The evidence presented on the relationship between skills and development is based on a medium number of global and context–specific reviews, and are of high quality: Allais (2012) and McGrath (2012) draw on extensive bibliographies and have been peer-reviewed; Merensky-Hartinger (2014) and Adams (2011) are commissioned and published by GIZ and UNESCO. The World Bank (a. 2013) study offers an in-depth analysis of private sector contributions to job creation and poverty reduction. Case studies are context- and project-specific, selected to provide examples of skills development approaches associated with sustainable development theories and objectives. A number of other studies and publications give an insight into the role of the private sector in skills development. While some of these are not defined as evidence under the DfID guidelines, they do offer useful insight into existing programmes and valuable assessment of lessons learned. For these reasons they have been included.

 

Key messages:

  • Private sector companies are likely to have a better understanding of what skills are needed for the workplace. Training provided by the private sector may also allow for smoother transitions into employment. Private firms will seek to recoup the return on investment in training. If they cannot, they will not be willing to finance training in the future.
  • Public training providers must seek to deliver the skills demanded by private enterprises, including management and entrepreneurialism.
  • Governments are encouraged to set policy frameworks that allow for competition and encourage innovation and technological change as well as in correcting market failures.
  • Policy makers need to remove obstacles to firm creation such as poor business climate, and high taxation or excessive start-up costs.
  • Poor data can lead to skill gaps, mismatches and compromises the efficiency of the system. Good data will help to connect the demand and supply sides of the training market. Stronger monitoring and evaluation is needed. Removing constraints to skills development and recommendations on best practice are needed.
  • To be successful, TVET policies must address gender disparities, inequalities and stereotypes that characterise some TVET programmes. Girls and women should on the other hand be given special attention in TVET programmes considering that they are at the lower ranks of skills development, employment and income generation.

4.1 Main failures

Examples of market failures are included throughout this topic guide. Factors such as a lack of jobs growth, the high cost of labour tied to labour legislation, and unrealistic wage expectations may all result in unemployment. Training may not be the most cost-effective intervention in this case. More cost effective interventions may include labour market programmes, such as counselling, job search assistance, remedial education and even direct job creation (Adams 2011). Main market failures are identified as follows: 

  • Lack of information, both on returns to training and on what type of training to undertake and jobs available.
  • Poor market regulation, firms don’t trust qualifications, therefore individuals are unwilling to invest in it.
  • Lack of management capacity to identify training needs for firm/staff.
  • Credit constraints – either to pay for training or because additional, trained staff require additional capital.
  • Large public sector providers with poor incentives to respond to market demands.
  • Unwillingness to invest in staff training as staff turnover is high – externality poaching.
  • Labour market imperfections, use of networks rather than fair and open competition reducing the demand for training.

A good understanding of market failures is necessary to understand the relevance of the skills agenda.

4.2 Private sector investment in training

In the Africa private sector, under-investment in training is common. Demand for jobs is high, and as a result, the formal sector is unlikely to focus on career development and training programmes. Some jobs are protected from competition, so a dynamic skills development programme is less critical. The instability of the informal sector means offering training is unlikely. To overcome these market failings, a shift in the incentives for African firms and multinational companies will be central to develop skills further. The development of partnerships between the private sector and higher learning institutions will be needed to support the curriculum development process. Public providers of education and training must better consider how to deliver those skills which are crucial to all private enterprise, including management and entrepreneurialism (Kingombe 2012).

A key factor in strengthening competitiveness and growth is recognised as workplace related and vocational skills development. Firm-based apprenticeship training schemes have a number of advantages over vocational schools. Certain techniques and customer interactions may be more effectively taught in a work environment than in a classroom. Firms are likely to have a better understanding of what skills are needed for the workplace. Training provided by firms may also allow for smoother transitions into employment. However, firm-based vocational training schemes are not without their challenges. They may not work in all countries. Training provided by firms is hard to verify by a third party. It may be too complex to be specified in a contract in a way that is legally enforceable. Firms may be able to renege on their training promises without punishment. Apprenticeship training schemes are more successful in countries with a strong commitment to training provision. This may be due to the existence of a well-structured regulatory framework and monitoring institution (Dustmann and Schönberg 2012).

4.3 Return on investment

To be competitive, firms must recoup the return on investment in training. If they fail to do so, they will not be willing to finance general training and the training market will break down completely. Evidence suggests that where there is limited commitment to training provision, training intensity is lower than the socially optimal training intensity under commitment to training provision. Training intensities under no commitment are only about 28 per cent of those under commitment to training provision. The inability of firms to commit to training provision results in substantially lower training intensities, which leads to lower enrolment rates into apprenticeship training (Dustmann and Schönberg 2012). The common way to measure the net payoff of TVET investment by both individuals or private businesses and the public sector is the rate of return. The private rate of return (PRR) estimates the future income payoff to resources spent by individuals on various kinds of TVET and the social rate of return (SRR) estimates the future income payoff to the totality of resources (private plus public) spent on these same kinds of TVET. To estimate PRR, the benefit stream must be corrected for all additional taxes paid on the additional income earned by investors in TVET and academic education. To estimate the SRR on the same TVET and academic education, public spending must be added per pupil on each type of TVET and on academic education to the private costs so as to estimate social costs, and use private income streams not corrected for taxes paid on additional income to estimate social benefits attached to each type and level of TVET and to academic education (Kingombe 2012).

4.4 Legal enforcement challenges

Countries that would like to expand firm-based apprenticeship training need to ensure that apprenticeship contracts are legally enforceable and that firms are able to commit to training provision, possibly through stricter regulation of the apprenticeship system, such as the monitoring of training firms, and examination of training achievements by external institutions. Subsidising apprenticeships does not improve commitment and therefore may not be the most efficient way to expand apprenticeship training (Dustmann and Schönberg 2012). Using Ethiopia as an example, Altenburg (2010) cites the private sector as the main driver of structural change from low-productivity activities in agriculture, petty trade and skill-extensive services to new knowledge-intensive activities. Governments need to set policy frameworks that allow for competition and encourage innovation and technological change as well as in correcting market failures. New activities that do not emerge spontaneously must be encouraged where necessary. Ethiopia’s government supports private sector development as it is recognised as an engine of economic growth and productivity.

4.5 Market competition for different skills

Imperfections in labour markets can reduce incentives to invest in skills, both among employers and employees. Without perfect market competition for different skills, employers might invest less in training their workers who can be poached by others. Workers may not invest in their own training if employers have market power and are able to keep wages down. If employers do not create high-productivity jobs because there are no skilled workers, and workers do not invest in skills because there are no jobs, there may be coordination failures.

Standard problems with credit markets can also affect the supply of skills. The lack of information available on skills can bias decisions about investing in skills. To overcome these problems, it is important to correctly identify and address the market failures. This may involve increasing the bargaining power of workers, reducing barriers to entry in product markets, facilitating the diffusion of new technologies that will create demands for skilled labour, designing contracts that reduce the likelihood of poaching, opening credit lines for specific types of training, and providing information about labour market conditions and the quality of various training providers (Almeida et al. 2012).

Subsidies may be required to address coordination failures or improve incentives to invest in training. They should be targeted to individuals and firms that could benefit from training, but would not invest in it. Subsidies should be explicit and preferably financed out of general revenues instead of payroll taxes, which increase labour costs and eventually decrease the demand for labour. Where needed, special training programmes could be developed to meet the needs of vulnerable groups without access to formal programmes. This may be due to their existing low skill levels or because they work in the informal sector where access to training funds is more difficult. These programmes could develop decision making skills and communications, as well as job-specific skills. Ideally, individuals would be linked to internships or programmes that support transitions into self-employment, resulting in a positive impact on labour markets (Almeida et al. 2012).

4.6 Individual investment in professional development

Individuals may not invest in their own professional development as return on their investment in skills training may not be immediately clear. Governments may have a role to play in setting policy frameworks that encourage innovation and correct market failures. In some cases, individuals may not spontaneously seek professional development because interrelated investments are needed to be made simultaneously to exceed the possibilities of individual entrepreneurs.

Return on investment may not be immediate for individuals. If the workers are wage employed, there is no guarantee that employers will reward higher competence with higher wages. Even if employers accept that the training has productivity benefits, it may be in their interest to try to capture as much of this benefit as possible without paying for it. Governments may need to intervene to accelerate structural change and develop industrial linkages and spill overs between training schemes. Governments can set policies to encourage individual investment in skills, but the main driver of structural change remains the private sector (Altenburg 2010).

Individuals may not invest in their own professional development for many reasons, including a lack of information, limited cognitive capacity to process complex problems and psychological factors that act as a barrier to committing to training. Inaccurate information on returns to training may lead to under or overinvestment. A lack of reliable information on the quality of training may put people off. Also, there may be misunderstandings regarding employment prospects once trained. Some individuals may lack non-cognitive skills, such as discipline and perseverance, which may be necessary skills required to complete a training course. Governments can overcome some of these issues by improving information about post training employment prospects, certifying training providers, defining qualification frameworks, providing counselling and offering incentives to individuals to invest in their own professional development (Almeida et al. 2012).

4.7 Youth unemployment

Vocational education and training does not guarantee a solution to youth unemployment. Youth unemployment is often assumed to be due to a lack of relevant skills, making training a preferred option for public intervention. A host of other factors, including a lack of jobs growth, the high cost of labour tied to labour legislation, and unrealistic wage expectations may cause unemployment. Training may not be the most cost-effective intervention in this case. More cost effective interventions may include labour market programmes, such as counselling, job search assistance, remedial education and even direct job creation (Adams 2011).

4.8 Entrepreneurship

The international community or country government can encourage entrepreneurship, which fosters growth, job creation, technology adoption, innovation and poverty alleviation, all of which drives economic development. There is substantial differences across countries in the type of entrepreneurial activities undertaken. In transition economies of Central and Eastern Europe that have dynamic private sectors, the importance of productive (opportunity) entrepreneurship for growth, job creation, competition and innovation is clear (Brixiova 2010).

Analysis of entrepreneurship training for women has shown to have mixed results. There are many benefits to developing female entrepreneurship leading to earning, including changes in the household allocation of resources that improve family well-being, especially of children. Female entrepreneurship can provide employment opportunities to women allowing them to balance both work and family roles. In Pakistan and Tanzania, management training improved management practices and business outcomes for male but not female entrepreneurs. These findings may reflect wider constraints facing women in societies, including access to effective learning in schools (World Bank b. 2013).[3]

In Africa’s least developed countries (LDCs), there is a lack of productive (opportunity) entrepreneurship. In many African countries a substantial productivity lag exists between small, often indigenous, firms and larger firms, which are frequently foreign-owned or owned by ethnic minorities. It has been argued that improving infrastructure and basic social indicators should be the priority, putting the emphasis on the role of the state in development. In the 1980s and 1990s the role of the private sector predominated with market-led development. Persistent weaknesses and market failures have characterised Africa’s LDCs. Leaving the development of a productive private sector to markets alone may not work as successful entrepreneurship is often associated with mere survival rather than involvement in highly productive activities. Entering new activities involves substantial fixed costs and risks which may not be undertaken by the private sector without extra incentives and support from the state. Well-targeted government interventions can ease constraints to productive entrepreneurship and facilitate private sector take-off. Identifying the factors that impede firm creation in Africa’s LDCs will be essential. The evidence points to the lack of skills as an important additional constraint to starting new firms (Brixiova 2010).

An absence of entrepreneurship hampers productivity, creation of skilled jobs, innovation, and poverty reduction. Some of the main constraints faced by entrepreneurs in Africa’s LDCs, include their own skill shortages and those of potential workers. African labour markets typically have an abundance of the necessity for and the scarcity of the opportunity of entrepreneurship. Government interventions may help stimulate private sector take-off, but due to the scarcity of budgetary resources and the numerous constraints, policy actions need to be well-targeted and address the most pressing ones to be effective. To overcome the scarcity of skilled job openings, policy makers need to remove obstacles to firm creation such as poor business climate, and high taxation or excessive start-up costs. Where a scarcity of skilled workers is the problem, training policies may be most effective. Policy selectivity and sequencing can assist with dealing with an evolving dynamic economy. Active labour market policies, including information exchange between available jobs and searching workers, has the potential to be important. Better information contributes to the efficiency of the matching process between skilled openings and workers. Search time would decrease. The quality of job matches and job duration would also improve (Brixiova 2010).

4.9 Transitional failures

Evidence suggests that the lack of means, skills and knowledge make the transition from school to work particularly difficult for young Africans. Many also find it hard to transition between sectors of employment (between farming and a wage job, for example). Translating what they gained from education into productive employment is a challenge. In many cases there is no structured path to follow. In some situations, young people may have been working while also attending school for a long time. Others move into apprenticeships after they finish school, but others do not. Some young people do odd jobs and are supported by their families for as long as five years before they settle into wage jobs or (mostly) self-employment. First-generation school leavers aspiring to be wage workers lack a family history in formal employment. The knock on effect of this is that they may lack the networks to help them to find jobs (Filmer and Fox 2014).

4.10 Systems reform

The evidence on reform of labour market laws is mixed. Theoretical arguments surrounding the impact of Employment Protection Legislation (EPL) on labour market outcomes are generally ambiguous. Some evidence suggests that EPL can reduce turnover and change the composition of employment. There is a positive association between EPL and self-employment. There is some evidence to suggest a negative relationship between EPL and employment. More research is needed to produce better data on the impact of EPL on labour markets (Sanchez Puerta 2010).

As the numbers of young people who are completing basic and secondary education increase, there will be increased pressure on higher education to become more accessible. The knowledge economy demands broadening access to higher education and improving its quality. In countries with limited resources, the challenge will be increasing both the coverage and the quality of education at a lower cost. Information technology has opened up new horizons education and enabled expansion. The Internet has facilitated access to education. Distance education offers a variety of choices in terms of content, schedule, pace, and duration of education, as well as recruitment criteria. It also reduces the cost of education at a time when public funding for higher education was being cut (Depover and Orivel 2013).

4.11 The importance of data on training provision

There is a need to collect data and evaluate the efficiency of existing education programmes to guide educational policy and decision-making. To make sensible policy choices assessment of the present situation is needed, specifying the goals to be reached, the means to attain them, and monitoring what has been accomplished so far. Planning is needed to organise learning: by mapping, targeting, acting and correcting (Depover and Orivel 2013). In particular, sex-disaggregated data is very important in TVET as without disaggregation, discrepancies and discrimination will remain hidden. In order to achieve better outcomes from TVET systems, better planning is needed. If real-time management information systems are lacking, it may be hard to assess the operations of each institution and department. Many of the operational difficulties of the heads of the institutions, faculty and students go unreported. Those which reach the decision-making authorities, have little backing of data and facts. More robust data are needed to improve decisions on TVET systems that must be taken (World Bank c. 2013).

TVET systems must be evaluated. Evaluation mechanisms must be designed to include data collection, benchmarking, and determine the frequency and scope of the evaluation. The design of evaluations needs to incorporate existing reporting mechanisms to reduce the workload of reporting, so that the evidence of the findings can be discussed and given due consideration. Data collected must be analysed so the findings lead to further action or improvement. Consideration of the findings against the goals of the TVET system can identify coherence or divergence from the intended goals (World Bank c. 2013). Robust TVET systems require information for evaluation. A lack of reliable data can lead to skill gaps, mismatches and compromises the efficiency of the system. Information is needed to connect the demand and supply sides of the training market. Feedback mechanisms provide the required data needed to take corrective measures. Cost-benefit analyses, for example, may allow policymakers to weed out unsuccessful programmes and use scarce fiscal resources for those activities that have net benefits (World Bank c. 2013). Stronger monitoring and evaluation is needed to identify constraints to skills development and market failures. In particular, evidence on best practice would be useful to inform donor actions.

4.12 Skills training and gender issues

To be successful, TVET policies must address gender disparities, inequalities and stereotypes that characterise some TVET programmes. Girls and women should, on the other hand, be given special attention in TVET programmes considering that they are at the lower ranks of skills development, employment and income generation (Rubagiza 2010). However, it is important to recognise that there may be gender barriers to accessing TVET programmes, as well as gender barriers to accessing decent employment. Gender discrimination may prevent women from obtaining the training necessary for finding better payed jobs (Kingombe 2012). Gender discrimination may be manifested in various ways. For example, stereotypes about the types of job that are deemed suitable for men and women may channel boys and girls into different training programmes and reinforce enrolment patterns. This may restrict girls from accessing certain training programmes, which may result in them being less likely to enter certain career pathways. Interventions, such as targeted scholarships, financial support or modification of selection criteria, may help to address these challenges. Also, having female instructors or trainers may increase the number of females enrolling in programmes that have in the past been male dominated (Almeida et al. 2012). To ensure that gender issues are addressed, the Government of the Republic of Zambia explicitly included equity (specifically with regards to gender, disability and vulnerability) as an objective in their strategy for delivering skills training. This approach is in line with the framework adopted at the 2000 World Conference Forum, Dakar, Senegal, which also included eliminating gender disparities in education as a goal (Kingombe 2012).

Young women may be particularly disadvantaged by dimensions of the transition from school to work, such as family formation, compared with young men. Social norms may enforce job segregation by gender. For instance, young women in the household enterprise sector work mostly in narrowly defined fields such as dressmaking, even though a range of other occupations could be more lucrative (Filmer and Fox 2014). A study which analysed data from Ghana, Pakistan and India found that traditional gender roles limit female participation in the skills systems of all three countries. Ghanaian women were found to be particularly disadvantaged from accessing TVET due to high levels of teenage pregnancies and/or early marriage. In India, the proportion of women with skills training was a third of that of men. In Pakistan women who want to learn skills are expected to do so in two broad trade areas – dressmaking and crafts (Palmer et al. 2012).

Gender bias may be compounded by a lack of secure accommodation and training facilities being a long distance from home. To overcome these challenges, it is suggested that the government offers financial incentives to encourage girls to study in as it is. Such incentives would help to offset some of the trainee’s direct and indirect costs (World Bank c. 2013). There is some evidence that in countries such as India, where a gender bias may restrict women from accessing education and training, the provision of distance education will enable women to overcome these barriers (Depover and Orivel 2013). Another example of an initiative designed to overcome gender bias is the Adolescent Girls Initiative (AGI), a programme that works across eight countries. The beneficiaries are young girls between 16 and 24 years of age. The goal of the initiative is to assist girls to make the successful transition to the labour market. There are different challenges in each country, so the AGI was designed to suit the context of each individual country, built around common elements including subsidies for short-term technical training in demand-driven trades, life-skills training to address age and gender issues, and capacity building of training providers. The AGI implements a strong outreach and communication strategy to reach out to the disadvantaged groups, including girls (World Bank c. 2013).

Public TVET systems and providers may address gender issues at the level of access but if gender issues at the employment level are not addressed, barriers will remain. There is a danger that young women may be trained for jobs that are not accessible to them due to failings of the labour market. Smaller employers, in particular, may not be very progressive and interventions may be required to create change. Tomaševski (2001) argues that by focussing on the gender dimensions of education we learn how much change is needed to transform education into rights-based education. The opportunities that girls have after schooling influence the attractiveness of accessing education for the girls and for their parents. These prospects are determined by the ability of girls and women to exercise all their human rights – from equal political participation and representation, to equal access to bank loans. Arbache et al. (2010) offer an analysis of gender disparities in Africa’s labour market. They argue that the gap is not simply the result of discrimination in the labour markets, but the result of various factors, including access to education and credit, cultural values and household duties, and, above all, labour market conditions.

4.13 Country examples

Zambia

Through its Ministry of Science and Technical Vocational Training (MSTVT), the Government of the Republic of Zambia instituted the Technical Education, Vocational and Entrepreneurship Training (TEVET) Reforms in 1994. The reforms led to the formulation of a number of TVET strategies and policies. The Technical Education, Vocational and Entrepreneurship Training Authority (TEVETA) was created to regulate all forms of TVET. All training providers are required by law to register with TEVETA. In Zambia, the broad development objectives of the national TEVET Development Programme includes the establishment of a training system that was responsive to the demands, improvement in the quality of training, assurance of equity (gender, disability and vulnerability) in the delivery of training and the development of mechanisms for assurance of financial sustainability of the training system (Kingombe 2012).

DfID programme case study

The Skills Improvement Programme (SKIP) is a DfID funded programme in Zambia that was started in 2014 and will end in 2020. The aim of the programme is to achieve higher incomes for TEVET graduates in Zambia by providing greater numbers of women and men with skills beneficial to gainful employment. This will mean that  national TEVET systems are strengthened and more graduates will have relevant, quality technical/vocational skills, with more equitable access to skills development for disadvantaged groups.

Ethiopia

Ethiopia achieved an increase of 5,565 per cent in TVET enrolment from 1999 to 2007. The significant increase in TVET enrolment has been managed by a combination of government funding, intensive short-term teacher training and building of TVET centres. However, the rationale was still that of a supply-driven system. Future TVET reform requires a paradigm shift towards a demand- and outcome driven system. This applies to the management of the TVET system, the institutions involved, as well as the training itself. Performance, rather than input or supply, is the deciding factor for success (Kingombe 2012). The Ethiopian government has prioritised the creation of the preconditions for a market-based and socially inclusive industrial transformation. To gain competitive advantage and move away from feudalism, Ethiopia has targeted the rural poor with investments in technological learning. However, the Ethiopian industrial policy process is not entirely transparent. It is not clear when firms are eligible to receive preferential treatment in term of access to licenses, land, credit and foreign exchange, on what condition ailing firms will be bailed out, and whether these conditions vary between state-owned, endowment-owned, and independent private firms. Also, it is not always clear to what extent political considerations reflect the business strategies, and vice versa. Checks and balances need to be built into any political system, making policy decisions transparent and holding policymakers accountable. Industrial policy should move away from predefining sectors and move towards a system based on open-ended entrepreneurial searching that responds to windows of opportunity. Private entrepreneurs are usually much better equipped to recognise trends and take advantage of new opportunities than government agencies. Governments can help to create a learning environment that is without bias and that engenders entrepreneurs who observe market trends and are ready to take risks, and to support their business projects (Altenburg 2010).

Local entrepreneurs should be encouraged to develop markets. Entry barriers in the domestic market should be low compared to export markets. The government has a role to play in improving framework conditions and nurturing local entrepreneurship with a focus on market expanding innovations. Good policy coordination and clearly defined responsibilities will be needed to succeed. In Ethiopia, the Ministry of Capacity Building was established, but there may be overlap with other ministries. Better defined powers and responsibilities will be needed. More space needs to be created for private service providers to compete with existing public suppliers. Policymakers can then reward those who perform better (Altenburg 2010).

Singapore and Pakistan

Singapore’s Institute for Technical Education (ITE) and Pakistan’s Sindh Technical and Vocational Training Authority are two examples of apex training authorities. They both have clearly defined oversight functions and the capacity to encourage participation of non-state providers while improving the service delivery capacity of public training providers. Competition is fostered in the training market. Communication is strong between training institutions and stakeholders to optimise TVET provision. In certain circumstances, the government may have a role in addressing coordination externalities that affect the development of strategic sectors. Successful examples include the experiences of the Republic of Korea, Taiwan, China, and Singapore. These countries have incorporated demand-driven TVET into their national industrialisation strategies. Known collectively as the Asian tigers, they pursued strategic government-led coordination to encourage a more effective alignment of skills demand and supply as well as sustainable investments in higher-level skills. Institutional mechanisms coordinated economic and training policy, effectively linking industrialisation strategy and TVET programmes. An example of a successful coordinating mechanism is Singapore’s Economic Development Board (EDB), which has coordinated successful skills development schemes during the agency’s first three decades (1961–91) (Almeida et al. 2012).

Niger

In 1998, the Government of Niger started reforms of the TVET sector. The National Office of Vocational Training (ONAFOP) was opened, which offers opportunities to finance training for and by the informal sector and build capacity in the TVET sector. TVET is a priority in Niger because it is considered by the government to constitute an effective means to insert and maintain the youth in the labour market. TVET policy enables synergy between the training systems and employment, delivering to the evolving needs of the labour market. This is built on the relationship between the government and all the partners working in TVET. Despite these reforms, the enrolment of women in TVET in Niger fell from 40 per cent to 17 per cent between in 1999 and 2007. During the same period the percentage of secondary students enrolled in TVET programmes declined from 6 to 1 per cent (Kingombe 2012). Further research is required to explain this drop in enrolment, and in particular the fall in women enrolling in TVET.

India

In India, West Bengal is the fourth populous state. It currently has a youth bulge in its population due to demographic transition. The labour market is dominated by the informal sector, which accounts for more than 90 per cent of all employment. Less than 1 per cent of youth have any formal vocational training. Training delivery is weak and under resourced. There are a lack of performance incentives. Research indicates that female youth workers receive more training than male youth workers. However, nearly all vocational training for employed workers and self-employed workers is of the non-formal kind. The exception is the employed urban female youth, whether employed or self-employed, who have more formal vocational training compared to any other disaggregated category (World Bank c. 2013).

Vocational training in India has varying entry requirements and course durations. The Craftsmen Training Scheme[1] and the National Apprenticeship Scheme of the Ministry of Labour and Employment (MOLE) at the national level, and delivered through industrial training institutes (ITIs), is the most recognised vocational training programme in India. In West Bengal, there is a clear social demand for industrial training institute (ITI) places, with seven applicants for every space. In this area, girls tend to enrol in non-engineering trades whereas most ITIs offer engineering trades, traditionally filled by males. This reduces job-related motivation for girls to join ITIs. Lack of secure hostel facilities and distance from home further compound the gender bias. Financial incentives offered by the government may encourage girls to study. There are also gender constraints to skills development in the informal sector, with long distances from home to the training providers reducing parents’ motivation in sending their children, especially girls. Also there is a suggestion in the literature that some households prefer to use scarce resources on developing the skills of male children (World Bank c., 2013). Distance education may overcome some of the constraints and enable women to earn a degree, regardless of gender, caste, or social class (Depover and Orivel 2013).

The TVET system is financed in an ad-hoc way and is dominated by the public sector. There is little monitoring and evaluation, and no quality assurance either internally within the system, or externally from the industry and end-users, namely employers. The demographics are putting pressure on the system to expand, but without up-front reforms to improve quality, governance and accountability, any expansion of the system will be costly and wasteful. Any TVET strategy needs to address quality and cost-effectiveness before expansion. Strategies should also consider how private provision, public private partnerships and various forms of demand side financing and cost-sharing can both generate resources for skills development and make the system more competitive, efficient and integrated. Resource allocation mechanisms must take performance into account to avoid reproducing current inefficiencies. An enabling policy framework must be developed by the government to encourage coordination among various departments providing skills training with sound quality assurance, monitoring and evaluation mechanisms, and promote private sector participation in provisioning and enhancing quality (World Bank c. 2013).

Rwanda

In the past, TVET in Rwanda had a low status. TVET was delivered by public schools under the charge of the Ministry of Education, private schools and those belonging to faith-based organisations. In 2007, all the 55 public and private schools offering industrial and technical courses had an enrolment of 11,815 students, of which girls accounted for 22.5 per cent in 16 disciplines. Professional and technical education was offered in 146 schools, 100 schools providing accountancy and/or office management were teaching 13,424 students, while 25 agriculture and/or veterinary schools were teaching 2,835 students. Total TVET enrolment was skewed by large numbers in the fields of accountancy and secretarial/administration (which represents 54 per cent of the whole TVET enrolment), and as many as 68 per cent of all female students are enrolled in these two business options. With regard to initial vocational training  offered to primary school leavers, there were 54 schools, 32 of these being private. Enrolment in all the 20 optional/trades in initial vocational training was around 7,366, of which females accounted for 45 per cent (Rubagiza 2010). The Workforce Development Authority (WDA) is charged with overseeing TVET in Rwanda. WDA  envisages a new multiple entry/exist system that is integrated with the rest of the education system. A TVET policy published in 2008 highlights the importance of TVET programmes and the need to improve the quality and relevance of TVET. The policy makes clear that Rwanda suffers from serious deficiencies of trained human capital especially in the technical professions. Other problems include the mismatch between the kind of training provided and the labour market requirements, especially the lack of graduates with practical hands-on competencies, lack of enough funding for the sub-sector, shortage of qualified teachers and the stigmatisation of TVET programmes. The policy aims to provide the economy with qualified and competitive workers and to train citizens able to participate in sustainable growth and poverty reduction by ensuring training opportunities to all social groups without discrimination. It hopes to create equitable access to TVET for men and women. Equality and equity are included as policy principles, as promoting equality and equity implies prevention against all forms of discrimination and adoption of affirmative actions to eliminate all kinds of disparity. Gender equality is central to these efforts. Sensitising and encouraging girls to join TVET, especially to enrol in ‘modern’ fields such as ICT, is highlighted under the cross-cutting issues (Rubagiza 2010).

4.14 Quality of evidence

The evidence presented on market failures and skills strategies in relation to skills development is drawn from a medium number of both global and context–specific documents. These include discussion papers, commissioned reports from international bodies (World Bank; UNESCO) and peer-reviewed papers. All are of high quality, presenting substantial bibliographies and discussions of methodologies applied during research. The selected documents ensure representation of evidence from industrialised, middle-income and low-income contexts, and country case studies are regionally drawn from across SSA, South Asia and South-East Asia. Palmer et al. (2012) provide high quality analysis of three case studies (Ghana, India and Pakistan) in terms of skills, lives and livelihoods. Rubagiza (2010) offers a medium quality paper focusing on gender and TVET in the context of Rwanda. Arbache et al. (2010) deliver an assessment of gender disparities in Africa’s labour market, published by the World Bank. Although the paper by Tomaševski (2001) was published over a decade ago, the theoretical arguments regarding access to education and gender are of high quality and remain pertinent.

 

[3] This points to the fact that encouraging entrepreneurship for women will mean looking at other factors such as attitudes (men are supposed be in business. It’s not good for women to deal with the public), mobility (safe transport to get to markets to buy inputs, do market research, make sales), financing (some banks only lend to men or women with a male guarantor. They require collateral such as land, what women rarely hold titles to). Skills are so closely related to jobs and therefore also the wider environment of workplace policies, safety and security, transport and bank lending policies. Investment in women’s skills development has, no doubt, positive effects. South Korea for example, made skills development for women a pillar (1 out 3 pillars) of their economic growth strategy and it has worked. But for the investment to be really productive, it has to be supported by a range of wider gender equality promoting reforms, attitudinal, institutional and infrastructural. Frida Khan, gender reviewer.

[4] This is an example of a gender stereotype present in the TVET terminology. Frida Khan, gender reviewer.

Key messages: 

  • Most countries in the world are striving to improve skills levels and training systems. This is being done through various policies including improving qualification frameworks, reforming education systems, reforming public providers and providing private providers a level playing field.
  • Skills training must respond to what is Local people already involved in successful businesses or service provision can become effective trainers, passing on their skills to others.
  • Relationships must be established between education and training systems and labour markets to ensure synergy.
  • Training in enterprises needs to be supported more. National TVET systems may be able to effectively support micro and informal enterprises. More research is needed in this area.
  • People with disabilities should have access to the skills and training they require. Lifelong learning can assist impoverished people with disabilities to escape from poverty and dependence.
  • Efforts are needed to improve access to quality basic education, which provides the foundation skills needed to go on to acquire more specialised skills.

5.1 Strategic priorities for the present

Evidence shows that TVET interventions have promise and are worthy of investment to assist youth in developing countries. A systematic review found that TVET interventions increase the number of hours worked in paid employment by young women but not young men. Statistically, the effects of TVET are shown to be small. However, a small increase in the rate of paid employment may translate into large numbers of young people entering the labour market, where programmes are delivered nationally. It is recommended that the cheapest and/or most culturally acceptable models are implemented until further data is provided on which approach is best. Future programmes must be evaluated rigorously. Different stakeholders must consider how to improve programmes to create larger effects on the outcomes (Tripney et al. 2013).

5.2 Strategic priorities for the future

Improving skills levels, reforming education and training systems, and improving qualification frameworks are among the policy priorities of most countries around the world. Countries in the Southern African Development Community (SADC) region have demonstrated an understanding of how the TVET system should and can operate, reflecting both international trends and the technical advice they have received from development partners, particularly the multilateral agencies. McGrath et al. (2013) describe the key elements of model TVET reform to include:

  • A qualifications framework
  • Quality assurance
  • Policy coherence concerns
  • National governance reform
  • Employer involvement
  • Public provider governance reform
  • A role for private sector providers

Additional elements include:

  • Decentralisation
  • New funding arrangements
  • New learning technologies

5.3 TVET reform

In many countries in the global South, TVET reform is an aspiration for the future, rather than a current reality. However, many vocational education systems would benefit from such reform in developing countries. Reforming public providers and providing private providers a level playing field are at the centre of most TVET reforms. Less focus is placed on training in enterprises, which could be supported more. Evidence on enterprise-based training is limited, particularly in the informal economy. The SADC region lacks established traditional apprenticeship systems. The evidence is particularly lacking on how national TVET systems can effectively support micro and informal enterprises (McGrath et al. 2013).

Under systemic reform employers are given more power to shape policy directions, often through qualifications frameworks, quality assurance systems, outcomes-based and ‘institutionally neutral’ funding (such as voucher type systems), and managed autonomy for public providers. These approaches collectively form the global TVET toolkit. The aim is to improve the social and economic status of the poor by increasing their employability. However, this consensus has conceptual and political limitations. Using implementation in South Africa as an example, Allais (2012) describes three problems with this approach. First, policy choices remain entrenched by a narrow definition of ‘skills development’, viewing skills only as tasks, which is as a logical consequence of the notion of employer-specified competencies in an unregulated labour market. Second, an extremely complex qualifications and quality assurance system has been introduced for a small and weak provision system. Third, as skills are separated from power, social policy, the structuring of labour markets, and the organisation of occupations and jobs, they are presented as a substitute for even very modest redistribution of wealth (Allais 2012).[5]

5.4 Linking skills training to local demand

Offering training in skills that are not required is a frustrating waste of resources. The skills that are required in a community can be identified through market surveys and analysis of the local context. Local people already involved in successful businesses or service provision can in many cases become trainers, passing on their skills to others. Such people can also provide essential information on what skills are demanded (Ransom 2010).

In Ethiopia, participation in general education is increasing. Considering the number of graduates who will be entering the labour market in the next few years, the Government of Ethiopia aims to provide them with options for further education and training in order to increase their employability. A demand driven, flexible, integrated and high quality TVET system is what they are working towards. To achieve this, all stakeholders have been involved in the planning, policy making, training delivery and monitoring and evaluation of the TVET system. An aspect of this reform includes increased engagement with the private sector. However, the promotion of demand-driven TVET alone will not be sufficient to ensure quality and relevant skills training. Work must also be done to improve the qualifications and dedication of teachers through complementary policies (Kingombe 2012).

The Punjab Economic Opportunities Program (PEOP) is being implemented by the Government of Punjab with support from DfID. PEOP aims to alleviate poverty and create inclusive growth in the poorest areas by increasing the employability and earnings of poor and vulnerable families. As part of the programme, a baseline study was undertaken to inform programme design. The study found that educational attainment in the region is low and that existing job-specific skills are heavily skewed in favour of specific sectors for rural males and for females. A massive deficit was reported in core skills including numeracy and literacy. The baseline study found over 92 per cent of households nominated at least one male and female member for training, suggesting significant demand for skills from the participants. The study findings imply that training for men will need to be designed to cater to those already working. For women, the programmes must cater for those who are currently unemployed. The study identified several patterns in the labour market and opportunities for skills training (Cheema et al. date unknown).

The Punjab Skills Development Fund (PSDF) commissions vocational training by engaging training service providers (TSPs) through a competitive bidding process. Skills for Jobs 2012 (SFJ 2012) was designed to expand publicly-subsided and accredited training provision. It was implemented between September 2012 and December 2013 and trained 18,500 individuals. A tracer study involved interviewing former trainees. The results show that SFJ 2012 successfully reduced the unemployment rate from 90 per cent to 71.7 per cent and resulted in a 195 per cent increase in employment. SFJ 2012 also succeeded in reaching out to females who had not attended trainings previously. The training also successfully increased monthly income by 22.9 per cent. The authors conclude that it is imperative to complement training schemes with assistance in job search and self-employment endeavours to further improve labour market outcomes. Appropriate systems and processes must be in place to develop links between trainees and employers. Access to microfinance will benefit trainees who want to be self-employed. The results of the study underscore the need to improve the labour force participation rate and support the case for lowering educational entry requirements for vocational courses (PSDF 2015).

In general, the public sector has been slow to respond to demand for skills. The private sector has been shown to be more responsive and able to adjust faster to changing needs. Private skills providers need to play a larger role in delivery of demand led training to those in the informal sector. The delivery of short modular courses may be well suited to those who cannot afford long spells away from their work. In the context of demand-driven skills systems, many countries, including Botswana, Egypt, Ethiopia, Mauritius, Namibia, South Africa and Tunisia are working to establish new TVET national qualifications frameworks (NQFs). Along with occupational standards for sectors experiencing employment growth and skill shortages, NQFs seek to establish recognition for all education and training achievements within the broad perspective of lifelong learning (Kingombe 2012).

5.5 National qualifications frameworks

To improve skills capacity, relationships need to be developed between education and training systems on the one hand, and labour markets on the other. Qualifications frameworks are a useful policy tool to achieve these and other goals. NQFs are being implemented by national governments and encouraged by international organisations and bilateral agencies, despite the limited evidence of their impacts, strengths, and weaknesses. Key lessons and strategic priorities are not well documented in the literature. There has been little evidence that NQFs are achieving their goals. This is possibly due to the time lag between intervention and results, although it is more likely that NQFs have failed to deliver on skills development. In the case of the oldest low-/middle-income country – case, South Africa, it is very clear that the NQF has not achieved a skills revolution in 20 years. There is some specific evidence of qualifications frameworks failing to achieve their goals. Considerable evidence of difficulties associated with implementing qualifications frameworks is also available. Limited evidence exists to suggest that NQFs have substantially improved communication between education and training systems and labour markets. In the context of developing qualifications frameworks in several countries, most report a mismatch between educational provision and labour market needs as a major problem. A key aim of many of the qualifications frameworks is to improve employers’ understandings of what qualifications mean. NQFs ensure that employers are involved in qualifications design, thus ensuring that qualifications are of the right standard (Allais 2010).

5.6 Capacity development for education for all (CapEFA)

The CapEFA programme currently operates in 28 countries and oversees five regional initiatives. It works with national governments, technical partners, civil society and private sector actors, and employing an explicit capacity development approach. An assessment is made of the existing education sector strengths to identify the country’s ‘capacity baseline’. Support is given to country leadership in the design, implementation and monitoring of strategies for reinforcing key EFA task areas. For skills, CapEFA supports reviews of current legislation and policy. Institutional frameworks for TVET are revised in light of relevance issues and widening skills, income generation and entrepreneurship opportunities for marginalised population groups, particularly girls and women. These reviews are based on a critical understanding of each countries’ socio-economic development model, labour markets, TVET traditions, skills, strengths and the articulation of TVET with other parts of the education system (Faccini and Salzano 2011).

5.7 Women’s labour force participation

There is evidence that some developing countries have experienced increases in women’s labour force participation in a relatively short period of time. In Latin America, since the 1980s, more than 70 million women have entered the labour force. This has raised the women’s labour participation rate from 36 per cent to 43 per cent. In Colombia, the rate increased from 47 per cent in 1984 to 65 per cent in 2006. The growth has been much lower in the Middle East and North Africa, where women’s labour force participation grew by 0.17 per cent per year over the last three decades. The rapid transformation has been attributed to increases in labour force participation among married or cohabiting women with children, rather than to demographics, education or business cycles. Changes in social attitudes may have contributed to the transformation. Evidence suggests that public policies have an important role to play. A combination of targeted investments and interventions in social and physical infrastructure may boost women’s labour force participation and earnings. Policies can address the availability of services (such as lack of electricity or daycare facilities), make it easier for women to accumulate productive assets and can remove norms or regulations that imply biased or even discriminatory practices, preventing women from having equal employment opportunities. Public provision or subsidisation of child care can reduce the costs women incur at home when they engage in market work. Improvements in infrastructure services have been shown to free up women’s time spent on domestic and care work. Correcting biases in service delivery institutions, such as the workings of government land distribution and registration schemes, allows women to own and inherit assets. Active labour market policies, the promotion of networks and the removal of discriminatory regulations can make work more rewarding for women (World Bank b. 2013).

5.8 Skills development for people with disabilities

Equality of opportunity in training and work for people with disabilities should be a basic principle. Lifelong learning can provide people with disabilities in developing countries the skills they need to escape from poverty and dependence. To access relevant training, efforts are needed to extend access to quality basic education. This will provide the foundation skills needed to go on to acquire more specialised skills. Access to mainstream education is essential. Ordinary secondary schools may offer vocational education courses, assessments, career guidance and counselling. Such services may be vital for people with disabilities to make the transition from school to work (Ransom 2010).

5.9 Emerging good practice

Stronger links between the public and private sector will be developed through improving the relevance of the skills that individuals acquire. Failures in current institutional arrangements must be addressed to improve accountability. Skills training should respond to market mechanisms, with training centres having more independence in the management of curricula, the selection of students, and human resource policies. However, relying on market mechanisms might not be enough. More information should be provided to potential students about career prospects and the quality of different providers. Training centres need to be certified to do this. Training authorities require strong partnerships with employers and other stakeholders to be successful. They also need decision-making powers and have the authority to oversee (without direct involvement in) the operations of individual TVET institutions (Almeida et al. 2012).

In Africa’s least developed countries, successful entrepreneurship results from a need to survive, rather than a need to be involved in highly productive activities. Commencing new activities may not be possible without incentives and support from the state, due to the substantial fixed costs and risks involved. Well-targeted government interventions can ease the most binding constraints to productive entrepreneurship and facilitate private sector take-off (Brixiova 2010).

5.10 Impact of training and skill-building programmes

Evidence shows that the impacts of specific training and skill-building programmes have been mixed. A combination of classroom education and on-the-job training has proven to work best in the long term, especially for women and low-income youth. More evidence is needed on the impact of training programmes on quality of jobs. There is some evidence from Germany and Switzerland that unemployment may be reduced, especially among young people, by implementing a dual vocational training system. Country context and market needs must be considered when developing a dual vocational training system for a low-income country (World Bank a. 2013).

The dual system is grounded in Germanic historical socio-politico-economic evolution and is yet to be proved useful for other countries except as an ideal type. A comprehensive approach is needed whereby all stakeholders are included in the process. Funding for training must be made available and assistance with transition into the workforce provided. Efforts must be made to change the image of vocational programmes in some countries. Accreditation of programmes would make it easier for employers to recognise the training that has been completed. Employer associations could also be involved in administering final exams. Programmes that make it possible for graduates of vocational training programmes to move easily into higher education if they wish to do so are encouraged (World Bank a. 2013).

5.11 Informal workers

As many as 87 per cent of the global youth population work in the informal sector, many in vulnerable employment conditions. Informal workers are encouraged to complete training to become more productive and move to the formal economy. Apprenticeship programmes could benefit these workers by giving them access to training and to new technology. Working with the private sector to develop these programmes would also link them to market needs and reduce reliance on public sector financing (World Bank a. 2013). However, the evidence raises questions about the scope to expand apprenticeship schemes. As such schemes depend on employers, they are very limited by economic opportunities and by the state of the institutional training regime. This links back to the dual system point above. The division of wage work, farming, and self-employment differ greatly by gender and across countries. Non-wage work represents more than 80 per cent of women’s employment in sub-Saharan Africa, but less than 20 per cent in countries of Eastern Europe and Central Asia (World Bank b. 2013). The variance is illustrated in the figure below:

A job does not always come with a wage

Skills TG Figure 2

5.12 Skills training in the workplace

Involving employers in the design and delivery of training contributes to better outcomes for all, including the disadvantaged. Evidence shows that the engagement of employers in both formal and non-formal skills training improves the relevance of the skills offered and employment outcomes. There is some evidence to suggest that skills training in the workplace showed positive effects on employment, while classroom training tended not to have positive impacts on either employment or earnings. Training programmes that had employer sponsorship and were offered in enterprises have been shown to perform better (Adams 2011). Information failures and the lack of competition result in markets working inefficiently. Among the market institutions influencing the efficiency with which markets for skills work are those that provide information about jobs and skills in growing demand, the skill competencies required by different jobs, where and how the skills can be acquired, and the quality of skills produced by different suppliers. The institutions meeting the demand include those producing labour market information, career counselling, occupational standards setting, skills testing and certification, accreditation of providers, and qualification frameworks that provide recognition of past learning and assess the equivalency of learning acquired from different sources (Adams 2011).

5.13 Access to TVET

Evidence shows that skills programmes and other support services have been successful in improving employment outcomes for disadvantaged youths. In particular, vocational education and training can help widen the opportunities for young women. Research has shown that women are reluctant to enrol in courses where employment is traditionally male-dominated, and when they do, they often face discrimination in the labour market. Anti-discrimination measures and other demand side actions are likely to encourage women to enter non-traditional fields of study. In newer occupational specialisations such as information technology, gender-specific patterns may not have yet formed. In such cases, access to technical and vocational skills for young women can make a difference to their employment opportunities (Adams 2011).

5.14 Skills in the BRICS

Brazil, Russia, India, China and South Africa (BRICS) want to diversify their economic base and reduce their dependence on exporting raw materials, produce higher value-added goods and services, facilitate the creation of new economic activities, and foster innovation. To generate the educated and trained labour force this requires, they must:

  • Improve the quality and relevance of TVET.
  • Integrate inactive and unemployed youth into the world of work.
  • Raise skills levels in the working-age population to enhance productivity and competitiveness.

Future economic growth and social cohesion depends on improving skills levels of a population that is either ageing or still increasing rapidly. Large numbers of youth and adults who live in BRICS need opportunities to acquire foundation skills. Brazil, China and South Africa have almost reached universal literacy among youth aged 15-24, but have high adult illiteracy, particularly in rural areas. India’s youth illiteracy rate has been declining rapidly, and measures to universalise basic education and improve quality should ensure this progress continues. India must continue its literacy campaigns for the next few decades, and include literacy and numeracy modules in its skills development programmes, if it is to significantly reduce the high percentage of youth and adults without basic literacy skills. TVET development differs markedly across BRICS countries. A lack of data makes international comparisons difficult. To progress, BRICS need to develop systems for data collection and analysis to assess skills levels in their populations, identify skills shortages, gaps and mismatches, and forecast future skills needs (UNESCO 2014).

5.15 Other country examples

Ethiopia

In the Developing Entrepreneurship among Women with Disabilities (DEWD) programme, women played a central role in gathering information on the business aspirations of women with disabilities and women having a dependent with a disability. Business constraints and case studies were also recorded. Market surveys were conducted to identify new opportunities. Following this initial analysis, 20 women were trained to be trainers and a further 450 women were trained in basic business skills. Following the training, some of the women were given loans to implement their business plans through local microfinance institutions. The DEWD programme provided poor women with disabilities with business skills and assisted them to develop business activities (Ransom 2010).

Somalia

The Somali Youth Livelihoods Program (SYLP) – known locally as Shaqodoon (Somali for ―jobseeker) successfully established systems that bridged supply and demand with necessary support to young people and employers. The programme provided Somali youth with greater opportunities to access work opportunities. The programme was found to be successful in providing internships or paid job placements in the private and public sectors for 87 per cent of the 9,280 youth who completed the training and placement component – exceeding targets. Youth, parents, business owners, and government authorities considered the training effective and the placement opportunities beneficial for youth’s long-term employment prospects. Lessons from the programme include the importance of strengthening the capacities of the regional ministries of education to meet their role of leading the overall coordination of TVET sector activities. Priorities and capacity issues must be reviewed. External technical advice may be required. Programme staff and government authorities should jointly agree on monitoring mechanisms and useful indicators. It is advisable that systematic and ongoing research about market needs and trends (formal and non-formal) is carried. Funding must be allocated to pay for it. The relevant government departments must support more effective skills training and market and entrepreneurial development (Cook and Younis 2012).

Côte d’Ivoire

There are six ministries in charge of TVET in Côte d’Ivoire:

  1. The Ministry of Culture and Francophonie (MCF)
  2. The Ministry of National Education (MEN)
  3. The Ministry of Higher Education and Scientific Research (MESRS)
  4. The Ministry of Vocational Education and Professional Training (METFP)
  5. The Ministry for Families, Women and Social Affairs (MFFAS)
  6. The Ministry of Youth, Sport and Urban Health (MJSSU).

CapEFA has been working with stakeholders in Côte d’Ivoire to identifying what can be done to remedy the fragmentation of TVET in the country. Despite political instability, the government succeeded in establishing a coordination committee composed of 16 members from the six responsible ministries (Faccini and Salzano 2011).

Afghanistan

CapEFA has been working in Afghanistan to strengthen the TVET Working Group (WG) which is the official forum in the country under the Human Resource Development Board. It is chaired by the Ministry of Education (MoE) and the Ministry of Labour, Social Affairs, Martyrs and Disabled (MoLSAMD). The purpose of the group is to coordinate joint activities towards the establishment of a modern TVET system in Afghanistan according to overarching national strategies, aligning the programmes with the sector and improving coordination among key donors and the Government of Afghanistan. The group’s core functions include policy recommendations, technical advice, strategic alignment, coordination and resource mobilisation (Faccini and Salzano 2011).

DfID programme case study

The Helmand Growth Programme was funded by DfID between 2010 and 2014. The total programme spend was £16.6 million. The aim was to increase the potential for licit economic growth in selected districts of central Helmand. It was planned to achieve this by improving the job prospects and skills base of Helmand’s youth. In addition the programme would improve market linkages for the agricultural private sector and improve the business community’s capacity to support emerging businesses and potential investment in the province. Skills development for businesses would also be improved. When it closed, the programme activity included the following:

  • Improved employment status or successful self-employment due to market-based skills training.
  • Greater productivity through better business skills and more competitive industry clusters.
  • Increased access to training and improved market linkages for farmers and agri-businesses.
  • Increased potential for licit economic growth and improved livelihoods by continuing to provide development assistance in Helmand beyond the life of the Provincial Reconstruction Team (PRT)
  • Private sector actors organised into an association or chamber of commerce based on a sustainable business model.
  • Technical support to implement improvements in surrounding economic infrastructure (road, canals and irrigation, and power).

 Through these activities, the programme achieved the following results:

  • 21,038 people trained through the INVEST project including 6,235 women.
  • 14,601 of people trained through the INVEST programme found full-time employment.
  • Over 400 farmers report increased incomes as a result of improved market linkages.
  • 26 per cent increase in yield in per hectare for participating farmers.
  • Systems developed for the rapid design and commission of key infrastructure programmes adapted to fluid and complex operating environments such as Helmand Province.

Now the programme has ended, it is clear that sustainability was not built sufficiently into the design or implementation. Future programmes should incorporate sustainability from inception or make it more explicit in programme design. Also, planning to ensure transition and maintenance of infrastructure investments needs to be in place prior to implementation or at least 12 – 18 months prior to cessation of donor funding. Another lesson learned is that the buy-in of key stakeholders in government, the private sector and civil society needs to be secured at design level, or at least, early in implementation. A detailed political economy analysis should also be a critical component of programme design, implementation and risk management.

Rwanda

The Ministry of Education in Rwanda aims to improve access to and quality of upper secondary schools, teacher training colleges, higher learning institutions (HLIs), and demand-driven TVET courses to supply the demand for the higher-level skills and competencies relevant to labour market needs. In 2010, the government announced that all students would be entitled to free education until the end of upper secondary school (or equivalent). Following the introduction of this policy, access to fee-free education beyond lower secondary is being phased in, starting in 2012. As of 2011, 144,695 students (of which 49 per cent were girls) were enrolled in upper secondary education, including technical secondary schools (55,033 students). An additional 11,315 students were enrolled in vocational training centers (VTCs), and 73,674 students were enrolled in higher learning institutions, of which 43 per cent were female. Curriculum development has also been improved. Some private sector partnerships have been developed to promote catalytic skill capacity and expand practice-based learning. The aim is to ensure that what training institutions offer is more closely aligned with labour market demands. The 12 Year Education Policy is a key element for national economic growth and job creation. Capacity development, financing mechanisms, infrastructure, equipment, teachers, and trainers will need to be increased to implement the policy. This implementation will be led by the Workforce Development Agency (World Bank d. 2013).

Pakistan

The Sindh Technical Education and Vocational Training Authority (STEVTA) works to implement skills development programmes in the province. To expand access to skills development opportunities, the government has devised and started implementing a major youth training programme called Benazir Bhutto Shaheed Youth Development Program – BBSYDP. The BBSYDP has a major role in the skills acquisition strategy of the government. It is aimed at providing employment oriented skills training to 100,000 people in Sindh. The programme is being implemented through STEVTA technical institutions, training facilities in over 10 governmental departments as well as the private sector. The training courses offered last between 3 months and a year. Since its establishment, STEVTA is playing a pivotal role in bringing all the stakeholders together to reorient, reform, and deliver technical education in Sindh (World Bank 2010).

DfID programme case study

The Pakistan Skills Development Programme (SDP) will receive £89.5 million from DfID. It started in July 2015 and aims to increase access to jobs/income earning opportunities for poor and vulnerable people. The main programme activities will be financial support to the Government of Punjab for training through the Punjab Skills Development Fund (PSDF), increasing the sustainability of the PSDF, assisting with legal, regulatory and structural reforms of the skills sector and delivering technical assistance to design a challenge fund-type facility to support innovative partnerships for skill delivery.

Businesses in Pakistan are declining in competitiveness. This is in part due to low labour productivity. Existing skills training programmes fail to take into account the different socio-economic contexts and learning needs of different segments of the population. The current skills sector is inadequate to support required growth. Existing trainings are of poor quality and lack relevance to market needs. Existing registered training capacity is only 24 per cent of what is needed. Most poor acquire training informally. Over 85 per cent of the public resources are channelled through public sector skill providers. Evidence indicates that the private sector could deliver skills training in a more effective way. The private sector lacks incentives to invest in skill training as returns on investment are low. PSDF’s experience indicates that further support is needed to build the capacity of the skill providers to deliver better quality.

Liberia

Liberia’s civil war, which came to an end in 2003, was hugely destructive, displacing the majority of Liberia’s 3 million inhabitants, halting economic activity, deepening poverty, and depriving a generation of basic education. In the post war era, the bulk of Liberia’s youth remain poor and underemployed. Despite the security situation improving, rural youth continue to make their living through unlawful activities, including unlicensed mining, rubber tapping, or logging. Many remain involved with armed groups. The government, the UN, and NGOs fear that these youth are a possible source of instability. Agriculture is regarded as a major source of employment and income for rural Liberians. Landmine Action (LMA – now known as Action on Armed Violence) runs an intensive, best practices agricultural training programme, targeting ex-combatants and other high-risk youth in rural hot spots. Ex-combatants are recruited and offered several months of skills training and psychosocial counselling, along with a start-up package, to give youth a peaceful, sustainable, and legal alternative to illicit resource extraction, ease their reintegration into society, reduce the risk of their re-recruitment into crime and insurrection in the future, and to improve security in hotspot communities. The programme had a large and significant impact on agriculture. More than a year after the completion of the programme, programme participants were at least a quarter more likely than the control group to be engaged in agriculture, and 37 per cent more likely to have sold crops. A high level of interest in agriculture among these rural youth was recorded in both those who received the programme and those who did not. Participation rates in illicit activities rates remained unchanged, but participation levels dropped. Prior to the programme, in 2009, 44 per cent of youth were engaged in illicit activities, falling to 42 per cent two years later (in both the treatment and control group). A qualitative study of the programme impact suggests that access to markets may have been an important constraint on success. To be most effective, agricultural training programmes need to stress to trainees the need for proximity to markets, and encourage graduates to settle closer to major markets both for inputs and produce. Skills training must link graduates to concession owners and agribusiness as employees, including through placement schemes in commercial farms or plantations (Blattman and Annan 2011).

5.16 Skills in the SADC region

There is widespread and genuine commitment to improve TVET systems within the SADC region. Progress has been made in this area, but the absence of strong independent evidence on the impact of specific reforms prevents a better understanding of best practices. The countries of southern Africa vary hugely in terms of size, both of their overall populations and their TVET systems. McGrath et al. (2013) details the current policy position of TVET in 13 countries:

1. Botswana

Botswanan TVET was reformed substantially in the 1990s with the establishments of the Tertiary Education Council (TEC) in the 1994 Revised National Policy on Education and the Botswana Training Authority (BOTA) under the Vocational Training Act of 1998. These two bodies responsible for vocational education and skills development have similar mandates but partly operate at different levels of the system and have two different target audiences. Concerns about this policy incoherence led to the National Human Resources Development Strategy of 2009, which sought explicitly to bridge the divide between education and training, and sector-based, labour-market orientated planning. This led, in particular, to the decision to establish a National Human Resources Council under the Ministry of Education and Skills Development, funded by the European Union (EU), which will absorb the functions of BOTA and TEC.

2. Democratic Republic of Congo (DRC)

Technical education and vocational training in DRC is managed by six ministries, hence the establishment of the Inter-Ministerial Commission for Technical Education and Vocational Training in 2006 to bring about synergy and regulation of TVET. The Inter-Ministerial Commission has, as specific objectives, an institutional framework for TVET; curricula and programmes to enhance employability; ongoing advocacy for TVET; and the mobilisation of resources for TVET. Vocational training is seen as an integral part of general education, which provides access to work and to further training.

 3. Lesotho

Lesotho’s TVET policy still follows the 1984 Act. Although a new policy was developed with World Bank support in 2004, this remains in draft form and it is unclear when, indeed if, it will be implemented. The Ministry of Education works, therefore, from the Education Sector Strategic Plan (ESSP) 2005-2015, which has specific TVET goals regarding access and equity in technical and vocational training; quality; relevance; the reduction of HIV/AIDS; and partnerships. Without a final policy in place, these goals, as well as a TVET vision advocating new governance arrangements, funding, provision, qualifications, quality assurance and traineeships, are compromised.

4. Malawi

Malawi embarked on a major reform of its TVET policies in the late 1990s, culminating in the TVET Act of 1999, which established the Technical Entrepreneurial and Vocational Education and Training Authority (TEVETA). The inclusion of ‘entrepreneurial’ in the agency’s name was driven by the realisation that Malawi needed to do more to support self-employment and the informal economy, and that skills development was an important component of this. The goal of the TEVETA 2007-2012 Strategic Plan was to drive the TVET sector towards adequate and sustainable generation of an internationally competitive and skilled workforce capable of spearheading the country’s production and socio-economic growth in a socially responsible manner. The current guiding policy for the education sector in Malawi is the National Education Sector Plan (NESP) 2007-2017, although recent policy support work has been done by UNESCO. A notable strategy is the attempt to reintroduce TVET in some 24 model primary and 12 secondary schools that have technical and vocational wings, and the construction of five TVET wings in teacher training colleges.

5. Mauritius

The Mauritius Institute of Training and Development (MITD) was set up in November 2009 under the MITD Act through the merger of the Industrial and Vocational Training Board (IVTB) and as part of the Technical School Management Trust Fund. The MITD is responsible for the public TVET delivery system and has also been entrusted the awarding function for all local TVET qualifications. The MITD has as specific objectives achieving excellence in technical and vocational education and training; promoting research and knowledge; increased access to vocational education through the setting up of training centres; exchange of programmes and courses with other institutions of technology; and the apprenticeship of persons who are, or will be, employed in commercial, technical and vocational fields. Earlier reforms had led to the establishment of the Mauritius Qualifications Authority in 2001. The Education and Human Resources Strategy Plan (EHRSP) 2008-2020 underlines the importance of the quality of the workforce for sustaining economic and social development in Mauritius. Equally, the Government Programme 2005/2010 sets out clear objectives for TVET, including the establishment of new polytechnics specialising in areas of potential economic growth; a levy-grant scheme; and a review of the current training system to give new direction to TVET.

6. Mozambique

The 2001 Strategy for Technical and Professional Education in Mozambique 2002-2011 stated the goals of training more technicians, creating new jobs and improving training quality through competence-based technical and professional training with the participation of public and private sectors, and the creation of a qualifications framework. Moreover, the Public Sector Reform Strategy 2002-2011 promised the improvement of the quality of training institutions; the implementation of curriculum reform through modular courses addressing rural development; and the introduction of a qualifications system for professional skills from basic to higher levels. Three levels of TVET (elementary, basic and middle) are being developed for the technical training of school-age young people to prepare them for a vocational specialism.

7. Namibia

Namibia was an early introducer of a national qualifications authority in 1996 as part of a first wave of post-independence reforms that included the establishment of a Vocational Training Board. The most recent policies and legislation have been the Vocational Education and Training Policy of 2005 and the Vocational Education and Training Act of 2008. This Act established the Namibia Training Authority, which is responsible for regulation of TVET. There is a drive towards giving public providers more autonomy and to establish a registration and accreditation system that includes private providers.

8. Seychelles

Policy formulation and development on TVET in Seychelles has been undertaken in a variety of forms and by different sectors or sub-sectors, for instance by the Department of Education as part of its mandate for education and training and by the National Human Resources Development Council (NHRDC) as part of its mandate for human resources development. However, there is no integrated policy framework even though the need for such was articulated by the then Minister of Education in 2006. A draft Policy Framework on Technical and Vocational Education and Training was developed that year but has not been finalised. The process is also compromised by significant blockages linked with management/resource capacity at sector and/or sub-sector level related to policy formulation and development. The need for coherence and coordination is seen as crucial. A Seychelles Qualifications Agency was established in 2005. A Tertiary Education Bill, envisaged for 2011, will legally define TVET in the tertiary sector.

9. South Africa

South Africa has had a raft of legislation affecting TVET since 1994. One of the first Acts of the new government established the South African Qualifications Authority in 1995. In spite of its overarching vision, the departments of education and labour largely proceeded with parallel policy developments. The Further Education and Training (FET) Act of 1998 led to the reorganisation of 152 apartheid-era public technical colleges into 50 multi-site FET colleges and set out broad and long-term intentions for curricula transformation, learning and teaching, funding, quality assurance and institutional arrangements. The emphasis of the second FET Colleges Act of 2006 was on increased college autonomy illustrated largely by new staffing arrangements. A new curriculum policy framework was gazetted in 2006 ushering in a suite of FET National Certificates (Vocational) (NCV) as the official curricula for college learners. The National Plan of 2008 aimed to increase the number of college learners from around 400,000 in 2002 to 1 million by 2014. Colleges were recapitalised by the government in order to modernise and improve facilities, but the participation target was adjusted in 2010 to 650,000 learners. The Skills Development Act of 1998 established a parallel set of industry qualifications, called learnerships, as well as a National Skills Authority to advise the Minister of Labour, a set of Sector Education and Training Authorities and a National Skills Fund, underpinned by a new levy-grant system. In 2001, a Human Resources Development (HRD) Strategy was introduced to strengthen articulation between the two departments but major concerns remained regarding policy coherence. This has been addressed by a new HRD Strategy and a reform of the NQF architecture that has seen the establishment of a new Quality Council for Trades and Occupations (QCTO), mirroring existing structures for general and further education and for higher education. Perhaps most significantly, the second wave of reforms resulted in a new Department of Higher Education and Training being established in 2009. This is leading to a further wave of reforms that are still being developed.

10. Swaziland

The key TVET legislation in Swaziland is the Vocational and Industrial Training Act (VITA) 1982, supplemented at the policy level by the National Education Commission Review in 1985. However, a new Technical and Vocational Education and Training and Skills Development (TVETSD) policy was implemented in 2010 with support from the World Bank. This has a vision of developing a quality, relevant, sustainable TVETSD system, including an NQF. Since this policy is in a very early implementation stage there is as yet no information on progress.

11. United Republic of Tanzania

Mainland Tanzania and Zanzibar have different TVET policies, legislation, systems of national governance, quality assurance agencies and levels of development. Therefore, these two entities are dealt with separately.

  • Tanzania Mainland – Tanzania has two separate vocational systems under different government ministries: Vocational Education and Training (VET) and Technical Education and Training (TET). VET is governed by the Vocational Education and Training Act of 1994, which covers training leading to a skilled occupation. TET is governed by the National Council for Technical Education Act of 1997, which covers tertiary education obtained in a non-university institution and refers to education and training undertaken to equip learners with higher levels of skill, knowledge and understanding and enable them to take responsibility for an area of specialisation. There are draft policy plans to reorganise the two components into a single system.
  • Zanzibar – VET in Zanzibar is governed by the Zanzibar Vocational Education and Training Policy of 2005 and the Vocational Training Act of 2006, which was amended by the Vocational Training (Amendment) Act in 2007. This legislation established the Vocational Training Authority (VTA) to supervise vocational training in Zanzibar by determining standards of training, assessing training centres, and by evaluating and approving the capacity and skills of trainers and trainees.

12. Zambia

In 1996, Zambia reformed its TVET system and established the Technical Education, Vocational and Entrepreneurship Training Authority (TEVETA). During the period 2001 to 2007, Zambia, with the support of international cooperation partners, implemented the TEVET Development Programme (TDP). The TDP was created to act as a vehicle for the implementation of various interventions aimed at improving major components of TEVET reforms, including responsiveness to the demands of both the formal and informal sectors of the economy; improvement in the quality of training; greater equity (gender, disability and vulnerability) in the delivery of training; and mechanisms for ensuring the financial sustainability of the training system. However, implementation has been constrained due to an inadequate supply of mid-level management skills to administer the system.

13. Zimbabwe

A systematic reform of the post-independence TVET policy in Zimbabwe has not yet taken place. However, a number of reform initiatives are noteworthy. In 2005, the Higher Education Examinations Council was established with responsibility for TVET programmes in polytechnics, to sit alongside the Apprenticeship Authority, which is responsible for lower-level TVET qualifications. A policy review of 2006 stressed the need for an overall human resources development strategy and this was followed by a draft skills policy in 2010. A qualifications framework and authority have been proposed but not yet implemented.

5.17 Quality of evidence

Evidence on existing systems for skills training feature an extensive series of country-specific examples at policy and project level, drawn from a small number of high-quality systematic reviews published by UNESCO and World Bank. The cases cover a broad range of geo-political contexts. Further evidence includes similar, though less extensive, reviews of inclusive initiatives targeting skills training for the disabled, women and girls, and youth. In all cases, the evidence is of good quality, and is transparent in acknowledging gaps in evidence or cases of systemic failure or underachievement.

 

[5] In a DfID context, a key issue is the lack of an adequate political economy analysis/theory of change underpinning proposed reforms. Reflecting on the critique in Allais (2012), the reforms assume that the developmental capacity of the implementing country is far higher than it will be and that there is a political consensus that will support the reforms – the latter is a replaying in less overtly Marxist language of much of her analysis. Simon McGrath, expert advisor.

Key messages: 

  • General training increases worker productivity, translating to higher earnings in a competitive labour market. It makes workers more employable. This may act as a disincentive for firms to pay for general training, preferring to pay for specific training.
  • Productivity leads to higher earnings and more stable, less vulnerable, livelihoods. Earnings and employment challenges reflect the broader challenges and opportunities of a globalised world.
  • Cognitive and socio-emotional skills must be developed in early childhood and during basic and secondary schooling. Acquiring these skills is an important determinant of employment dynamics and subsequent earnings later in life.
  • Injections of capital (in the form of start-up grants, cash infusions and capital transfers, among others) stimulate self-employment and raise long term earning potential.
  • Programmes that involve participatory methods of learning, technology development, and dissemination have greater success. In particular, these approaches can build women’s skills.
  • Foundational skills facilitate further learning. The basic school system must be effective to allow for acquisition of skills later on.

6.1 The impact of training on productivity and earnings

General training is understood to increases a worker’s productivity and make them more employable, translating to higher earnings in a competitive labour market. It would therefore make sense for firms to only pay for specific training, rather than general training. However, in their classic theoretical account of the economics of enterprise-based training, Acemoglu and Pischke (1998) offer a theory of training whereby employers pay for general training.[6] For firms to invest in general skills provision, market imperfections must exist. Workers may not be willing to pay for general skills themselves, as at least part of the return will go to the firms that they work for. Filmer and Fox (2014) argue that productivity is the key to higher earnings as well as to more stable, less vulnerable, livelihoods. The challenge that young people face in terms of earnings and employment reflects the broader challenges and opportunities of countries themselves in a globalised world. The key employment issue is that productivity. Earnings are low and aspirations are higher than they have ever been. Despite some progress being made, most young people in Africa will not have an easy or structured path to a sustainable livelihood. Filmer and Fox (2014) call on all stakeholders, including governments, private firms, private and nongovernmental training providers, and young people themselves, to fulfil their role of contributing to this transition.

The lack of evidence on the impact of TVET programmes on labour market outcomes make it hard to draw conclusions about what works. Returns on investment in TVET vary widely across systems and over time. There is some evidence from OECD countries that the employability of students graduating from TVET and from general tracks are similar but students graduating from general tracks tend to earn higher wages. It is challenging to isolate the effect of TVET, as student characteristics influence path selection and level of earnings. Students entering TVET programmes typically have lower test scores and may have less family support than their peers in the general track. Available survey data on the impact of TVET on labour market outcomes in developing countries are mixed and inconclusive. Returns to pre-employment TVET have been shown to be positive, but are not consistently greater or worse than those associated with general education (Sanchez Puerta et al. 2015).

A review of programmes designed to raise incomes of the world’s poor found that skills training and microfinance programmes have made little impact on poverty or stability. The most effective programmes to stimulate self-employment and raise long term earning potential appear to be injections of capital. Evidence suggests that start up grants, cash infusions, in kind capital transfers and other ‘hand-outs’ have a good record of increasing earning potential (Blattman and Ralston 2015). Evidence from European countries indicates that TVET has a positive and significant effect on the economic performance of firms. The effects of different types of training on productivity is unknown. A clear relationship between size of investment and size of the effect on productivity is hard to establish. Evidence from non-OECD countries indicates a positive significant effect of training for skilled workers, and no effect for unskilled workers. This is of concern, as many people in low-income settings have received a substandard initial education, and therefore may receive less benefit from further training than compatriots with better initial education (Cedefop 2011).

6.2 Pathways to productivity

Filmer and Fox (2014) provide detail on the two pathways to productive work:

  • Human capital—the supply side, meaning the abilities, education, skills, family connections, networks, and other characteristics that are embedded in an individual and allow that person to find opportunities to be productive, increase earnings, and achieve income security
  • Business environment—the factors outside the worker’s immediate control that affect productivity (access to land, capital, and finance; infrastructure; technology; and markets), as well as the government policies, regulations, and programmes that may affect the choice of economic activity and how the activity is conducted.

6.3 Skills in the agricultural sector

Developing countries face many challenges in the provision of job-relevant TVET, including offering quality programmes, a lack of industry experienced instructors, few industry partnerships, and lack of adequate resources to offer access to high quality workshops and equipment. In these contexts there is often limited training provision to promote productive employment in the agricultural and informal sectors (Sanchez Puerta et al. 2015). In the agriculture sector, farmers often learn from their neighbours. More educated farmers are more likely to adopt new technologies. To be productive as a farmer, specific skills are required, built on a foundation provided by basic education. Skills, such as processing, marketing, machinery operation and repair, transport, logistics, and quality control can be developed. In some countries, agricultural vocational training institutes traditionally have provided these skills. These institutes have a mixed track record, mostly owing to the disconnect between academic, lecture style teaching and the need for on-the-ground, practical training. Agricultural extension programmes have a disappointing history in Africa, mainly because of poor incentives and accountability. Evidence suggests that programmes that empower farmers by giving them a choice of providers and services from among a range of public, private, and non-governmental agencies are more successful. Research has shown that programmes that involve participatory methods of learning, technology development, and dissemination have greater success. In particular these approaches can build women’s skills. Business incubators and rural alliances that create relationships between commercial buyers and producer organisations can boost agricultural incomes. In addition, communication technology can benefit, and benefit from, the participation of young people (Filmer and Fox 2014).

6.4 Skills and schooling

As with the agricultural sector, an important step towards productivity in other sectors is to get basic schooling right. Foundational skills facilitate further learning (Filmer and Fox 2014). A good basic education and cognitive development is important for future skills development. Any strategy aimed at increasing and improving skills capacity must create the conditions for adequate early childhood development, laying a strong foundation in basic and secondary education, and improving tertiary education (Sanchez Puerta et al. 2015). In low-income contexts, the majority of the labour force has very low levels of education. Even the minority of people who have degrees may not have acquired the skills necessary to succeed in the labour market. In particular, analytical and interactive skills may be missing. Employers frequently complain that workers’ lack the required skills for their business. This skills mismatch appears pervasive across countries. Adequate primary and secondary schooling is necessary to develop cognitive and socio-emotional skills that are needed for employment and productivity in adult life (Sanchez Puerta et al. 2015). TVET outcomes in sub-Saharan Africa have been disappointing. Evidence has shown that secondary and post-secondary vocational training can cost three times more than basic secondary education, yet often provides no better foundation for private sector jobs. To be successful, training must be geared toward labour market demand. In the higher education sector, policies and curriculums must be geared toward private demand to ensure maximum employment of university graduates. Financing in public universities should include a private component to improve equity in access, as tuition payments become means-tested rather than free for all. Also, those who pay will demand value for money (Filmer and Fox 2014).

6.5 Government support for TVET

Governments in sub-Saharan Africa need to focus on support for public goods in TVET such as quality assurance and information. Access to training for poor and disadvantaged youths should also be a focus. Governments may need to provide financial support for training in either the public or the private sector. Governments support for training should aim to emphasise portable skills rather than the firm- or job-specific skills that employers should already have an incentive to provide. Results from programmes for disadvantaged youth that integrate training with internships indicate some success. Poor management practices in the private sector suggest considerable scope for improving productivity by investing in business and management skills training and perhaps even in individualised management consulting. The evidence for such programmes is mixed but promising (Filmer and Fox 2014).

6.6 Skills in rural areas

Evidence suggests that the education levels of working youth are consistently lower in rural areas (Elder et al. 2015). Youths in rural areas can increase their productivity with more and better schooling. Higher productivity increases demand for schooling, triggering a virtuous cycle (Filmer and Fox 2014). In low-income contexts, more young professionals in urban areas are better matched to their jobs than in rural areas. In low-income countries there is also a larger differential in the average education levels of youth working in rural and urban areas compared to the middle-income countries. Skills are central to improving employability and livelihood opportunities, reducing poverty, enhancing productivity and promoting environmentally sustainable development. Skills shortages halt the productive and sustainable transformations of rural areas. Rural disadvantages in education limit scope for employment among those youth remaining in rural areas who did manage to complete their education (Elder et al. 2015).

6.7 Country examples

Ghana

In Ghana, a national skills development strategy is in preparation under the auspices of the Council for TVET (COTVET). For the strategy to be successful, Darvas and Palmer (2014) recommend it is:

  • Responsive to the challenges stemming from social demand (employment, equity)
  • Relevant to the private sector and labour market demand
  • Informed by market and nonmarket failures
  • Harmonised with the national economic development priorities (diversification, shared sustainable growth)
  • Effective in terms of incentivising the training providers to align with these expectations

The strategy should aim to complement, and be complemented by, related reforms in other sectors, such as the private sector, the informal economy, information and communication technologies, and agriculture. It must ensure that TVET stakeholders can coordinate, implement and monitor the development of policies to stimulate both demand and supply. COTVET must coordinate across sectors, government agencies, and various types of providers. Standards for training services and a qualification framework must be developed (Darvas and Palmer 2014). Training providers will benefit from a needs-assessment and rationalisation process. This will help to establish what support is needed and what incentives may be required to facilitate the change to a demand-driven approach. The rationalisation process would likely result in the institutions being more specialised. Courses that are not in demand may be stopped. Success will demand TVET institutes have sufficient autonomy and incentives to (re)connect with industry requirements. This process of decentralisation will bring training supply closer to market needs (Darvas and Palmer 2014).

Targeted scholarship schemes could promote access to TVET, especially for the poor, and for women, who could be enabled to enter trades that traditionally do not employ females. Improving junior high school (JHS) level education will help to make access to post-JHS TVET programmes more equitable. Reducing direct and opportunity costs of training will also help. The government should be less directly involved in training provision by taking more of a coordination role. It will need to provide incentives, standards, accreditation, quality assurance, and information. Any qualification system should be independent of government control, since the government cannot be expected to provide objective judgment over a service that it provides. The national qualification system will be more effective if focused on training and skills that help people get jobs and improve earnings, enterprise growth, and productivity. The qualification framework should be developed in sync with the competency-based training system that is being gradually introduced in Ghana (Darvas and Palmer 2014).

TVET financing will be more effective if funding is based on results and performance. Planners need to keep in mind that public funding can distort the training market or lead to market failures. Financing and incentive systems can be used to promote demand-driven training, to reward quality and productivity, and to promote equality and breaking out of a low-skills equilibrium. Incentives may help to improve the performance of trainee and instructor industry attachments and to encourage industry associations to provide employment (Darvas and Palmer, 2014). Information systems can be utilised to assist with monitoring and evaluation. On the demand side, more (disaggregated) wage data need to be collected to reveal what the market is demanding in terms of skills. Effective data collection instruments that go beyond inputs, such as student numbers, would help. Data on outputs (such as the number that graduate) and outcomes (such as the proportion of graduates that find work) would be helpful to inform planning. Key stakeholders’ capacities require strengthening, including at the institutional and district levels and within informal trade associations. The capacity of Ghanaian institutions, governmental and non-governmental, to conduct TVET research needs to be strengthened. Further research into the political economy of the TVET reform process is needed (Darvas and Palmer 2014).

Ethiopia

Research in Ethiopia took nearly 1,000 unemployed and underemployed applicants and offered them low skilled jobs in five industrial firms. A lottery system was used to allocate the jobs and randomly offer cash and training to half of the unsuccessful job applications. The results indicate that most people quit the permanent industrial jobs within a few weeks as the work was unpleasant and risky. A year later, the people offered jobs were no better off economically than their peers in the control group. However, their health was worse. The cash and training group reported being happier, having started businesses and increasing their wages by a third (Blattman and Ralston 2015).

Liberia

The Adolescent Girls Initiative in Liberia provided young women with six months of skills training followed by six months of active placement. Six months after the classroom sessions, women’s earnings were about $8 per week greater than the control group. Earnings were higher among women trained for self-employment rather than job skills (Blattman and Ralston 2015).

Uganda

Blattman and Ralston (2015) describe two programmes in Uganda – WINGS and the Youth Opportunities Program (YOP). The WINGS programme in Uganda targeted 15 ultra-poor households in small war affected villages. Most participants were women. A not for profit organisation offered them five days of business skills training, $150 in cash, as well as encouragement and support to become petty traders. Evidence suggests that those who started small trading enterprises nearly doubled their earnings. Household consumption increased by a third to $39 per month. For the YOP, the Ugandan government invited men and women from 18 to 35 years old to form groups and prepare proposals for vocational training and enterprise development. The groups received grants of $8,000, equating to $400 per person. Evidence indicates that, four years later, the wages of members of the groups who had received grants had increased by 40 per cent and hours of work were up 20 per cent (Blattman and Ralston 2015).

6.8 Quality of evidence

Evidence on skills training for employment and higher earnings is based on a medium number of documents from a range of sources, and is of mixed quality. For example, Filmer and Fox (2014), Elder et al. (2015) and Cedefop (2011) present discussion and/or analysis drawing on substantial data sets, and Tripney et al. (2013) present a systematic review based on a detailed methodology and drawing on a broad spread of countries. Darvas and Palmer (2014) present discussion around a specific country-based context. Sanchez Puerta et al. (2015) present a briefing note with no examples or case studies, and no supporting bibliography. Acemoglu and Pischke (1998) is a peer-reviewed paper published by MIT, but dating from 1998.

 

[6] Although focused primarily on the USA and other advanced economies, Acemoglu and Autor (2011) offer a further insight into the impact of training on productivity and earnings in their chapter titled Skills, Tasks and Technologies: Implications for Employment and Earnings, from the Handbook of Labor Economics, Volume 4b, Elsevier (http://economics.mit.edu/files/7006).

Key messages: 

  • There is less support for TVET compared to other education sectors. Commitments and will to fund TVET is much weaker than efforts to fund schooling or higher education. New and innovative ways must be identified to mobilise financial support for TVET.
  • There is a need for a radical shift in skills development to respond to the increasing demand for training opportunities with greater private sector involvement, better coordination, effective use of new technology and the media, and interventions with a sectoral focus.
  • Private training providers have a role to play in skills development if the quality can be assured. The demanded skills training cannot be solely provided by the public sector. Alternative sources, including from the private sector, must be found and co-ordinated.
  • Private financing of skills development is linked to the expected return in that investment and to greater involvement by those financers in its development.
  • There is a considerable knowledge gap regarding the effectiveness and efficiency of specific policy instruments to promote employer-provided training for employees. More research is needed.
  • Education and training systems must be integrated into national skills strategies. This will ensure that, on completion of training, the economy can absorb the skilled workforce.

7.1 Financing TVE and TVET

Globally, commitments and will to fund TVET is much weaker than efforts to fund schooling or higher education. No fast track initiative exists to fund TVET. There has been neglect and conceptual confusion of EFA Goal 3, which is to ensure that the learning needs of all young people and adults are met through equitable access to appropriate learning and life-skills programmes. The perceived difficulty of engaging in this area has led to frustration with attempts to finance TVET. TVET has risen much higher up the agendas of both developing country and donor governments, largely as a response to the youth bulge described in the introduction. Despite this, there has not been a significant shift in funding. There is pressure on both donor and developing country budgets. New  and innovative ways must be identified to mobilise financial support for TVET. Many developing country governments treat the financing of public TVET as they do academic schooling by using an input driven approach. Institutions receive budgetary allocations related to the number of instructors, number of trainees, previous year’s budget etc. The allocations remain the same whether the institution is performing well or not, with no link to efficiency, attainment of minimum training standards, outputs, or outcomes. This encourages a culture of apathy since there are no incentives, or disincentives, for performing well or badly. Data on financing for TVET follows the bias towards Ministry of Education data, and the bias towards supply side data. Public expenditure on TVET should not only include data from ministries of education. Aggregated data from other public ministries responsible for TVET should be included. Estimates of private financing of TVET – both private formal providers, and enterprise based training, formal and informal – should be included (King 2011).

7.2 Private financing of skills development

A synthesis paper on the role of the private sector in skills development argues that a radical shift in skills development is both needed and is beginning to take place. To succeed, this shift must respond to the increasing demand for training opportunities with greater private sector involvement, better coordination, effective use of new technology and the media, and interventions with a sectoral focus. Private sector intervention will generally not happen without facilitation by another party, whether it be government, donor or non-government organisation. Employers are more likely to engage in skills development if the benefits of doing so are apparent, the business environment is favourable and there is minimal bureaucracy attached (Dunbar 2013). Private training providers have a role to play in skills development if the quality can be assured. More private finance is needed in the developing world to fund skills development. Governments cannot and will not provide all the funds for training. Alternative sources must be found and co-ordinated. The greatest challenges to skills development, including the funding issue, are found in countries with unstable governments and low-growth or stagnant economies and in remote agrarian communities with little industry. The private sector may be able to support learners financially while they are non-productive or partially productive (Dunbar 2013).

Dunbar (2013) offers the following analysis of the emerging policy consensus on financing training:

Role of training finance in meeting policy objective Explanation
1 Redefined government role Redefinition of government role (diminished, but still critical), entailing reduced public budgetary support for formal sector institutional training.
2 Funding diversification Diminished government financing role is to be accompanied by a diversification of sources of financing, greater cost recovery and cost sharing.
3 Cost sharing Moves towards increased cost sharing, with higher, more realistic training fees (with scholarships for the needy) and perhaps state-backed student/trainee loans.
4 Training levies Funding diversification measures to include training levies on enterprises.
5 Income generation Funding diversification measures also include income generation by public training institutions.
6 Decentralisation Income generation objectives would be furthered through decentralisation of control over public sector providers and greater institutional autonomy.
7 Private sector Government to encourage private sector provision of training.
8 Funding public training institutions Replace arbitrary, ad hoc funding arrangements by objective formula funding related to inputs, outputs and outcomes. Consider case for subsidy of selected private training institutions.
9 Trainee/consumer choice More voice is to be accorded to trainee/consumer choice; vouchers may help develop the demand side of the market where subsidy needs to be retained.
10 Levy-grant Levy-grant mechanisms to be introduced where formal sector enterprises under-train.
11 Training funds National training funds to be developed, to take a broader and longer term view of training expenditures in a national context.
12 Training authorities Where institutionally possible, fully-fledged, autonomous national training authorities to be established.
13 Stakeholders Increased participation of stakeholders (especially employers) in national training policy formation and execution.
14 Disadvantaged groups Continuing and enhanced government role in skills development as an integral part of a package of measures to assist disadvantaged groups.
15 Informal sector Central attention to be paid to largely neglected training needs of small micro enterprises and informal sector producers.

The finance related issues are based on research by the World Bank. They all impact on reaching the main training policy objective of facilitating the development of effective, efficient, competitive, flexible, and responsive (demand-driven) training systems to meet national economic and social needs, and the needs of individuals (Dunbar 2013).

Private financing of skills development is intrinsically linked to the expected return in that investment and to greater involvement by those financers in its development. The availability of reliable information is critical if learners are to access funds for training. The evidence suggests that levy systems and tax incentives are unlikely to work well in countries where industry is not well-developed and administrative or organisational capacity is weak. Also, levy systems and tax incentives tend to favour large companies unless mitigating measures are introduced. Evidence from voucher schemes shows mixed results but includes stimulation of the private training market and increased demand from learners. Student loans are high risk and work best when employment prospects of graduates are good and there is a strong likelihood of repayment (Dunbar 2013).

7.3 Policy instruments to promote training

Müller and Behringer (2012) found there to be a considerable knowledge gap regarding the true effectiveness and efficiency of specific policy instruments to promote employer-provided training for employees. A limitation of indirect subsidies, such as tax incentives, is that even if firms can be convinced to utilise tax incentives, unanticipated substitution effects may impair effectiveness. Tax incentives may be ineffective in targeting specific groups of workers or enterprises. Evidence suggests they favour large enterprises and highly educated individuals and therefore work best to overcome aggregate under-investment.

Direct subsidies allow more effective targeting. As with all subsidies, there is a risk that certain forms of learning may be favoured. With regard to training funds in combination with firm levies, compulsory schemes may be detrimental and erode employer investment, outweighing the potential benefits. In order to function well, levy schemes require a sufficient number of contributing firms and the administrative capacity for raising funds and disbursing them in line with specified criteria. Consequently, levy schemes have encountered serious problems in some developing countries. The most success has been reported in fast-growing countries (e.g. Singapore), where the positive development of training provision need not necessarily be attributed entirely to the functioning of the respective levy scheme (Müller and Behringer 2012).

7.4 Pre-employment and enterprise training funds

Johanson (2009) reviewed pre-employment and enterprise training funds in over 60 countries. The evidence suggests that national training funds are an increasingly common vehicle for financing training, despite a lack of rigorous evaluation of the impact of training funds on the skills and employability of the workforce in developing countries.

The three main types of training funds identified are:

  • Pre-employment training funds
  • Enterprise training funds
  • Equity training funds

7.5 Strategic approaches to skills development

The OECD Skills Strategy (2012) provides a policy framework that guides countries on how to invest in skills for creating jobs and boosting economic growth. Although the strategy is focused on OECD member countries, it provides useful context that is relevant for non-member countries. Valiente (2014) explains how the strategy puts skills policies at the very centre of national strategies for economic recovery. Their positioning as such is particularly pertinent in the context of the global economic crisis. National strategies should be aiming to transform countries into internationally competitive high skills economies. Education and training policies can contribute to these strategies by:

  • Developing the relevant skills for the knowledge economy
  • Incentivising the participation of inactive individuals in the labour market through retraining and up-skilling.
  • Fostering entrepreneurship and supporting employers in the creation of highly skilled jobs.

Education and training systems must be integrated into national skills strategies to upgrade the demand for skills of an economic structure that is unable to absorb a highly skilled workforce. These systems must no longer be regarded as passive recipients of the demands from employers and markets (Valiente 2014). The following best practices allow countries to adopt a comprehensive and systematic approach to skills policies, and are based on lessons learned by developing the OECD Skills Strategy (2012):

  • Prioritise investment of scarce resources: Since it is costly to develop a population’s skills, skills policies need to be designed so that these investments reap the greatest economic and social benefits.
  • Combine short- and long-term considerations: Effective skills policies are needed to respond to structural and cyclical challenges, such as rising unemployment when economies contract or acute skills shortages when sectors boom, and to ensure longer-term strategic planning for the skills that are needed to foster a competitive edge and support required structural changes.
  • Build a case for lifelong learning: By seeing skills as a tool to be honed over an individual’s lifetime, a strategic approach allows countries to assess the impact of different kinds of learning – from early childhood education through formal schooling to formal and informal learning later on – with the aim of balancing the allocation of resources to maximise economic and social outcomes.
  • Foster a whole-of-government approach: If skills are to be developed over a lifetime, then a broad range of policy fields are implicated, including education, science and technology, employment, economic development, migration and public finance. Aligning policies among these diverse fields helps policy makers to identify policy tradeoffs that may be required and avoid duplication of efforts and ensure efficiency.
  • Align the perspectives of different levels of government: With major geographical variations in the supply of and the demand for skills within countries, there is a strong rationale for considering skills policies at the local level. This would help countries to align national aspirations with local needs.
  • Include all relevant stakeholders: Designing effective skills policies requires more than co-ordinating different sectors of public administration and aligning different levels of government: a broad range of nongovernmental actors, including employers, professional and industry associations and chambers of commerce, trade unions, education and training institutions and, of course, individuals must also be involved.

The OECD skills strategy (2012) states that to achieve a high-quality pool of skills, a country must consider three main policy levers:

  • Those that improve the quality and quantity of skills
  • Those that activate the skills for the labour market
  • Those that ensure that skills are used effectively

7.6 Country examples

Nicaragua

Macours et al. (2013) analyse the potential returns for targeting mechanisms in poor rural communities in Nicaragua. As interventions aimed at increasing the income generating capacity of the poor have a potentially important role to play in reducing poverty, the findings are relevant to many developing countries. In Nicaragua, skills interventions resulted in increased participation in non-agricultural employment and higher income from related activities. Investing in targeting would not increase the impact of the programmes. Pro-poor targeting does not come at the cost of reducing the overall impacts of these interventions. Self-targeting, that is based on baseline demand, can lead to important exclusion errors. Self-targeting may reduce the poverty-reduction potential of these types of interventions, especially when low aspirations limit the poor’s ex-ante demand for productive interventions, and when the interventions have the potential to increase those aspirations. However, self-targeting may have limited poverty reduction by excluding the poorest (Macours et al. 2013).

South Africa

In South Africa, during the Mbeki Presidency, skills development was regarded as central to improving social and economic performance. ‘Skill’ took a key role in the debate on international competitiveness, economic growth and poverty reduction. Through the 2003 Immigration Act, a new strategy for attracting such skills from outside the country has been developed, as well as forming the core of the 2001 Human Resources Development Strategy. In their book, McGrath et al. (2004) examine the multiple and shifting meanings that ‘skill’ has taken on in South Africa. There is a particular focus on unpacking the notion of ‘skill’ as ways of supporting the national project and suggesting how best to deal with the issue of ‘skill’ in South Africa. The authors explain how ‘skill’ is included in contemporary policies and practices, and frame the historical and international contexts.

7.7 Quality of evidence

The evidence presented on the current status of skills development includes a medium number of high-quality systematic reviews published by the World Bank and OECD, each describing detailed methodologies and drawing on substantial data-sets and case studies, and which can be regarded as highly reliable sources. In some cases, these publications have a lower focus on analysing TVET-related policy in LMICs. Further evidence on new approaches to focussing on TVET is drawn from a proposals report produced for UNESCO ahead of EFA Global Report 2012, a published peer-reviewed research paper, and a country-specific analysis of TVET policy published in 2004, each of which are of high quality. There are a small number of country case studies featured: due to various geographic, social and/or political factors, the countries selected could be regarded as atypical.

8.1 Introduction

This topic guide focused on skills immediately necessary for employment and increased productivity in low-income settings. It focused on TVET skills, which are concerned with the acquisition of knowledge and skills for the world of work. The importance and value of obtaining basic skills is recognised as these are a pre-requisite for higher order skills development. The purpose of this guide is to introduce the reader to relevant ideas, concepts and theories relevant to skills development. It serves to point the reader in the right direction to relevant sources for further details. For the purpose of this paper, skills are understood to be competencies that can be gained from experiences during and after childhood, especially through education. This paper focused in particular on skills concerned with the acquisition of knowledge and skills for the world of work.

The evidence that does exist shows the positive impact of training on future employment and earnings. Young people require skills that prepare them for decent jobs so they can thrive and participate fully in society. A global effort is required to improve training that develops foundational skills for entering the workforce, allowing young people to actively participate in society. Skills training can also improve self-awareness, empathy, decision making, goal setting, and communication skills for youth. Skills development is needed for both formal and informal employment. However, the data suggests there is a positive link between education and training and working in a job that is not farming. Formal education, therefore, is likely to lead to formal employment. Basic skills are needed to perform basic tasks or acquire further skills. High skills are needed for critical thinking and decision making. Although there is a global paucity of reliable data on skills development, the evidence that does exist suggests that provision and access to skills is unequal in different countries, regions and contexts. It is known that marginalised groups are less likely to be able to access skills. In the past, TVET has received less attention than other education sectors such as primary and secondary schooling. However, in recent times, there is increasing momentum behind the skills development agenda. This groundswell of support is highlighted by the fact that there is likely to a specific target to measure skills development in the SDGs, which is testament to the increasing support for further development in this area.

8.2 Skills and development

This topic guide has highlighted evidence that indicates that TVET is shown to be more effective when focused on skills closely linked to market demand. However, a solid general education is required as a prerequisite. Youth development, skill acquisition and future employment opportunities depend in part on youths having a solid academic foundation. This is shown to be particularly significant for those members of communities who are socially disadvantaged. Women have been shown to benefit more than men from skills training, as in the labour market they are often starting from a greater state of disadvantage. There have been mixed reports about the impacts of training and skill-building programmes. Although there is some evidence available about the benefits of developing TVET systems, TVET does not guarantee a solution to youth unemployment. Other factors must be addressed, such as economic growth, cost of labour, legislation, and unrealistic wage expectations. Increased productivity is often viewed as the goal of skills development. However, considering TVET solely through a productivism lens may not address all the issues and challenges. To successfully develop or reform training systems, other theories and paradigms, including a rights based perspective, are required. Evidence has shown that in many countries there is a mismatch between the supply and demand of skills both within countries and in the global economy, with demand for skilled workers outstripping supply. There may be resistance from the private sector to invest in training due to uncertainty over the returns. Evidence illustrating the benefits may need to be produced. Involving all stakeholders, including employers, in the design and delivery of training contributes to better outcomes for all. It may be appropriate for the private sector to offer apprenticeship programmes to provide access to training and to new technology. In some countries, clusters of specialised businesses may facilitate knowledge-sharing and provide training.

8.3 Market failures

The mismatch between the supply and demand of skills must be addressed for progress to be made. In many cases, the private sector will have a better understanding of what skills are needed for the workplace. Training provided by the private sector may also allow for smoother transitions into employment. However, training provided by the private sector may need regulating, which can be challenging. The private sector will expect to recoup the return on investment in training. If they cannot, they will not be willing to finance training in the future. Governments are therefore encouraged to set policy frameworks that allow for competition and encourage innovation and technological change as well as in correcting market failures. It is a challenge to persuade individuals that it is worth their effort, time and resources to invest in their own training. Individuals may not invest in training for many reasons, including a lack of information, limited cognitive capacity, psychological factors, inaccurate information on returns to training and misunderstandings regarding employment prospects once trained. Individuals may also lack the incentive to invest in their own training if employers have market power and are able to keep future wages down. Targeted subsidies can correct market failures or improve incentives to invest in training. In particular, vulnerable groups may need to be targeted. Other government interventions can help to correct market failures. Such interventions include increasing the bargaining power of workers, reducing barriers to entry in markets, facilitating the diffusion of new technologies to create demands for skilled labour, reducing poaching of labour, credit for training, and providing information about labour market conditions and the quality of various training providers.

Evidence suggests that entrepreneurship leads to growth, job creation, technology adoption, innovation and poverty alleviation, all of which drives economic development. Well-targeted government interventions can ease constraints on entrepreneurship and facilitate private sector take-off. Where possible, policy makers are encouraged to remove obstacles to entrepreneurship such as poor business climate, excessive taxation and other prohibitive start-up costs. To improve the delivery of TVET systems, better planning is needed, based on solid data. Poor data can result in skills gaps and further entrench the mismatch between supply and demand. If policy makers have access to improved data and respond to it appropriately, this situation will improve.

Technological advances, such as the internet, have revolutionised education including skills training. Learning from a distance has brought the cost of training down as well as increasing choice of the content, schedule, pace, duration and recruitment criteria. One area where technological advances may improve service delivery is in overcoming gender barriers to training.

Different countries are likely to face different gender challenges regarding training. To be successful, TVET programmes must address gender disparities, inequalities and stereotypes. Gender barriers may exist for both accessing TVET programmes and accessing employment. TVET policies must address these barriers. Girls and women may require special attention in TVET programme planning to take into account that they are at the lower ranks of skills development, employment and income generation. Gender discrimination may prevent women from obtaining the training necessary for obtaining better payed jobs. Stereotypes about jobs may channel boys and girls into different training programmes and reinforce enrolment patterns. Government interventions may help overcome some of the gender challenges, by encouraging girls to enrol in certain programmes. Financial incentives may help channel female enrolment. Offering distance education may reduce problems associated with travelling to training locations.

8.4 Existing systems

There is a current drive amongst most countries in the world to improve skills and training systems. There are many examples of reform of existing systems and interventions to provide a level playing field. To be successful, training must deliver the skills that are required. Local people are often in the best position to both advise on what skills are needed, but also to help deliver the training that is required. Special attention must be paid by policy makers to the needs of people with disabilities to access the skills and training they need to improve their situation. Skills provide a route to escape from poverty and dependence, and the barriers people with disabilities face to entering the training market must be overcome. Efforts need to improve access to quality basic education, which provides the foundation skills needed to go on to acquire more specialised skills.

8.5 Skills for employment, employability and higher earnings

Evidence shows that general training increases worker productivity, translating to higher earnings in a competitive labour market. General training also makes workers more employable. This may act as a disincentive for firms to pay for general training, preferring to pay for specific training. Productivity leads to higher earnings and more stable, less vulnerable, livelihoods. Earnings and employment challenges reflect the broader challenges and opportunities of a globalised world. Early childhood development, including cognitive and socio-emotional skills, are essential for future employment and subsequent earnings later in life. When youths lack of the means, skills and knowledge to make the transition from school to work, or between sectors of employment, they may end up not fulfilling their potential, both in terms of productivity and contribution to society. The basic school system must be effective to allow for acquisition of skills later on. Evidence for the returns on investment from TVET systems varies widely across contexts and over time. More research is needed to show what works. There is some evidence that start-up grants, cash infusions and capital transfers stimulate self-employment and raise long term earning potential, but more research is needed.

There are many challenges to establishing a TVET system. For example, in some countries there is a lack of industry experienced instructors, few industry partnerships, and lack of adequate resources to offer access to high quality workshops and equipment. The more local members of society can be involved in programmes, the better. In fact, evidence has shown that programmes that involve a level of participation have greater success. In particular, these approaches can assist with developing women’s skills. To improve TVET systems, governments and policy makers are advised to focus on quality assurance and improving the quality of information available. Higher education must be geared toward private demand to ensure maximum employment of university graduates. Also policy makers are advised to consider geographical characteristics. Youths in rural areas often have consistently lower education levels. Rural disadvantages in education limit scope for future employment among those youth remaining in rural areas who did manage to complete their education.

8.6 The geopolitical landscape

As mentioned above, traditionally there has been a lower level of support for TVET compared to other education sectors. Commitments and will to fund TVET is much weaker than efforts to fund schooling or higher education. To make a difference, new and innovative ways must be identified to mobilise financial support for TVET. Skills development programmes must shift and focus on responding to the increasing demand for training opportunities with greater private sector involvement, better coordination, effective use of new technology and the media, and interventions with a sectoral focus. As long as there is a level of regulation and quality assurance, private training providers have a major role to play in skills development. Evidence may be needed to encourage the private financing of skills development, as there is likely to be an expected return on investment by those providing the financing. There is currently a considerable knowledge gap regarding the effectiveness and efficiency of training. More research is needed. To be successful, education and training systems must be integrated into national skills strategies. This will ensure that, on completion of training, the economy can absorb the skilled workforce.

Acemoglu D and Pischke J-S. 1998. ‘Why Do Firms Train? Theory and Evidence’. The Quarterly Journal of Economics; 113(1)

This paper offers a theory of training whereby workers do not pay for the general training they receive. The superior information of the current employer regarding its employees’ abilities relative to other firms creates ex post monopsony power, and encourages this employer to provide and pay for training, even if these skills are general. The model can lead to multiple equlibria. In one equilibrium quits are endogenously high, and as a result employers have limited monopsony power and provide little training, while in another equilibrium quits are low and training is high. Using microdata on German apprentices, the authors show that the predictions of the model receive some support from the data. Although published in the late 1990s, it offers important theory that is still relevant to the discussion on skills.

Adams A. 2008. Skills Development in the Informal Sector of SubSaharan Africa. The World Bank. Washington DC.

The informal sector of sub-Saharan Africa is comprised of small and household enterprises that operate in the non-farm sector outside the protected employment of the formal wage sector. The sector was identified 40 years ago by the International Labour Organization (ILO) representing a pool of surplus labour that was expected to be absorbed by future industrialisation, but rather than gradually disappearing, it has become a persistent feature of the region’s economic landscape accounting for a majority of jobs created off the farm. Acknowledging its potential as a source of employment for the region’s expanding workforce and improving its productivity and earnings is recognised as a priority for poverty reduction. This study examines the role played by education and skills development in achieving this objective. Until now, few studies have used household labour force surveys to capture the skills profile of the informal sector and study how different means of skills development – formal education, technical and vocational education and training, apprenticeships, and learning on the job – shape productivity and earnings in the informal sector as compared with the formal wage sector. This study uses household labour force surveys to look at the experience of skills development in five African countries – Ghana, Kenya, Nigeria, Rwanda, and Tanzania – that together account for one-third of the nearly 900 million persons living in SSA. The study defines the non-farm informal sector as the self-employed (own account and with workers), contributing family members, and wage workers in small and household enterprises. Of the nearly 36 million working off the farm in the five countries, 7 out of 10 are working in the informal sector. The importance of this study is its quantitative assessment of how different sources of skills development are related to the sector in which one works and the earnings received in that sector. It further highlights a set of economic constraints to acquiring skills in the small and household enterprises of the informal sector that will have to be overcome if skills are to become a means for improving productivity and earnings in this sector. The study offers a comprehensive strategy for improving employment outcomes in the informal sector through skills development with examples of successful interventions taken from international experience and the five countries.

Adams A. 2011. The Role of Skills Development in Overcoming Social Disadvantage. Background paper prepared for the Education for All Global Monitoring Report 2012. UNESCO, Paris

This paper was written as part of the planning phase for the Education for All Global Monitoring Report 2012. Its objective is to highlight current policies that support skills development and to identify gaps that present potential for progress. Theories of skills acquisition have moved on from being exclusively linked to formal education settings. Other sources of skills development are now considered. This includes skills development through informal at work learning, apprenticeships and enterprise-based training. It also includes government and non-government funded training and education institutes. Past policy interventions and country experiences can provide important lessons on past policies and inform new ways of thinking. The first section of this paper explores definitions and theories about skills development. It considers measuring and monitoring of success. The second section provides an overview of evaluating skills development implementations. The third section reflects on reform trends and challenges in reaching the socially disadvantaged with skills and the policy gaps that need to be filled.

Adams A, Johansson de Silva S and Razmara S. 2013. Improving Skills Development in the Informal Sector Strategies for Sub-Saharan Africa. The World Bank. Washington DC.

This study examines the role played by education and skills development in achieving sub-Saharan Africa’s full potential. It uses household labour force surveys to look at the experience of skills development in Ghana, Kenya, Nigeria, Rwanda, and Tanzania. The household labour force surveys capture the skills profile of the informal sector and study how different means of skills development – including formal education, technical and vocational education and training, apprenticeships, and learning on the job – shape productivity and earnings in the informal sector as compared with the formal wage sector. It quantitatively assesses how different sources of skills development are related to the sector in which one works and the earnings received in that sector. It highlights economic constraints to skills acquisition. It delivers a comprehensive strategy for improving employment outcomes in the informal sector through skills development with examples of successful interventions taken from international experience and the five countries.

Allais S. 2010. The implementation and impact of National Qualifications Frameworks: Report of a study in 16 countries. International Labour Office, Geneva.

This report aimed to produce empirical evidence and analysis of countries’ experiences of introducing a qualifications framework as part of a strategy to achieve skills development and employment goals. A qualifications framework is intended to improve understanding of qualifications (degrees, certificates, or recognition of experiential-based learning and capabilities) in terms of the information they convey to an employer about prospective workers’ competencies. Frameworks can also explain how qualifications relate to each other. This study aimed to develop an understanding of how employers are using qualifications frameworks in their hiring decisions and whether qualifications make a difference to workers in the job market.

This report reviewed existing research on the English National Vocational Qualifications (NVQs) and the early reforms leading to the Scottish Credit and Qualifications Framework, as well as the other three ‘early starter’ qualifications frameworks (Australia, New Zealand, and South Africa) in five case studies based on existing research and documentation. A further 11 case studies were based on new fieldwork. Chile and Mexico were researched as these countries started work on the development of Labour Competence Frameworks in the late 1990s, even though they do not yet have NQFs per se. Botswana, Malaysia and Mauritius can be described as ‘second generation’ NQFs. Bangladesh, Lithuania, Russia, Sri Lanka, Tunisia, and Turkey have more recently started developing qualifications frameworks, with Russia being the most recent. The study also involved a review of available literature, a critical analysis of the different roles of qualifications in educational reform, and the development of a proposed typology of qualifications frameworks.

Allais S. 2012. ‘Will skills save us? Rethinking the relationships between vocational education, skills development policies, and social policy in South Africa’. International Journal of Educational Development 32(5)

This paper explores skills development in South Africa. It considers the relationships between vocational education and development. Policy interventions and new institutions and systems for skills development have failed to increase the number of skilled workers in South Africa. South African media and policy circles report that a skills shortage and an inflexible labour market are causing unemployment. Skills are being included as part of a ‘self-help’ agenda, alongside wage subsidies and a reduction of protective legislation for young workers, instead of collective responsibility for social welfare. Skills policies are founded on state regulation and qualification and quality assurance reform. Little emphasis has been placed on building provision systems and on curriculum development. The South African experience exemplifies how difficult it is to develop robust and coherent skills development in the context of inadequate social security, high levels of job insecurity, and high levels of inequalities. The weaknesses of market-led vocational education are detailed.

Almeida R, Behrman J and Robalino D. (eds). 2012. The Right Skills for the Job? Rethinking Training Policies for Workers. The World Bank, Washington DC.

This book is concerned with upgrading job relevant skills. It focus on three types of training programmes relevant for individuals who are leaving formal general schooling or are already in the labour market. These are

  • Pre-employment technical and vocational education and training (TVET). TVET is usually offered within the formal schooling track and tends to be administered by the ministries of education.
  • On-the-job training (OJT).
  • Training-related active labour market programmes (ALMPs). ALMPs do not take up much time and target low skilled or informal workers who do not have access to TVET or OJT.

The book discusses the strengths and weaknesses of these programmes and contextualises them with market failures that can lead to underinvestment in training and misalignment between supply and demand for skills. Examples are given of programmes that are part of the problem and not the solution. Recommendations are made to improve the design and implementation of current skills development systems. Important design features are reported, as are gaps in the evidence.

Altenburg T. 2010. Industrial policy in Ethiopia. German Development Institute, Bonn

This report assesses industrial policy in Ethiopia. Industrial policy is a contested issue, especially for low-income countries. Proactive policies are required to make the transition from low-productivity resourced-based societies with large informal sectors to more productive, knowledge-based and formalised patterns of productive organisation. However, channelling resources into preferential activities may reduce allocative efficiency. This can create perverse incentives for stakeholders including investors and bureaucrats. This problem is exacerbated in low-income settings, where political checks and balances may be weak. The Ethiopian government has created the preconditions for a market-based and socially inclusive industrial transformation. It has demonstrated commitment to investing in technological learning in order to build new competitive advantages through programmes to strengthen the technical and vocational education system. Universities and specialised supporting institutions have been established. Diversification and industrial development are the objectives. Agricultural demand-led industrialisation and export promotion are central in its strategy. For the last ten years, the Ethiopian economy has grown at 11 per cent annually, mainly due to favourable agro-climatic conditions, high coffee prices, considerable inflows of aid and remittances, and a boom in construction. However, the economic structure has not changed much and competitiveness has not increased. This study focuses on the policymaking process in the leather/leather products and the cut flower industries.

Arbache JS, Kolev A & Filipiak E (Eds). 2010. Gender Disparities in Africa’s Labor Market. World Bank, Washington DC.

Evidence indicates that in several countries in Africa, women’s earnings are a fraction of male’s earnings. It is argued in this book that the gap is not simply the result of discrimination in the labour markets, but rather the result of multiple factors, including access to education and credit, cultural values and household duties and labour market conditions. Gender disparities are shown to grow when economies are not functioning well and labour markets are very small. Job rationing causes those with better human capital and those with more power in the household—usually the men—to take the few jobs that are available. In regions with small formal sectors, gender disparities in earnings are high. Firm-level and sector characteristics are additional powerful factors in explaining the gender disparities in the labour market. Multifaceted strategies are required. Governments must actively encourage environments that support economic growth and job creation, as well as by promoting equal access for women to education. Attitudes that limit what women may achieve must be addressed. Gender Disparities in Africa’s Labour Market helps to fill the knowledge gap and identify the links between gender disparities and poverty reduction.

Blattman C and Annan J. 2011. Reintegrating and Employing High Risk Youth in Liberia: Lessons from a randomized evaluation of a Landmine Action agricultural training program for ex-combatants

Despite a lack of rigorous evidence, states and aid agencies encourage employment programmes to rehabilitate men who are at risk of returning to violence, in the belief that peaceful work opportunities will deter them from crime and violence. This paper presents an evaluation of a programme of agricultural training, capital inputs, and counselling for Liberians who had previously been involved in fighting and who were illegally mining or occupying rubber plantations. Men who accepted the programme were shown to increase the time they spent employed on farms. Their profits also increased as they shifted work hours away from illicit activities. Mercenary work was also reduced. Some men did not receive their capital inputs but expected a future cash transfer instead, and they reduced illicit and mercenary activities most of all. Relatively small changes in returns to peaceful work, especially future and ongoing incentives led to a change in illicit and mercenary labour supply. However, the evidence also indicates that the impacts of training alone, without capital, appear to be low.

Blattman C and Ralston L. 2015. Generating Employment in Poor and Fragile States: Evidence from Labor Market and Entrepreneurship Programs. World Bank, Washington DC.

This paper reviews the evidence on what interventions designed to raise incomes in fragile states work, and whether stimulating employment promotes social stability. Skills training and microfinance have shown little impact on poverty or stability, especially relative to programme cost. In contrast, the evidence suggests that injections of capital (cash, capital goods, or livestock) may stimulate self-employment and raise long term earning potential, often when partnered with low-cost complementary interventions. Such capital-centric programmes, alongside cash-for-work, may be the most effective tools for putting people to work and boosting incomes in poor and fragile states. Such programmes could help to reduce crime and other materially-motivated violence modestly. However, a degree of caution should be taken regarding the effects of employment on crime and violence, as some forms of violence do not respond to incomes or employment.

Brixiova Z. 2010. ‘Unlocking Productive Entrepreneurship in Africa’s Least Developed Countries’. African Development Review; 22(3)

Structural transformation and productive entrepreneurship can create jobs and accelerate growth. For many people living in poverty in Africa’s least developed countries, subsistence agriculture is the main source of employment. Jobs and growth will improve their chances of increasing their standard of living. However, progress of a dynamic private sector in industry or high value-added services remain elusive. This paper develops a theoretical framework to examine the main obstacles to entrepreneurship in Africa’s poorest countries. There are clearly skill shortages in these economies. Development of entrepreneurship cannot be left to markets alone. The state has a role to play as well. Carefully conceived and implemented state interventions including training can help to establish small and medium enterprises that are required.

Cedefop. 2011. The impact of vocational education and training on company performance. European Union, Luxemburg

This study presents a meta-analysis of the evidence available in literature on the economic benefits of VET at company level. It includes 62 studies and 264 estimated effects, covering many different company performance and training indicators. The meta-analysis concludes that VET has a positive and significant effect on the economic performance of firms. The effects of different types of training is hard to assess as the evidence is limited. This is due to this aspect not being recorded in most studies. Similarly, a clear relationship between the size of investment and size of the effect on productivity was hard to establish for the limited comparability of the VET variables and estimated effects collected.

Cheema A, Khwaja A, Naseer M F and Shapiro J. (date unknown). Designing active labor market policies in Southern Punjab – Evidence from household and community surveys. Centre for Economic Research in Pakistan, Pakistan.

The Punjab Economic Opportunities Program (PEOP) is a flagship programme of the Government of Punjab being implemented in partnership with DfID. PEOP aims to alleviate poverty and create inclusive growth in the province’s high poverty districts – Bahawalnagar, Bahawalpur, Lodhran and Muzaffargarh – by increasing the employability and earnings of poor and vulnerable families. This report summarises the design-relevant findings using a random district-representative sample of 10,946 households in 709 Primary Sampling Units (PSUs) surveyed (out of a total 809 PSUs to be surveyed as part of the Baseline Household Survey Activity) in the programme districts. The contribution of the report is ultimately to prioritise between a set of possible interventions (i.e., arguing there is more support for some versus others) and in providing analysis that informs design specific programme features.

Cook G and Younis A. 2012. Somalia youth livelihoods program – Final evaluation. USAID, Somalia.

The objective of the Somali Youth Livelihoods Program (SYLP), known locally as Shaqodoon, was to establish systems that bridge supply and demand with necessary support to young people and employers. It aimed to provide Somali youth with a greater opportunity to access work opportunities. This evaluation presents quantitative and qualitative information and data that indicate that it was largely successful. The programme succeeded in providing internships or paid job placements in the private and public sectors for 87 per cent of the 9,280 youth who completed the training and placement component – exceeding targets. Youth, parents, business owners, and government authorities considered the training effective and the placement opportunities beneficial for youth’s long-term employment prospects. This evaluation provides information and lessons learned to USAID on both the programme and the implementer (the Education Development Center).

Darvas P and Palmer R. 2014. Demand and Supply of Skills in Ghana: How Can Training Programs Improve Employment? World Bank, Washington DC

As many as 24 million youths live in Ghana. In the last 20 years it has shown impressive gains in economic growth and in poverty reduction. Sustained growth requires three steps:

  • Increase productivity in the strategic economic sectors
  • Diversify the economy
  • Expand employment

Raising the quality and quantity of skills provides a contribution to these drivers of sustained growth. Skills development in Ghana encompasses foundational skills (literacy and numeracy), transferable and soft skills, and technical and vocational skills. These skills are acquired throughout life through formal education, training, and higher education; on the job through work experience and professional training; through family and community; and via the media.

This paper is concerned with TVET in Ghana at the pre-tertiary level. TVET alone does not guarantee productivity gains or job creation. A mixture of cognitive, non-cognitive, intermediate, and higher technical skills is required to enhance competitiveness and contribute to social inclusion, acceptable employment, and the alleviation of poverty. The public financing approach and general lack of incentives to improve TVET in Ghana help to perpetuate a supply-driven, low-quality skills system that responds very poorly to the needs of the economy, and especially its growth sectors. It is recommended that the national skills strategy in Ghana should aim to complement, and be complemented by, reforms that are underway in related sectors (for example, private sector development and employment, the informal economy, information and communication technologies, and agriculture). Sustainable financing for the skills development fund (SDF) is an example of an innovative reform. Channelling TVET resources through a SDF facilitates the allocation of funds in line with general national socioeconomic priorities and specific priorities identified by the Council for Technical and Vocational Education and Training (COTVET).

Depover C and Orivel F. 2013. Developing countries in the e-learning era. UNESCO, Paris

Digital technologies provide opportunities for rural and remote populations. In the education context, digital technologies permit the development of adapted and diversified pedagogical models, with an economic approach aiming at more than just economies of scale. In many developing countries, needs often exceed resources. In these contexts, distance education provides many benefits. Digital technology can reduce geographical isolation, improve education cost structures. They can also allow for monitoring of social and economic remoteness.

Dunbar M. 2013. Engaging the private sector in skills development. HEART, Oxford

This report aims to provide an understanding of the role of the private sector in skills development, both as employers and as skills providers. The objective was to find potential opportunities to support private sector integration in all aspects of skills development, particularly in low-income contexts. In addition, the research explored the twin issues of access to finance for skills development stakeholders; and financial support from the private sector for skills development programmes. The volume of recent work focused on skills is considerable. It is clear that a radical shift in skills development is both needed and is beginning to take place. To succeed, this shift must:

  • Respond to demand for training opportunities with greater private sector involvement
  • Improve co-ordination efforts between stakeholders
  • Make effective use of new technology and the media

Private sector interventions generally need facilitation either by a government, donor or NGO. Employers are more likely to engage in skills development at any level, if the benefits of doing so are apparent, the business environment is favourable and there is minimal bureaucracy attached. Their engagement is being proactive.

Dustmann C and Schönberg U. 2012. ‘What Makes Firm-based Vocational Training Schemes Successful? The Role of Commitment’. American Economic Journal: Applied Economics; 4(2)

This document focuses on possible market failure in the firm-based vocational training market. It considers that training requirements may be complex. If this is the case, they will be unlikely to be specified in a legally enforceable contract. This makes it hard for firms to commit to training provision. Training tends to be lower where there is no commitment. Firm based vocational training schemes tend to be more successful in locations where commitment to training provision is established. The authors present a model of firm provided training, illustrating best practice.

EFA GMR. 2012. Youth and skills – Putting education to work. Education for All Global Monitoring Report 2012, UNESCO, Paris.

This report focuses on skills and education. It examines how skills development programmes can be improved to boost young people’s opportunities for decent jobs and better lives. Many young people leave the education system without the necessary skills to find work and contribute to society. These education failures impact on economic growth and social cohesion. Poor and inadequate training prevents many countries from realising potential benefits of their growing young populations.

EFA GMR. 2015. Education for All 2000-2015: achievements and challenges. Education for All Global Monitoring Report 2015, UNESCO, Paris.

In 2000, at the World Education Forum in Dakar, Senegal, 164 governments agreed on the Dakar Framework for Action, Education for All: Meeting our Collective Commitments, launching an ambitious agenda to reach six wide-ranging education goals by 2015. This report provides a complete assessment of progress towards the Framework’s goals. Looking forward, the report also identifies key factors that must be considered when planning and implementing the post-2015 global education agenda. Chapter 3 focuses on youth and adult skills. Young people need decent jobs. Global efforts are needed to ensure that young people have the foundational skills required to enter the workforce and actively participate in society. The focus of this chapter is access and barriers to secondary education. It analyses which skills and values are required for social progress. Education alternatives are suggested for people who have left school but still require skills development. The changing discourse on TVET and adult education is discussed.

ETF and World Bank. 2005. Reforming Technical Vocational Education and Training in the Middle East and North Africa: Experiences and Challenges. Luxembourg, Office for Official Publications of the European Communities.

This report by the European Training Foundation (ETF) and the World Bank is the result of a joint analysis of the main challenges for the reform of technical and vocational education and training (TVET) in the Middle East and North Africa. The role of TVET in the provision of quality and relevant learning opportunities in the region is explored around five themes: improving governance, financing, quality and relevance, the role of the private sector and the acquisition of skills in the informal sector. Key findings from country reviews of Egypt, Jordan, Lebanon and Tunisia are presented in the report.

Elder S, de Haas H, Principi M and Schewel K. 2015. Youth and rural development: Evidence from 25 school-to-work transition surveys. International Labour Office, Geneva

This report uses data from the school-to-work transitions surveys (SWTSs) from 2012-2013. It assesses the labour market conditions of youth in rural and urban areas. From this perspective it offers insights into prospects for fundamental transformations of rural sectors within the development process. While confirming some blurring between rural and urban areas in terms of sectoral distribution of employment, it is concluded that low-income countries in particular have a long way to go in the diversification of rural economies beyond agriculture and petty trades and even further in building the capacity of rural labour markets to generate decent employment opportunities for young people.

Faccini B and Salzano C. 2011. Capacity development for education for all (CapEFA): Translating theory into practice. UNESCO, Paris

UNESCO’s 2011 Education for All Global Monitoring Report suggests that national barriers to EFA have been largely under-estimated and that, over the past decade, insufficient attention has been paid to strategies for overcoming them. This report offers reflection upon UNESCO’s capacity development approach and details achievements and lessons learned through the CapEFA programme. Examples are given on how specific capacity challenges to EFA are being addressed through nationally owned and driven capacity-development strategies, multi-stakeholder partnership arrangements and platforms for South-South cooperation.

Filmer D and Fox L. 2014. Youth employment in Sub-Saharan Africa. World Bank, Washington DC

This report examines obstacles faced by households and firms in meeting the youth employment challenge. Its main focus is on productivity in agriculture, nonfarm household enterprises (HEs) and in the modern wage sector. Productivity is linked to higher earnings as well as to more stable, less vulnerable, livelihoods. Specific areas are identified where government intervention could reduce those obstacles to productivity for households and firms, leading to brighter employment prospects for youth, their parents, and their own children.

George G, Surgey G and Gow J. 2014. ‘South Africa’s private sector investment in training and its erosion as a result of HIV and AIDS’. South African Journal of Economic and Management Sciences; 17 (2)

The South African economy is dependent on the productivity of its labour. To maximise productivity the labour force must possess the appropriate skills. The private sector invests more funds than the government on training. However, the HIV and AIDS epidemic is eroding this investment. Based on an estimate of the HIV and AIDS death rate and data on training expenditure by the private sector, this study concludes that the loss for all sectors was estimated at almost R10 million (R9,871,732) during the study year, equating to USD1,183,661 per annum. This represents on average 0.73 per cent of the investment in training. The real costs of HIV and AIDS on business, which includes absenteeism, declining productivity and other costs, are difficult to quantify, but they are likely to significantly exceed this lost training investment as a result of increasing morbidity and mortality rates due to HIV. It is in the private sector’s best interest to ensure that a sound HIV and AIDS policy is in place. Companies must also invest in effective prevention programmes and provide the appropriate treatment to employees if needed or unavailable through the public health sector.

Glick P, Huang C and Mejia N. 2015. The Private Sector and Youth Skills and Employment Programs in Low- and Middle-Income Countries. RAND Corporation, USA.

This paper provides a comprehensive look at the way the private sector is involved in youth skills and employment in low- and middle-income countries, considering the broad range of programme types and firm types. It presents and interprets the available evidence of the effectiveness of this involvement. It also presents an understanding of where the private sector has been most effective at promoting young people’s labour market success, and what could be done to enhance the role of the private sector to achieve this objective. In attempting to understand firms’ engagement and effectiveness, the authors draw on a basic economic framework that considers this behaviour in light of factors such as costs, perceived returns, information, and externalities.

Green F. 2011. ‘What is Skill? An Inter-Disciplinary Synthesis’. LLAKES Research Paper 20. The Centre for Learning and Life Chances in Knowledge Economies and Societies, London

After some adaptations this paper formed Chapter 2 of: Green F. 2013. Skills and Skilled Work An Economic and Social Analysis, Oxford University Press, UK. 

This synthesis is concerned with the definition of the word ‘skill’. It argues that the word skill often has different meanings when being used in different contexts. Economists, sociologists and psychologists all ascribe high importance to skills, yet frequently define skills in different ways. Skill and competence are often interchanged. A simple functional concept is suggested that offers the prospect of dialogue and progress in skills analysis. The author argues that skills have three key features: they are productive, expandable and social.

Huxley S. 2010. Youth Participation in Development: A Guide for Development Agencies and Policy Makers, DfID-CSO Youth Working Group, London UK.

This guide has been developed to assist donor agencies (multilateral and bilateral) and policy advisors in a range of organisations working with and for youth. It will also be useful for government, NGO and civil society partners. This guide aims to increase understanding of the growing importance of, and greater potential for, youth participation in development practice and to explore key issues and approaches. But it goes beyond the rhetoric of many policy advocacy papers, which simply argue for a focus on youth participation. Rather, this guide provides information on how to actually work with youth at a practical operational level in respect of policy and programming. It does this through the provision of promising practice case studies (and their associated resources), and a number of quality standards that will help organisations to get started. Central to this guide is its focus on working with excluded sub-groups of young people, and the importance of building partnerships between adults and youth in a culturally sensitive manner. This is the foundation for all youth mainstreaming work. The guide draws on and synthesises the experience of a wide range of institutions, donor agencies and practitioners.

Jackson T. 2012. ‘Cross-cultural management and the informal economy in sub-Saharan Africa: implications for organization, employment and skills development’. International Journal of Human Resource Management; 23 (14)

The informal economy has grown in importance within sub-Saharan Africa, yet there are debates about its role within national economies that appear not to take cognisance of the interests and the weak power base of those working within the informal economy. This article argues that a cross-cultural perspective should be taken in understanding the geopolitical context of informal organisations, the power relationships involved and how the contributions and future of skills development, employment and organisation within the informal and wider economies can be better understood and researched. It initially alludes to the informal sector being closer to local communities, and more appropriate to developments in Africa, but draws on postcolonial theory to better understand the nature and role of such organisation within an interface of structural and phenomenological influences that question the nature of the ‘indigenous’ as an artefact. Some of the parameters of research in this area are drawn within this work while recognizing that further development is needed in both theory and methods. This article thus attempts to lay the foundations for a cross-cultural conceptual framework leading to a methodology that can inform both practice and policy in this neglected but important area.

Johanson R. 2009. A Review of National Training Funds. The World Bank, Washington DC

This review presents pre-employment and enterprise training funds from over sixty countries. The characteristics, advantages, and limitations of each are presented. Key design questions are discussed and examples of good practice illustrated. National training funds are increasingly used to finance training. This paper presents a typology of three main types of training funds by purpose:

  1. Pre-employment training funds
  2. Enterprise training funds
  3. Equity training funds

It highlights a lack of rigorous evaluation of the impact of training funds on the skills and employability of the workforce in developing countries.

Johanson R and Adams A. 2004. Skills Development in Sub-Saharan Africa. World Bank Washington, DC.

In no region other than Africa is the trade-off drawn more sharply between the achievement of skills development with technical and vocational education and training (TVET) and providing universal basic education. Both are important to economic growth and poverty reduction, but the fiscal and administrative capacity of the state to meet both goals is limited. The presence of HIV/AIDS and its deskilling of the labour force compounds the problem. Defining the role of the state more strategically in the provision and financing of TVET is essential to achieving Education for All and the poverty reduction goal of the Millennium Development Goals. Confronting this trade-off is the objective of Skills Development in sub-Saharan Africa. Written to inform clients, donors, and World Bank staff about TVET experiences over the past decade, Skills Development in Sub-Saharan Africa builds a dialogue around this experience. The study sets out to update knowledge and explore issues and recent developments in TVET and distil lessons as a guide to future skills development in the region. The focus of the analysis is on the economics of skills development. Provision of financing of TVET are examined through the lens of economic efficiency, balanced with attention to social equity.

Kamoche K, Chizema A, Mellahi K and Newenham-Kahindi A. 2012. ‘New directions in the management of human resources in Africa’. International Journal of Human Resource Management; 23 (14)

The last decade has witnessed a notable increase in the volume of publications on human resource management (HRM) in Africa, particularly in reputable management journals. Yet, within the broader context of the mainstream HRM debate, advances in research and theoretical sophistication have not quite kept pace with the actual practice of management. This is particularly notable when it comes to the progress that organisations in Africa have made in product innovation and service delivery, the creation and application of advanced technology, as well as in the adoption of progressive/innovative HRM practices.

Ki-Moon B. 2014. The road to dignity by 2030: ending poverty, transforming all lives and protecting the planet. United Nations General Assembly Sixty-ninth session Agenda items 13 (a) and 115

This is a synthesis report of the UN Secretary-General on the post-2015 sustainable development agenda. It details a universal and transformative agenda for sustainable development of people and the planet, underpinned by rights. In the report, the Secretary-General makes the point that for progression, it will be essential that young people receive relevant skills. These can be delivered through quality education and lifelong learning. Skills developed at an early age are important, as are life skills and vocational education and training.

King K. 2011. Eight Proposals for a Strengthened Focus on Technical and Vocational Education and Training (TVET) in the Education for All (EFA) Agenda. UNESCO, Paris

This paper presents eight proposals that are based on several bodies of work on skills development. They aim to incorporate the detail of the discussion on skills development, some new ways of thinking about the topic, some priority areas and neglected issues, key topics, as well as data and research needs. The eight proposals are as follows:

  • Moving towards conceptual clarification of skills
  • Skills development for poverty reduction
  • Technical and vocational education and training and the enabling environment
  • Training in the informal or unorganised sector
  • School-based technical and vocational education
  • Improving the monitoring of low-hanging fruits in relation to TVE, and noting the higher-hanging fruits in vocational training and in the informal sector
  • Financing TVE and TVET
  • Identifying the situation of the poorest young people in the global politics of skills development

Section 7 is of particular interest for this chapter.

King K. 2012. ‘The geopolitics and meanings of India’s massive skills development ambitions’. International Journal of Educational Development; 32(5)

This study considers the drivers and meanings behind the dramatic rise of TVET in the policy and political agenda of India. It explores assumptions about the existing traditions and character of India’s culture and cultures of skills development. There is a paucity of long-term research on the TVET/skills development sector, although the recent growth in interest may remedy this in the long term. Skill acquisition in the informal sector may lack an explicit commitment to train, but may facilitate learning on the job.

Kingombe C. 2012. Lessons for Developing Countries from Experience with Technical and Vocational Education and Training. International Growth Centre. Working Paper; 11 (1017)

Globalisation and technological changes to economies necessitate enhancement of literacy education and training. This paper focuses on the Draft National TVET Policy for Sierra Leone (DNTVET). This has been described as a high priority for the Government and all the skills development (SD) stakeholders in the Second Poverty Reduction Strategy Paper (PRSP-11, 2009-2012). Enterprise and skills development, including the focus on youth employment, were emphasised. If Sierra Leone is to successfully make the transition to a middle-income country, successful skills development will be essential. Based on frontier research on the lessons learned from recent TVET reforms in other developing countries, this paper aims to inform the future comprehensive design and implementation of strategies for TVET in Sierra Leone. It suggests how to address future challenges and opportunities to ensure that the good performance of TVET reforms contribute to the promotion of sustainable growth through private sector development.

Macours K, Premand P and Vakis R. 2013. Pro-Poor Targeting of Business Grants and Vocational Skills Training. World Bank Policy Research Working Paper 6389. World Bank, Washington DC

Various interventions aim to increase the capacity of poor people to generate income. Vocational training, micro-finance or business grants are commonly implemented. If perceived returns from these interventions differ from actual returns, individuals who put themselves forward to participate may not be those for whom the programme is the most effective. This paper details an unusual experiment with very high take-up of business grants and vocational skills training, randomly assigned among nearly all households in selected poor rural communities in Nicaragua. On average, the interventions resulted in increased participation in non-agricultural employment and higher income from related activities. It is investigated whether intervention targeting could have resulted in higher returns by analysing heterogeneity in impacts by stated baseline demand, prior participation in non-agricultural activities, and a wide range of complementary asset endowments. The results show little heterogeneity along observed baseline characteristics. However, the poorest households are more likely to enter and have higher profits in non-agricultural self-employment, while less poor households assigned to the training have higher non-agricultural wages. This heterogeneity appears related to unobserved characteristics that are not revealed by stated baseline demand, and more difficult to target. In this context, self-targeting may reduce the poverty-reduction potential of income generating interventions, possibly because low aspirations limit the poor’s ex-ante demand for productive interventions while the interventions have the potential to increase those aspirations. To summarise, the paper finds that targeting productive interventions to poor households would not have come at the cost of reducing their effectiveness. By contrast, self-targeting would have limited poverty reduction by excluding the poorest.

McGrath S, Badroodien A, Kraak A and Unwin L (eds). 2004. Shifting Understandings of Skills in South Africa Overcoming the historical imprint of a low skills regime. Human Sciences Research Council, Cape Town

The objective of this ebook is to critically engage with South Africa’s current skills development strategy and to analyse the prospects for a successful upskilling of the population. It contains chapters written by leading South African academics. It also includes content from skills formation systems experts. This ebook attempts to examine what is understood by the term ‘skill’ in the South African context. It does so in relation to how skill and skills are being employed in contemporary policies and practices within South Africa. It affirms the need to see such debates in both historical and international contexts. The authors share the policy concern with how to facilitate development and the role of skill and skills development in that focus. How skill supports the national project is a focus. Recommendations are made for how best to deal with the issue of skill in South Africa.

McGrath S. 2012. ‘Vocational education and training for development: A policy in need of a theory?International Journal of Educational Development; 32(5)

This paper argues that the role of vocational education and training in development needs to be considered from a theoretical standpoint. Current approaches in vocational education are outdated. Recent theoretical thinking about development offer a new perspective through which to understand the value of vocational education and its role in developing countries. There is a paucity of research into TVET. In particular, research into its theoretical foundations is particularly lacking. The implications for implementing TVET programmes in developing programmes needs to be readdressed in light of recent approaches to human rights, capabilities and human development.

McGrath S, Lugg R, Papier J, Needham S and Neymeyer S. 2013. Status of TVET in the SADC Region. UNESCO, Paris.

This report focuses on TVET in the South African Development Community (SADC). It finds that there is a very weak current knowledge base for TVET in the region. This report is a first step towards better knowledge on TVET for better policies and practices. TVET is recognised as important in SADC’s protocol on education and training (1997) as well as by the Education for All agenda. The benefits of TVET are known to include:

  • Economic growth and poverty alleviation
  • Facilitating the transition of young people to decent work and adulthood
  • Improving productivity
  • Helping the unemployed to find work
  • Assisting in reconstruction after conflicts and disasters
  • Promoting social inclusion.

Major concerns exist about the progress of TVET in southern Africa. SADC and UNESCO intervened by commissioning a pilot TVET monitoring tool. A regional review of TVET fed into a new strategic programme of action for regional cooperation. Although the available data presented some limitations, the report provides a foundation for future strategic interventions based on the evidence available.

The definition of TVET was a key challenge. TVET can be replaced by other concepts such as human resources development or skills development, which are seen in some contexts as being broader notions. A better inter-regional understanding of definitions is needed. A glossary of key terms and a taxonomy of how these relate to each other theoretically could feed into the theory of how their acquisition and development should be sequenced and structured.

The challenges around understanding TVET, and how it can be measured, have required a pragmatic definition of TVET to be adopted for this report that largely focuses on initial vocational education and training within dedicated provider institutions that engage with the lower and intermediate levels of national qualifications.

Merensky-Hartinger T. 2014. Greening TVET Colleges Initiative in South Africa. Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), Bonn.

South Africa is making policy efforts to invest in a green economy. It is hoped that the green economy will drive growth, provide jobs and ultimately reduce poverty. It has been identified as a key sector for employment creation with the potential for creating at least 300,000 additional direct jobs by 2020. Job creation is expected in the fields of natural resource management, waste management, green energy generation and energy and resource efficiency as well as emission and pollution mitigation. TVET is recognised as an important step towards sustainable development. TVET programmes must educate and train people to meet the new skills requirements arising in both the green economy as well as economic sectors which are greening. TVET must provide a skilled and capable workforce that contributes to and benefits from a growing greening economy towards the sustainable development of planet earth. TVET must provide adequate skills development to meet the requirements of a greening economy, and contributes to achieving the national and international targets of sustainable development and climate protection.

Middleton J, Ziderman A and Adams A. 1993. Skills for productivity, Oxford University Press, Oxford.

This study discusses the need for developing countries to improve economic productivity. It draws on lessons from successful country experiences with skills training to develop an approach to the development of public training policies. The authors suggest that improving the job skills of the work force in developing countries is necessary if they are to compete in today’s economic climate. The book is written for policymakers, academic and professional advisers, training professionals, and the staff of international agencies supporting economic and social development. A flexible, trained workforce can greatly improve economic efficiency and appropriate policies can greatly improve efficiency and equity of skills development. The main focus of the study is on programmes offered by private and public pre-employment vocational and technical schools and vocational training centres. The study provides options for public policy and strategies for reform.

Müller N and Behringer F. 2012. Subsidies and Levies as Policy Instruments to Encourage Employer-Provided Training. OECD Education Working Paper 80. OECD, Paris

This paper presents evidence of policy instruments intended to promote employer-provided training. This includes the stated rationale and objectives of the training, the target groups and operational design. It also presents a summary of the evaluative evidence regarding their operation. The analysis focuses on policy instruments providing financial assistance or incentives, specifically, subsidies (including tax incentives and grants) and levy schemes that devote at least some share of their resources to continuing training. Training leave regulations are considered only to the extent that they can be treated as a form of subsidy or a levy scheme, depending on the main financing mechanism involved. Instruments are only concerned with improving the quality of training or enhancing transparency in the training market are not addressed in this report. The paper discusses the strengths and weaknesses (or risks and opportunities, respectively) of different types of instruments or particular elements of instrument design. It also details successful instrument design.

OECD. 2012. Better Skills, Better Jobs, Better Lives – Highlights of the OECD Skills Strategy. OECD, Paris

Skills transform lives and drive economies. Skills have become the global currency of 21st-century economies. There is evidence that countries can do better in developing and using the skills that are available to them. Building on its whole-of-government approach to policy making and its unique evidence base, the OECD has developed a global Skills Strategy that helps countries identify the strengths and weaknesses of their national skills systems, benchmark them internationally, and develop policies that can transform better skills into better jobs, economic growth and social inclusion. The Skills Strategy supports countries in adopting a systematic and comprehensive approach to skills policies that can:

  • Prioritise investment of scarce resources
  • Combine short- and long-term considerations
  • Build a case for lifelong learning
  • Foster a whole-of-government approach
  • Align the perspectives of different levels of government
  • Include all relevant stakeholders

To reach the goal of having and making the best use of a high-quality pool of skills, a country must consider three main policy levers: those that improve the quality and quantity of skills; those that activate the skills for the labour market; and those that ensure that skills are used effectively.

Olenik C. and Fawcett C. 2013. State of the field report: Examining the evidence in youth workforce development. USAID youth research, evaluation and learning project. USAID, Washington DC.

This paper provides information on the latest research and evaluation of workforce development programming for youth. While the focus is on work done in developing countries, results from a handful of particularly relevant studies in the United States are also included. The paper presents a framework for guiding the interpretation of the impact that workforce development has on youth outcomes. An analysis of the trends in the field that increase positive youth employment outcomes is also included. The latest evidence of what works in achieving these outcomes, along with a discussion of gap areas in need of further investigation is also presented.

Olenik C. and Takyi-Laryea A. 2013. State of the field report: Examining the evidence in youth education in crisis and conflict. USAID youth research, evaluation, and learning project. USAID, Washington DC.

This paper summarises evidence on youth education in crisis- and conflict-affected settings. The role of education and youth engagement in these contexts is discussed. A summary of the research available indicates that life skills training has resulted in increased self-awareness and empathy, as well as, decision making, goal setting, and communication skills for youth. It focuses on research and evaluation of workforce development programming for youth. It is focused on developing countries, but some case studies from the United States are included. A framework for guiding the interpretation of the impact that workforce development has on youth outcomes is presented. Trends in the field that increase positive youth employment outcomes are analysed. Evidence of what works in achieving positive outcomes are provided, as well as evidence gaps.

Page J. 2012. Aid, structural change and the private sector in Africa. WIDER Working Paper; 21

This paper argues that foreign aid is partly responsible for the lack of structural change in Africa. Africa’s development partners have devoted too few resources and too little attention to two critical constraints to private investment, infrastructure and skills, focusing instead on easily understood, but potentially low impact regulatory reforms. The author argues that a new aid strategy that catalyses private investment in high value added sectors, is needed. Support for strategic interventions to push non-traditional exports, support industrial agglomerations, build firm capabilities, and strengthen regional integration should anchor a new donor agenda to create good jobs and sustain growth.

Palmer R, Akabzaa R, Janjua S, King K and Noronha C. 2012. Skill acquisition and its impact upon lives and livelihoods in Ghana, India, and Pakistan. In Colclough C (ed). 2012. Education Outcomes and Poverty, A reassessment. Routledge UK

This book examines the impact of education on the lives and livelihoods of people in developing countries, particularly those living in poorer areas and from poorer households. This chapter outlines the different national contexts of skills development in India, Pakistan and Ghana. It assesses how accessible the skills systems are for the poorest members of society. The authors draw on field data to comment on the relationships between formal schooling and access to and acquisition of and utilisation of TVET. It was found that traditional gender roles limit female participation in the skills systems of all three countries analysed.

Psacharopoulos G. 1981. ‘Returns to education: an updated international comparison’, Comparative Education; 17 (3): 321 – 341.

The question of the profitability of investing in human capital remains controversial. Three main methods for estimating the rate of return to investment in education are described: the elaborate method, the earnings function method, and the short-cut method. Application of cost-benefit analysis measures in 44 countries yields four patterns that have important policy implications: (i) top priority should be given to primary education as a form of human resource investment due to high returns, both social and private; (ii) secondary and higher education should also be pursued in a programme of balanced human resource development; (iii) the larger discrepancy between the private and social returns in higher education indicates room for private finance at the university level; and (iv) falling returns to education that result as a country develops and/or the capacity of its educational system expands are minimal under time-series analysis and do not warrant abandonment of educational expansion.

Psacharopoulos G. 1985. ‘Returns to education: a further international update and implications’. Journal of Human Resources; 20 (4): 583 – 604.

This paper updates evidence on the returns to investment in education by adding estimates for new countries and refining existing estimates to bring the total number of country cases to over 60. The new cross country evidence confirms and reinforces earlier patterns, namely, that returns are highest for primary education, the general curricula, the education of women, and countries with the lowest per capita income. The findings have important implications for directing future investment in education which, for efficiency and equity purposes, should concentrate on these priority areas.

Psacharopoulos G and Loxley W. 1985. Diversified secondary education and development. Johns Hopkins University Press, Baltimore.

Secondary schools that offer prevocational courses in conjunction with traditional ones have flourished over the past decade in many developing countries. In fact, interest in these “diversified” schools seems to be growing because more and more governments are seeking assistance to establish diversified curricula. Although the World Bank has been investing heavily in these educational programmes, there have not been any studies on the impact of diversified education on economic development. This study was intended to begin a comparison of the advantages accruing to students and graduates of diversified schools and those with more traditional types of formal training. The report describes the research design of the two case studies in Colombia and Tanzania and discusses sampling and survey instruments as well as the results of the case studies of both countries.

Punjab Skills Development Fund (PSDF). 2015. Tracer Study of Skills for Jobs 2012. PSDF, Pakistan

Punjab Skills Development Fund (PSDF) commissions vocational training by engaging training service providers (TSPs) through a competitive bidding process. It designs training schemes that allow for quality and cost competition among training providers from different sectors. Skills for Job 2012 (SFJ 2012) was one of the schemes that had been designed by PSDF to expand publicly-subsided and accredited training provision. The first phase of the scheme ran from September 2012 to December 2013 and trained 18,500 individuals. In April 2015, Research Consultants (RCons), a survey firm, was commissioned by PSDF to conduct a tracer of a randomly selected female sample of 685 trainees of SFJ 2012. The trainees were interviewed in person by RCons for collection of data. The study primarily examines the labour market outcomes of the trainees under this scheme in four districts of southern Punjab, namely Bahawalpur, Bahawalnagar, Muzaffargarh and Lodhran. This report presents the findings of the tracer study.

Ransom B. 2010. ‘Lifelong learning in education, training and skills development’. In Barron T and Ncube J (Eds). 2010. Poverty and disability. Leonard Cheshire Disability, London.

This chapter considers the lifelong learning that people with disabilities in developing countries need to escape poverty. These include both competencies and qualifications. People with disabilities require skills to reach their potential. This potential refers to economic potential (earning a living) as well as social potential (contributing to society). Skills can be acquired in various ways through non-formal and formal channels and in a variety of settings. A number of case studies are provided.

Rubagiza J. 2010. Gender Analysis of the Technical and Vocational Education and Training (TVET) Policy in Rwanda. Forum for African women educationalists (FAWE Rwanda)

Rwanda has in recent years has made progress in promoting gender equality and women’s empowerment. 56 per cent of the parliamentarians in Rwanda are women – the highest in the world. Rwanda has managed to close the gender gap in gross and net enrolments in primary education. Despite these achievements, challenges remain. For example, it is still a challenge to achieve gender parity and equality in the TVET sector, which is characterised by gender inequalities and stereotyping. Girls and boys are channelled or channel themselves into different paths, which result in different outcomes and in particular different earnings. This report considers the 2008 TVET Policy in Rwanda from a gender perspective. It outlines gender and education related interventions for the policy with emphasis on girls and young women.

Sanchez Puerta M. 2010. Labor Market Policy Research for Developing Countries: Recent Examples from the Literature What do We Know and What should We Know? The World Bank, Washington DC.

This paper is focused on research in developing countries into labour market institutions, behaviour and policies. Theoretical and empirical implications of employment protection legislation on labour outcomes are analysed. Issues that exist around shifting from job to worker protection are discussed. Particular focus is given to the different alternatives to severance pay, including unemployment insurance and unemployment insurance savings accounts and their application to developing countries. The paper also includes an analysis of the effect of active labour market programmes, particularly of training, on labour market outcomes. Finally the causes and consequences of informality in the labour market are explored. Efforts to model the informal sector are highlighted. Evidence gaps are presented, suggesting directions for future research.

Sanchez Puerta M, Robalino D, Strokova V, Lord N and Perinet M. 2015. Skills and jobs – lessons learned and options for collaboration. World Bank, Washington DC

Knowledge and skills acquisition is central to human capital development and economic development. Workers with more education have better employment opportunities, have the potential to earn higher wages and have more stable and rewarding jobs. Skills can improve how adaptable and mobile workers are. The more skills present in an economy, the more productive other workers and capital becomes. Skills facilitate the adaptation, adoption, and ultimately invention of new technologies, leading to economic diversification, productivity growth, and raising the living standards of the population. This paper examines the different types of market failures, and subsequently reviews the role that governments have played in training systems around the world. It presents a set of proposals for reforming and improving these systems to improve labour market outcomes.

Tripney J, Hombrados J, Newman M, Hovish K, Brown C, Steinka-Fry K and Wilkey E. 2013. Post-Basic Technical and Vocational Education and Training (TVET) Interventions to Improve Employability and Employment of TVET Graduates in Low- and Middle-Income Countries: A Systematic Review. Campbell Systematic Reviews; 9

The dramatic increase of low-income, low-skilled youth in labour markets is of concern, particularly in developing countries. In some of these countries, young people are nearly three times as likely as adults to be unemployed. Youths are also more likely to work in the informal labour market than adults, in low quality jobs that offer limited socio-economic security, training opportunities, and working conditions. There is unlocked potential that would benefit both individuals and society. TVET is regarded as a means to expand opportunities for marginalised youth. This review systematically examines the evidence base to provide a picture of the types of TVET interventions being used to raise employment. It aims to identify TVET programmes that are effective and ineffective, and to identify areas in which more research needs to be conducted.

Tomaševski K. 2001. Removing obstacles in the way of the right to education. Swedish International Development Cooperation Agency (Sida), Stockholm

This publication begins with the need to dismantle prevalent misconceptions because they hinder the advancement of education as a human right. Those conceptual obstacles which are particularly widespread are tackled, and their dark sides highlighted. This publication strives to provide food-for-thought because there are reasons for denying that education is a human right and these have to be brought into the open and countered effectively. Although published in 2001, this publication raises important theoretical arguments regarding access to education. In particular, the assessment of gender dimensions for access to education are relevant to this topic guide.

UNESCO. 2012. Shanghai Consensus: Recommendations of the Third International Congress on Technical and Vocational Education and Training ‘Transforming TVET: Building skills for work and life’ Shanghai, People’s Republic of China 14 to 16 May 2012. UNESCO, Paris.

The 3rd UNESCO TVET Congress was held in Shanghai in May 2012. More than 500 representatives from 117 countries attended the Congress, which looked at ways of transforming TVET to make it more responsive to the needs of 21st century societies. The Shanghai Consensus details the recommendations to come out of the Congress, based on the discussions that were held on the challenges faced by TVET systems. It comments on the appropriate responses aimed at building a better understanding of the contribution of TVET to sustainable development and at defining strategic directions for cooperation among countries and with the international community to support TVET for all. The Consensus makes recommendations within the framework of the overall efforts in favour of access, inclusion and equity, education for sustainable development and a culture of peace.

UNESCO. 2014. BRICS Building Education for the Future. UNESCO, Paris

This paper reports a comparative analysis of education trends in Brazil, Russia, India, China and South Africa. Collectively these countries have emerging economies and are known as BRICS. The analysis indicates that the BRICS have shared aspirations but different development trajectories. There are good opportunities for educational progression through knowledge exchange and joint activities. Following an overview of BRICS education systems, major policy issues related to quality and equity are highlighted. BRICS are seeking to sustain and widen the benefits of growth. In this context skills development and TVET are explored. TVET has been identified by all BRICS as a vital ingredient of more inclusive and sustainable development. The paper considers how BRICS are charting new approaches to international development cooperation in education. Due to the varied experiences of individual countries, there are opportunities for BRICS to cooperate in several areas of education. Collaboration could lead to enhanced quality of education data, facilitate student mobility, improve the relevance of skills training to the labour market, and deepen the knowledge base on BRICS development cooperation in education.

UNESCO. 2015. Unleashing the Potential – Transforming TVET. UNESCO, Paris

This publication takes stock of the steadily increasing demands and expectations on TVET systems around the globe and presents recent policy trends in the field of TVET. The authors provide insights into what it takes to unleash the potential of TVET systems around the world. They propose an integrated analytical approach that takes into consideration such factors as economic growth, social equity and issues related to sustainability so that TVET can contribute more effectively to contemporary policy issues such as youth unemployment, gender disparities and climate change. The book calls for a transformation of TVET systems to enable them to respond to the demands of their contexts. This transformation should enable TVET systems to acquire agility to stay current and responsive to the rapidly changing demands of the twenty-first century.

United Nations. 2014. Report of the Open Working Group of the General Assembly on Sustainable Development Goals. United Nations General Assembly Sixty-eighth session Agenda items 14, 19 (a) and 118

This document details the report of the Open Working Group of the UN General Assembly on the SDGs. It details recommendations for the post-2015 development agenda. A total of 17 SDGs are recommended. Goal 4 is to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. Target 4.4 is focused specifically on TVET, aiming to increase the number of youth and adults who have relevant skills, including technical and vocational skills, for employment, decent jobs and entrepreneurship. Target 4.7 more generally on skills, aiming to ensure that all learners acquire the knowledge and skills needed to promote sustainable development, including, among others, through education for sustainable development and sustainable lifestyles, human rights, gender equality, promotion of a culture of peace and non-violence, global citizenship and appreciation of cultural diversity and of culture’s contribution to sustainable development.

Valiente O. 2014. ‘The OECD skills strategy and the education agenda for development’. International Journal of Educational Development; 3

There is increased recognition of the importance that skills policies need to play in the post-2015 agenda. International organisations are presenting their views on the global situation of skills and the policies that should be implemented. The article reviews the policy framework of the OECD Skills Strategy and its implications for the education and development debate in the post-2015 scenario. This strategy introduces two main innovations compared to the previous work of the OECD in education and skills. The first one is the integration of analytical contributions from the new political economy of skills in a policy framework traditionally dominated by the human capital orthodoxy. This shift has important implications for how the OECD understands the relation between education and work in capitalist societies and on the policy recommendations they make to countries. The second innovation is the extension of the geographical focus of the organisation in order to assess the situation of skills and skills policies not only in high-income countries, but also in low- and middle-income countries as well. The article argues that, despite these two salient innovations, there remain some absences and shortfalls in the policy framework of the OECD Skills Strategy that will limit its effectiveness, particularly in low- and middle-income countries.

World Bank. 2010. Institutional Assessment of Sindh Technical Education and Vocational Training Authority. World Bank, Washington DC

Quality training that allows young people to find work is essential for economic and social development. This working paper assesses the strengths and weaknesses of the Sindh Technical Education and Vocational Training Authority (STEVTA) as a provincial apex body in technical education and vocational training (TVET). STEVTA has reduced fragmentation of training policies and programmes. This paper assesses the STEVTA’s legal foundation, governance, management, organisation, human resources, financial resources and management, and networking with external organisations. The assessment recommends that the Government of Sindh and STEVTA need to:

  • Strengthen its governance by establishing a clearer reporting structure for the management of the authority’s director, and by increasing the involvement of the private sector in the board
  • Enhance its institutional capacity through hiring of teachers in its institutions based upon increased funding and a sustainable human resources rationalisation plan for the system that is coordinated with planned physical investments in institutions
  • Build strong operational capacity by establishing rules of business and management information systems, and drafting a strategic plan.
  • Provide continued and consistent governmental support to give STEVTA stability and funding to fulfil its mandate: employment through skills.

World Bank. a 2013. IFC jobs study – Assessing private sector contributions to job creation and poverty reduction. World Bank, Washington DC.

This report focuses on the direct and indirect effects of private sector activity on job creation. It examines the conditions under which the private sector can best contribute to job creation and poverty reduction. This report also provides estimates of the magnitude of the employment-generation effects. The private sector provides approximately 90 per cent of jobs in developing countries. It is essential to understand the constraints that private companies face in creating jobs. The public sector and development finance institutions must assist by creating an environment without obstacles that is conducive to employment and productivity. This report considers how the private sector generates jobs, what constraints limit job creation, and how these problems can be mitigated. There is a double challenge in terms of creating both quality and quantity of jobs. In 2011, there were 200 million people unemployed worldwide. As many as 600 million jobs must be created in the next decade to ensure that unemployment does not increase even further as millions of young people enter the workforce. Evidence suggests that private sector job creation can improve development and lead to poverty reduction. The public sector must provide a supporting role to provide the necessary macroeconomic environment and a supportive investment climate. To achieve this, the public sector may need support from development finance institutions, who can also work directly with private companies. Job creation, socioeconomic development, and poverty reduction are not independent. Policies focused on these themes must be integrated. Job policies should be a central part of any development policy.

World Bank. b. 2013. Jobs. World Development Report. World Bank, Washington DC.

The World Development Report 2013 focuses on jobs. Jobs stresses the role of strong private sector led growth in creating jobs and outlines how jobs that do the most for development can spur a virtuous cycle. The report finds that poverty falls as people work their way out of hardship and as jobs empower women to invest more in their children. Efficiency increases as workers get better at what they do, as more productive jobs appear, and as less productive ones disappear. Societies flourish as jobs foster diversity and provide alternatives to conflict.

World Bank. c. 2013. Strategic Reform Road-map for the Technical and Vocational Education and Training Sector in West Bengal. World Bank, Washington, DC.

The focus of this report is human development and skills development in West Bengal, in the context of economic growth. The current status of skills development are presented, along with potential ways aligning the production of skills and economic growth needs. Characteristics of the technical and vocational education and training system that produces skills are analysed in terms of their synergy with what is in demand from employers in the organised and informal sectors, governance and quality assurance systems, emerging partnerships between the government and private providers of skills, and the availability of financial resources for skills development. Primary surveys, secondary data analysis, in-depth consultations with stakeholders, and declared policy priorities provide the data upon which this report is written. A strategic framework is presented including a road-map for reforming and reorienting technical and vocational education and training in West Bengal.

World Bank. d. 2013. Post-Basic Education and Training in Rwanda: Skills Development for Dynamic Economic Growth. World Bank, Washington DC

This report details the key aspects of the Rwandan education sector. It highlights quality improvement in basic education. It takes the perspective that Rwanda’s Post-Basic Education and Training (PBET) system is main method of skilled labour force generation, helping Rwanda with the transition towards a middle-income, knowledge- and expert-based economy. PBET is defined as all formal education and training for which the entry requirement is the completion of at least basic education. The first chapter describes Rwanda’s recent growth trends, ambitions for the future, and the role that skills development must play to ensure that these ambitions can be reached. The following chapter shows an analysis of the Rwandan labour market, exploring trends in both labour supply and demand, with an emphasis on the educational attainment of the labour force. Chapter three describes the context of PBET policies and strategies and the structure of the PBET system, highlighting the key features of its various segments. The fourth chapter focuses on the governance, management, and financing of the PBET system. The final chapter describes suggested policy options that would contribute to the promotion of a well-integrated and managed system.

World Bank. 2014. Youth employment in Sub-Saharan Africa (Vol. 2). World Bank, Washington DC

Sub-Saharan Africa has just experienced one of the best decades of growth since the 1960s. Between 2000 and 2012, gross domestic product (GDP) grew more than 4.5 per cent a year on average, compared to around 2 per cent in the prior 20 years. In 2012, the region’s GDP growth was estimated at 4.7 per cent- 5.8 per cent if South Africa is excluded. About one-quarter of countries in the region grew at 7 per cent or better, and several African countries are among the fastest growing in the world. Medium-term growth prospects remain strong and should be supported by a rebounding global economy. The challenge of youth employment in Africa may appear daunting, yet Africa’s vibrant youth represent an enormous opportunity, particularly now, when populations in much of the world are aging rapidly. Youth not only need jobs, but also create them. Africa’s growing labour force can be an asset in the global marketplace. Realising this brighter vision for Africa’s future, however, will require a clearer understanding of how to benefit from this asset. Meeting the youth employment challenge in all its dimensions, demographic, economic, and social, and understanding the forces that created the challenge, can open potential pathways toward a better life for young people and better prospects for the countries where they live. The report examines obstacles faced by households and firms in meeting the youth employment challenge. It focuses primarily on productivity, in agriculture, in nonfarm household enterprises (HEs), and in the modern wage sector, because productivity is the key to higher earnings as well as to more stable, less vulnerable, livelihoods. To respond to the policy makers’ dilemma, the report identifies specific areas where government intervention can reduce those obstacles to productivity for households and firms, leading to brighter employment prospects for youth, their parents, and their own children.

World Bank. 2015. The role of skills training for youth employment in Nepal: an impact evaluation of the employment fund. World Bank Group Results Series, February. World Bank, Washington DC

 The Employment Fund Project (EF) was founded in 2008 and is currently one of the largest youth training initiatives in Nepal. 15,000 youths are engaged with annually. EF competitively contracts training and employment service providers. Training courses are market-driven. Providers must complete a Rapid Market Assessment during the competitive bidding process. Services include formal technical and vocational education and training (TVET) institutions, public and private providers, as well as skilled artisans. In 2010, in partnership with EF funders, the Adolescent Girls Employment Initiative (AGEI) was launched. The objective was to expand the programme to reach an additional 4,410 Nepali young women aged 16 to 24 over a three-year period. Evaluation of the programme indicates it had positive impacts on the following labour market outcomes:

  • Employment rates
  • Finding employment
  • Earnings

 

 

 

 

 

 

 

 

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Higher Education /topic/higher-education/ Thu, 17 Dec 2015 08:59:20 +0000 http://www.heart-resources.org/?post_type=topic&p=27130 Read more]]>
ForewordExecutive SummaryKey Messages1. Introduction2. About Higher Education3. Evidence of Impact4. Policy Issues5. Barriers6. Aid and the International Development Agencies7. Partnerships8. Innovations9. Conclusion10. Annexes

As the international community moves from the Millennium Development Goals (MDGs) to the Sustainable Development Goals (SDGs), higher education (HE) is more critical than ever. Addressing questions such as quality public services, sustainable agriculture, equitable distribution of resources, environmental protection and effective governance requires high-level skills, research and innovation generated at the local and national levels. National governments, bilateral and supranational agencies are now viewing HE as central to development in low and middle-income countries (LMICs), after years of relative neglect. Yet there remains the challenge of how to release the developmental potential of universities, and avoid the elite capture and disconnection from society that has characterised many of these systems in the past.

HE has undergone a period of intense massification since the Second World War, with sharply rising enrolments in high, middle and low-income countries alike. The global gross enrolment ratio has now risen to 33% – although that aggregate figure hides significant disparities, with the rate in high-income countries (HICs) at 74% and in low-income countries (LICs) at 8% (UNESCO, 2015). As has been seen at other levels of education in periods of rapid expansion, massification has placed significant pressures on the quality of HE systems and on the government funds available to support them. Furthermore, despite the increases in enrolments, there is still considerable unmet demand, on account of increases in the youth population in a number of countries, as well as the expansion of primary and secondary levels, and the perceived importance of tertiary level diplomas in the employment market.

The rapid growth of institutions and lengthening queues of prospective students have brought with them inevitable challenges. Some commentators (e.g. Carpentier 2012) have described the situation as a threefold challenge of equity, quality and funding. Despite expansion of the system, opportunities to access HE are still scarce for disadvantaged groups, particularly low-income and rural populations, and in some contexts, women and those from particular ethnic or linguistic groups face significant barriers. Quality problems in many lower-income countries express themselves in dilapidated buildings, overcrowded lecture halls and curricula out of touch with the changing societal context. In the context of budgetary constraints, funding an expanding system is an obvious challenge. Transferring the costs to students and their families has clear implications for equity, while reducing funding has a knock-on impact on quality.

Responding to these challenges in the context of globalisation, HE around the world has been characterised by trends of commercialisation and internationalisation. These trends have brought new opportunities, but have presented additional risks. In an attempt to generate new funds, public universities have been encouraged to engage in income-generating activities, and cost-sharing schemes of various forms have been set up in most countries. In addition, there has been a dramatic growth in the private sector, particularly in for-profit institutions. These private providers have provided a welcome increase in capacity, but have for the most part been inaccessible to the poor, and have uneven quality. Internationalisation has been a key driver of many universities, though the beneficial effects have largely been restricted to institutions in HICs. For many institutions in Africa, Asia and Latin America, student and staff mobility, prominence in international rankings and international research collaboration are a distant dream. Developments in technology have enabled a range of new forms of distance learning, including massive open online courses (MOOCs), opening up new possibilities, although constrained by insufficient infrastructure and learner autonomy in disadvantaged regions.

This complex scenario, combined with the critical importance of HE, presents a great onus on effective policy-making. Governments and development agencies need to study closely the trajectories of universities and HE systems to formulate the most effective policies for enhancing their potential. As is the case in many areas of education, rigorous research and adequate evidence are not always available; in addition, many of the questions are ultimately of a political and moral nature, involving contested issues of public/private, fairness and conceptions of knowledge. This topic guide presents a roadmap through these questions, assessing the available research and evidence around HE systems and their impact, the effectiveness of interventions and barriers to change. Reconciling the competing demands of equity, quality and funding requires a broad understanding of these questions, and the way they manifest themselves in particular political and cultural contexts.

Dr Tristan McCowan
Reader in Education and International Development
Institute of Education, University College London

Higher Education (HE) plays a major role in building a nation’s intellectual capital required for poverty reduction, sustainable development and positive engagement in the global knowledge economy. The relative neglect of HE in many less developed countries (LDCs) and recent complex global forces have challenged the performance of HE in LMICs. National governments and international agencies are now working to increase capacity in HE so that it can better fulfil its role in national development, but this is not easy. This topic guide aims to answer the questions, how can the capacity of HE systems and structures in LMICs best be built and how can effective partnerships be generated to best support the process.

About higher education

In this topic guide, HE is defined as optional, formal education in specialised fields that is undertaken after completing secondary education and encompassing academic study and/or professional or advanced vocational training. The primary function of HE is the production, distribution, and consumption of knowledge, through teaching, research, and community engagement. The purpose of HE is traditionally viewed as an investment to build the necessary human capital for economic development but has more recently become more complex and nuanced to include the role it can play in building an inclusive and diverse knowledge society. Building the capacity of HE in LMICs must be effective to allow competition on the global stage.

Many global trends have impacted on and provided the catalyst for change in HE, generating a renewed interest from governments and donors. The economic, political and societal forces of globalisation have pushed HE towards greater international involvement. Some of the most visible aspects of this trend are student mobility with students choosing to study outside their country and pursuing global online programmes and courses. Over the past 50 years, there has been an unprecedented increase in HE enrolment (massification) due to governments wanting more university graduates to allow them to remain competitive in the expanding world economy, and individuals wanting access to HE to improve their own social mobility.

Numerous studies over the past 15 years have challenged the primary focus on basic education. HE is now receiving the attention it deserves in the role it plays in economic and social development. The lack of growth, attention and support for quality HE has impacted on the ability of higher education institutions (HEIs) to train essential officials such as teachers, economic managers and political leaders, all of whom are responsible for ensuring that certain standards of the quality of education are reached. A holistic and comprehensive approach to education that considers the interrelationships between the different levels of education is required.

Movement towards evidenced based practice (EBP) since the mid 1990s has enhanced the demand for good quality research. Governments have increasingly put pressure on educational researchers to ensure their work is relevant and useful to practitioners and on practitioners to ensure their work is based on research. Whilst educational policy and practice is evidence informed not evidence based this does not lessen the importance of the role of research in HE.

Every individual, irrespective of their socio-economic status, race, ethnicity, disability, gender and sexuality has a right to access HE. However, net rates of access are low in most countries, particularly in low income countries (LICs) with disadvantaged groups poorly represented and enrolment expansion largely restricted to the middle classes in urban areas. Widening participation in HE is a potentially powerful force for democratisation and social justice and many countries now have affirmative action or positive policies to address these inequalities, though with varying success. HE also has the potential to contribute to post-conflict reconstruction, state-building and peace building by connecting to a wide range of post-conflict recovery tasks; although this area is largely under-studied. This includes re-pooling human capital depleted by war and displacement, research on local social and developmental challenges, and a long-term sustainable approach to capacity building.

Evidence of impact

Empirical evidence suggests that HE can have a significant effect on the economic growth of nations. Estimates of diminishing returns to increasing levels of education were used to almost exclusively concentrate on primary education. Recent evidence, however, suggests that HE can produce economic benefits and can cause economic development (GDP per capita) arguing for the need to improve HE now to allow time for positive effects on economic development. Private benefits for individuals include better employment prospects, higher salaries, labour market flexibility and a greater ability to save and invest. These benefits can result in better health, reduced population growth and improved quality of life. Public benefits, less well studied than private benefits, also exist and include higher productivity and output per worker, higher net tax revenue and less reliance on government financial support. Moreover, HE has greater benefits than just financial rewards by manifesting entrepreneurship, job creation and good economic and political governance along with the positive impacts of research on economies.

Common to the success of good HE systems are, amongst others, the link between economic and educational planning; quality public schooling; high participation rates with institutional differentiation; labour market demand; cooperation and networks; and consensus about the importance of HE for development. Lack of clarity, co-ordination and support can undermine HE success.

The probability of working in the formal sector increases with increasing levels of education but decreases in the informal sector. Significant differences in the match between demand and supply across country labour markets exist in the Sub-Saharan Africa (SSA) region. Increasing numbers of youths attaining post basic levels of education coupled with the moderate growth rate of the primary employer of graduates, the formal sector, means that young skilled workers are increasingly encountering difficulty in securing employment. The formal private sector has few opportunities for the highly educated which is a cause for concern, especially because the public sector is not likely to grow rapidly in the coming years. However, overproduction of graduates could be a good long-term investment that can contribute to future economic growth providing that the graduates are of high enough quality and entrepreneurial to start more technology-intensive firms that in turn employ more graduates.

HE can also produce non-market benefits for individuals and society. These include the formation of professionals in areas such as education, health and public administration, political participation and stability, the strengthening of governance, leadership and democracy, enabling of spaces for critique and scrutiny of government and policy, the preservation, study and development of local and national culture and heritage and health, empowerment and positively influencing attitudes and practices. However, there is limited evidence on these non-market education externalities and their indirect and delayed effects on development goals.

Policy issues 

There are many good reasons for investing in HE but there are also many policy questions and debates for national governments and international agencies to consider. Four of the major policy issues are considered: human capital flight, cost of HE, capture of HE by elite groups and the purpose of HE.

Participation in HE increases social mobility which can lead to student migration or human capital flight i.e. ‘brain drain’ through students migrating domestically to more developed areas such as cities, students failing to return home after attending scholarship programmes abroad or students educated within a country moving abroad for work. The latter is likely to increase due to a lack of suitable employment within the job market and massification at HEIs. Consequently, the number of skilled persons in public service reduces, undermining the potential for socio-economic development, technological catch-up and absorptive capacity. In addition, the limited capacity of local personnel required to implement international aid has resulted in many countries reducing aid to HE. In contrast, some consider brain drain as a ‘brain gain’ when taking into account the beneficial effects of remittances, returning migrants and the aspiration to become more educated to be able to migrate. Other evidence considers brain drain as ‘brain circulation’ as the diaspora have a readiness to impart their developed knowledge and skills to their homeland and maintain links with knowledge institutions there.

Expanding and reforming HE is costly, and more so than for lower levels of education. However, HE is not only used for teaching and learning but also includes other activities such as research, community outreach, and HEIs are linked to services such as hospitals and knowledge exchange. A direct comparison of the cost of HE to lower levels is therefore unfair. All levels of education are important and should not be traded off against each other but rather treated holistically to allow the positive mutual benefits each level gives to the others.

In most LMICs, HE programmes, especially those at the higher level with potentially the highest rate of return, and the best HEIs, capture elite groups (defined as individuals of superior status, be it economic, political, educational, ethnic or otherwise). Therefore, many question if a country that cannot provide every child with a primary education should cover almost 80 of the costs for all HE students, most of whom are elite, or if the focus should be on allocating public spending and international aid more effectively.

The high cost of HE inevitably leads to policy debates about the purpose of HE. Some argue that HE should only train future leaders and high-level professionals, and should not expand indefinitely. Whilst others think that participation in HE is a right for all and supply-led expansion may boost national productivity and development in the context of the global knowledge economy.

Barriers

HEIs face a number of barriers as they try to expand and increase their performance in response to rising social aspirations and demand for social equity, changing demographics, growing socio-economic relevance and massificaton from elite to a mass system. These include increasing the supply of HE to a growing number of students and a more diversified student body, finding additional funding, infrastructure, maintaining the quality of teaching and learning, prior preparation of students and ensuring sufficient numbers of quality academic staff.

Public funding of HE is often inefficient and insufficient. HEIs in LDCs with limited resources face the challenge of containing costs as they expand, become increasingly internationalised and meet the expectation of providing high quality education. Private provision of HE is rapidly expanding as an alternative to publically funded HEIs. Good management and governance of private HEIs is important to ensure high quality delivery while simultaneously encouraging further investment.

The formal employment sector is not able to absorb the increasing numbers of graduates due to slow growth. However, HE in LMICs is not delivering graduates with the generic skills, such as thinking and behavioural skills, and the technical skills required to address labour market and innovation requirements. This may reflect the quality of teaching and learning. Moreover, the share of graduates in science, technology, engineering and mathematics (STEM) remains too low to support much technological capability. SSA countries are being called upon to slow down the pace of expansion and shift their attention to propping up the quality of their HE systems. HE systems in LMICs are also not providing research of adequate quality to boost technological advancement in business. The interactive and reinforcing nature of under-funding, variable quality and relevance, and non-use and non-support of local research presents a bottleneck to research and research capacity development.

Despite rising enrolment in HE and the demands for social equity, certain demographic groups are poorly represented in many LMICs. There are significant barriers to accessing and remaining in HE depending on context, gender, family wealth, region of origin, race/ethnicity and disability. Lack of access to earlier education levels can also lead to inequities in access to HE. Policy makers are failing to sufficiently address the connection between education levels and the need to address inequalities early and consistently. Furthermore, equity statistics remain poor in some countries and disaggregated data is key to informing policy makers why certain groups are more vulnerable.

HEIs are often managed as disconnected individual institutions. To improve performance and outcomes, HE needs to be seen as a “system” including both institutions and the stakeholders that partner and interact with them – business, public sector, research institutes, earlier education institutions (schools) and other skill providers.

Aid and international development agencies

There is a long record of investment in HE in LDCs by international donors and agencies which has passed through a number of different phases, but remains a low proportion of total foreign aid. External investments include (a) training and scholarship programmes, (b) establishing networks and consortia and (c) building institutional capacity. With a renewed interest in HE there are indications that investment may increase but there is a lack of consensus on investment priorities. Overseas development assistance for HE continues to be spent in diverse ways, and more international donor coherence along with a holistic approach to HE is required for real impact. Increasingly, a number of universal principles have been adopted by most donors in how they work in HE for development, including demand drivenness and ownership of the South, output financing, and accountability and transparency in partner matching. A review of the evidence indicates a number of common lessons learned which should be taken into account when looking to the future. The most important is the need for more appropriate methodologies and well-managed monitoring and evaluation systems, at both programme and project levels, from which evaluations of external investments in HE can draw their data.

Partnerships

Partnership between HEIs in LMICs and other actors including HEIs in HICs, the public sector (e.g. local and national government), the private sector (e.g. business and industry) and civil society (e.g. citizens groups, NGOs, not-for-profit research institutes) range from the relatively formal public-private partnerships (PPPs) to more informal collaborative arrangements. External international agencies and donors can play a central role in the process of establishing, facilitating, funding and incentivising partnerships between HEIs and the other actors in LMICs.

Partnerships can be very beneficial but incredibly hard to deliver successfully. Although the specific challenges that occur will depend on the type of partner and partnership, the literature highlights a number of common factors that may inhibit any such partnership. These include imbalances in resources, funding to initiate but not sustain the partnership (particularly affecting teaching and learning partnerships which are not as immediately effective as research partnerships), poor monitoring and evaluation, cultural divide and a lack of confidence in the weak research capacity for input into the innovation process. A number of general principles have been identified which can help overcome these challenges and guide the development and management of future effective and sustainable partnerships for HE capacity building.

Innovations

HE in LMICs contexts needs reforming so that it can fulfil its potential in national development. How to most effectively reform HE is a debated topic and many innovations and initiatives in policy and practice have been designed and implemented. However, each innovation in policy and practice has implications which should be fully taken into account by national governments and the international development community before they are implemented. Robust empirical evidence on their impact is lacking. Evidence that is available suggests that one or two initiatives is insufficient to address the challenges facing HE in LMICs and a combination is necessary, but exactly what innovation to blend together is open to debate and will depend on the feasibility of reform and the specific country context.

Conclusion

This topic guide has illustrated that HE can make a positive contribution to national economy and society and is now high on the post 2015 development agenda. Multiple sectoral and institutional changes and reforms are required to meet the new challenges and deliver on the demands of ensuring a highly skilled workforce, a well-informed and democratic populace, sustained economic growth, and sufficient technological innovation to solve global problems such as environmental sustainability and population growth. The challenges facing and the pressures to reform HE, and lower levels of primary and secondary education, are greater and more complex for LMICs; a significant undertaking for LMIC governments.

Multilateral and bilateral donors can complement efforts of national governments in LMICs to improve HE by providing funding and educational resources or training senior HE staff on education management techniques, curricula development or governance and administration. A variety of other potential partners in the private and public sector and in civil society can also help increase the quality, relevance and effectiveness of HEIs and wider HE systems in LMICs.

  • Global forces, such as the growth of the knowledge economy and the recognition of the important role of higher education (HE) in national development has put HE systems worldwide under tremendous pressure to increase performance. HE systems in LDCs are particularly under pressure as, already at a disadvantage, they are struggling to meet the increasing demands placed on them and therefore, risk further marginalisation. Addressing the inequality within HE systems around the world and strengthening their teaching, research and system capacity to contribute to inclusive economic and social development, particularly in LMICs, are two challenges facing the international community.
  • Empirical evidence suggests that HE can have a significant and positive impact on the economic growth of nations and plays a vital role in societal development in areas such as political participation and stability, democratisation, governance, health, civic engagement, empowerment and gender parity. Together they provide a persuasive argument for national governments and international agencies to invest in HE.
  • However, doing so raises a number of policy questions, which require governments to make some strategic decisions. These include how to fund the expansion and reform of HE, whether to allocate public funding and if so, how much and how to manage the risk of lower returns through increased mobility and human capital flight. These questions are not easy to answer. They present serious issues which are difficult to address. Nevertheless, they are not insurmountable and, in the long run, investments in HE and in the whole education sector will pay off.
  • Barriers to building the capacity of HE systems in LMICs include critical shortages of quality staff, limited capacity of governance, leadership and management, inadequate financial support, issues with diversifying funding, problems with the quality and relevance of teaching and research, limited capacity for research, knowledge generation and adaptation capabilities, challenges in meeting increasing demand for equitable access and difficulties in building and retaining the human capital needed for capacity development.
  • There is a long record of various types of investments by international development agencies in HE in DCs, but there is no conclusive evidence to suggest which type of intervention is most effective. Current international donor trends continue to reflect many different approaches and priorities raising questions and concerns about donor coherence and overall sustainable impact. The evidence highlights the need for more appropriate methodologies and well managed monitoring and evaluation (M&E) systems at programme and project levels, from which evaluations of external investments in HE can draw their data.
  • Partnerships between HEIs and other actors, such as industry, business, the public sector and civic society, have considerable potential for building capacity in HE and evidence shows that the international development community can play a central role in the process of establishing and maintaining such partnerships. However, there are many complex processes underpinning a HE partnership, such as cultural differences, power differentials and resource limitations and they are very hard to deliver successfully. Nevertheless, there are a number of principles that can guide the development and management of effective and sustainable partnerships but it is important to remember that not all actors are suitable as partners. Identifying the right partner and the pre-partnership process is critical.
  • There are many innovations and initiatives in policy and practice which can be used to successfully reform HE in LMICs to enhance its contribution to national development. However, how to most effectively reform HE is debated. There is a lack of robust data and evidence about how successful each of these innovations are. Nevertheless, experience suggests that an approach combining one or two initiatives is insufficient to address the challenges facing HE in LMICs and a combination is necessary. The question of which innovations should blend together is open to debate and will depend on the feasibility of reform and the specific country context.

Since the early 1990s the global community has prioritised the development of basic education. However, many recent studies have shown that higher education (HE) is a vital asset to the national and global community in the current context of the knowledge economy. HEIs are key in delivering the knowledge requirements, competencies and skills (human capital) for providing individuals with better employment prospects – higher salaries and a greater ability to save and invest. Graduates have been shown to have more positive attitudes towards democracy, human rights and protecting the natural environment, and there is increasing evidence that high levels of quality education in general and of HE in particular, are essential for the design and productive use of new technologies which provide the foundations for a nation’s innovative capacity. Moreover, access to strong HE programmes is essential for training professionals in basic education, health and a range of other key governmental and non-governmental agencies. The research and community engagement activities of universities can also have a direct impact on solving local and national development challenges. As a result, capacity building of HE has become an increasingly important focus for governments in LMICs and for multilateral and bilateral donors alike.

A number of highly complex and global forces have impacted on HE in recent years. These include globalisation, internationalisation and massification. These have been catalysts of HE reform but have also presented significant challenges to HE structures and systems in all countries but particularly in LMICs where evidence shows that the quality, relevance and effectiveness of HEIs and the wider HE system was already weak. The challenges LMICs are facing include, but are not limited to, increasing the supply of HE to a growing number of students, and a more diversified student body, increasing the labour market relevance of HE, increasing the amount, quality and relevance of research, managing a larger and more complex HE system, maintaining quality of teaching and learning, the prior preparation of students for HE and ensuring sufficient numbers of academic staff. Innovative partnerships between HEIs, national governments, the international development community and other actors in the public and private sectors have been striving to increase the performance of HE in LMICs. Such initiatives include granting more autonomy, management and academic freedom to HEIs, diversifying funding sources, building and maintaining relationships with organisations in the labour market, and supporting a more diversified and complex HE system. Even so, the data indicates there is still some way to go. Whilst there is a large body of literature on the design and implementation of such innovations and investments, robust empirical evidence on their impact and ‘what works’ seems to be lacking. Nevertheless, they do provide important lessons learned.

This topic guide aims to answer two main questions; how can the capacity of HE systems and structures in LMICs be built and; how can effective partnerships be generated to best support the process. To answer these questions, the guide presents evidence of the critical role of HE for overall national development, examines the key policy issues and barriers to building capacity in HE in low income settings and reviews the evidence from a number of different innovations that have attempted to overcome these barriers.

The majority of evidence used in this guide was based on recommendations from (and often provided by) an academic advisor with extensive experience and in depth knowledge of the issues being addressed and, through conducting previous systematic literature reviews on HE for DfID, familiar with the availability and quality of evidence available. Other literature was found using educational and organisational databases including the British Education Index, Education Resources Information Center (ERIC), Education Research Complete, EBSCOHost, the National Foundation of Educational Research in the UK, UNESCO and the Social Sciences and Humanities Research Council of Canada. Limits were set from 2005 to the present following guidance from DfID.

It should be noted that this topic guide is not intended to be a comprehensive ‘go to guide’ for all information and solutions for building capacity in HE in LMICs, but to introduce and provide an overview of the key issues involved and to signpost the reader to the most relevant and best sources of information and evidence available for further information and reading. A list of recommended reading for each section is provided in annex A.

This section of the topic guide summarises selected key concepts about higher education (HE). It discusses what it is, what it does, what it looks like, how it has changed in the past half century and why there is a renewed focus on it for national governments and the development community alike. In doing so, it acknowledges some of the tensions and debates about HE and seeks to bring greater conceptual clarity to these issues.

2.1       DEFINING HIGHER EDUCATION

HE can be defined as optional, formal education in specialised fields undertaken after completing secondary education. Traditionally, the term referred to academic study taking place at universities, but today it also encompasses professional or advanced vocational training at university-like institutions, colleges or professional schools attached to universities (such as nursing schools or teachers’ colleges). While some scholars and practitioners use the term interchangeably with tertiary education (TE), others consider TE to be an umbrella term encompassing both HE and further education (FE) or continuing education (CE), where the latter refers to post-secondary learning of a more technical and vocational nature. Within the context of this guide, HE refers to post-secondary education, and therefore does not include other forms of adult learning such as literacy programmes. (For more information about FE and skills training please see the HEART Skills Topic Guide).

2.2       TYPES OF HIGHER EDUCATION

According to the World Bank (2013), while universities are seen as a key part of all HE systems, globally there is a burgeoning group HEIs in addition to universities both public and private, including, but not limited to colleges, technical training institutes, community colleges, nursing schools, teacher training institutions, research laboratories, and distance learning centres. As education systems vary widely around the world, UNESCO has developed the International Standard Classification of Education (ISCED) to facilitate cross-country comparison, collaboration, and analysis. Annex B provides a detailed description of ISCED 2011.

2.3       FUNCTIONS OF HIGHER EDUCATION

The primary function of HE is the production, distribution, and consumption of knowledge, through teaching, research, and community engagement. The types of knowledge generated, the beneficiaries of that knowledge, and how that knowledge is used have changed over time (Marginson, 2011). Prior to 1945, the main aim of HE was seen to be to better the mind of the elite and to facilitate scholarly discussion and breed debate of a theoretical and abstract nature (Himanka, 2015Kruse, 2006). Key economists in the 1950s and 1960s theorised that people could be ‘invested in’ to build human capital and that their economic success depended on rates of return to their stock of this capital. HE was seen as a way to build the necessary human capital for successful development, and thus funds were invested in manpower planning/forecasting directed at those considered the ‘brightest and best’. Today, while some scholars continue to highlight HEs’ importance for economic success, discussions about its purpose(s) have become more complex and nuanced to include the role it can play in building an inclusive and diverse knowledge society (UNESCO, 2009). Annex C details the functions of HE as set out in the landmark World Declaration on Higher Education (1998) (UNESCO, 1998).

2.4       GLOBAL TRENDS IMPACTING HIGHER EDUCATION

Altbach et al. (2009) believe that an ‘academic revolution’ has taken place in HE in the past half a century involving significant and complex changes. Many of these changes are a result of global trends and forces, which have impacted on HE. These have provided the catalysts for the reform of HE and have generated a renewed interest in it. Although several of these trends are inter-related, in this section they are presented separately for clarity.

2.4.1      The growth of the knowledge economy

The ‘third industrial revolution’ in the 1990s led to the formation of a knowledge economy where cognitive resources were at the centre of human activity and social dynamics (Meek et al., 2009) and in which growth was dependent on the quantity, quality, and accessibility of the information available, rather than the means of production. This led to a new focus on technology, which can ensure information is more readily available and can simplify communication and collaboration. The growth of the knowledge economy has had important implications for HE. As society has become more knowledge-based, HE has increasingly been drawn into the making and advancement of ‘knowledge nations’ (Schreuder, 2013) as one of its main functions is to generate quality research, knowledge and originality. In other words, as governments have come to realise the primacy of knowledge they have simultaneously come to realise that HE is the key driver in providing the knowledge, using the growing stock of global knowledge, assimilating and adapting it to local needs (Schreuder, 2013), crafting new technology and creating a skilled population that can use this knowledge and advance further knowledge, innovation and creativity (UNESCO, 2009).

Although the increased importance of knowledge provides great potential for countries to strengthen their economic and social development it also raises the danger of a growing ‘knowledge divide’ (Meek et al., 2009) between MDCs, who are currently generating most of this knowledge, and LDCs, many of which are failing to tap into the vast and growing stock of knowledge because of their limited awareness, poor economic incentive regimes, larger informal sector, weak institutions (including HEIs) and a lack of ICT that can facilitate the effective communication, dissemination and processing of information. Combined with trade policy liberalisation, the knowledge revolution is leading to greater globalisation and increased international competition, which is eroding the natural resource and low labour cost advantage of most LDCs (Meek et al., 2009).

2.4.2      Globalisation and internationalisation

Globalisation and internationalisation are related concepts but are not the same. Globalisation can be defined as the economic, political and societal forces pushing HE towards greater international involvement. Internationalisation includes the policies and practices undertaken by academic institutions to cope with the increased global academic environment (Altbach and Knight, 2007). HEIs have always been, to some extent, international (Schreuder, 2013Altbach and de Wit, 2015) but in the last few decades it has become more central on the agenda (de Wit, 2011). Some motivations for internationalisation include commercial advantage, knowledge and language acquisition and enhancing the curriculum. Specific internationalisation initiatives comprise of branch campuses, cross border collaborative arrangements, establishing English medium programmes, setting up degrees on international issues such as global and multicultural studies, peace education and offering global online programmes and courses, etc (de Wit, 2011). One of the most visible aspects of this trend is increased student mobility with many students choosing to study outside their country. International students have become big business in some cases (Altbach and Knight, 2007).

2.4.3      Massification

Over the past 50 years, there has been an unprecedented increase in HE enrolment globally. Recent figures demonstrate that expansion continues today: according to the World Bank World Development Indicators, gross enrolment ratios[1] for HE programmes at Bachelors levels and above have risen from 24.1% in 2005 to 32.9% in 2013. The pressure for expansion has come both from above and below. From above, governments have felt the need for more university graduates to allow them to remain competitive in the expanding global knowledge economy, and, from below, individuals around the world have insisted on access to HE in order to improve their own social mobility (Wallerstein, 2012). There have been greater numbers of young people eligible to participate in HE as a result of the expansion of basic education, increased enrolment and completion rates following programmes to achieve education for all (EFA). Although the question whether HE is a ‘universal right’ that should be made available to all is hotly debated (McCowan, 2012), moving from elite to mass HE is considered important to attain objectives of poverty reduction and increased national development and therefore, is unlikely to change.

2.4.4      The connection to socio-economic development

According to Colclough et al. (2009), during the 1980s, economists studying the impact of different levels of education in DCs (mostly for the World Bank) concluded that the rate of return to primary level was higher than for secondary and higher levels of education. This led to the theory of diminishing returns to education. The findings also suggested that the benefits of HE after secondary school proved substantially higher for the individual than the state. Such research was very influential in determining national and international development agendas and encouraged a focus on basic education. The World Conference on Education for All held in 1990, privileged basic education over other sectors of education, and the Millennium Development Goals set targets for universal primary education (UPE) to be reached by 2015. Numerous studies conducted in the past 15 years have challenged many of the conclusions drawn by the World Bank. The Organisation for Economic Co-operation and Development (OECD), for example, released a report in 2008, which argued that HE is a vital asset to the global community as it encourages social and economic development through the strengthening of a population’s knowledge bases, the creation of human capital and the application and dissemination of such knowledge (Santiago et al., 2008). Such studies generated a renewed interest in the role of HE for national development. Researchers also started to pay attention to the non-economic benefits of HE (McMahon, 2009) developing a much broader understanding of how human capital can build domestic capabilities. Such researchers argued that HE has a key role to play in benefitting the public as a whole by enabling individuals to contribute to others and future generations beyond their own personal interests (Boni, and Walker, (eds.) 2013Pillay, 2011Bloom et al., 2006). Psacharapoulos (2006) provides a simple diagrammatic classification of the public, private, market and non-market benefits of HE. This is presented in annex D.

2.4.5      The interrelationship with other levels of education

A discouraging and growing cycle of educational failures in basic education programmes in DCs were found to be, in part, caused by a lack of growth within HE. Researchers have increasingly argued that without access to strong HE programmes, the inability to train essential officials such as teachers, economic managers and political leaders, all of whom are responsible for ensuring that certain standards of the quality of basic education are reached, will persist and continue to present a barrier to the achievement of quality basic education. For example, quality in basic education cannot be achieved without quality pre-service teacher training programmes which take place at HE level. As a result, it has become more and more apparent that what is required in today’s knowledge society is a holistic, comprehensive, nuanced approach to education that considers the interrelationships between the different levels of education and does not neglect HE. The World Bank (2013) and other multilateral and bilateral donors and international development agencies have acknowledged this and have made a commitment to promote and support HE initiatives.

2.4.6      The movement towards evidence based practice (in education and in development)

HE is viewed as not only vital for improving the quality and relevance of basic education through supplying qualified and skilled personnel but also by providing the evidence about ‘what works’ in bringing about worthwhile educational improvement and national development. While HE has always had a research function, the recent movement towards EBP in education since the mid-1990s has enhanced the demand for good quality research with governments increasingly putting pressure on educational researchers to ensure their work is relevant and useful to practitioners and on practitioners to ensure their work is based on robust evidence (research). Although many educationalists argue that the potential of educational research is to say simply and with certainty what works, it is limited due to the complexity, instability, values and uncertainty inherent in education which are located within the broader context of other social relationships, culture, values and purposes (Myhill and Jones, 2007) in general, most agree that research can empower policy makers and practitioners to make informed decisions about appropriate courses of action in particular circumstances. In this sense, educational policy and practice is evidence informed not evidence based (Munn, 2008McIntyre, 2005). Nevertheless this does not diminish the importance of research and the role of the HE system in producing it, especially in resource poor or fragile states. Such countries, faced with huge educational challenges and limited resources, do not have the luxury to waste them on something that does not work or to conduct blue sky research or research for theoretical purposes alone.

The link between research and policy in the area of human development is also of increasing interest and with its research and development function, HE is also now thought to play a vital role in giving operational effect to a joined-up, evidence-based development approach, in a way which puts peoples’ needs first, and which has poverty alleviation – and beyond that, poverty eradication – as its overarching goal (McEvoy, 2010).

2.4.7      Demands for equity and social justice

In postmodern discourse, the politics of difference along with ideas of diversity and plurality being a resource rather than a deficiency were prominent and led to demands for equal rights, social justice and equity by various marginalised groups such as women and disabled people. Despite some progress, there remains considerable inequity, especially in DCs and people’s access to and interaction with key institutions, including HEIs, which continue to be shaped by power imbalances in the political, economic and social spheres resulting in inequality between demographic groups and geographical regions and chronic poverty passed between generations. The need for social equity to achieve poverty reduction for sustainable development has been recognised by the international community, but recent decades have seen rising inequality and inequities, which are in turn partly responsible for the world ‘lagging behind’ on headline goals such as the MDGs. This development strategy nevertheless, has impacted on HE, which has the potential to contribute to social justice by importing equity agendas through the composition of its staff and student populations and exporting it by striving to achieve it across the rest of society (Brennan and Naidoo, 2008). Therefore, whereas HE was once the sphere of the elites, it is mostly now seen as being accessible to a substantial part of the age group (Beerkens-Soo and Vossensteyn, 2009) with the SDG for HE establishing that right.

2.4.8      Peace building and reconstruction

Conflict and fragility present some of the most urgent challenges facing the developing world. They present threats to regional and global security and are major obstacles to poverty reduction and the achievement of the MDGs (DfID, 2010) and SDGs. Therefore, many donors have been scaling up their work in fragile and conflict affected states (FCAS). This has also contributed to renewed interest in HE as HE has the potential to contribute to post-conflict reconstruction, state-building and peace building. In post-conflict contexts HE can connect to a wide range of post-conflict recovery tasks, including re-pooling human capital depleted by war and displacement, research on local social and developmental challenges, and a long-term sustainable approach to capacity building (Milton, 2013). In spite of an increasing global recognition of the importance of HE in FCAS and a growing number of projects aimed at increasing HE capacity, the evidence base on the effectiveness of HE interventions and policies in these settings is weak and there is a need for greater sharing of knowledge on HE in post-conflict contexts (Milton, 2013).

2.5       IMPLICATIONS FOR HIGHER EDUCATION IN DEVELOPING COUNTRIES

Given that HE is now widely seen as a ‘silver bullet’ for policy makers to fire at a range of targets, including the creation of more and better jobs and job-seekers, the promotion of social equity, cohesion and a culture of peace, and the enhancement of global competitiveness, creativity, and innovation (Finegold, 2006), the global HE system is under more pressure than ever. The pressure is particularly significant for HE in LMICs. Inequality among national HE systems and within countries has increased in the past several decades (Unterhalter and Carpentier, 2010) and HEIs in most LMICs are already at a significant disadvantage in their ability to create, absorb and use knowledge. The massification of the system is an aggravating factor and means LMICs risk further marginalisation in the future as they simultaneously try to expand their HE system whilst improving quality all within continuing budget constraints. In fact, if the means of implementation (MOI) target for the Sustainable Development Goal on Education to make more scholarships for students from LMICs to pursue HE in other countries by 2020 is reached without an adequate investment in HEI development in these LMICs, this increased marginalisation is almost a certainty, particularly given that there is no mention of capacity strengthening for HEIs in LMICs. As Unterhalter and Carpentier (2010) state, HE is both a potential source of and solution to inequalities which confront LMICs. The challenge the international community is faced with is twofold: addressing the inequality within HE systems around the world and strengthening their capacity to contribute to inclusive economic and social development.

2.6       MEASURING EFFECTIVE HIGHER EDUCATION

But what does an effective HEI system for the national development in a global knowledge economy context look like? Although there is no single blueprint for the best or most effective HE systems, structures or policies (Meek et al., 2009) and there is some considerable debate about what makes a ‘world-class university’ (Salmi, 2009), there are a number of ranking systems, which attempt to measure the world’s HEIs according to their performance. There are clear methodological issues with all of the systems and they largely favour HEIs that use English as the main medium of instruction, offer a large array of disciplines and programmes, and have substantial research funds from governments Altbach et al. (2009). However, as these rankings are widely used and increasingly influential, two of the most prominent are briefly discussed in this topic guide. The QS World University Rankings ranks universities according to six performance indicators: academic reputation, employer reputation, faculty/student ratio, research citations per paper, proportion of international faculty and proportion of international students. The Times Higher Education World University Rankings uses 13 performance indicators to judge universities across their core missions of teaching, research, knowledge transfer and international outlook. Both of these rankings rely heavily on surveys of academics, suggesting that well-known universities are predisposed to do well. Regardless of quality, many universities in LMICs have little chance in even making the list, lacking the resources to promote their ‘brand’ and build reputation in an increasingly competitive world. According to Badat (2010), there is little to no value in these global rankings because they are incapable of capturing the meaning of the diverse qualities of a university.

Recently, a new, more progressive ranking system has emerged called the Universitas 21 ranking. This system assesses national HE systems, as opposed to individual institutions, against four dimensions – resources, environment, connectivity and outputs. While HICs are still likely to be ranked more highly, these rankings might prove useful for LMICs attempting to understand where their strengths and weaknesses lie. In fact, the report includes an analysis where results are adjusted according to different levels of development. Such data could prove valuable for planning, by providing a more nuanced, comprehensive picture of the HE system that goes beyond resources and brand recognition.

The previous section introduced the theory of a relationship, but what does the best available evidence say? This section summarises the empirical evidence on the returns to investments in higher education (HE) and national development and briefly discusses how robust the evidence is. The section is divided into two parts. The first part examines the evidence relating to the economic (or market) benefits of HE and the second to the societal (or non-market) benefits.

3.1.      THE MARKET BENEFITS OF HIGHER EDUCATION

Conventionally the contribution of education to economic development is analysed in terms of the relationship between the level of education and earnings and also in the form of rates of return[2] (available estimates on the social and private rates of return to investment in primary education are the highest, followed by secondary education). Returns to HE are the least. Such evidence was extensively used to discourage public investment in HE and to concentrate almost exclusively on primary education in the 1980s and 1990s. Recent evidence, however, suggests that HE can produce both social and private benefits. Estimates of regional average social and private rates of return are shown in the table below. Although there are variations in the rates of return between several countries, generally they show that investment in HE yields positive rates of return to the individual (19%) and society (10%) (Psacharopoulos & Patrinos, 2002).

Returns to HE

Region Social (%) Private (%)
Asia* 11.0 18.2
Europe/Middle East/North Africa* 9.9 18.8
Latin America/Caribbean 12.3 19.5
OECD 8.5 11.6
Sub-Saharan Africa 11.3 27.8
World average 10.3 19.0

*Non-OECD. Source: Psacharopoulos & Patrinos 2002

The contribution of HE to economic development can also be measured with a simple regression equation. Using data from 49 countries in the Asia Pacific region, Tilak (2003) found a significant effect of HE (gross enrolment ratio and HE attainment) on the level of economic development (as measured by GDP per capita). Tilak (2003) pre-empted the argument that there only exists a correlation between the two by allowing a time lag for HE to cause economic development (GDP per capita from 1999 was regressed on the enrolment ratio around 1990). This suggests that action to improve HE needs to be taken now to allow time for its effect on economic development. Also, there are very few countries with higher levels of HE being economically underdeveloped, while all the economically rich countries have not necessarily advanced in the development and spread of HE.

Tilak (2003) also showed that the proportion of the adult population with HE (a measure of the stock of human capital) is an important indicator of the level of development. This ‘stock’ indicator represents the cumulative efforts of a country in the development of HE over the years. The larger the stock of the adult population with higher levels of education, the higher the potential for economic growth Tilak (2003). India’s rise onto the world economic stage is attributed by some to its decades-long successful efforts to provide high-quality, technically orientated HE to a significant number of its citizens Bloom et al. (2006). Research by Bloom et al. (2006) supports the idea that expanding HE may promote faster technological catch-up and improve a country’s ability to maximise its economic output. Results show that SSAs current production level is about 23% below its production possibility frontier. A one-year increase in the HE stock would raise the growth rate of GDP per capita by 0.24 percentage points and African output growth by an added 0.39 percentage points in the first year. This implies that a one-year increase in HE stock may boost incomes by roughly 3 per cent after 5 years and ultimately by 12% Bloom et al. (2006).

The private market benefits for individuals include better employment prospects, higher salaries, labour market flexibility and a greater ability to save and invest Psacharapoulos (2006). Public benefits, although less well studied, also exist and include higher productivity and output per worker, higher net tax revenue and less reliance on government financial support Psacharapoulos (2006). Rates of return focusing solely on the private and public financial rewards fail to encompass the broader benefits of HE manifested through entrepreneurship, job creation and good economic and political governance along with the positive impacts of research on economies Pillay (2011).

The complex relationships in economic development with a focus on the context in which universities operate (political and socio-economic), the internal structure and dynamics of the universities themselves, and the interaction between national and institutional contexts have recently been studied. Initially a review of the international literature on the relationship between HE and economic development was conducted by Pillay (2011). This was followed by the study of three successful systems – Finland, South Korea and the North Carolina state in the US – that have harnessed HE in their economic development initiatives to distil implications for African countries (Pillay, 2010). Common to the success of all these systems is, amongst others, the link between economic and educational planning; quality public schooling; high tertiary participation rates with institutional differentiation; labour market demand; cooperation and networks; and consensus about the importance of HE for education and development. Finally the key findings of eight African countries and universities – Botswana, Ghana, Kenya, Mauritius, Mozambique, South Africa, Tanzania and Uganda – were analysed and discussed (Cloete et. al., 2011). The following three main conclusions were drawn:

  • There was a lack of clarity and agreement (pact) about a development model and the role of HE in economic development, at both national and university levels, in all eight cases. There was, however, an increasing awareness, particularly at government level, of the importance of universities in the global context of the knowledge economy.
  • Research production at the eight African universities was not strong enough to enable them to build on their traditional undergraduate teaching roles and make a sustained contribution to development via new knowledge production. A number of the universities had manageable student–staff ratios and adequately qualified staff, but inadequate funds for staff to engage in research. In addition, the incentive regimes did not support knowledge production.
  • In none of the countries in the sample was there a coordinated effort between government, external stakeholders and the university to systematically strengthen the contribution that the university can make to development. While at each of the universities there were exemplary development projects that connected strongly to external stakeholders and strengthened the academic core, the challenge remains how to increase the number of these projects.

3.1.2      Linking higher education to the labour market

More-developed SSA economies have better-educated workforces (Majgaard and Mingat, 2012). There is a positive statistical relationship between the share of the working-age population that has attended upper secondary or HE and the per capita GDP across the 23 SSA countries (Majgaard and Mingat, 2012 Figure 7.6). Although GDP per capita alone explains only 44% of the variance in educational attainment.

The probability of working in the formal sector increases with increasing levels of education, almost 80% of those with HE work in the formal sector, whilst the probability of working in the informal sector decreases with increasing levels of education (Majgaard and Mingat, 2012 Figure 7.8). Significant differences in the match between demand and supply across country labour markets exist in the SSA region. For example, unemployment among 25- to 34-year-olds with HE varies between 1% in Lesotho and 48% in Mali. In this age cohort unemployment is less than 10% in nine of 23 SSA countries but exceeds 20% in nine other countries (Majgaard and Mingat, Table 7.5).

Increasing numbers of youths attaining post basic levels of education coupled with the moderate pace of growth of formal sector employment means that young skilled workers are likely to encounter increasing difficulty in securing employment in the formal sector in the near future than in the past. With older generations of workers already well entrenched in the labour market and likely to hold on to their formal sector jobs until retirement, the prospects of formal sector employment are not particularly bright for young skilled workers (Majgaard and Mingat, 2012).

The formal private sector has few opportunities for the highly educated which is a cause for concern, especially because the public sector is not likely to grow rapidly in the coming years (Majgaard and Mingat, 2012). There is a potential for productivity increasing through an upgrading of skill profiles among workers, but because the formal private sector is growing only at the same rate as the labour force, its absorptive capacity will be limited. Producing more HE graduates than the labour market can absorb, at first sight, appears to make little economic sense, particularly when HE is largely subsidised by public funds. Nevertheless, a certain level of overproduction may be a good long-term investment that can contribute to future economic growth if the graduates are of high quality. The infusion of higher-skilled and entrepreneurial workers could induce new starts of more technology-intensive firms that in turn employ more graduates (The World Bank, 2010). In countries where many skilled workers emigrate, universities may need to train extra workers to meet domestic demand. Emigration of skilled workers is not necessarily a long-term loss to the country because many remit their earnings to the home country. In this context, skilled workers may even be considered an export from the home country. However, if most recent graduates cannot find gainful employment or cannot find jobs that match their skills, it may be an indication that the education system needs some form of rebalancing, such as shifting its emphasis on quantity to an emphasis on quality.

3.2.      THE NON MARKET BENEFITS OF HIGHER EDUCATION

HE is central to crucial societal tasks, including the formation of professionals in areas such as education, health and public administration, political participation, the strengthening of governance and democracy, enabling of spaces for critique and scrutiny of government and policy, the preservation, study and development of local and national culture and heritage, and health. Although there has been substantial interest in HE economic role, there has been only limited acknowledgment within the empirical literature of these non-market education externalities and their indirect and delayed effects on development goals (McMahon, 2009, McMahon, 2004). This is largely because they are more difficult to understand and to quantify. Nevertheless, some evidence is obtainable from both developed and developing country contexts and this is summarised in the table on the next page.[3]

 

IMPACT A SAMPLE OF THE EVIDENCE
HE is related to positive overall human development. Studies by Tilak (2003) and Cloete et al. (2011) found that the higher the level of education in a population, the higher the level of overall human development, especially in terms of life expectancy and GDP per capita.
HE has a positive effect on political stability and democratisation. In a survey of current third-year students in Kenya, South Africa and Tanzania, Luescher-Mamashela et al. (2011) found that HE can enhance democratic attitudes and behaviours. A report from the UK Department for Business, Innovation and Skills, 2013) also found that HE has a positive effect on democratisation and political stability as graduates are more likely to vote and participate politically. Gaining a degree was found to be a powerful antidote to political cynicism.
HE can support positive developmental leadership and good governance Research supported by the Developmental Leadership Program (DLP) illuminated unmistakeable links between HE and developmental leadership in Ghana, Somaliland, and Mauritius (DLPROG) (Jones, Jones and Ndaruhutse, 2014). The in-depth case study of Ghana by Jones, Jones and Ndaruhutse (2014) found that quality senior secondary and HE were critically important factors in forming leaders with the skills, values and networks needed to achieve major democratic, economic and media reforms.
HE can positively impact attitudes and practices. An OECD (2010) study found that higher levels of education impacted positively on various citizenship dimensions, especially in terms of positive attitudes towards immigration. The marginal effect of HE on holding a positive valuation was a 41% compared to only 18% for SE. Findings from a study by Truex (2011) in Nepal show that improving access to HE can reduce the presence of corruption norms and practices.
HE promotes greater social capital A survey in the USA revealed that, with respect to the number of hours volunteered for community service, within each education group, 22% of those with some post-secondary education give their time to community service activities compared to only 12% of those with only a SE (National Center for Education Statistics, 1995). Bynner and Egerton (2001) using the National Child Development Study in the UK also found a link between HE and participation in community affairs, democratic processes, egalitarian attitudes, parenting and voluntary work.
HE build human capital HE provides skilled professionals for important public services such as education and healthcare (Tikak, 2003). In this sense, HE has a ‘’dual effect’’ (Oketch et al., 2014) it not only enhances the capabilities of the individual but also the general population through the subsequent work of the graduates
HE positively influences health.

 

Numerous studies have consistently shown that HE graduates are less likely to smoke, less likely to drink excessively, less likely to be obese, more likely to engage in preventive care, have better mental and general health, lower fertility rates and better nutrition habits (Tilak, 2003UK Department for Business, Innovation and Skills, 2013; OECD,  2010Oketch et al., 2014). HE has also been strongly linked to lower rates of HIV/AIDS across the African region (Giyimah-Brempong, 2010).
HE can empower individuals and groups Malik and Courtney’s (2011) study in Pakistan proved that participation in HE can open up new options for women as individuals and lead towards significant changes in the direction of greater gender parity. In Eritrea, access to university was found to improve the freedom of women through greater capacity to earn, the avoidance of restrictive marriages and a better choice of future life with regards to career, travel and further study (Müller, 2004).

3.3       ABOUT THE EVIDENCE

Basic education has been prioritised by the global community since early 1990s because it was considered to be the bedrock of all education and national development. This was difficult to argue against because of the paucity of empirical evidence about the benefits of HE. However, recent studies, many referenced in this topic guide, have shown that HE is a vital asset to the national and global community as it can promote social and economic development through the strengthening of a populations’ knowledge base, the formation of human capital and the application and dissemination of such knowledge. Nevertheless, whilst HE in developing nations across the world provide a range of positive benefits to individuals and society, both in terms of economic growth and broader capabilities, a report by Oketch et al. (2014) found that in many cases these benefits are currently underestimated. One of the main issues encountered is that whilst there is a large number of innovations and interventions to improve HE for national development, the vast majority of studies investigating interventions focus exclusively on intended outcomes, rather than seeking to capture any wider development impact. Moreover, the actual benefits are currently limited in magnitude as HE is being constrained by a range of limiting factors. These are discussed in detail in the next two sections of this guide.

[1] The total enrolment in tertiary education, regardless of age, expressed as a percentage of the total population of the five-year age group following on from secondary school leaving

[2] A summary statistic of the relationship between lifetime earnings and the costs of education

[3] The evidence provided is a small representative sample of that available demonstrating the non-market impacts of and was selected as it was considered robust, covered the key issues and is also available as an open access source. Other sources of evidence of the non-market impact of HE can be found in the reference section.

Previous sections of this topic guide have highlighted the many positive individual and societal benefits of higher education (HE) and have provided a powerful argument for expanding and increasing investment in HE systems in LMICs. Nevertheless, although there is a strong rationale for investing in HE, attempting to do so raises many policy questions and debates for national governments and international agencies to consider. This section briefly examines four of the major policy issues and presents some of the different points of view expressed in the debate. It is acknowledged that this is not an exhaustive list.

4.1       HUMAN CAPITAL FLIGHT

There is strong evidence that participation in HE increases social mobility as it confers to an individual an advantage based on their level of qualification relative to others. This increased social mobility can have negative consequences for LMICs as it allows for increased student migration or Human Capital Flight (often referred to as ‘brain drain’). This is the emigration of highly trained or qualified people from a particular country (or region in a country) to another. For LMICs, the brain drain occurs in two ways. The first is when students are sent overseas (or to another area) to study, often on scholarship programmes, and fail to return. The second is when students are educated within the country and then move overseas for work as often as there are limited opportunities in the domestic labour market. Unfortunately, as a result of massification, this second phenomenon is likely to intensify. The number of highly educated individuals will increase and competition within the job market at the higher levels will grow. Furthermore, as individuals reach HE goals, they will become reluctant to work at a lower tech or a lower paying job.

Brain drain reduces the number of skilled persons in public service and actually undermines their potential for socio-economic development, technological catch-up and absorptive capacity. According to the African Capacity Building Foundation, African countries lose 20,000 skilled personnel to the developed world every year. This means there are 20,000 fewer people in Africa to deliver key public services, drive economic growth, and articulate calls for greater democracy and development (Sriskandarajah, 2005). It also means that international efforts to increase aid to these countries may have less impact as the local personnel required to implement them are absent. This has led to many countries reducing aid to HE (Varghese, 2010). It should be noted that brain drain can also happen domestically with students often migrating to more developed areas, such as cities.

Some argue that brain drain is not a major problem and can actually end up as a ‘brain gain’ as the brain drain hypothesis fails to account for the effects of remittances, the beneficial effects of returning migrants, and for the possibility that being able to migrate to greener pastures induces people to pursue education. Once these factors are taken into account, the migration of highly skilled people becomes a net benefit to the countries they leave (Stark and Fan, 2007Schiff, 2005) There is some recent evidence from Ghana to support this theory (Nyarko, 2011). Others contend that it could be seen as a ‘brain circulation’ as empirical studies have shown that the diaspora has highly developed skills from their overseas study and a readiness to impart knowledge to their homeland and maintain links with knowledge institutions there (Mohamoud, 2005). Mechanisms need to be found to use the intellectual capital of the diaspora for development at home such as the CODESRIA initiative (see section 8).

4.2       THE COST OF HIGHER EDUCATION

Other critical policy issues facing governments are financial. These include how to pay for the costs of expanding and reforming HE; how much public funding should be used and should funds be reallocated from other sectors or lower levels of education. The costs of HE per student are high, much higher than for both primary and secondary students. According to UIS (2011) in 2009 most countries in SSA spent at least 10 times more on a HE student than on a PE pupil. Spending (US$) per student in Uganda on HE was 14.8 times more than on PE and in Rwanda it was 27.5 times higher. On average, eight out of every $10 spent on university education in Africa is subsidised by country governments (Ibid.). With looming population growth and limited public spending, many governments in LMICs have to make strategic decisions on how to budget for education. Many question whether any country that cannot provide every child with a primary education should be covering almost 80% of the costs for HE students and should fund the expansion of HE at all. Some argue that it is better to keep funds directed at the lower levels of education as this can stimulate more household spending for HE without threatening the growth of the HE sector. UIS (2011) highlights the recent experience of Burundi which brought the number of out-of-school children down from 723,000 in 1999 to just 10,000 in 2009. Over the same period it increased its investment in education from 3.2% of GDP to 8.3%. But what made the real difference was the decision to dedicate a much larger chunk of the budget to primary education, effectively moving public money away from secondary schools and universities. For more statistics on education spending by sub sector in LMICs visit UNESCO.

It should be noted that expenditure on HE is not only used for teaching and learning but includes a wide range of activities including research, community outreach and linked HE ‘schools’ such as hospitals and knowledge exchange activities. It is therefore, unwise to directly compare HE spending with both primary and secondary education because their functions and needs are very different. Most LMICs already have a significant proportion of their HE funding coming from private sources, even in public universities, but as private funding alone can lead to distortions in course distribution and severe inequities (as it does not allow for the affirmative action policies that can address such issues) (Altbach et al., 2009), many argue that it is important to continue to allocate public funding to HE and in fact the task for international agencies should be to bolster public spending on HE, and then ensure it is allocated effectively, rather than advocate for its reduction. The argument that public funds should be transferred from HE to primary education was put forward in 1980s and 1990s and led to huge reduction in public spending on HE in Africa. It is now clear that this was to the detriment of long term development and innovation, economic growth, and the viability of the whole education system in these countries and this policy should not be continued.

4.3       CAPTURE OF HE BY ELITE GROUPS

The amount of public money spent on HE also raises questions of equity. In most LMICs, HE programmes and particularly those at the higher levels, with potentially the highest rates of return and the best HEIs, are usually captured by elite groups (defined as individuals of superior status be it economic, political, educational, ethnic or otherwise). This phenomenon is described in detail in annex E. Therefore, the policy question becomes, whether a country that cannot provide every child with a primary education should cover almost 80% of the costs for HE students, who tend to come from wealthier or more privileged backgrounds.

There are many strategies both at policy and practice levels which can and have been successfully employed to promote equity in access to and completion of HE for disadvantaged populations. Some HE systems in LMICs have reconciled these tensions through stratification (by maintaining a small elite core of high-quality universities, but supplementing it with a demand-absorbing lower quality sector) and others by implementing affirmative action, targeted scholarships, and sensitisation campaigns or by establishing separate courses, classes or even HEIs and catch up courses. Many of these with examples are presented in section 8 of this topic guide.

4.5       THE PURPOSE OF HIGHER EDUCATION

Due to the high costs, expanding HE is inevitably linked to broader policy debates about the purpose of HE within a society and what its role is in enhancing national socio-economic development. Governments need to develop a shared vision about HE (World Bank, 2000). Some argue that HE should only be a training ground for future leaders and high-level professionals, not an experience that can and should be available to all citizens. They argue that the expansion of HE systems can and should not continue indefinitely and that there should only be as many places as there are subsequent jobs for graduates.

Conversely, there is an argument that governments and international agencies should continue to invest in expanding and reforming HE, as participation in HE is a right and should be accessible to a large percentage of the population. This is especially the case given that supply-led expansion might boost national productivity and development in the context of the global knowledge economy as highlighted in sections 2 and 3 of this guide.

4.6       CONCLUDING THOUGHTS

These policy questions about expanding and investing in HE cannot be ignored and are not easily reconciled. They present serious issues for governments and international agencies alike and have (successfully) been used in the past to justify the under investment, degradation and decimation of the HE sub sector by governments and donors alike in many LMICs prior to 1998. However, most international agencies (including the World Bank and DfID) have now realised that it is not a wise course of action to reduce funds for HE in LMICs, as it leaves them without the intellectual capital required for poverty reduction and sustainable development and they will lonely fall further and further behind more MDCs.

Moreover, it should not be a case of putting one level of education in opposition to another or prioritising one over another. All levels are important. Recent experience has shown that good quality basic education is not possible if there is not good quality HE. However, there is not good quality HE without good quality basic education. Therefore, it is necessary to provide strong holistic support across all levels of education. What is required is a systemic view of the education sector.

Investments in HE will ultimately pay off and the positive benefits will outweigh or even eliminate the potentially negative ones. For example, providing good quality domestic undergraduate and postgraduate education is one way to alleviate the brain drain as it will mean that going abroad is an option and not the only way to get a good quality degree (Costin, 2015). The first African Higher Education Summit on “Revitalising Higher Education for Africa’s Future”, held in Dakar, Senegal from 10-12 March, 2015 concluded that investing in HE is the best way to build a strong state economy and that countries need a confident ‘bold, long term vision’.

As a result of decades of under investment, little higher education (HE) infrastructure currently exists in most DCs and where it does, capacity is generally weak. There is a clear need for reform to increase performance and improve results in order for HE to enlarge its contribution to sustainable development. Whilst many LMICs are attempting to do this, their governments cannot easily access the expertise or resources needed to commit to the necessary reform and there are many complex and daunting obstacles standing in the way of developing robust, high quality and effective systems of HE. The reforms needed and barriers to implementing these reforms are outlined in this section along with a brief introduction to the pathways in overcoming these obstacles.

CHALLENGES FOR HE BARRIERS IN LMIC CONTEXTS  PATHWAYS FOR REFORM
5.1. Provide mass HE to all citizens:

The growing demand for HE requires a balanced growth on the supply side of staff (academic and administrative) and facilities (including infrastructure)

Increasing the supply of HE in LMICs is hampered by many factors. The increasing demand for HE has not been accompanied by corresponding funding (World Bank, 2010van Deuren, 2013) so there are inadequate resources to invest in institutions, infrastructure and facilities (Johnstone, 2011).64 There are also challenges in finding qualified academic staff due to competition from the labour market. Graduates, especially with higher degrees, are also in demand by the private sector and the government (Ashcroft and Rayner, 2011)65 where salaries tend to be higher. In many LMICs a number of new providers (including private for-profit institutions) have emerged to meet the demand for HE but in several countries, this increase has coincided with a relaxing of state regulation with implications for quality and effectiveness of such institutions. Increasing the supply of HE in LMICs requires increased funding and a more innovative approach. Berkeens-Soo (2009) argues that increasing the supply of HE cannot be achieved by simply expanding the existing elite HE system but requires efforts in both ‘horizontal’ and ‘vertical’ diversity. However, this presents challenges in acquiring the necessary finance (see 4.9) and managing a complex and diversified system (4.10). Others contend that meeting increased demand can be achieved through innovative delivery modes such as the use of ICT (USAID, 2014).
5.2 Be globally competitive:

The internationalisation and the subsequent commercialisation of HE around the world has meant that HEIs in LMICs are in competition with those in HIC.

 

 

In the context of rising demand, the lack of capacity and existing weaknesses in many HE systems in LMICs means that countless HEIs are now at crisis point. This has opened the doors to an influx of foreign entities looking to offer academic programmes to students in DCs. Although there are some benefits to this, as Naidoo (2007) points out, foreign providers are often exempt from domestic regulations and may view these international programmes as money making schemes, focusing on scale and cost effectiveness rather than on quality or relevance and so deliver ‘’off the shelf’’ products, with poor pedagogy and assessment that are unsuitable for the local context. It may also mean that national public universities may lose income, and the necessary support for HE capacity building may not be forthcoming (Ibid.). The internationalisation of HE has also caused internal ‘brain drain’ concerns, as international branch campuses often recruit qualified faculty members from existing public institutions (Schendel and McCowan, 2015). Altbach and Knight (2007) believe LMICs are currently at crossroads and need to take measures to ensure international programmes and practices benefit the public and are not just a profit making centre. Naidoo (2007) agrees and suggests LMICs implement regulatory frameworks which require HEIs to respond to local needs in an international context and which contribute to the public good.
5.3 Adapt learning to the knowledge age:

In line with the demands of the global knowledge economy, HE is expected to impart to students the skills, knowledge and dispositions related to innovation and the ability to learn how to learn (life-long learning)

Transforming ways of teaching and learning presents a challenge to HE systems in DCs which generally have outdated, irrelevant and knowledge based curricula, which fail to transfer up to date knowledge and skills and which are delivered through traditional pedagogical approaches with learning assessed through summative knowledge based recall tests (van Deuren, 2013Wang, 2012). As a result, employer surveys report that in LMICs HE graduates are weak in problem solving, business understanding, using a computer and teamwork skills (The World Bank, 2009). There is a need for HEIs to build and maintain relationships with organisations in the labour market to develop updated competency based curricula reflecting their needs and including new forms of teaching and learning aimed at training professional skills and attitudes (The World Bank, 2003) (see 5.4). By raising the level and quality of HE, LMICs may be able to stimulate innovation, promote the diversification of products and services, and maximise returns from capital assets through more efficient allocation and management (The World Bank, 2009).
5.4 Increase labour market relevance:

The increased relevance of HE for economic development urges the need for graduates qualified for the new type of labour market.

Rapid expansion in HE, coupled with moderate growth in suitable employment opportunities, has resulted in considerable unemployment among recent university graduates in a number of LMICs. Most of these countries suffer from slow growth of the formal sector, which is traditionally the employer of first resort among highly skilled workers. The relatively faster growing informal sector, on the other hand, cannot effectively absorb the rapidly growing numbers of HE graduates (Majgaard and Mingat, 2012). This is compounded by the mismatch between the supply and demand of graduates. In many LMICs there is an uneven distribution of students across disciplines. SARUA (2012) reports that in the Africa region, registrations for the study of humanities and social sciences are high whereas those for science, technology, engineering, and mathematics (STEM) along with business, management and other commercial fields remain low in most LMICs. In East Asia, LMICs also have an uneven distribution of HE students across disciplines. In Cambodia, for example, whereas around 58% of HE students are enrolled in social sciences, business and law, approximately 10% are studying science and 15% engineering and manufacturing (Di Gropello et al., 2011). Whilst some argue that HE should continue to support a wide diversity of disciplines to nurture all of the competencies necessary for a well-functioning society (Smith, 2014) others suggest that enrolment quotas and/or providing scholarships for particular disciplines should be set up in an attempt to incentivise the study of such subjects (Altbach et al., 2009). Others suggest that HE systems in LMICs in particular should engage in and strengthen entrepreneurship education in order for HE to contribute to economic development (Ibid.).
5.5 Provide high academic quality and capacity It is a challenge for LMICs to transform the ways of learning and assessment in HEIs as the academic capacity is already low. Under investment and limited funding have restricted institutional ability to hire additional lecturers to cope with the rising student numbers, which has resulted in large class sizes at many institutions. Limited funding has also led to a rapid decline in the wages of academics. As a result, many faculty members find supplementary jobs, which limit their time for teaching, mentoring and research and others opt to leave the sector altogether in search of more highly paid positions (Holm, 2012). The lack of postgraduate programmes in many contexts, as well as a decline in the prestige of the profession, has also left very few new faculty members in the “pipeline” (Tettey, 2010Tilak, 2013). As a result, the majority of university teaching staff worldwide now have only a bachelor’s level degree (Altbach et al., 2009). In addition to these human resource implications, declining funding has curtailed the ability of institutions to invest in their infrastructure or maintain their libraries. More and better qualified academic staff is needed but there are problems in recruiting and retaining them (see 4.12). Furthermore, academic staff at HEIs need to be given the time and attention to engage in continuing professional development so they themselves can learn and use new skills and forms of teaching and assessment as included in a new curricula. The World Bank (2009) calls on LICs to slow down the pace of expansion and shift their attention to propping up the quality of their HE systems, but this is a challenge in view of rising demand (4.1) and international competition (4.2).
5.6 Generate effective and relevant research:

In the current knowledge economy, a priority of many governments is to make sure that their top HEIs are operating at the cutting edge of intellectual and scientific research and development.

HE systems play a critical role in training the professionals, scientists and researchers needed by the economy and generating new knowledge in support of the national innovation system (Di Gropello et al., 2011), however, international rankings and research output indicate that HE systems in LMICs are not providing research of adequate quality to boost technological advancement in business. Exploring the challenges involved in setting up globally competitive universities in African countries, Salmi (2011) found that conditions for research have been severely compromised by poor remuneration, heavy teaching loads, the inability to mentor young faculty, and inadequate infrastructure. The interactive and reinforcing nature of under-funding, variable quality and relevance, and nonuse and nonsupport of local research presents a bottleneck to research and research capacity development (Van Deuren, 2013). Van Deuren (2013:11) provides four pre-requisites for strengthening HE research output and relevance in LMICs. These include (1) better qualified staff (2) a stronger relationship between teaching and research (3) availability of adequate infrastructure and supportive funding and (4) building university – industry linkages. However, achieving all of these present challenges in themselves as indicated by other sections of this chart.
5.7 Provide a more equitable HE system:

The need for social equity to achieve poverty reduction for sustainable development has increasingly been recognised and HE systems are now required to supply education to a greater mix of students than in the past

Despite rising enrolment in HE and the demands for social justice, equity concerns are still prevalent across LMICs and access to HE is often restricted to a small proportion of the population (often referred to as elites) leaving certain demographic groups poorly represented. Context, gender, family wealth, region of origin, race/ethnicity and disability can be significant barriers to access. These are largely related to issues of the quality of earlier schooling, funding mechanisms and institutional admissions policies. It is not only a case of equal access to HE in general for underserved populations but equal access to the same kinds of institutions and HE programmes as students from the elite groups, and an equal chance to complete HE. Annex E examines these issues in more detail. Patterns of inequity are not easily erased and require aggressive policies which are well thought through and designed (Di Gropello et al., 2011). It also requires the collection and analysis of more high quality, disaggregated data so that policymakers are well informed about why certain groups are more vulnerable than others and what can be done about it (ibid.).
5.8 Educate a more diversified student body:

Massification, internationalisation and the demand for social justice has led to a more diversified student body, including students from diverse demographic sub groups and international and part time students, and it is expected that the student population will become more varied (Altbach et al. (2009).

 

 

Increased access to a more diversified student body has created additional challenges for HE systems in LMICs as new groups of school leavers entering HE are often not well prepared for study at this level (Johnstone, 2011). The lack of readiness is the result of limited academic opportunities originating at earlier levels of education. Historically, underserved populations access lower quality primary and especially secondary education and this has been found to be a stronger predictor of HE quality and completion than a student’s socioeconomic status. The lack of preparation negatively affects both access and completion. In terms of access, successful performance in HE entrance examinations is linked to prior academic experience. For example, in Vietnam, students from disadvantaged groups score lower marks on the National University Entrance Examination (without this being related to ability) and are less likely to enrol in high-quality HEIs (World Bank, 2011). Annex E provides more detail on the issue of completion. HE expansion needs to be linked to efficiency improvements in primary and in particular secondary education and in the transition from secondary to HE. The World Bank (2010) suggests that to promote the inclusiveness of HE, governments in LMICs need to fully understand the interrelationship between education levels and adopt a comprehensive vision of the sector as a whole. Within HEIs, different forms of teaching and support mechanisms may be required to increase completion rates but this will either require new and different academic staff or increase the burden on existing staff (Ashcroft and Rayner, 2011).
5.9 Increase funding:

Expanding demand and enrolment along with the acknowledged need for quality improvement of HE systems in LMICs requires additional budgets and adequate financing.

 

 

Financing the expansion, diversification and quality improvement of HE system presents many challenges for LMICs, which already struggle to provide even the most basic of resources to all its citizens. According to Johnstone (2013) the worldwide costs of HE are high and are increasing at rates greater than prevailing rates of inflation and government revenues in most countries. With surging HE costs and enrolment growing more rapidly than financial capabilities, public funding is not sufficient to meet demand. Increasing constraints on public spending has also led to debates about the legitimacy of any public subsidies or financial support for HE which can be seen as a ‘luxury’ (Schendel and McCowan, 2015) as it seems to bring more private than public benefits (Marginson, 2011) and those public benefits may be lost through human capital flight (Kapur and Crowley, 2008). This has put pressure on governments to minimise public support for HE and, as a result, expenditure per student in HE has declined at the same time that student numbers have increased (The World Bank, 2010). This has had an adverse impact on quality including faculty staff retention. In response to these financial pressures a number of solutions are suggested at policy and practice levels for both the cost and revenue side. These include sharing costs among all stakeholders – students, taxpayers, parents and future employers (Altbach et al., 2009).
5.10 Transform governance structures at the systems level:

As demand for HE continues to grow and governments acknowledge the role of HE in promoting development, it is important to ensure that the system is managed in an effective way.

In the past, HE systems in most LMICs have had highly centralised legal frameworks. However, this can make it difficult for HEIs to be responsive to changes in the labour market and limit their contribution to economic and social development (USAID, 2014). Therefore many countries now recognise the need to change to new forms of governance. This presents a challenge in terms of what model of management to implement. Whereas central control system limits flexibility, loose oversight can lead to low quality education with minimal return on the investments for students and the public (Susanti, 2010). Moreover, as HE systems are becoming more complex with different types of institutions, including many private ones, pursuing different goals and student bodies, and managing and monitoring the sector is more demanding and requires more specialisation, which puts pressure on government staff in LMICs. Management and governance of private HEIs is particularly challenging and is discussed in more detail in annex G. It is generally recognised that the state is not the best arbiter of how HEIs should operate and the management of complex academic communities cannot be done effectively by remote civil servants (Fielden, 2008). Therefore, LMICs should (and have) moved away from a central control model to an advisory or supervisory model where the state regulates and monitors the HE system. There are however, many different models, which could be adopted, depending on need and context. These are discussed in section 7.
5.11 Transform governance and management at the institutional level:

The growing trend of autonomy and accountability of HE systems in LMIC has introduced new tasks for HEIs, which require new ways of working, planning, budgeting, decision making and monitoring.

Strong leadership and effective institutional management are critical to the quality and effectiveness of HEIs especially in an autonomous system. Unfortunately, due to the limited authority given to institutions in the past, most HEIs in LMICs suffer from poor, inefficient and highly bureaucratic systems with poorly trained and qualified personnel and inefficient, ineffective and outdated management and administration infrastructure (USAID, 2014). This makes performing the new tasks very challenging. As institutions acquire greater autonomy, there is a clear need to strengthen the leadership and management skills of senior HEI leaders and administrators. Leadership capacity building needs to focus on developing the qualities relevant to the new challenges facing HE, including those similar to a CEO, as HEIs are now similar to major enterprises in a competitive global market (Di Gropello et al., 2011).
5.12 Increase the supply of human capital:

A critical goal of HE in LMIC contexts is to increase the supply of human capital to contribute to national socio-economic development.

 

Increasing the supply of human capital relevant for national development is a challenge for LDCs countries when the best of the human capital leaves, or migrates, to other countries. This ‘human capital flight or ‘brain drain’ is often a consequence of increased social mobility acquired through participation in HE, combined with a lack of employment opportunities and poor salaries in home countries. The opportunities for migration have increased as a result of globalisation and the internationalisation of HE. Most papers acknowledge the need for policies and practices to be adopted by both destination countries and countries of origin. Kapur and Crowley (2008) examine a variety of options and argue that the first and foremost priority to stem the brain drain is ensuring security and political stability but where that is not a major issue, reforming HE is crucial to retaining talent.

The international community can play an important role in supporting HE reform in LMICs. This section briefly reviews the landscape of interactions between international players and HE systems in LMICs. It highlights the international development community’s initiatives and learning in supporting higher education (HE) in DCs to become both locally relevant and centrally placed to contribute meaningfully to sustainable national development. The section focuses primarily on the role of the international bilateral donor.

6.1       INTERNATIONAL ASSISTANCE TO HIGHER EDUCATION

Between 2002 and 2013, the more developed nations (MDCs) invested an estimated US$42.6 billion into the growth of HE programmes within LDCs. While this figure alone appears overwhelming in size, it should be looked at in light of the US$1.6 trillion in total overseas development assistance (ODA) these developed nations invested during the same time period.[1] In this sense, by 2013, the US$42.6 accounted for only 2.7% of the overall international development budget. With a renewed interest in HE there are indications that this figure will begin to increase. However, this raises the question of how international agencies can best invest their ODA in HE.

6.2       TRENDS IN ODA TO HIGHER EDUCATION

There is a long history of investment in HE in LMICs by external and international development agencies made as a contribution to international development. A rapid review of this history by Varghese (2010) highlights the different phases and trends since the 1950s.

1950s-1960s Initially assistance to HE was used primarily to provide graduate training in donor countries. Later it was used to establish new HEIs in recipient countries with over 200 being built during the decade by various international donors.
1970s-1980s Assistance to HE declined due to the results of rate of return studies, which showed lower returns to investment in HE in comparison with primary levels. Fears over the brain drain, structural adjustment and capture of HE by elite groups also contributed to the neglect.
1990s External donors adopted a unified approach for primary education and education for all (EFA). HE was on the agenda but not high up.
2000s The rapid progress towards EFA and an increasing demand for skilled labour contributed to an expansion of education at all levels. Other studies emerged, such as the OECD 2008 report (Tertiary Education for the Knowledge Society) which argued that HE is a vital asset to the global community and for national development. Many donors are now following a dual track of investing in primary and post-secondary education with a renewed emphasis on investing in HE.

6.3       A TYPOLOGY OF ODA TO HIGHER EDUCATION

In a review of evaluations of external investments in HE, Creed et al. (2012) identify a typology of investments and assesses the impact of three distinct types. A brief explanation of each with a discussion of the evidence of impact found in the literature with links to specific examples is provided below.

i. Education and training

Intervention – Providing professional training for individual students or staff from LIMCs. Includes scholarship or fellowship programmes.
Evidence of impact or otherwise – Awards can act as a catalyst for development and the benefits of a single scholarship can reach many people (Commonwealth Scholarship Commission in the United Kingdom, 2009). Evidence indicates a high rate of completion with many alumni applying what they have learned by training others or supervising PhDs (Creed et al., 2012Kottmann and Enders, 2011). There is mixed evidence of a brain drain as a result of these programmes.  Some studies indicate that participants in programmes ‘don’t come back’ whereas others indicate over 80% return. It is difficult to measure the effectiveness of such programmes only through complex tracer studies (Boeren, 2012).
Examples – USAID’s merit-based scholarship programme for Pakistani nationals to pursue master’s degrees in education at universities in the United States (MESP). The DANIDA Fellowships programme (dfcentre).

ii. Consortia and networks

Intervention – Linking individuals and/or departments in HEIs in HICs with individuals and departments in HEIs in LIMCs.
Evidence of impact or otherwise – Evidence from evaluations shows programmes have resulted in a significant transfer of knowledge, research knowledge and skills to DCs have generated a lot of good will resulting in sustainable partnerships and a shift towards home grown, new local level courses, doctoral programmes, leadership and skills in competitive funding proposals (Creed et al., 2012Africa Unit, 2010). There are many risks and challenges to establishing effective consortia and networks across HEIs. These include power, resource imbalances and cultural differences (Africa Unit, 2010AAU, 2012). These are discussed in detail in the next section of this topic guide.
Examples – DelPHE (2006-13) with funding from DfID and its predecessors, aimed to promote partnerships between universities and other HEIs working on collaborative activity linked to the MDGs (DELPHE). CIDA University Partnerships in Cooperation and Development Program (UPCDP) (UPCDP).

iii. Institutional development

Intervention – There is evidence of successful capacity building especially in policy, infrastructure, academic support systems (e.g. ICT, library, QA) and raising research capacity (Creed et al., 2012).
Evidence of impact or otherwise – Requires long term approaches and commitments (Creed et al., 2012), the disadvantage is that sustainability is not treated as urgently as in other projects and poor institutions may not be stimulated to look for alternative sources of funding (Sida, 2006). Requires long term approaches and commitments (Creed et al., 2012), the disadvantage is that sustainability is not treated as urgently as in other projects and poor institutions may not be stimulated to look for alternative sources of funding(Sida, 2006).
Examples – The US$ 90 million external multi-donor support to University of Makerere in Uganda for the development of new research strategies and directions and strengthening graduate training and management.

 

6.4       CURRENT TRENDS AND PRIORITIES

The SDGs for education includes a target to ensure equal access for all women and men to affordable quality technical, vocational and tertiary education, including university. On the point of global commitment to these goals there is a change in attitude to HE across the international donor community. Between 2013 and 2014 the UK Department for International Development (DfID) established a HE taskforce, launched a comprehensive literature review on the impact of tertiary education on development and co-hosted a retreat conference. USAID has also positioned HE and workforce development as one of its four education priorities, and launched a statement indicating that 2015-16 will see a funding priority for work in this area.

While there appears to be a common appreciation of the need for HE for development in LMICs there is less consensus on what the investment priorities in HE should be. Besides DfID, a number of other influential bi-lateral donors prioritise support for HE and a quick review of their approaches indicates that ODA for HE will continue to be spent in diverse ways.

NORAD: HE and research are priority areas for Norway’s development cooperation policy. The NORHED programme intends to strengthen the institutional capacity and performance of HEIs in LMICs to deliver quality education and research. This includes capacity development within system development, administration and infrastructure, with particular attention to gender balance considerations. NORHED announced in 2013 that it will fund 46 joint projects between HEIs in DCs and Norway, mostly in eastern parts of Africa. The bulk of the funding will go to institutions in Ethiopia, Uganda, Malawi, and Tanzania (NORAD).

USAID: Goal 2 of the current USAID Education Strategy is improved ability of tertiary and workforce development programmes and the agency has a substantial HE portfolio. USAID supports programmes that increase access to vocational/technical/HE and training for underserved and disadvantaged populations, improves the quality of HE and research in support of country development priorities and improves the relevance and quality of workforce development programmes. USAID has a substantial scholarship programme (USAID).

SIDA: SIDA provides funding to develop facilities and human capacities to encourage research and teaching in universities. The primary objective of the IHERD programme is to increase the policy relevance of research and to promote evidence-based policy making in HE, research and innovation for development. This will be achieved through stimulating a shift in the research agenda by reviewing existing research, by commissioning new research and by fostering links with leading researchers and research institutions in the IHERD field. SIDA support to the University of Dar Es Salaam is a good example of such a programme (SIDA).

JICA: JICA works with Japanese universities to provide support to universities in LMICs specifically selected on account of leading the HE sector in their respective country and region. JICA support aims to improve education and research capabilities through the improvement of teacher quality; facilities, research materials and equipment; the strengthening of university management systems; the promotion of industry-university-community cooperation; and the construction of university networks. Support is mainly provided to engineering, agriculture, and public health sectors. JICA focuses support to the ASEAN University Network/Southeast Asia Engineering Education Development Network (JICA).

DANIDA: The Danish Building Stronger Universities in LDCs initiative aims to develop long-term, mutually beneficial partnerships between universities and research institutions in LDCs and Denmark (DANIDA).

AFD: French support for HE has increased in the recent past and is devoted mostly to helping universities in Francophone Africa to restructure their staff qualifications to meet international standards. It also tries to build science and technology capacities in the region. A large share (nearly 50%) of the aid is spent on scholarships for postgraduate students in France. Recent French initiatives include support to the International Institute of Engineering Water and Environment (2IE) in Burkina Faso, AFP, and the creation of the National College of Tourism, Tanzania.

Others: It is not only bilateral donors that support HE for development in LMICs. In 2000, four US based foundations collaborated to establish the ‘Partnerships for Higher Education in Africa’ (PHEA) contributing more than US$ 150 million to support capacity development. Annex H provides a detailed account of the PHEA approach, accomplishments and lessons learned.

6.5       CRITIQUES OF CURRENT TRENDS AND PRIORITIES

In his review of aid to HE, globally, Varghese (2010) provides a critique of current development assistance to HE. He argues that international aid to HE is concentrated on only a few countries, is fragmented, spread too thinly and too often utilised at the institutional level to support selected faculties, centres or areas within a department. This, he concludes, is why international development assistance has not made as significant contribution to the overall improvement of the institution or achieved any visible impact on the sector as a whole. McEvoy (2013) agrees that more international donor coherence along with a holistic approach to HE is required to have real impact. He points to the significance of the EFA declaration which gave expression to the consensus of the international community on the importance of basic education and triggered an annual peer review process, which resulted in some commendable progress (particularly in increasing enrolment).

Others contend that international donor programmes in HE are focussed too much on academic cooperation based on mutual interest rather than being geared towards the institutional development of HE and the broader development objectives agreed by the entire donor community such as the MDGs, SDGs and poverty reduction strategy papers. Bursary or fellowship programmes for example are often seen as more of a benefit to the donor country as having home educated graduates around the globe is one of the greatest forms of soft power a country can have. Some question whether support to HE in this form can really be considered as aid (Is it Aid?).

Some Commonalities: Despite these differences in what they do, increasingly, a number of universal principles have been adopted by most donors in how they work in HE for development and these are already addressing some of the above-mentioned critiques. These are highlighted in a worthy review of issues and trends in international development HE programmes by Boeren (2012) and include, among others, demand drivenness and ownership of the South, output financing, accountability and transparency in partner matching.

6.6       LOOKING BACK TO LOOK FORWARD

The decades of international assistance to HE have generated a number of other lessons learned about effective interventions, which should help in looking forward. The following are some of the more notable indicated in a review of the literature: 

LOOKING BACK   LOOKING FORWARD
Reviews and evaluations of HE development programmes by Creed et al. (2012)Oketch et al. (2014) and Clifford (2013) found it very difficult to draw any broad conclusion about the effectiveness of different types of HE interventions for development or what makes for a good intervention under the different types identified. This was mainly because there was all too often a lack of well managed monitoring and evaluation systems, at both programme and project levels, from which evaluations of external investments in HE draw their data. As knowledge generated from M&E is necessary to demonstrate the performance of programmes, to steer implementation towards the intended result and for informing future investments, it should be taken seriously right from the design stage of any education sector investment in HE. Different types of intervention will have different conditions for success and this will involve different types of M&E and impact assessments.
A review of HE programmes in Africa by USAID (2014) found that reforming institutions and strengthening institutional performance is one of the most challenging aspects in development and can lead to a ‘capability trap’ where countries or institutions mimic best practice but are actually ‘all show and little real action’, and this is one of the biggest causes of implementation failure. It is possible to create the right conditions and incentives to build institutional capacity with external assistance (financial and/or technical) but to do so requires careful thought and attention to the role of external assistance and a focus on how to approach HE capacity strengthening, rather than on what should be invested in. Development advisors and consultants from international agencies should avoid recommending best practice mechanisms that cannot possibly work in the setting they are proposed for and stop insisting that countries making changes run before they can walk (Pritchett, et. al., 2010)
Drawing from Mozambique’s experience with international aid to HE for the purpose of capacity building in teaching and learning, Chilundo (2006) found that the main weakness in most programmes leading to implementation failure was a lack of local ownership and input. It is important to formally involve all stakeholders (government, civil society, national and international partners and HEIs) and engage in constant dialogue with national stakeholders and international partners, as only this can lead to the successful design and implementation of international aid.

[1] Information taken from the Borgen Project; http://borgenproject.org/foreign-aid-higher-education/ with data from OECD (2012)

It has been increasingly acknowledged that partnerships with ‘other actors’ in the public and private sector can improve the quality and relevance of education, including higher education (HE). This section reviews the evidence available on what types of partners and innovative partnerships could support capacity building initiatives in HE in LMICs. It also briefly examines the role that the international development community can play in establishing and maintaining such partnerships. As partnerships for development in HE are not easy, the section ends by discussing some of the main challenges partners might face and some potential strategies to overcome them.

7.1       A DEFINITION

The concept of partnership can mean several things to individuals and institutions as well as in different cultural contexts. Perhaps the most appropriate description of an effective educational partnership in HE for the purpose of this guide is provided by the Africa Unit (2010: 20).

An effective educational partnership is a dynamic collaborative process that brings mutual though not necessarily symmetrical benefits to the parties engaged in the partnership. Partners share ownership of the projects. Their relationship is based on respect, trust, transparency and reciprocity. They understand each other’s cultural and working environment. Decisions are taken jointly after real negotiations take place between the partners. Each partner is open and clear about what they are bringing to the partnership and what their expectations are from it. Successful partnerships tend to change and evolve over time.

7.2       THE ‘OTHER’ ACTORS

Potential partners for HEIs are presented in the table below.

POTENTIAL PARTNER MOTIVATIONS FOR HE MOTIVATIONS FOR PARTNER EXAMPLE OF PARTNERSHIP
Higher education institutions

(e.g. HEIs in developed or HICs with HEIs in less developed or LMICs)

(In LDCs) Provide staff with opportunities for professional development; promote internationalisation; institutional capacity building; help to attract more funds; and receive assistance in the achievement of national development goals Africa Unit (2010). (In DCs) For internationalisation: to create opportunities for staff to work in new and different socio-political and cultural environments giving a competitive advantage in what is becoming an increasingly global market for HE (ibid.) For development: to develop the capacity of HEIs in LMICs to accelerate poverty reduction in their local, regional and national context and promote sustainable development (British Council, 2015). The partnership between University of Bradford, UK and University of Jos, Nigeria (annex I). The Global University Network for Innovation (GUNi) is a partnership created in 1999 with 208 members from 78 countries to strengthen the role of HE in society.
The public sector

(e.g. local and national government)

HEIs can increase their service to society by influencing policy and practice through research, consultancies and secondments. Working with the public sector can increase research funding available for disciplines in relevant areas such as education, environmental protection and health; this can contribute to improving the relevance and practical teaching of HE subjects including initial teacher training, medicine, nursing and law. Knowledge production and transmission are vital for a modern society and receive a lot of attention from policy makers, especially in light of budget constraints that are pushing governments to reduce public spending and increase efficiency of public policies and service. National and local governments can use the results of research conducted by HEIs to improve efficiency in public services in areas such as education and health and for wider civic benefit. HEIs are often internationally wired and have global connections, which can be harnessed for civic benefit. HEIs can also be important to the local economy (Local Government Association, 2013). It is difficult to provide a specific example of how HE research has improved policy and practice in the public sector as there is no direct linear relationship between research and practice and research and policy. The processes by which research findings are transformed into practice are subtle, difficult to trace and often take a long time so the link is not always made (Nutley et al., 2007). However, other kinds of partnerships, such as consultancies or secondments, have provided more tangible benefits. The East African School of Library and Information Science (EASLIS) has implemented knowledge transfer of information management practices through its internship programme since 2006 (Magara et al., 2011).
Private Sector

e.g. business, industry

The private sector can provide HE with additional resources such as providing internship positions for students; making their staff available for guest lectures, bringing their expertise to universities; working together with HE to establish standards to inform the curriculum and educational experience of students in relevant fields; be supportive in the creation, support, and staffing of research laboratories through gifts, donations, and research funding; provide facilities and services and increase the relevance of HE (Creso, 2013). HE can provide skills and knowledge to the private sector such as giving technical assistance to local firms; can ensure that graduates have the skills and knowledge required to effectively contribute to the workforce; support faculty to engage in consulting and commercialisation activities and conduct research relevant to business and industry (Ibid.) The Corporate Graduate Link (CoGL) at the University of Zambia. (UNZA)
Civil Society

e.g. citizens groups, associations, NGOs, not-for-profit research institutes and independent

think-tanks (as actors of civil society)

Civil society participation deepens the contributions of HEIs to human and social development through their research and teaching functions. It can contribute to the relevant and practical teaching of HE subjects particularly in the social sciences and on issues such as gender sustainability, peace and global citizenship, climate change, human rights, democratisation, governance and transparency; it can increase research funding available for social and human disciplines in relevant areas. HE can contribute to the local and international social and global human development agenda by bringing research expertise to generate practical and useful knowledge through its research and service functions. HE students often volunteer for local community charity work in areas such as conservation, helping the elderly, organising recycling, supporting people with disabilities and working with children. Kenyatta University’s, Kenya Community Outreach and Extension Program (COEP). (COEP)

 

7.3       TYPES OF PARTNERSHIPS

There are a variety of partnerships for capacity building in HE, ranging from the relatively formal public-private partnerships (PPPs) to more informal collaborative arrangements. The former type is generally characterised by relatively clear commitments by the participants, stipulated in binding legal contracts. The latter include, among others, more open-ended processes in which the participants engage in dialogue and negotiation.

7.4       THE ROLE OF THE INTERNATIONAL DEVELOPMENT COMMUNITY

External international agencies and donors can play a central role in the process of establishing partnerships between HEIs and the other actors in LMICs. They can act as a facilitator, provider of funding and incentives to develop and encourage HE partnerships and even be a critical source of ‘how to’. The USAID funded HELM project, for example, organised a workshop for participants from HE institutions across Indonesia, entitled “Building a Market Strategy for Higher Education Institution’s Products and Services,” in order to strengthen their capacity to build mutually beneficial partnerships and do business with the private sector (HELM). The Educational Partnership in Africa (EPA), funded by the UK government to help African universities improve entrepreneurship, social enterprise, and enhance graduate employability, facilitated a partnership between Ho Polytechnic in Ghana and the City College Brighton and Hove to improve the matching of engineering graduates with the modern workplace (EPA). DFAT Australia currently partners with the Asia Pacific Technical College and private sector in Papua New Guinea to address the nation’s need for skills development and increase in post-secondary education (DFAT in PNG). In fact, a review of case studies of effective university-industry partnerships in Africa by Cresno (2013: 33)98 found that ‘’almost every successful example identified by informants include one or more of these entities [international cooperation and aid agencies] as a partner.’’

7.5       ISSUES IN DEVELOPING AND MAINTAINING A PARTNERSHIP

An analysis of the definition of partnerships provided above suggests there are many complex processes underpinning them and although they can be very beneficial, the evidence indicates that partnerships for development are very hard to deliver successfully. Although the specific challenges will depend on the type of partner and partnership, the literature highlights a number of common factors that can inhibit any partnership. It is important that donor agencies anticipate some of these issues in order to pre-empt them. A number of principles which emerge from lessons learned from both successful and unsuccessful models along with findings from key empirical studies, can guide the development and management of sustainable partnerships for HE capacity building. Common challenges and potential resolutions are presented in the table below.

CHALLENGES POSSIBLE SOLUTIONS
Cultural differences A number of studies reviewing partnerships in HE found that one of the most complex challenges in establishing and maintaining a partnerships is brought about by difference in missions and visions, constituencies, demands and ways of working between HEIs and partners which makes it difficult to agree and harness their respective requirements for working effectively with each other. This can even occur between educational institutions which operate in different education and socio-cultural contexts (Africa Unit, 2010AAU, 2012Latham, 2009Tandon, 2007). To alleviate the challenge presented by cultural differences, the Africa Unit (2010) stresses the importance of engaging in a thorough pre partnership process including identifying the needs and motivations for a partnership from the outset and the need for partners to understand each other’s cultural and working environment. Other studies suggest that successful cooperation requires the selection of the right partner in the first place (Boereni, 2000).
Sustainability issues Empirical research conducted by the British Council (2015a) to review UK – Africa partnership schemes, found that many were unsustainable because of the project-oriented short term nature of the partnership and funding scheme. Once funding ended, so did the partnership. This was found to particularly affect teaching and learning partnerships compared to research partnerships. An empirical study by Boeren (2000)[1] which examined the sustainability of Dutch support to HE capacity building in LMCs provides a list of nine major requirements and conditions for sustainable partnerships. Prominent among these is the need to re-orient partnerships from project based to product focussed. In this way partnerships will be more flexible and dynamic, rather than time bound.
Lack of resources Other challenges include the lack of necessary resources to carry out the partnership. The Africa Unit (2010), in examining partnerships between UK and African HEIs, found that “time”’ to carry out all the activities was the major challenge (Latham, 2009). The costs of contracting with other actors, especially the private sector, were often found to be high when compared to the scope and size of the benefits of the partnership programme. The British Council (2015a) study found that in order to ensure the long term sustainability of partnerships the time scale and funding factor needs to be realistic and sufficient and plans for future funding should form part of the project proposal. The Africa unit (2010) recommends that staff time should be funded so they have the time available to fulfil their partnership responsibilities.
Weak institutional

capacity

Another major challenge to the development of partnerships relates to weak HE institutional capacity. An empirical study by the AAU (2012) found that most HEIs do not have the structures and qualified academic and management staff to engage productively and effectively with partners in the private sector and government.

 

 

Respondents in the AAU (2012) study believe that a strong leadership at the HEI level is necessary as a first step to building institutional capacity. This was followed by the establishment of an administrative structure and environment, to support partnerships with the ‘outside world.’ HEIs need to build academic expertise that mirrors national economic and industrial sectors and human development issues and for HEIs to engage in more applied research and teaching.
Lack of confidence Partly as a result of the lack of capacity, the AAU (2012) study found that industry had no confidence in HEIs as potential partners to input into the innovation process. This has led to a reliance on foreign technologies and some suspicion of local innovations. HEIs are therefore not viewed as sources of useful information and expertise. The Africa Unit (2010) suggests that partners have clear agreements about their roles and responsibilities in the partnership and about what they bring to the table. These roles and responsibilities should reflect what each institution is realistically able to do which is dependent on their capabilities and skills (current and anticipated). Support should be provided if this reveals weakness in capacity training. The study also argues for flexibility in the partnership and that it should be prepared to change and adapt roles if necessary as the capacity and leadership of each partner develops.
Power and resource differentials The British Council (2015a), the Africa unit (2010) and Tandon (2007) all found that power, resource and funding imbalances could be a major challenge to effective partnerships. The British Council (2015a) found that power differentials often led to a paternalistic attitude of some UK HEIs and this was a challenge to maintain the partnership. Given historically unequal power relations, it is crucial that one partner is not seen to be setting the agenda of the partnership and that partnerships should have equal benefits for both partners. Although these do not need to be symmetrical (Africa unit, 2010), PHEA (2010)emphasises the importance of partnerships which respond to Africa HEI demand and treat consultation as key to effective support.
Governance issues Many informants in a study by Cresno (2013) on HE – industry partnerships in Africa specifically mentioned the lack of a clear policy framework establishing the role of HEIs in society and its contributions to national development as a challenge to establishing partnerships, especially with the private sector, as it meant that many potential partners in society did not understand the role of HE and what it could do.

 

The need for a clear national policy framework from governments that encourage partnerships is a strong message that emerges from the literature. Participants in an empirical study by Cresno (2013) call for a ‘national policy on innovation’ or a ‘national research policy’ which defines, in specific terms, the role of the HEIs and how they relate to other sectors of the society; deemed important for national development. They also emphasise the need to implement and monitor the policies once they are developed.

7.6       SOME FINAL THOUGHTS

All partnerships are different and it is important to understand that not all situations are suitable for partnerships and not all actors are suitable as partners. Partnerships can be good and can bring positive benefits, but require careful planning and consideration to ensure they really do deepen and expand appropriate capacity. The literature strongly indicates that the pre-partnership planning process is the most critical phase which requires negotiation and transparency and during that phase it is necessary to:

  • Choose a partner with care and one with whom there is an overlapping goal and which has unique but complementary assets and skills to contribute to the partnerships. Partnerships only work when the right partners come together.
  • Be sure that the partnership brings added value and that the added value is worth the effort required to maintain the partnership. Partnerships can end up costing more in time, money and resources than anticipated.
  • Ensure that the roles, responsibilities and accountabilities of each partner are clear from the outset and the partnership leverages appropriate and realistic partner capacities and competencies. Partners should not be expected to do something that they cannot.

[1] Although dated, this document has been included as the summary is provides is considered to be very useful and still relevant

Although the need to act quickly is acknowledged, there is less clarity on how to reform higher education (HE) and establish a system of consistently high-quality institutions that will have a positive impact on development in the broader society. The purpose of this section is to review a number of innovations and initiatives in policy and practice aimed at building HE capacity, which have been often supported by international agencies and implemented in a range of contexts. Where possible and relevant, the implications for future policy and practice are presented. Despite being introduced under separate headings, it should be noted that many combine more than one aim. For example, increasing the private provision of HE can expand access but is also a strategy to finance HE provision and reduce costs to the state.

8.1       PROVIDE MASS HE FOR ALL CITIZENS

Issue Demand for HE in LDCs is growing and is expected to continue to grow (Altbach et al., 2009World Bank, 2010), meaning there is a need for continued expansion of the system.
Innovations Many initiatives aimed at increasing the reach of HE in the literature involve the use of information and communications technology, such as e-learning, online distance learning (ODL), massive open online courses (MOOCs) and blended learning. Kepler, for example, is a nonprofit university programme designed for the developing world. Launched in Rwanda in 2013, it uses accredited courses from leading United States universities to meet the needs of the Rwandan market. Kepler works in close consultation with the Rwandan private sector to identify the skills needed by graduates, and during the course students have the opportunity to choose internships with potential employers and develop employment-specific skills. Other interesting case studies include the South African Institute for Distance Education (SAIDE), funded by the William and Flora Hewlett Foundation (http://www.oerafrica.org) and the Partnership for Higher Education in Africa (PHEA) Educational Technology Initiative (ETI), a multi-year initiative addressing HE e-learning in African universities (PHEA).

Another solution has been the provision of a larger, more diversified, more connected and more complex HE system with HEIs pursuing different goals and audiences. These include ‘niche’ institutions (Schendel and McCowan, 2015) or private HEIs. Private institutions can absorb the spill over from the pool of fully qualified but unsuccessful applicants to public institutions. Ethiopia has undergone unprecedented expansion of its HEIs. Whereas the number of public universities grew from two in 1991 to a high of 22 in 2007, the private domain grew more quickly with 64 accredited private HEIs in the same period. Private HEIs can offer a limited range of programmes, which also tend to be more market driven. ‘Ashesi’ is an exciting example of a successful private university in Ghana which offers a small, highly focused curriculum (see ashesi and ashesi-ghana).   

Implications ICT represents a unique opportunity to HE to reach more students and to offer more students with courses that are on a par with those delivered by world-class universities. However, there are many implications for both policy and practice. A report by Escher et al. (2014) examined the use of MOOCs in boosting HE in Africa and found that they raise issues of access and affordability and to reach their full potential, several technological, cultural and administrative challenges need to be addressed. In order to benefit from online coursework, students must be familiar with both the use of a computer and the norms of self-guided instruction Kapur and Crowley (2008) and have access to electricity and connectivity which cannot be assumed for LMIC contexts particularly those from less advantaged backgrounds. A review of the progress and impact of ICT use in MOOCs, ODL and blended learning in HE in Asia by UNESCO (2014) found that only 5% of the students who enrolled actually completed the course. USAID (2014) provides a thorough discussion on the benefits, challenges and implications for policy and practice of using e-Learning in LMIC contexts and is worth reviewing.

Private HEIs are often supported for their ability to react more flexibly to ‘market demand’ (World Bank, 2010) and the idea that they can provide a better quality education, given their access to alternative (i.e. non-governmental) sources of funding and the market-based competition that can be fostered between providers (ibid.). However, this is not often the reality. In many LMIC contexts there has been a proliferation of private providers of a very low academic standard, Brazil being a case in point (McCowan, 2007) (see annex J). The expansion of private provision can also exacerbate problems of quality within the public sector. New private institutions often recruit faculty from existing public universities (Schendel et al., 2013) which negatively affects standards across the sector, as faculty members become less able to devote their full attention to teaching or research at any one institution. The solution to these perceived or real quality problems suggested by Gyimah-Brempong and Ondiege (2011: 44) is close regulation and governance of these institutions such as in South Africa.

8.2       TRANSFORM GOVERNANCE STRUCTURES AT THE SYSTEMS LEVEL

Issue As demand for HE continues to grow and governments acknowledge the role of HE in promoting development, it is important to ensure that the system is managed in an effective way.
Innovations In the recent past, many LMIC governments have undertaken new reform measures related to the governance and management of the HE system. A variety of alternative governance models are possible ranging along a continuum from, at the one end, a state control model, where the centre seeks to control HE systems, to, at the other end, a state supervisory model where the centre monitors and regulates them (Fielden, 2008). Most countries have recently moved along the spectrum and put the accent on the supervisory model focussing primarily on autonomy and greater institutional enterprise (Di Gropello et al., 2011). According to Fielden (2008) most of these countries have the following elements: (1) legislation that establishes HE as independent entities, (2) withdrawal of the state from certain direct control and management functions, (3) the creation of buffer bodies or agencies to carry out some of the financial control and supervision functions, (4) the adoption of funding models that give institutions greater freedoms and encourages them to develop new sources of income, (5) the creation of external quality assurance agencies and, (6) the development of new forms of accountability through reporting on performance and outcomes in achieving national and institutional goals. For example, in Ethiopia, the 2003 HE proclamation granted autonomy to HEIs in finance and internal organisation, establishing linkages and the administration of personnel. It introduced a block grant system enrolment based budgeting and cost sharing process. In Ghana, reforms initiated in 2007 included new institutional evaluation procedures, the merging of courses, the introduction of a credit system, cost recovery measures and new finding formula, the creation of new governing bodies and buffer institutions, new staff recruitment procedures and the transition from staff from civil service to HE employees. A culture of centralised planning and bureaucratic decision making is deeply rooted across all areas of public service provision in Socialist Viet Nam, but moves towards autonomy and decentralisation in HE has also taken place for the purpose of achieving greater efficiency and effectiveness. Annex K presents a simple typology of four models for governance of public HE with examples of countries implementing them. For a discussion of the regulation of private HEIs see annex J.
Implications Varghese (2013) examines national reforms and resulting governance models of HE in five African countries, Ethiopia, Ghana, Kenya, Nigeria and South Africa and found that in most instances they have helped to improve the governance and operational efficiency of HEIs and reduced reliance on the state for funding. The reforms in Ghana for example were found to have helped promote a greater sense of responsibility among staff and students and stimulated intellectualism. They also strengthened the decision-making process at the faculty level and enhanced teaching and research. The reforms in Ethiopia however, received some criticism. Many feel that some of the reforms have led to a paradigm shift from academic competency to operational competence. The study concludes that the best role for the state is to develop a framework for operation and regulating the system rather than in terms of financing, managing and controlling HEIs. A similar study of governance reforms in Asian countries by Varghese and Martin (2013) also found that reforms in the governance of HE systems in most, but not all countries, have generally had a positive impact resulting in more active and creative HEIs. The study provides a number of lessons learned for countries looking to move towards autonomy, including (1) autonomy policies as requiring coherent national policies, both horizontally (across departments and ministries) and vertical (centre to region) (2) the introduction of autonomy to be progressive with multiple reform layers, each building on the previous one (3) autonomy to first be piloted in a limited number of HEIs (4) autonomy to be considered as the means to an end and not as the ultimate aim, and (5) the understanding that there is no one model for ideal governance reform in HE.

8.3       IMPROVING MANAGEMENT AND GOVERNANCE AT INSTITUTIONAL LEVEL

Issue With greater autonomy many HEIs need support to help them fulfil the new tasks it involves such as setting up priorities, developing strategies and study programmes, mobilising resources and creating new structures for greater institutional governance.
Innovations

 

Although a wide variety of capacity building initiatives exist, there seems to have been an almost exclusive focus on training as the prime method given its simplicity in planning and funding (James, R. & Wrigley, 2007). Other possible interventions include technical advice, support to project management and support for lobby and advocacy work (Datta et al., 2012). A number of international donor interventions aim to improve HEIs institutional governance and management, mostly through the development and exchange of ‘best practices.’ The USAID funded HE Programme (HEP) in Afghanistan is an example of an initiative to improve general leadership and administration, financial management and external stakeholder collaboration (USAID HEP). The emergence of new forms of cross border education provides a number of opportunities for institutional capacity building. Institutional partnerships, for example, can be used to develop capacity in management and governance. Although many partnerships rely on historical links between Northern and Southern institutions, South-South partnerships have also emerged. China, for example, has cultivated a number of partnerships with universities in Africa, establishing institutes on many campuses and investing in training programmes across the continent (King, 2010).
Implications Experience has shown that institutional capacity building is challenging and success largely depends on the relationship between actors, the context and the measures chosen. What works in one context will not necessarily work in another. Therefore, a strong emphasis is needed on understanding the country context (DfID, 2010). Nevertheless, although each context is different, there are some common themes about how to build capacity in the literature. Most studies recommend a ‘multi actor perspective’ in containing different methods such as action learning, experimentation, mentoring coaching and advise (van Deuren, 2013). Ashcroft and Rayner (2011) write about capacity development in SSA and propose a process of critical enquiry using an action research model. Van Deuren (2013) presents a list of 10 general principles to be applied in capacity building interventions taken from a review of the literature. These include (1) local ownership and leadership, (2) relation to national priorities and systems, (3) external support focusing on facilitation and investment in local leadership, (4) capacity building as requiring knowledge and profound understanding of local context, (5) a readiness to adapt to local situations using open discussions, (6) a long term perspective while not forgetting short term action plans and interventions, (7) a comprehensive systems wide approach, (8) being prepared for changing needs and flexibility, (9) mutual trust and a relational approach, and (10) relevant systems for monitoring and evaluation.

8.4       REDUCING THE POVERTY DYNAMIC

Issue To a large extent, access to HE in most LDCs is restricted to the higher socio-economic groups as entry is determined by highly competitive exams and often the ability to pay. This issue has become more pronounced in recent years, as HEIs are increasingly charging fees in order to address their substantial financial shortfalls.
Innovations Initiatives to address the poverty dynamics of HE include the provision of scholarships, student loans, stipends and even opening outreach centres in poverty stricken areas. Some countries, such as Kenya, have elected to introduce ‘parallel streams’, in which large numbers of fee-paying students enrol alongside those assuming free-of-charge places. Others, such as Brazil, have chosen to expand access by stratification, maintaining free public universities but allowing for the rapid expansion of a private sector to absorb the majority of the demand. Prouni meaning ‘university for all’ is a Brazilian educational policy regarding increasing access to higher learning for the low income population. The policy is designed to encourage universities to allocate unfilled places free of charge to low-income students in return for exemption from tax payments (De Araujo, 2012).
Implications Although there is some suggestion that the parallel system in Kenya has contributed immensely towards the financial stability of public universities and enabled them to supplement their funds, other evidence indicates that such a system has eroded the quality of HE as lecturers are overwhelmed by the large number of students and cannot deliver to the expected standards (The Nation Report), (Wangenge-Ouma, 2007). Whilst the policy in Brazil has increased enrolment in HE amongst poorer students, there are concerns that it only involves private institutions (De Araujo, 2012) and only addresses issues of enrolment not retention meaning that a high dropout rate amongst the poorest students still persists (McCowan, 2007).

8.5       INEQUALITIES OF ACCESS

Issue Certain sub groups (e.g. disabled, ethnic, racial, cultural minorities and women in some cases) find it difficult to compete for places in the HE system. Equity concerns in HE are widespread across many LMICs given its potential to boost national productivity in the context of the global knowledge economy.
Innovations Some initiatives aimed at promoting equity in access include affirmative action, targeted scholarships, sensitisation campaigns and even the creation of separate courses, classes or institutions. Uganda’s Makerere University introduced an innovative gender mainstreaming directorate (GMD) and initiative as part of the university’s strategic plan. This initiative highlights the accomplishments of women and works to create a network and infrastructure of support (GMD UM). Ghana, Uganda, Tanzania and Kenya all implement affirmative action policies for females including weighted admission (Makerere University), women’s allocation to residence hall space (Ghana) or lowering cut-off points for university entrance (Kenya). Initiatives in policy and practice not only target women. An interesting example of an innovation in Mexico to address very limited representation of indigenous groups in HE was the creation of a completely new type of institution from the ground up, including the setting up of new buildings, a newly recruited teaching faculty and new course content and structure. These ‘’Intercultural Universities’’ (UIs) were characterised by indigenous, bilingual and intercultural education alongside close social contact between staff and students (Lehmann, 2013). Their objectives, progress and difficulties encountered to date are discussed in Schmelkes (2009).
Implications A study by Onsongo (2009) found the affirmative action policies in Ghana, Uganda, Tanzania and Kenya successfully increased female enrolment in HE. However, although these practices increased equity in admission, they did not receive much support. It was felt that women were being consigned to an inferior status, girls from well-known schools or well-connected backgrounds were benefitting and politicians believed it to be a quota system from which the respective areas they represent should enjoy university admission. A study by Clifford et al. (2013: 32) also acknowledges the potential negative consequences of such policies. Where policies aimed to support one group may have positive outcomes for that specific group, it may have unintended negative consequences on another, for example, women in India. The possible repercussions of affirmative action initiatives need to be considered carefully by policy makers. The World Bank (2000: 41) warns that policies and programmes to increase equity of access for disadvantaged groups will only prove sustainable if they do not undermine the standards of excellence on which HE is based. Merit criteria cannot be relaxed, as awarding degrees or certificates to people who do not deserve them is not in the public interest. The answer, the paper argues, is to combine tolerance at entrance to HE with rigour at exit, with members of disadvantaged groups must receive consistent remedial support during their time in HE.

8.6       HIGHER EDUCATION READINESS

Issue Massification and increasing access for disadvantaged groups has led to the diversification of the student body and the entry of new student populations with more limited academic preparation. As a result, there is often a lower retention and completion rate amongst these groups with the privileged classes retaining their relative advantage in HE in nearly all nations (Shavit et. al., 2007).
Innovations The literature offers few examples of innovations at HE level in LMIC contexts to address HE readiness. However, there are some initiatives directed at secondary level. The Higher Education Readiness programme (HER) in Ethiopia is a small scale enterprise supported by the Institute of International Education which works with young women in secondary school from underserved communities with scholarship support combined with innovative leadership and life skills training to help them complete their secondary education and equip them with the tools needed to continue on to university (Ethiopia HER). There are some initiatives in HIC contexts which are designed to prepare students for HE study in the UK and these may have some relevance for LMICs. INTO is an independently-owned company partnered with and providing study centres at a number of universities to allow international students the opportunity to study in the UK, China and the US by offering university preparation and English language modules. Courses provided by INTO at the University of Exeter have been proven to help international students’ progress to undergraduate and graduate degrees in the UK (INTO Exeter).
Implications The skills needed for preparedness differ between and within countries and even between subjects studied. Therefore, there is no one size fits all solution. A report by Altbach et al. (2009) suggests the focus of innovations should move away from access and readiness to completion. Accountability in HE he argues should not be based on enrolment but outcomes with links to funding. The World Bank (2000) also recommends a focus on completion and the provision of ‘catch up’ programmes.  Nevertheless, the consensus in the literature is to improve the links between secondary school outcomes and HE and the need to establish mechanisms to do that, rather than on ‘catch up’ programmes. An empirical study by the British Council (2015b) on university preparedness in Mexico provides a list of factors that influence readiness for HE at primary and secondary schools which policy makers should consider. The report emphasises the need for secondary schools to develop both cognitive and non-cognitive (soft) skills in students, such as language, communication, interpersonal skills, as these are all predictors of success in HE and will give students the ability to adapt to the nature of study at HE.

8.7       FINANCINING OF HIGHER EDUCATION

Issue Expanding demand and enrolment in HE, combined with increasing constraints on public funding, debates about the legitimacy of public financial support for HE in lower-income contexts and the recognised need for quality improvement of HE, have motivated governments to minimise public support for HE and to find innovative and sustainable financing mechanisms.
Innovations The most common financing mechanisms are based on cost-sharing initiatives such as tuition fees. These are being implemented for HE in many LMICs (and indeed HICs). These can be effective. In China, for example, a large scale cost recovery initiative was implemented in the mid-1990s. As a result, whilst per capita expenditure on HE doubled, the level of Government support declined. The share of total costs paid by students doubled, with fees increasing by over 200% (Li, 2007Zhong, 2005). Whilst cost sharing initiatives have increased revenue for HE, they have jeopardised the ability of some students to participate. Therefore, such schemes are often accompanied by student loans and financial aid for low-income students. Tanzania, for example, introduced a cost-sharing policy that expects beneficiaries to contribute gradually to the cost of their education. Different types of loan systems have been implemented. The most popular seem to be deferred loans, where students are responsible for repaying tuition fees in the future. Deferred loans fall into two types, the ‘mortgage type’ and the ‘income contingent’ (ADB, 2009: 18). The latter is where students sign a contract when they enter university and promise to pay a share of their earnings to particular investors for a fixed period after they graduate. Such policies are in operation in Ethiopia, Botswana and Lesotho (The World Bank, 2010) and seem to be the preferred option for many educationalists. Some countries such as Vietnam have comprehensive and complex packages for charging fees and for fee reductions (Di Gropello et al., 2011). Other innovations include dual track policies where a certain number of free (or almost free) places are offered based on particular criteria, for example, performance related or means tested. Uganda, for example, retains government funding for a limited number of places and uses a private entry fee paying scheme for the remaining places (Ibid.). Other types of dual rack systems involve variable fee rates where tuition fees are set differently for different programmes of study. In China for example, fees for science and engineering are less than for languages and medicine (Di Gropello et al., 2011). Rather than tuition fees, some countries charge user fees. In Nigeria, student contributions are made through a variety of fees including examination fees, registration fees, library fees and hostel maintenance fees, to name a few. In some cases, public private partnerships are being used to improve the efficiency of HE services provided to students such as meals, housing, and transportation, such as those found in the Ivory Coast (see annex L). Such PPPs can ensure public expenditure is allocated as a priority to academic activities and research rather than to the provision of services to students. In the USA, lotteries have become a significant source of funding for HE (Altman, 2010). HE has also been diversified to offer lower cost and more effective delivery alternatives, such as distance education and private provision, which have been discussed elsewhere.

Marketisation has also become an important way for HEIs to generate revenue from private sources. In this sense, HE is seen as a commodity that can be sold. Strategies include HE-owned for profit companies, co-ventures with private non HE institutions, attracting investment by international companies in HE franchises, the admission of full fee–paying students, opening branches in other countries and franchised degree programmes or curricula. Many LMICs now host HEIs from MDCs or use foreign curricula. They use this to gain prestige, attract more students and gain income. HEIs in MDCs also try to attract students, however, usually international students, to earn profits by charging high fees (Altbach and Knight, 2007).

  It is not just a case of attracting more private funding that is important but better allocating the public funding that is available. In a few cases, impressive reforms to improve internal efficiency have been implemented, and governments are adopting more effective budget management practices, including formula, performance or competitive funding. The Ghana Education Trust Fund (GET) described in annex M is an interesting example of one such innovation.
Implications In terms of the financing of HE, the World Bank (2010) makes a strong case for a comprehensive approach combining a number of different methods to ensure more financially sustainable HE systems. The way in which the measures are combined and the pace at which the reforms are implemented will depend on the situation and constraints specific to each country. Experience shows that reforming the financing of HE is challenge, and can generate controversies, tensions and meet institutional resistance. Therefore, policy makers should carefully present the arguments, assess the impacts of proposed solutions, and engage in a wide consultation so that stakeholders are better informed. In addition, reforms should be implemented incrementally (ADB, 2009).

8.8       RELEVANCE AND EMPLOYABILITY

Issue Equipping its workforce with the right skills is an important part of LMICs’ efforts to accelerate economic growth and further modernisation. However, numerous reports indicate mismatches between supply and demand of graduates in LMICs and consequently high graduate under and unemployment.
Innovations Innovations designed to better connect HE with the labour market are quite widespread and some examples of how developing nations have been trying to achieve this through partnerships with the private sector have been discussed previously in this guide. Other examples, which have been established in HICs but may have implications for LDCs include national policies and close monitoring of the supply of demand for HE graduates. In Sweden for example, the National Agency for Higher Education publishes an assessment of the future balance in the labour market. Annual reports have been published since 2003 indicating the proportion of university graduates that have been successful on the labour market (12-18 months after graduation). In the case of surplus or shortage of graduates, the number of places offered in different programmes is adapted (de Weert, 2011). Governments have also set up enrolment quotas and/or provided scholarships for particular disciplines, in an attempt to incentivise the study of certain subjects. For example, the UK Government provides additional funding support to broad subject areas that have been identified as both strategically important to the country and vulnerable in terms of their longer term sustainability. These strategically important and vulnerable subjects (SIVS) include STEM, MFL and quantitative social sciences (de Weert, 2011). Botswana has a similar policy. Some HEIs work directly with the private sector to tailor the content of the courses it offers. The partnership between the North Carolina Community College and the Manufacturing Association is acclaimed as an extremely successful example of collaboration (Pillay, 2010). Many LMICs see entrepreneurship as a way of reducing high unemployment rates and as central to economic growth and development and include it in the HE curricula. In Kenya, entrepreneurship education is offered at undergraduate, graduate and PhD levels (Gyimah-Brempong and Ondiege, 2011).
Implications A study by the IPPR (2013) found that many industries and businesses engage with universities only when it comes to recruitment. That is too far late to have any real impact. They should be connected to what students learn from their first day on campus if they don’t want to be disappointed by a lack of skills upon graduation. However, Gyimah-Brempong and Ondiege (2011) believe this is because most countries only really pay lip service to HE-industry links or when it suits them and it should be taken more seriously. Much of the literature reviewed suggests that connecting HE to the labour market requires serious and concentrated national efforts and policy. Di Gropello et al. (2011) advocates for more public intervention in HE to mend the disconnect between HE and industry. However, a recent empirical study by the British Council (2015) involving young people found that HE may have to adapt to another new reality as students no longer see their future in conventional salaried employment. Entrepreneurship and social enterprise have become the new valued areas of interest.

8.9       HUMAN CAPITAL FLIGHT

Issue Student or graduate mobility and migration in the form of ‘brain drain’ is one of the reasons many donors shy away from extending aid to HE, as it was thought that foreign study programmes combined with domestic universities producing larger number of graduates than the labour market could absorb, encouraged the migration of the educated in LDCs to MDCs.
Innovations One way to alleviate the brain drain is to better connect HE to the labour market and improve the quality of HE in LDCs. More targeted attempts to ease student migration include UNESCO and Hewlett Packard’s Brain Gain Initiative (UNESCO-HP) which attempts to build a sustainable university e-structure for science involving Africa and the Arab states and the Teacher Education in Sub-Saharan Africa initiative (TESSA). The IOM 2001 Migration and Development for Africa programme, emphasises short-term visits and the transfer of knowledge through the internet and diaspora groups rather than focus on the permanent return of skilled migrants to developing nations in Africa as has happened in the past. IOM and the Council for the Development of Social Science Research in Africa (CODESRIA) also has an initiative where diaspora academics mentor post graduate students (CODESRIA). A paper by the United Nations Conference on Trade and Development (2007) summarises a number of options that could be employed by both destination countries and countries of origin. The paper emphasises that policies in the country of origin need to encourage graduates to stay in order to help in the development process. Examples of policies that could be introduced include tying HE funding to the proportion of graduates who work in the country, selecting people to study abroad from only those who are currently employed in the country and holding their positions for them, forgiving or reducing student loans for graduates who do not emigrate, and ensuring meritocracy in a transparent way in job markets.
Implications

 

International donors and national governments should always take into account the possibility of student migration in their policy and practice in HE capacity building. However, a current study suggests that whether a country gains or losses in the brain drain depends on country-specific factors and there is no one size fits all solution (Docquier, 2014). Therefore, the international community and policymakers should gauge the costs and benefits of the brain drain in their specific context in order to design appropriate responses.

8.10     IMPROVING RESEARCH CAPACITY

Issue Research is a core function of HE and a well-developed system for research and knowledge generation is important within the emerging knowledge economy. However, limited investment in HE in LMICs has restricted their ability to fully participate in the global research community, and research output in terms of quality and quantity is generally low (Di Gropello et al., 2011).
Innovations A number of initiatives have been undertaken to improve the research capacity of HE in LMICs. These include strengthening graduate study programmes, improving the management of research, providing funding and linking with other institutions and academics to conduct research and exchange good practice and increasing the distribution and access to academic journals. Some specific examples include the Irish Aid/Higher Education Authority project ‘’Doctoral Training for Development in Africa Initiative,’’ (IE) aimed to build HEI research capacity specifically for poverty alleviation and the achievement of the MDGs. The project tested three different models of partnerships, Africa led, bilateral and multilateral (Uduma, O. et al., 2012) all of which proved successful. The South Africa–Netherlands Research Programme on Alternatives in Development (SANPAD), a doctoral research preparation programme for candidates on the African continent, aimed especially at black women (Smit et al., 2013) is another successful example. The DfID funded Capacity Strengthening Initiative: UK-Africa Consortia with the Royal Society is aimed at funding scientists who want to develop collaborative research consortia between the UK and SSA (Royal Society-DfID). Examples of innovative research networks include the Regional Initiative in Science and Education (RISE) and the Collaborative Research Support Programs (CRSP) which is described in detail in annex N.
Implications Evaluations of the doctoral training programmes conclude that their success was largely because they were mutually beneficial, locally led and based on a long term, multi-source funding with capable partners and these areas should be taken into account when building research capacity. A study by the British Council (2015a) also suggests that these are all major elements of effective partnerships for developing research capacity. In examining the challenges facing building research capacity for development, specifically in Africa, Sawyerr (2004) concludes that there are two elements that need to be addressed. They include an active component (skills, competencies, attitudes and values of researchers) and an environmental component (societal, institutional, material and management) – and initiatives which selectively focus on only one of these will not transform the research scene. Only initiatives that address them all, Sawyerr (2004) argues, will remove the knowledge deficit in HE in LMICs and yield substantial and immediate gains, and this should be taken into account.

8.11     IMPROVING TEACHING AND LEARNING QUALITY

Issue The expansion of HE combined with the lack of funding has had an adverse effect on the quality of the programmes that HE in LDCs offer and there are concerns that they are not producing the technical, behavioural, and thinking skills required to increase productivity and growth in the modern world.
Innovations Innovations to improve the academic capacity of HEI have focussed on new forms of teaching and learning for new students, new learning goals and new curricula. In recent years, there have been many attempts and regional partnerships designed to support improvements in the quality of teaching and learning in HEIs in LMIC contexts, for example, the Inter-University Council for East Africa, 2010 (IUCEA). A number of donor projects have attempted to improve teaching quality, such as the USAID funded Decentralized Basic Education Two (DBE2) project in Indonesia. The project responded to requests from a number of universities and developed a training programme on teaching methodologies specifically for teaching in HE. The Active Learning for Higher Education (ALPHE) programme was developed in partnerships with HEIs in Aceh and expanded to other provinces. By the end of the project in 2011, the programme had reached 117 HEIs. The final evaluation of the project found that ALPHE had been very successful in improving practice and that many HEIs had institutionalised or integrated the programme into their own CPD training for lecturers (USAID DBE2).
Implications Experience has shown that fostering academic capacity and quality in teaching in learning requires long term investment and that the results are not as immediate as support for other components. A study by Schendel (2013) in Rwanda, clearly demonstrates the need for continued and sustained efforts at improvement. A review of quality teaching in HE for the OECD by Henard and Roseveare (2012) found that fostering quality teaching in HE is a multi-level endeavour and requires support at three inter-dependent levels: the institution wide level (management and government, policy design and quality assurance mechanisms), the programme level (actions designed to measure and enhance the design, content and delivery of teaching programmes) and the individual level (helping lecturers to achieve their missions and encouraging them to innovate and adapt student oriented practices). Innovations which focus on only one of these levels to the exclusion of the others may be doomed to failure.

8.12     A COMBINATION OF INNOVATIONS

As this discussion has illustrated, a wide number of initiatives and innovations have been implemented to reform HE. Whilst there is a large body of literature on the design and implementation of such policies and programmes, robust empirical evidence on their impact seems to be lacking. However, the evidence that is available suggests that one or two initiatives alone are insufficient to address the challenges facing HE systems in LMICs and a combination is necessary. Exactly what innovation to blend together is open to debate and will vary according to context. To identify the initiatives to take, the World Bank (2010) stresses the need for countries and the international community to consider the ‘feasibility of the reform’ and what will or will not work in specific contexts. Many LMICs already combine initiatives. For example, the Botswana Government MOE HE education policy ‘Towards a Knowledge Society’ incorporated a comprehensive package of reforms to HE (Botswana).

This topic guide has illustrated that higher education (HE) is distinctively positioned to make a positive contribution to national economies and societies in the 21st Century and accordingly is now high on the post 2015 development agenda for national governments and donors alike. However, in order to successfully meet the new challenges and deliver on the demands they have been assigned, HE systems cannot depend on 20th Century policies and practices. Multiple sectoral and institutional changes and reforms are required. The pressures to reform are greater for LMICs because of the uneven distribution of human capital and funds that already exist.

Not only are the catalysts for reform greater for LMICs but so are the challenges. What has become apparent in this topic guide is that the challenges facing HE systems in LMICs are highly complex and inter-related like a ‘knotted ball of string’ (Altbach et al., 2009). Mass enrolment has created a demand for expanded facilities and more qualified staff. It has also resulted in a more diverse student body with different needs and expectations. Expansion in demand has also created the need for new providers. System growth requires additional funding and channels for obtaining it. All of this expansion and diversification has generated concerns for quality. Overcoming these challenges is complex and will involve massive expansion and restructuring of the HE systems in particular and, as this guide has clearly demonstrated, of primary and secondary education as well. HE cannot be considered in isolation from the lower levels of the education system: effective learning and equitable access in HE are dependent on the foundations laid at primary and secondary levels, and quality of schooling depends on effective training of teachers. Addressing all of these areas simultaneously is a significant undertaking for governments in LMICs.

However, governments are not alone in this endeavour. Multilateral and bilateral donors can complement efforts of national governments in LMICs to improve HE by providing funding and educational resources or training senior HE staff on education management techniques, curricula development or governance and administration. It is not just partners in the international development community that can support improvements in the HE system. As this topic guide has shown there are a variety of other potential partners in the private and public sector and in civil society that can help increase the quality, relevance and effectiveness of HEIs and wider HE systems in LMICs.

What is clear is that governments and HE systems in LMICs have a lot of work ahead of them if HE is to ultimately deliver on the demands laid at its door of ensuring a highly skilled workforce, a well-informed and democratic populace, sustained economic growth, and sufficient technological innovation to solve global problems such as environmental sustainability and population growth. We hope that this guide can go some way towards inspiring dialogue about how this might be achieved.

 

ANNEX A: RECOMMENDED READING

ABOUT HIGHER EDUCATION

  • Altbach, P. G., Reisberg, L. and Rumbley, L. E. (2009) Trends in Global Higher Education: Tracking an Academic Revolution. Paris: UNESCO. This document provides a very comprehensive and accessible overview of the global forces impacting HE and discusses how HE in developed and developing contexts has responded. It also examines potential future trends. Trends in Global HE

EVIDENCE OF IMPACT

  • Oketch, M., McCowan, T. and Schendel, R. (2014) The Impact of Tertiary Education on Development: A Rigorous Literature Review. London: Department for International Development. This provides a useful overview of the literature available on the impact of higher education for national development and includes insightful commentary on the quality and rigour of the studies included. The Impact of Tertiary Education on Development
  • Department for Business, Innovation and Skills (2014) The benfits of higher education participation for indivduals and society: Key findings and reports ‘the quadrants’. This report provides a good overview of the benefits of participation in higher education both for the individual and society. The benefits are usefully divided into society, market, non-market and the individual. The report provides many useful links to other studies too numerous to be included in this topic guide. The benefits of HE Participation
  • Majgaard K. and Mingat A. (2012) Education in Sub-Saharan Africa: A comparative Analysis. World Bank. This book analyses the education sector in SSA from a cross-country perspective. Aimed at drawing lessons that individual country studies alone cannot provide. Education in Sub-Saharan Africa
  • Pillay P. (2011) Higher Education and Economic Development Literature Review. CHET. This literature review explores the relationship between HE and economic development. Higher Education and Economic Development Literature Review
  • Bloom, D., Canning, D. and Chan, K. (2006) Higher education and economic development in Africa. Harvard University. The authors review evidence about the impact that HE can have on economic growth and poverty reduction, with a focus on SSA countries. HE and Economic Development in Africa

POLICY ISSUES

  • McCowan, T. (2015) Is there a Universal Right to Higher Education? British Journal of Educational Studies, vol. 60, no. 2 pp. 111-128. This article provides an overview of the policy issues of the purpose of HE and considers whether it should be a right that is available to all citizens or not. Is there a Universal Right to HE?

 BARRIERS

  • Di Gropello, E., Tandon, P. and Yusuf, S. (2011). Putting higher education to work: Skills and research for growth in East Asia. Washington, D.C.: World Bank. This is a comprehensive guide examing HE in the developing countries of East Asia. Measures are proposed to help these countries achieve rapid growth led by gains in productivity in a globally competitive environment. Putting HE to work
  • Fielden, J., and LaRocque, N. (2008) The Evolving Regulatory Context for Private Education in Emerging Economies: Discussion Paper. The World Bank Group International Colloqium on Private Education. This paper briefly examines international experience of regulating private education at the school and HE level. The report includes a short discussion of the potential benefits of increased private participation in education and proposes some possible good practice propositions for governments to consider. Private Education in Emerging Economies
  • Sawyerr, A. (2004) African Universities and the Challenge of Research Capacity Development. JHEA/RESA Vol. 2, No. 1, pp. 211–240. This paper considers the context of African research and environmental and human research capacity development. Challenges in developing long-term knowledge generation and application capacities are considered and some programmes that are helping to meet these challenges are described. African Universities

AID AND THE INTERNATIONAL DEVELOPMENT AGENICES

  • USAID (2014) African Higher Education: Opportunities for Transformative Change for Sustainable Development. This report is particularly useful as it reviews the evidence from a number of large USAID funded HE projects in Sub-Saharan Africa and uses it to provide lessons learned and concrete recommendations for how to effect positive transformation at both the system and institutional level. USAID
  • Creed, C,. Perraton, H. and Waage, J. (2012) Examining development evaluation in higher education interventions: a preliminary study. This study surveyed a range of interventions in higher education for international development from different agencies and presents a series of helpful observations of the impact of different types of interventions. Examining Development Evaluation

PARTNERSHIPS

  • The Africa Unit (2010) Good Practices in Educational Partnerships Guide, UK-Africa Higher & Further Education Partnerships. This document usefully provides a list and comprehensive discussion of 10 main principles for establishing effective partnerships between HEIs, which can be applied to any HE partnership. The Africa Unit.
  • The British Council (2015) Bridging the Gap: Enabling effective UK-Africa University Partnerships, British Council. This is a contemporary and relevant review of partnerships in HE. It provides a brief but valuable discussion of the challenges and potential solutions for establishing effective partnerships from empirical research with stakeholders. British Council

INNOVATIONS

The following are recommended as general texts, which review a range of case studies of innovations and initiatives to improve HE capacity. The reader should engage with the resources referred to in section 8 for more information and specific examples:

  • The World Bank (2010) Financing Higher Education in Africa: This is a very useful review of a range of options for the financing of HE. It usefully provides a number of different specific case studies from developing nations in Africa. The World Bank
  • Clifford M., Miller T., Stasz C., Goldman C., Sam C. and Kumar K. (2013) How effective are different approaches to higher education provision in increasing access, quality and completion for students in developing countries? Does this differ by gender of students? A systematic review. This review is useful as it looks at a number of different approaches for increasing access to HE and includes references to specific examples from around the World. Different approaches to HE provision
  • Association of Commonwealth Universities. A website which is a good source of publications and information on interventions/reforms in HE. ACU

ANNEX B: TERTIARY EDUCATION BY ISCED CLASSIFICATION LEVELS

ISCED level 5 programmes are typically practically-based and occupationally-specific and designed to provide learners with professional knowledge, skills, and competencies, in preparation for the labour market. Some level 5 programmes are designed to prepare learners for entry into other tertiary education pathways. Level 5 programmes are a minimum of 2 years in duration, though most are less than 3. Examples of level 5 education include (higher) technical education, community college education, technician or advanced/higher vocational training, associate degree, or bac+2 (baccalauréat + 2).

ISCED level 6 programmes are Bachelor’s or equivalent level programmes, designed to give learners the intermediate academic and/or professional knowledge, skills, and competencies necessary for a first degree. While these programmes are typically theoretical in nature, some may include practical components and are informed by research and/or professional practice. Level 6 programmes are either academic or professional in orientation and are offered at universities or other equivalent higher education institutions. Typically, the programme duration for Level 6 programmes is 3 to 4 years.

ISCED level 7 programmes are Master’s or equivalent level programmes, designed to give learners the advanced academic and/or professional knowledge, skills, and competencies necessary for a second degree (or equivalent qualification). These programmes include either theoretically-based and/or professionally-based content and are often informed by research and/or professional practice. Some include a significant research component, though this is not sufficient to lead to the award of a doctoral degree. Level 7 programmes are either academic or professional in orientation and are offered at universities or other equivalent higher education institutions. Typically, the programme duration for Level 7 programmes is 1 to 4 years.

ISCED level 8 programmes are doctoral or equivalent level programmes, designed to lead to an advanced research qualification. Level 8 programmes involve advanced study and original research in both academic and professional fields and are only offered at research-oriented tertiary education institutions, such as universities. Level 8 programmes must be at least 3 years in duration and culminate in the submission of an original thesis, dissertation or equivalent written work of publishable quality that will contribute to the knowledge base in a specific field in a significant way. Examples of degree programmes classified as ISCED Level 8 include PhD, DPhil, D.Lit, D.Sc, LL.D, Doctorate, etc.

ANNEX C: MISSIONS AND FUNCTIONS OF HIGHER EDUCATION

World Declaration on Higher Education for the Twenty-first Century: Vision and Action, UNESCO 1998 (UNESCO, 1998)

Article 1. Mission to educate, to train and to undertake research

We affirm that the core missions and values of higher education, in particular the mission to contribute to the sustainable development and improvement of society as a whole, should be preserved, reinforced and further expanded, namely to:

  1. educate highly qualified graduates and responsible citizens able to meet the needs of all sectors of human activity, by offering relevant qualifications, including professional training, which combine high-level knowledge and skills, using courses and content continually tailored to the present and future needs of society;
  2. provide opportunities (espace ouvert) for higher learning and for learning throughout life, giving to learners an optimal range of choice and a flexibility of entry and exit points within the system, as well as an opportunity for individual development and social mobility in order to educate for citizenship and for active participation in society, with a worldwide vision, for endogenous capacity-building, and for the consolidation of human rights, sustainable development, democracy and peace, in a context of justice;
  3. advance, create and disseminate knowledge through research and provide, as part of its service to the community, relevant expertise to assist societies in cultural, social and economic development, promoting and developing scientific and technological research as well as research in the social sciences, the humanities and the creative arts;
  4. help understand, interpret, preserve, enhance, promote and disseminate national and regional, international and historic cultures, in a context of cultural pluralism and diversity;
  5. help protect and enhance societal values by training young people in the values which form the basis of democratic citizenship and by providing critical and detached perspectives to assist in the discussion of strategic options and the reinforcement of humanistic perspectives;
  6. contribute to the development and improvement of education at all levels, including through the training of teachers.

Article 2. Ethical role, autonomy, responsibility and anticipatory function

In accordance with the Recommendation concerning the Status of Higher-Education Teaching Personnel approved by the General Conference of UNESCO in November 1997, higher education institutions and their personnel and students should:

  1. preserve and develop their crucial functions, through the exercise of ethics and scientific and intellectual rigour in their various activities;
  2. be able to speak out on ethical, cultural and social problems completely independently and in full awareness of their responsibilities, exercising a kind of intellectual authority that society needs to help it to reflect, understand and act;
  3. enhance their critical and forward-looking functions, through continuing analysis of emerging social, economic, cultural and political trends, providing a focus for forecasting, warning and prevention;
  4. exercise their intellectual capacity and their moral prestige to defend and actively disseminate universally accepted values, including peace, justice, freedom, equality and solidarity, as enshrined in UNESCO’s Constitution;
  5. enjoy full academic autonomy and freedom, conceived as a set of rights and duties, while being fully responsible and accountable to society;
  6. play a role in helping identify and address issues that affect the well-being of communities, nations and global society.

 

ANNEX D: RETURNS TO EDUCATION

Annex d table

Source: Psacharopoulos, G. (2006).

ANNEX E: CAPTURE OF HE BY ELITES

Most LMICs proclaim their citizens right to education as part of the constitution or as contained in other laws but this guarantee usually does not mean that education will be supported at higher levels. In the recent past, HE systems in most countries were clearly exclusive with access being restricted to a very small proportion of the population – the ‘elites’ (defined as individuals of superior status be it economic, political, educational, ethnic or otherwise).

Expansion of primary and secondary systems, the increasing need for HE qualifications on the job market, the demand for social equity and the recognition of HE as critical for social mobility has moved HE from an elite to a mass system. As HE expands to mass systems, so do opportunities for participation for more of the population. However, despite overall rising enrolment in HE and the demands for social equity, certain demographic groups remain under-represented in HE systems in most LMICs. Depending on context, variables such as gender, wealth, location, race, ethnicity or disability can disadvantage a person looking to participate in and complete HE programmes.

Although quantitatively speaking, access and enrolment have been improving in recent years for some of these disadvantaged groups, it still does not mean that they have the same opportunities to access the same HEIs. Research shows that marginalised populations attend particular types of HEIs and programmes of study and these are typically those that offer fewer opportunities for employment and future study. Furthermore, access to HE does not necessarily mean the same opportunities are available to all equally. Research also repeatedly shows that disadvantged populations once enrolled, are less likely to continue to degree completion than elites (Altbach et al., 2009).

In 2008 blacks who constitute 79% of the population in South Africa made up only 63% of the student population in HEIs whereas whites who made up only 10% of the national population made up 24% of the HE student population. Moreover, whites comprised 34% of all universities students whereas blacks made up 50% but white enrollment in technical universities was as high as 77%. The structure of enrollment suggests that black South Africans tend to enrol in less pretigious HEIs (Gyimah-Brempong and Ondiege, 2011).

There are a number of intersecting factors presenting barriers to these particular groups in achieving equitable access to HE. These primarily include:

  • Institutional admissions policies
  • Funding mechanisms
  • Earlier levels of education
  • Traditional cultural values

As admission to HE is often based on academic performance, access to HE in general and to the best HEIs in particular is determined by access to and quality of secondary schooling and therefore, is skewed towards households with higher incomes or social connections that can afford to send their children to the best secondary schools. Although this reliance on performance can ensure academic standards of incoming students, it discriminates against students from the lower socio-economic groups and those living in rural or remote areas where the quality of primary or secondary education is generally lower due to poor resource inputs and who can not afford the spiralling costs of HE. These issues are becoming more profound in light of the the recognition of the apparent link between HE and economic competitiveness in the global knowledge economy (Santiago et al., 2008), as nation states are aiming to increase the proportion of higher-level-educated individuals in the population, they want those most likely to succeed, and the adoption of fee paying structures (Ibid.).

Socio-economic status:

Access to HE is often dependent on socio-economic status. In many LMICs, participation in HE is dominated by students from the highest income quartiles. In a case study on Ghana and Tanzania, for example, Morley (2012) found that students from low socio-economic backgrounds were under-represented in all disciplines. Often public funding mechanisms serve to exacerbate such inequities by providing free education to the highest performing students who invariably come from the wealthiest households with access to the best secondary schools or even private tuition. Morley (2012) also found that current schemes to assist people from disadvantaged backgrounds to enter HE are not working and these groups need to be targeted more efficiently.

Ethnicity:

Not all races or ethnic groups have equal opportunities to access HE. Inequities by ethnic group often start early in education and are most often further exacerbated in the transition to HE levels. For example, Vietnam’s ethnic minorities have HE enrolment rates well below the national average (World Bank, 2011). Inequities by ethnic group exist in secondary education, HE completion rates and in the transition rate from secondary to HE compared to the majority.

Location:

Geography is often underestimated as a factor that limits equal participation in HE. HEIs are not evenly distributed across a nation and are often located in urban centres. Rural populations therefore are far more likely to be more distant to HEIs than urban ones, increasing costs related to transport, accommodation and other related recurring costs. Indigenous populations are even more likely to live in remote areas and this compounds the challenge of improving participation rates of these groups.

Disability:

Little is known about the state of participation in HE of students with disabilities. Categorising disability and evaluating access is extremely difficult outside of isolated case studies (USAID, 2014). Morley (2012) found that in Ghana and Tanzania, the facilities and programmes designed for students with disabilties did little to support them. In a review of different approaches to improving access and completion of HE in developing countrues, Clifford (2013) found that the lack of supporting infrastructure at HEIs hampered the ability of students with a disability to maintain their place and to succeed and that those that did had to rely on informal infrastructure.

Conclusion:

Policy makers are currently failing to address sufficiently the connection between education levels and the need to address inequalities early and consistently. Equity statistics remain poor in most countries and disaggregated data is the key to informing policy makers why certain groups are more vulnerable.

ANNEX F:  GENDER IN HIGHER EDUCATION

Globally, there has been an increase in gender parity in gross enrolment leading many to believe that HE is undergoing a process of feminisation (Morley and Lugg, 2009). However, this is not the case universally. While overall HE enrolment has increased, women are still underrepresented in certain disciplines, usually STEM and finance, as they tend to enrol more in the humanities and social sciences Clifford (2013) and at the higher levels of education that lead to greater earning potential (May and Rodgers, 2014; Semela, 2011; Sifuna, 2006). Moreover, patterns of disadvantage and exclusion soon emerge when gender is intersected with socio-economic status and other variables (Morley and Lugg, 2009). The table below illustrates this on a global scale.

Ratio[1] of female to male HE enrolment (%)

2008 2009 2010 2011 2012 2013
World 107.3 107.6 107.6 107.6 109.8 110.3
High income countries 125.2 125.9 126.2 126.0 125.1 123.5
Middle income countries 101.4 102.0 102.3 102.8 106.6 108.3
Low income countries 61.8 62.8 64.2 66.2 67.6 68.5

Source: World Bank’s World Development Indicators.

As the data shows, the ratio of females to males enrolled in HE is lower in MICs than in HICs and significantly lower in LICs where there are fewer than seven women enrolled for every 10 men. While HE continues to exclude capable and talented students because of their socio-economic status, ethnicity, and rural residence (World Bank, 2012), these factors can be compounded by gender. Therefore, women often find themselves doubly disadvantaged. Women students generally have higher dropout rates than males due to cultural emphasis on the traditional role of women and their family obligations, which is often in conflict with their desire to pursue advanced studies (Rihani, 2006).

In examining the situation in Kenya, Sifuna (2006) highlights some of the barriers that women face in accessing and participating in HE. These include, but are not limited to low participation and high failure rates in certain fields, such as medicine and engineering, high levels of sexual harassment, resistance from families, lack of opportunities and prospects for future employment and prevailing traditional and cultural views about educated versus non-educated women as wives and mothers.

 

 

ANNEX G: THE MANAGEMENT AND GOVERNACE OF PRIVATE HEIs

According to human rights agreements, governments have an obligation to ensure that their citizens receive a good education regardless of the source, be it public or private. This includes ensuring that teaching staff, facilities, equipment and materials and monitoring, including quality assurance, are of the best quality that can be provided with available funds in both the public and private sectors.

The regulation of private education is thus an important issue and can, when carried out correctly, enable high quality delivery while simultaneously encouraging further investment. In a paper examining the international experience of regulation of private education at the school and HE level, Fielden and LaRoque (2008) demonstrate that government regulations often appear to favour public over private provision in the absence of any public policy rationale. They also argue that the regulatory and funding frameworks in many countries do not promote growth in private education and likely reduce both the quality and sustainability of the private education sector and subsequent benefits that such provisions could bring. For Altbach (2002) and Susanti (2010), entirely open HE markets with no regulation undermine academic values and reinforce inequalities that already exist, giving the most powerful education providers and individuals, unrestricted access, making it difficult for countries, institutions, and individuals with limited resources to flourish. In many LMICs, a number of new providers (including private for-profit institutions) have emerged to meet the burgeoning demand for HE. Unfortunately, in several countries, this increase has coincided with a relaxing of state regulation, rather than a concerted effort to improve the rigour and effectiveness of state regulation mechanisms to achieve these dual goals of improved quality and further investment (Naidoo, 2007).

 

 

 ANNEX H: THE PARTNERSHIPS FOR HIGHER EDUCATION IN AFRICA (PHEA)

In 2000 the Carnegie Corporation, Ford Foundation, MacArthur Foundation and the Rockefeller Foundation launched the PHEA to coordinate their support for HE in Africa. The PHEA grants totalled US$ 440 million over ten years up until 2010. The PHEA support was focused in nine African countries: Egypt, Ghana, Kenya, Madagascar, Mozambique, Nigeria, Tanzania, South Africa and Uganda. The PHEA aimed to provide direct support to HE, respond to Africa HEI demand, focus on a subset of HEIs and treat consultation as key to effective support.

Most of the funding (84%) went directly to African grantees, including US$243 million in direct support to universities and colleges. In responding to demands, grants to institutional development usually supported priority areas identified by the universities themselves. Of the 65 HEIs supported, 27 received US$ 1 million or more. Seven received over US$ 10 million each. African regional networks were the second largest type of grantee receiving just under US$61 million.

In 2010, the PHEA published a review of its decade of investment in African HE. In this review, the PHEA cited among its accomplishments: enduring improvements in African HE, including the development of a Bandwidth consortium; developing HE capacity to manage their IT networks; using technology to improve teaching and learning; enhancing gender equity in enrolments and graduation rates; improving access for marginalised groups; strengthening physical infrastructure; expanding the capacity for policy research and advocacy; establishing new and more efficient systems for strategic planning and financial management; supporting the development of advocacy and policy reforms through the establishment of the HE Research and Advocacy Network (HERANA) including the creation of University News; library automation and resource mobilisation; and helping to develop the next set of African academics.

Top amongst the challenges identified by the PHEA for the near future was recruitment, development and retention of African academics. In the view of the PHEA, efforts are needed to strengthen and expand postgraduate capacity, including research productivity, to create institutional policies and practices that nurture junior academics and to adopt natural policy and regulatory environments that help build sustainable institutions and serve development needs.

Among the key lessons cited in the PHEA report were (a) that grants for institutional development must support priority areas identified by the universities themselves, (b) the foundations determined that a policy of going deeper rather than broader was more effective and, (c) a focus on institutional development and transformation rather than sectoral or systemic was more effective.

Source: PHEA (2010)

For more information and all publications from PHEA see http://www.foundation-partnership.org/

 

 

ANNEX I: HEI PARTNERSHIPS

The University of Jos in Nigeria identified the need to build the institutional capacity and infrastructure for the prevention, management and resolution of conflicts. It spelt out its aim to reposition iteslf as a centre for excellence in peace and confilct studies and a key reference point in Africa. The University then embarked on a series of foundational activities which resulted in the establishment of the Centre for Conflict Managament and Peace Studies (CECOMPS) in 2002. The estbalishment of CECOMPS was a well though out plan that was factored into the ‘’Second Strategic Plan’’ of the University of Jos. The University decided that it needed to enhance the capacity of CECOMPS for teaching and research in peace and conflict studies.

A consultative mission met at the University of Jos. Its aim was to establish the needs and interests of CECOMPS. One result was a proproasl for the upgrading of the Postgraduate Diploma in Peace and Conflict Studies into a MA programme after two years of running. Whils this was thought to create a great opportunity to enhance capacity building, it also posed several challenges. The biggest challenge was how the capacity of the Centre would be enhanced to be able to undertake such an upgrade.

A consultative workshop prepared the University of Jos to articulate its needs, strengths, limitations and future directions.

The University of Jos then decided that its aim of being a centre of excellence in peace and conflict studies could best be achieved through a partnership programme. Given that the University of Bradford has a long tradition of exposure and excellence as the world’s leading and largest department in peace studies, with a unique advantage of an Africa Centre, it was considered a suitable partner. The partnership was considered to be a means of strengthening the Africa programme of Bradford, while allowing the University of Jos to beneift from the academic excellence of the University of Bradford’s peace studies department.

Source: Wanni et al. The Africa Unit (2010: 23)

 

 

ANNEX J: PRIVATE HEIs IN BRAZIL

While enrolments in private institutions are growing across the world, there are still significant differences across countries in terms of the size and quality of the private sector.

With 74% of all enrolments in private HEIs, Brazil is a critical case in point. The country traditionally had a small number of mainly Catholic private institutions, but from the 1990s, a new breed of private institution started to emerge: teaching focused, commercialised, highly attuned to the market and able to expand in a short time-span. Their main function was to absorb the excess student demand from the public sector.

This rapid expansion — facilitated by the neoliberal policies of the administration in the 1990s — enabled a rapid increase in access to HE with some 4,966,000 of a total of 6,740,000 students enrolled in private institutions in 2013. Yet opinions are divided as to the desirability of this form of expansion (McCowan, 2007). First, many of these institutions are little more than high schools, with poor facilities, uneven quality of teaching, and mainly part-time hourly paid staff. Regulation has proved a challenge for the Brazilian authorities, particularly on account of the financial interests at stake. Second, the growth of the private sector has led to a stratification of opportunity, with the lower cost institutions generally providing a lower quality experience or at least lower prestige of qualification on the job market. Third, there are concerns over transfer of public funds (in the form of loans and tax breaks) to the private sector, particularly in light of the fact that the majority of these institutions are for-profit. Given the apparent dependence of society on the private institutions for absorbing demand, and the limited ability of the public sector to expand, these tensions are unlikely to be resolved in the short term.

Source: Schendel and McCowan (2015)

 


 

ANNEX K: FOUR MODELS OF MANAGEMENT AND GOVERNANCE OF HE SYSTEMS

Governance provides the institutional environment within which the educational enterprise functions. Efficiency in both system and institutional governance is necessary for the educational system to produce the desired results. Good governance includes promoting quality, responsiveness, transparency and accountability in the sector as well as providing it with appropriate standards, incentives and information. The governance of a HE system in a country is a tricky business. On the one hand, the need to produce skilled labour to meet development needs, the amount of public resources devoted to providing HE and the political power that students in HEIs wield suggest the need for government control of HEIs. On the other hand, the need for academic freedom, the freedom to innovate in both teaching and research and the ability to respond to changing environments suggest these institutions need to be free from political control as much as possible. The governance structure of HE that emerges is a balance between these contrasting forces. While some countries set up structures that allow for central government direct control, others set up buffers between the political administration and the governance system. 

GOVERNANCE MODEL

 

STATUS OF PUBLIC UNIVERSITIES EXAMPLES
State control

 

An agency of the MOE or state owned corporation Malaysia
Semi autonomous

 

An agency of the MOE, a state owned corporation or a statutory body New Zealand

France

Semi independent

 

A statutory body, a charity or a non profit corporation subject or MOE control Singapore
Independent

 

A statutory body, a charity or non profit organisation with no government participation or control but linked to national strategies and related only to public funding Australia

UK

Source: Adapted from Fielden (2008)

The simple typology presented above represents just four models of governance from Fielden (2008)82 which is based on the degree to which the political system has direct control of the decision making process in HE. However, even these extremes are not simple black and white. Within the state control model there has to be some freedom as a central ministry cannot control everything and within the independent model there is an implicit acknowledgement that the MOE is entitled to hold the institution accountable in many respects and must retain overall strategic control of the sector.

 

 

 

ANNEX L: PUBLIC PRIVATE ALLIANCE IN THE IVORY COAST

In the Ivory Coast, innovative experiments have been tried with a view of involving small private operators in student catering and services without the states’ financial participation. To that end, partnerships have been developed with the private sector and areas have been developed (with water, power supply and sewage), for instance, at the public university of Abobo Adjame, where the private operators set up facilities complying with technical specifications drawn up by the university administration. These specifications may include a standard installation layout, the services authorised, opening hours, quality standards and the obligation to provide at least one dish as a minimum price charged in a traditional university restaurant. In such cases, the role of public authorities consists essentially of defining the framework of operations and ensuring compliance with the technical specifications.

Source: The World Bank (2012)

 

 

 

ANNEX M: THE GHANA EDUCATION TRUST FUND

In 2000 the Ghanaian Parliament established the Ghana Education Trust (GET) Fund as a means of financing a more rapid expansion of the country’s education system than was possible on the basis of the Government budget alone. The fund was capitalised by increasing the existing value added tax by 2.5%. These revenues were adding earmarked for capital projects in the education sector, and their use for recurrent expenditures such as salaries is prohibited. By 2007, the GET Fund was generating approximately US$ 200 million annually. HE has received roughly 45% of GET funds since its inception.

The beneficiaries are the staff and students of Ghana’s HEIs. GET funding has been used to construct educational facilities, capitalise a student loan programme, provide scholarships for poor students, staff development, expand ICT infrastructure and support research and teaching activities, particularly the expansion of post graduate programmes and distance education.

The Fund is governed by an independent board of trustees accountable to Parliament and managed by a Government appointed administrator. Each year the fund’s allocation and its specific uses are approved by Parliament to ensure they address the nation’s most pressing educational needs.

Source: The World Bank (2010)

 

 

ANNEX N: THE COLLABORATIVE RESEARCH SUPPORT PROGRAM

USAID’s Collaborative Research Support Program (CRSP), has been running for over 30 years. It engages US HEIs and DC partners in research capacity building. In 2013 the programme was renamed the ‘Feed the Future Innovation Labs for Collaborative Research’. It is a collection of programmes which, at its core, has a collaborative relationship between HEIs in the US and DCs, including HEIs, research institutions, international research centres, NGOs and private sector entities. Collaborators conduct research on specific development programmes in LMICs and in doing so assist USAID in carrying out the international food and agricultural mandate. The programmes support long term commitments to partnerships that build human and institutional capacity through collaborative research directed at solving development problems in the host country.

In 2012, a review of the CRSP was commissioned by the Board for International Food and Development (BiFAD) with support from USAID and with a broad mission to review and evaluate the programme as a potential model for research capacity building. In doing so it was to assess other models in order to compare their performance.

The report identified a number of strengths of the programme including strong integration of development research and human and institutional capacity building; an interdisciplinary approach that enables the programmes to draw on a variety of analytical approaches, the ability to attract world class scientists in many cases, mutual benefit of the research to US and host countries; substantial leveraging of external resources; broad engagement with 6 US HEIs and 200 agricultural research institutions and significant positive impacts on people’s lives and economic well being.

The report also identifies a number of weaknesses to the programme. Most relevant included the need for more systematic priority setting and aligning of priorities with national and regional development agendas and strategies; the spread of funding to too many small projects; the lack of sufficient USAID oversight and coordination between Washington and the Missions; not enough institutional capacity building with training being done without a clear understanding of institutional performance gaps and not enough investment in rigorous assessments of impact.

Source: USAID (2014)

See also CRSP Review

[1] Ratio of female to male tertiary enrolment is the percentage of women to men enrolled at tertiary level in public and private institutions

 

 

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Early childhood development /topic/early-childhood-development/ Thu, 04 Dec 2014 16:23:17 +0000 http://www.heart-resources.org/?post_type=topic&p=24965 Read more]]>
Executive Summary1. Introduction2. What is integrated ECD?3. Before conception to birth 4. From birth to 2 years (infancy)5. The preschool years – 3 to 5 years6. Transition to school – 6 years onwards7. Conclusion. Towards more integrated ECD

Early childhood development (ECD) has become a priority for research, policy and programming, at national and global level, with increasing recognition of the interconnections between a nation’s development goals and the quality of services for all young girls and boys, and their families. The term ‘ECD’ is increasingly being used to reflect the evidence that young children’s survival, health, care and learning involves interconnected and dynamic growth processes from well before the infant is born through into their early school years.

ECD is thus a broad and complex field, covering multiple policy sectors, and diverse research traditions, but with the aspirations of constructing more inter-sectoral, and more integrated models of services delivery. The Topic Guide offers brief summaries of key research, evaluations and case studies, as well as links to more specialist resources relevant to this vision for ECD. It draws on a very broad range of published research and policy studies, spanning health; nutrition; water, sanitation and hygiene (WASH); social protection; and education. It includes experimental trials of innovative programmes as well as policy reports on systemic reform. Despite the ambitious scope, inevitably the Topic Guide is not exhaustive, and for example has limited coverage of child protection issues that are also at the heart of an integrated vision for ECD. Specialist services for specific groups, notably young disabled children are also essential within an integrated and inclusive vision, but detailed discussion is beyond the scope of the guide.

The case for working towards more coordinated, more integrated policy, programming, capacity building and research is not new. Early childhood pioneers have emphasised the importance of respecting children’s holistic development for at least two centuries; and flagship national programmes have been built up around service integration principles since the 1960s. There are many lessons to be learned. Introducing effective inter-sectoral integration can be a very positive step forward, but can also be very challenging to deliver in practice, especially in contexts with low resources and weak governance. The priority is to support practical steps towards quality holistic ECD in low- and middle-income countries where services for young children and families are growing rapidly, but not always coherently.

ECD is not just inter-sectoral. It is also dynamic. Just as the foetus, infant, young child and school student experience multiple transformations during their early years, so too, policy and programming must be sensitive to changing needs and priorities at different ages and stages, all embraced within the concept of ‘ECD’. The significance of early childhood can hardly be overstated. Chronologically, it spans nearly the first half of childhood. Developmentally, it is even more significant, shaping all that follows. ECD encompasses several quite distinct early developmental phases. In this Topic Guide we distinguish the period ‘from conception to birth’ from ‘birth to 2 years’, followed by the ‘preschool years’ and the ‘early school years’. These are not precise phases. They are shaped by cultural beliefs and institutional structures, as well as development changes in children’s capacities, vulnerabilities and emerging autonomy; their needs for care, ways of communicating, playing and learning; as well as the patterns of their daily lives in modern societies, including access to ECD services and schools.

The Topic Guide has three specific goals:

  • to summarise evidence across the full age span of ECD, identifying key developmental phases and transitions, beginning before conception through to early grades of school, and also recognising intergenerational and life cycle issues
  • to map the various sectoral entry points for delivering comprehensive holistic ECD services, and highlight the distinct research traditions, key evidence, policy priorities and programmatic expertise associated with each sector
  • to identify opportunities and challenges in achieving more integrated ECD at every level: building inter-sectoral policies, management, programming, professional training, service delivery and research.

Section 1 and Section 2 introduce the topic and the concept of integrated ECD, with an extended case study of one of the longest running national programmes, Integrated Child Development Services, in India, which was initiated in 1975 (see Case Study 1 in Section 2).

Section 3 covers the period before conception, through pregnancy, and including the first weeks after birth. The impacts of a mother’s health, well-being and education on their infant is well documented. Recent research now identifies specific epigenetic pathways from maternal nutrition at the time of conception through to long term development. Section 3 includes brief summaries of evidence on family planning, maternal nutrition and disease prevention, antenatal preparation and birthing practices, breastfeeding, neonatal care and early attachment relationships. Social protection and poverty reduction is an overarching policy priority during pregnancy and the neonatal period, within which specific initiatives can improve the health, well-being and prospects for mother and infant. An extended case study describes the large-scale federal Oportunidades programme in Mexico, introduced in 1997, which combines conditional cash transfers with coordinated health, nutrition and education interventions (see Case Study 2 in Section 3).

Section 4 focuses on the period from 0 to 2 years, when WASH, health and nutrition interventions have traditional prominence, along with early learning support via parenting programmes which are increasingly recognised as crucial within a comprehensive approach. One of the major research insights for this early life phase is that combining nutrition interventions with play-based learning and psychosocial support can have major long-term benefits for children. Section 4 also considers how employment opportunities, laws and practices around parental leave, and access to quality community-based childcare all impact on parents’ capacities and children’s well-being. Birth registration is identified as a crucial first step in children’s and parents’ entitlement to social protection and ECD services, especially for marginalised groups.

Section 5 looks at the 3 to 5 age group, commonly referred to as the ‘preschool years’, which anticipates enrolment into primary school – now a major transition for most of the world’s children. There is a marked shift in the emphasis of policy and research for this age group, with much stronger engagement from the education sector, and a strong tradition of research evaluating the impact of experimental, mainly centre-based, programmes. Multiple replications demonstrate the potential impact on educational and psychosocial outcomes through the life course, in a few cases tracked through into middle age. Several of these ‘classic’ studies have provided the underpinning data of economic analyses on the investment potential of quality ECD programmes, and these are now being widely replicated, including in low-income countries.

Attendance at preschool has growing significance in shaping life course trajectories for children. But in most regions, a very large gulf has opened up between the transformative promises offered by research and policy and the insufficient, often low quality and inequitable realities of access to services for young children and families. For the most part, these services are neither statutory nor compulsory, with limitations of finance and governance and a growing reliance in many low- and middle-income countries on NGO-led, faith-based and private-for-profit initiatives. There is well documented evidence of disadvantaged, disabled, and socially marginalised groups being under-represented – the very groups identified by global research as highest priority.

This age phase has also been a particular focus for experiments in service level inter-sectoral integration, notably through combining care and learning with nutrition, health checks and family support, and founded on evidence that holistic and child-centred interventions are more efficient, more appropriate and more user friendly for this age group – and their families. Integrated goals for this age group are frequently signaled as ‘early childhood care and education’ (ECCE) or ‘early childhood development, care and education’ (ECDCE). An extended case study describes the relatively recent, donor-led Ilifa Labantwana programme in South Africa (see Case Study 9 in Section 5). Ilifa Labantwana aims to influence policy implementation on integrated, scalable ECD interventions in a sustainable manner through a progressive cycle of research, advocacy, capacity building, finance modelling and support for government and providers.

Section 6 is about the transition years into compulsory school, a period dominated by questions around ‘school readiness’, which in this Topic Guide is treated as being not just about ensuring parents and children are prepared for school, but also about reforming school systems to be ‘ready’ for young children: accessible, high quality and inclusive. The dominance of education research and programmes for this age group is balanced in Section 6 with examples of nutrition, WASH and health interventions being integrated within school systems.

Examples of age and sector specific initiatives are offered throughout Sections 3, 4, 5 and 6, as well as more comprehensive and more integrated ECD programmes, from various regions of the world.

Finally, Section 7 of the Topic Guide steps back from specific programmes and research. Ten general conclusions are offered about achieving more integrated, or at the very least more coordinated inter-sectoral ECD, in summary:

  • Integrated ECD recognises that young children’s lives (and their parents’ lives) are lived holistically, not sectorally. Ensuring quality services are ‘joined-up’ at the point of delivery is a first indicator of progress.
  • Full-scale, systemic integration may not always be feasible, nor cost effective, especially in low- and middle-income countries. Building on sector-specific delivery platforms may be a cost effective and pragmatic way forward.
  • Horizontal integration requires coordination between social protection, health, nutrition, WASH, education, child protection, etc. An added challenge is to ensure integration within as well as between sectors.
  • Effective vertical integration links central government policies with local programmes and services, with clear lines of responsibility and effective two-way communications.
  • Vertical integration also includes middle level governance and finance streams, which can be a barrier to effective reform.
  • Effective coordination extends to non-state actors. In many countries the private sector, NGOs, and community groups are very significant service providers.
  • Integrated ECD systems are inclusive, with careful monitoring for equity, and especially targeted to the most marginalised, disadvantaged as well as disabled children.
  • Integrated ECD is also about ensuring continuity between age phases and smooth transitions between age-linked services.
  • Building capacity is a priority at every level. Training of sector specialists remains a priority, but with a shared vision for integrated ECD.
  • Implementing more integrated ECD involves being context sensitive, pragmatic and innovative; working in partnership with other stakeholders, including families and communities as well as children.

The evidence base for policy and programming in ECD is growing in quantity, quality, and consistency for most topics, from a relatively weak starting point only a few decades ago. Geographical and contextual reach has improved for some topics, offering greater confidence about both generalisability of core findings about risks to children’s development and suggesting specific entry points for interventions that have proven effectiveness. Case studies of large scale ECD systems across a range of political and economic contexts also draw attention to contextual considerations that affect policy development and programme implementation, especially regarding more comprehensive and integrated ECD reforms.

1.1          Early childhood development matters

Early childhood development (ECD) has become a priority for research, policy and programming, with increasing recognition of the interconnections between a nation’s development goals and the quality of services for all young girls and boys, and their families. While ECD was not explicitly addressed as a Millennium Development Goal (MDG), the UN Secretary General’s Report to General Assembly, 2010, recognised ECD as core to their achievement:

The Millennium Development Goals are closely interconnected in their impact on the rights of the young child. Poverty, maternal and child survival, nutrition, health, protection from violence, abuse and exploitation, gender equality and human development have short- and long-term consequences for the rights of young children, with implications for future generations, as poverty cycles are reproduced.

Now, a strong case is being made for ECD to be central within post-2015 development goals (Aber et al., 2013; UNSDSN, 2014). The core agenda to ensure that ‘no one is left behind’ – pointing strongly towards effective strategies for early intervention and prevention:

The evidence is clear, investing in ECD leads to gender equality and empowerment, better health and education outcomes, improved skills, abilities and productivity, narrows the income, ethnic, and geographic inequality gaps, provides timely intervention for persons with disabilities, and is a cost effective strategy for eliminating disadvantage.

The positioning of ECD at the heart of global development reflects the convergence of persuasive lines of policy analysis and research evidence that every young child is entitled to survival, to development and education, and that early childhood is a critical period: critical not only for individual children’s development, but for achieving social justice and for the prosperity of societies. Heckman and colleagues have been most influential in translating the case for ECD investment into the language of economics (Heckman, 2008; see also Figure 1 below).

Heckman Curve graph
Figure 1: The ‘Heckman Curve’ – the earlier the investment, the greater the return
(Source: Heckman 2008, figure 18, p. 311.)

Economic analyses of human capital investment largely build on longitudinal evidence from experimental early interventions that have tracked long-term cognitive, psychosocial, educational, social welfare and labour force outcomes (e.g. Schweinhart et al., 2005). They point to the earliest years as most cost effective for delivering returns (van der Gaag and Tan 1998; Barnett, 2009). Recognising the investment potential of ECD is not an alternative to respecting fundamental rights, and engaging the power of ECD to promote social justice and greater equality. Nor is investment in ECD an alternative to more structural poverty reduction strategies. All these lines of argument are complementary in building the case for ECD.

Progress in neuroscience provides scientific underpinning for a renewed emphasis on the critical importance of ECD. Decades of research have demonstrated effects of poverty, institutionalisation, undernutrition, deprivations and trauma, the role of risk and protective factors in children’s relative vulnerability/resilience and the potential for reversibility, and remediation (Rutter, 2006; Wachs and Rahman, 2013). Neuroscience research is beginning to reveal the physical expressions of these processes in the growing and changing structure and function of the brain (Oates et al., 2012; Shonkoff and Phillips, 2000; Center on the Developing Child, 2011). Toxic stress from early childhood adversity can lead to changes in learning, behavior and physiology. Physiological disruptions increase the chance of stress-related chronic disease which can further widen health disparities (Shonkoff et al., 2012).

Strong associations between poverty and child development outcomes have been found amongst preschool children within developing countries (Fernald et al., 2012a; 2012b) which contribute to the transmission of inequalities through childhood (Woodhead et al., 2013). A powerful catalyst for global policy engagement in these issues has been a series in The Lancet, which estimated that “…200 million children under 5 years fail to reach their potential in cognitive development because of poverty, poor health and nutrition, and deficient care” (Grantham-McGregor et al., 2007, p. 60). Subsequent papers in the series have elaborated on this ‘loss of developmental potential’ and on the evidence for effective early prevention and intervention (Engle et al., 2007; 2011; Walker et al., 2011).

Some areas of ECD research on these issues is robust and powerful, but with many gaps in applied research into programme effectiveness and implementation, with some geographies and age groups receiving much more attention than others. Also, rapid economic and social development is shifting the context of ECD policy and programming, for example: inequality and social inclusion is becoming a major challenge in rapidly urbanising and mobile low- and middle-income countries (Pells and Woodhead, 2014); school readiness issues now dominate in contexts where Education for All (EFA) goals for access to primary education have been achieved (Britto, 2012); and planning effective ECD interventions for parents and children in fragile states, post-disaster contexts, and disease emergencies becomes an increasing priority (UNICEF, 2011).

One of the biggest challenges for research, policy and programming is to build more integrated ECD systems: comprehensive, equitable, high quality services that span all sectors, client groups and age groups. Reviewing the evidence, UNICEF Executive Director Anthony Lake and World Health Organization (WHO) Director-General Dr Margaret Chan confirm that:

…to be most effective, interventions must be intersectoral, going beyond education to encompass health, nutrition, and protection. The healthy development of a child’s brain depends on multiple positive experiences. Nutrition feeds the brain; stimulation sparks the mind; love and protection buffer the negative impact of stress and adversity. And distinct interventions are mutually supportive, achieving the strongest results when delivered together.

1.2          Goals for the Topic Guide

The overall aim of this Topic Guide is to offer an overview of the rapidly growing field of ECD, Three specific goals have shaped the Topic Guide:

  • to summarise evidence across the full age span of ECD, identifying key developmental phases and transitions, beginning before conception through to early grades of school, and also recognising intergenerational and life cycle issues
  • to map the various sectoral entry points for delivering comprehensive holistic ECD services, and highlight the distinct research traditions, key evidence, policy priorities and programmatic expertise associated with each sector
  • to identify opportunities and challenges in achieving more integrated ECD at every level: building inter-sectoral policies, management, programming, professional training, service delivery and research.

The rest of this section elaborates on these goals; explains how the Topic Guide is organised, including the use of research summaries, case studies and links to wider resources; and summarises the approach taken in the Topic Guide to assessing quality of evidence.

A life cycle perspective on ECD

Early childhood is formally defined by the UN Committee on the Rights of the Child as “the period below the ages of 8 years” (OHCHR, 2005, p.2). For this Topic Guide, we define early childhood to include the period from around conception, in recognition that critical influences on ECD begin long before the infant is born, and even before the infant is conceived. On this definition, ECD covers a full eight years, nearly the first half of childhood. ECD is even more significant developmentally, as the most formative and critical period of the human life course, which shapes all that follows.

A life cycle framework is intergenerational, extending to the health, well-being, and ultimately the survival of the young woman on whom her newborn infant(s) will depend to survive, thrive and develop throughout their childhood and beyond. A life cycle framework also includes the role and capacity of fathers, siblings, other household members and caregivers, and wider kin and community, in supporting mothers’ well-being and infant development. Ultimately, what happens to children before they are 8 years old will shape life course trajectories through to becoming parents themselves.

The growing infant is highly responsive to the positive impact of a secure household, a healthy environment, good nutrition, quality care, and opportunities for play and learning. By the same token, every young girl or boy is highly susceptible to the negative consequences of deprivations, risks and shocks, inequalities and discrimination, related to their gender, ethnicity, disability, household poverty or location. Inequities at the beginning of life can be accentuated over the life cycle but ECD can also lay the foundations for greater equality and inclusive social and economic development (UNESCO, 2007).

Identifying the multiple pathways for harnessing ECD to achieve gender equality reinforces the argument for framing ECD within a life cycle perspective:

ECD offers several pathways through which gender equality can be achieved. The first pathway is through programs that directly serve the child, such as childcare and development, early learning, and preschool programs (formal and non-formal). This pathway improves outcomes for the girl child herself… A second pathway is through the benefits of ECD programs for the other female members of the family. When mothers are at work or otherwise unavailable, older sisters are often substitute parents for younger siblings. Evaluation data from several communities with ECD programs has demonstrated an improvement in girls’ enrolment in primary school…. Furthermore, mothers benefit economically from the provision of ECD services.

Moreover, a woman’s well-being directly affects the development of her child through childhood and into adolescence. For girls especially, deprivations during ECD transmit into adolescent outcomes, which in turn impact the next generation; vividly illustrated through life cycle analysis of the risks of undernutrition (Yousafzai et al., 2013).

In summary, the first goal of the Topic Guide is to highlight the importance of a life cycle perspective on ECD. Four broad age phases are identified in Sections 3, 4, 5 and 6, including core research evidence, evaluations and case studies that can inform policy and programming relevant to each age group.

Multi-sectoral and comprehensive

Secondly, the Topic Guide recognises ECD as (by definition) a multi-sectoral field for policy and programming and a multi-disciplinary field for research and evaluation. ECD has seen huge investment of research and policy effort, with significant knowledge systems now available, and well articulated expertise spanning health; nutrition; water, sanitation and hygiene (WASH); child protection; education; and social protection. Growing sectoral expertise is one of the strengths of current ECD, but also highlights one of the strongest challenges.

Each sector has a more or less well articulated conceptualisation of ECD priorities: about malnutrition and stunting, disease and vaccination, violence and child protection, early intervention and special needs, or preschool education and school readiness. It has been less common for an early education expert to engage with research on social protection, or an expert in care of newborns to consider factors affecting children’s health in school, and vice-versa. It is increasingly recognised that these ECD domains are interconnected and synergistic in terms of their impact on young children’s developmental pathways. For example, undernutrition impacts children’s physical development and makes them more vulnerable to disease. Undernutrition also impacts intellectual development, and in turn educational progress. There is also good evidence of long-term consequences for psychosocial well-being (Dercon and Sanchez, 2013).

Sectoral experts also prioritise specific age phases as most critical, with health-focused initiatives dominating the very earliest months and years, and education initiatives much more prominent during preschool and school transition years. The period between around 2 and 4 years old generally receives less attention from all sectors. Needless to say, children and their families don’t generally perceive their lives in sectoral terms, and children can be at risk where services are not ‘joined up’. The overall picture resembles a patchwork in many countries where it is urgent to move towards a more integrated vision.

Integrated ECD systems

A third goal for the Topic Guide is to identify steps towards achieving more integrated ECD systems – in other words moving from ‘multi-sectoral’ to ‘inter-sectoral’ – and effectively spanning different sectors and age phases within a holistic understanding of human development.

Objectives for more integrated ECD include:

  • to realise every young child’s right to survival, development and education, recognising the interdependencies between nutrition, health, learning, and psychosocial development
  • to support parents and other caregivers in fulfilling their responsibilities and achieving their aspirations for their children, including through social protection programmes, employment and housing policies as well as core sectors concerned with children
  • to provide more coherent, ‘joined-up’ services at the point of delivery, in ways that improve accessibility and relevance to children’s and families’ daily lives in rapidly changing societies
  • to improve long-term outcomes in health, learning and well-being through adolescence and into adulthood, including intergenerational benefits
  • to improve equity for all girls and boys, irrespective of their economic and social circumstances, abilities or disabilities, through services that are comprehensive, inclusive and high quality
  • to improve efficiency and cost effectiveness of ECD sectors and systems in delivering ECD goals in partnership with parents and communities
  • to foster evidence-based innovation in delivery of sustainable ECD programmes, especially in low resource contexts where professional capacity and governance systems may be at early stages of construction.

Building comprehensive policies, programmes and services that are holistic, inclusive and cover the full age span is one of the greatest challenges for the coming decades, especially in low resource contexts:

The entry points to influence young children’s development are diverse and involve multiple stakeholders. The various sectoral policies that affect ECD outcomes include healthcare and hygiene, nutrition, education, poverty alleviation, and social and child protection. These policies can be aimed at the pregnant woman, the child, the caregiver or the family as a whole. Interventions can take place in many environments, including the home, at a preschool or childcare center, a hospital or community centers.

Steps towards achieving more integrated ECD range from the most modest coordination and collaboration through to full-scale system reform and physical integration of services. These options are introduced in Section 2 and revisited again in Section 7.

1.3          Conceptual framework

A bio-ecological conceptual model is helpful as a starting point for a Topic Guide on holistic, multi-sectoral ECD. It is a systemic model that identifies multiple potential entry points and delivery platforms for ECD. The most obvious proximal entry points are the programmes in which young children participate. But the model also recognises distal entry points, including laws and regulations, social protection programmes, especially those that alter parents’ capacities to support their children’s development.

The growth of the young child (including the resources and risks for his or her development) are shaped by (as well as shaping) ‘micro-systems’ within the household and immediate environment (notably with the mother, father, siblings, other caregivers), which gradually extend into wider community contexts of health clinic, preschool, church, etc. The interconnections amongst these micro-systems comprise the ‘meso-system’, which more indirectly shapes each girl or boy’s development, notably links between parents and health workers, teachers, or church leaders. More distal ‘exo-system’ influences include mothers’ and/or fathers’ employment as this constrains their resources of time and money for housing, nutrition, learning resources and childcare. Public health infrastructure, transport networks, media and communications are also part of the ‘exo-system’. Each of these sub-systems is in turn embedded in a ‘macro-system’ of laws, policies, and institutions, across multiple sectors, as well as the cultural norms and values that moderate their impact on children’s lives. Finally, these are dynamic systems, within and across generations, signaled by the concept of ‘chrono-system’ (Bronfenbrenner, 1979; see Tudge et al., 2009 for a more recent review; see Figure 2).

 

A bio-ecological systems model of ECD
Figure 2: A bio-ecological systems model of ECD
(Source: Adapted from Bronfenbrenner (1979). The Ecology of Human Development: Experiments in Nature and Design.)

ECD interventions vary according to their sector focus, system focus and delivery platform:

  • Many interventions target the mother-baby micro-system, notably support for early neo-natal care, breastfeeding, early nutrition, attachment and learning. These may be delivered at a birthing clinic, community health facility or through home visiting.
  • Traditional ECD programmes are about constructing specialised micro-systems focused on childcare, early play and learning (notably various forms of preschool) which transition into more formal education. Each of these micro-system interventions is associated with specific goals and personnel at various skill levels.
  • Meso-system influences are often central to ECD goals, notably via parent education and support programmes, as well as many community-based initiatives.
  • Modern media offer new opportunities to supplement more traditional programmes, notably through television and digital technologies: targeted at parents (e.g. through key health messages); and/or to children themselves (e.g. through children’s television programmes, such as Sesame Street).
  • A wide spectrum of initiatives (across multiple sectors) are focused on improving the child’s exo-system, including creating more healthy environments, in terms of housing and WASH, ensuring basic safety and child protection as well as enabling children’s primary caregivers with the resources, time and capacities to support development, including via employment laws, parental leave programmes and social protection.
  • More comprehensive ECD reforms recognise that macro-system reform is essential in order to deliver long-term and sustainable programmes and services. ECD policy development is crucial as a starting point for identifying the most cost effective entry points within specific country systems, with account taken of the potential for municipal, community and NGO-led programmes, the role of donors, as well as potential scope for building public private partnerships.

Adding a timeline (age and stage) dimension into Figure 2 reinforces that ECD processes and systems are dynamic, and while some interventions are age-critical, others are more continuous:

  • Age-critical interventions include preparation of adolescents and mothers-to-be, support at birth, birth registration, establishing early breastfeeding and infant care systems, and vaccination against disease.
  • Interventions focused on broader age phases, include parent education, as well as preschools and the early grades of primary school.
  • Some programmes are more continuous through early childhood and beyond, notably social protection, WASH and health services, with specific delivery platforms tailored to children’s shifting micro-systems within households, communities, preschools and schools.

1.4          Scope and organisation of the Topic Guide

The main emphasis of this Topic Guide is on evidence relevant to low- and middle-income countries where strengthening ECD is a very high priority, but achieving an effective ECD system can be very challenging. Section 2 introduces the concept of more integrated ECD in more detail. This Topic Guide encompasses WASH, health, nutrition, education and social protection, as in Figure 3. These sectoral starting points recur through the Topic Guide, but with the aim to draw attention to opportunities for more inter-sectoral policy and programming via a variety of delivery platforms.

Specific topics are linked to four broad age phases in Sections 3, 4, 5 and 6 of the Topic Guide. The identification of age phases draws attention to the range of policy responses, services and professional capacities that are needed within an integrated ECD system, each tailored to significant stages and transitions in this most dynamic period of the human life cycle. Each of these age phases requires a package of coordinated programmes and services.

Mapping of age phases across sectors
Figure 3: Mapping of age phases across sectors

Figure 3 provides an overall mapping of age phases across all sectors, identifying specific entry points and interventions, most of which are elaborated in later sections. It is important to emphasise that the Topic Guide is not exhaustive of the opportunities for strengthening ECD, nor are the topics in specific age phases necessarily exclusively relevant to that age phase. See Britto et al. (2011) and Denboba et al. (2014, forthcoming) for other comprehensive frameworks.

Section 3 covers the period before conception, through pregnancy, and including the first weeks after birth. Section 4 focuses on the earliest years of infancy, when WASH, health and nutrition interventions have traditional prominence, along with early learning support via parenting programmes which are increasingly recognised as crucial within a comprehensive approach. Section 5 looks at the preschool years, when children aged around 3 to 5 years are increasingly enrolling in early childhood care and education programmes. This age phase has been a particular focus for experiments in service level integration. Section 6 is about the transition years into compulsory school, a period dominated by issues around school readiness, which in this Topic Guide is balanced with examples of nutrition, WASH and health interventions for the age group.

Examples of age and sector specific initiatives are offered throughout Sections 3, 4, 5 and 6, as well as more integrated ECD programmes, from various regions of the world. Finally, Section 7 of the Topic Guide steps back from specific programmes and research, offers ten general conclusions relevant to planning for more integrated – or at the very least more coordinated ECD services.

This Topic Guide covers a vast field of research, policy and programme experience. Inevitably, treatment of individual topics is relatively brief, intended to identify key research and provide illustrative case studies, with links to more detailed treatment elsewhere. Entry points that are tied in this Topic Guide to specific age phases are often cross-cutting, such as social protection and poverty alleviation programmes which apply to all age phases.

We also acknowledge gaps in the Topic Guide’s coverage, notably in the area of child protection. It is estimated that two thirds of young children experience some type of violence or harsh discipline, and some are victims of abuse and neglect, exploitation and trafficking (UNICEF, 2014). Strengthening child protection should be a feature of any ECD programme, as well as specific agencies or programmes dedicated to child protection. Also, inclusive services, including specialist diagnostics, early intervention for disabled children and other at risk groups are required for all age phases, but we can only give cursory treatment in this Topic Guide.

1.5          Assessment of evidence strength

This Topic Guide offers a brief introduction and guide to key research and programme evaluations across a vast field encompassed by ECD. It is not an exhaustive review of the evidence on any of the specific topics covered. Specialist systematic reviews have been a major resource, along with reports on specific sector-based research and evaluations. The Topic Guide also includes: (i) case studies of major national programmes that offer lessons on scaling-up integrated ECD, with evidence as available; (ii) systematically evaluated and rigorous interventions and pilot projects, including randomised control trials that demonstrate efficacy of specific interventions, with long term follow up evidence where available; (iii) innovative examples of steps towards more comprehensive and integrated ECD in various countries and regions.

One ongoing challenge for developmental science is the dominance of normative evidence, drawn from a narrow range of (mainly affluent Western) contexts informing core ‘textbook’ knowledge about how young children learn, the importance of secure attachment relationships, the role of parents, etc. Bornstein et al. (2012) estimate that less than 10% of research in developmental science comes from regions inhabited by 90% of the world’s population, with consequent over reliance on relatively small numbers of localised studies. Well designed studies are becoming much more widespread, which provides a stronger basis for drawing general conclusions, especially about probable effectiveness of interventions, and providing more nuanced contextual accounts that may shape appropriate interventions.

Dividing early childhood into age-phases is another normative feature of the developmental paradigm, which has been followed in this Topic Guide. In doing so, we acknowledge there is a risk of privileging chronological age as the major consideration for ECD programming. Societies vary in how far chronological age has traditionally been recognised and treated as the benchmark for expectations about children’s capacities, roles, responsibilities and use of time (Woodhead, 2009). The needs of young children have been understood very differently according to local convention and practices around the treatment of young girls and boys at different ages, and the extent to which individual differences are recognised (Harkness et al., 2013). Rapid social change is shifting these traditional beliefs, including the impact of universal birth registration, and age-graded education systems. The significance of research location, disaggregation by gender, disability, minority group status, poverty, intra-household dynamics, etc. is highlighted wherever possible, especially in the sections on inclusion and equity (notably 5.4; 6.4; and 7.7).

In preparing this Topic Guide we have assessed the strength of the evidence that we have used, based on the DFID Note on Assessing the Strength of Evidence (2014).

Given the wide ranging scope, and the diverse literatures drawn on, the Topic Guide does not formally assess single studies but does indicate throughout where evidence is especially strong, and where there are gaps. The overall assessment is given in Table 1. The Topic Guide also offers summary assessments tables for evidence reviewed in the major age phase Sections 3, 4, 5 and 6. These summary assessments are only indicative, and cannot encapsulate the full range of evidence cited.

Table 1: Overall evidence strength assessment for the ECD Topic Guide

Quality of evidence: Size of body of evidence: Consistency of results: Context
Variable, covering the full range of research designs, scale and rigour Medium but highly variable between topics Mixed but with consistent evidence on many topics Increasingly global with notable geographical gaps for some topics

As the quantity, quality and geographical range of ECD research increases, greater confidence can be offered about both generalisability of core findings about risks to children’s development and specific entry points for interventions that have proven effectiveness. Case studies of large-scale ECD systems across diverse political and economic contexts also draw attention to contextual considerations in policy development and programme implementation, especially the challenges of achieving more integrated ECD systems.

Some areas of research have received large investment (notably nutrition and health research). Other studies are growing but still patchy, especially systematic evaluations of innovative approaches to integrated service delivery in the poorest countries, and for the most disadvantaged groups, notably in Africa. Priorities include:

  • consolidating the quantity and focus of longitudinal evaluations of specific interventions in diverse contexts and geographies
  • research into innovative ECD delivery platforms including building on existing sectoral systems to achieve more inter-sectoral goals
  • capacity building initiatives at all levels, including specialist sectoral training and broad based para-professional training and parent support
  • evaluations of scale-up for targeted programmes that can promote equity and social inclusion from infancy through to school
  • governance and finance studies including on best ways to harness public, private and community initiatives towards more comprehensive and integrated services, in ways that are well managed, high quality and cost effective.

In a financial context that strongly prioritises cost effectiveness as well as programme effectiveness, value for money issues are crucial, especially when reviewing for example: a centre-based versus home visiting programme; or capacity building options based around a balance of high versus basic skill ECD specialists; or sectoral versus more integrated approaches. Cost effectiveness of ECD investment is powerfully demonstrated by leading economists, notably Heckman and colleagues (Heckman, 2006; 2008; Section 1). The World Bank has developed tools for analysing costs and benefits, including an ‘ECD Calculator’ (World Bank, 2014), mainly focused on school readiness indicators. The most recent World Bank report illustrates costs, impacts and returns on investment across a wide range interventions (Denboba et al., 2014 forthcoming, p. 3). Further work is needed to develop and apply ‘value for money’ tools, including assessing cost effectiveness of more integrated programmes with more comprehensive ECD outcomes.

This Topic Guide has three major goals, as outlined in Section 1: to summarise evidence on ECD; to map sectoral entry points; and to identify opportunities for more integrated ECD. There is universal agreement that ECD is by definition multi-sectoral. There is also widespread agreement that achieving more integrated ECD – moving from ‘multi-sectoral’ to ‘inter-sectoral’ – is more effective and cost effective. There is much less consensus about the feasibility or realistic prospect of full-scale ‘integration’ of ECD systems (from policy to service delivery) compared to more modest and pragmatic solutions. This section provides an introduction to this overarching issue.

In its guidance on rights in early childhood, the UN Committee on the Rights of the Child reminds States parties:

…that the right to survival and development can only be implemented in a holistic manner, through the enforcement of all the other provisions of the Convention, including rights to health, adequate nutrition, social security, an adequate standard of living, a healthy and safe environment, education and play (Arts. 24, 27, 28, 29 and 31), as well as through respect for the responsibilities of parents and the provision of assistance and quality services (arts. 5 and 18). From an early age, children should themselves be included in activities promoting good nutrition and a healthy and disease-preventing lifestyle.

Integrated ECD starts from the simple and compelling idea of comprehensive services that avoid fragmentation and bring together sectors and stakeholders at every level (ministries, professionals, policies, programmes, services, communities, parents and children) in the shared mission: to give every girl and boy the best start in life. But delivering on this simple and compelling idea can be very complex and controversial, depending on the political and financial context and capacity for reform, the pre-existing infrastructures and the priorities of donors, NGOs and other change agents.

2.1          A brief history of integrated ECD

Integrating early childhood services (notably nutrition, health and education) is not a new idea. Holistic visions of early childhood can be traced back many centuries, and translated into child-centred nurseries and kindergartens, originating especially in Europe, North America and other industrialised Western societies. Early examples include:

  • The comprehensive US Federal anti-poverty programme Head Start was initiated in 1964, in parallel with numerous smaller scale research-based interventions (Zigler and Styfco, 2004).
  • The Government of India initiated the national Integrated Child Development Services, ICDS programme in 1975 (see Case Study 1).
  • Innovative integration was already being achieved at a central government level in Sweden by 1975, when the National Board of Health and Welfare took responsibility for all preschool services, with a shift to the Ministry of Education in 1995 (Segal, 2010).
  • Around the same period, the Netherlands took steps to integrate preschool with early stages of the primary education cycle (Woodhead, 1979).

Ministry-level coordination is more common than full ministerial integration, while service level integration has been more widely introduced, for example in the form of multi-sectoral, multi-service ‘children’s centres’ in the UK (Siraj-Blatchford and Siraj-Blatchford, 2010). Steps towards greater professional coordination are a prerequisite for integrated ECD, beginning with professional training, illustrated by the evolution of the ‘social pedagogue’ in Nordic countries as a more holistic approach to working with young children (Cameron and Moss, 2011). Achieving integration is not just about system-level reform and innovation. Fundamentally, it is about respecting the interdependencies amongst young children’s fundamental needs, rights and domains of development respecting their distinctive ways of communicating, playing and learning, their vulnerabilities and their capacities, and the extraordinary series of transformations and transitions during the earliest years of life. It is also about recognising the diversity of contexts for ECD and capacities of parents or other caregivers to support their children’s development. It must also be acknowledged that the field of ECD is distinctive in the plurality of visions for young children, expressed through diverse programme models, curricula and pedagogies.

The first detailed example in this Topic Guide is appropriately the Integrated Child Development Services (ICDS), initiated by the Government of India in 1975. ICDS is one of the earliest established, most ambitious, and largest scale integrated programme in (at that time 1975) a low-income country. Summarising ICDS draws attention to some of the major challenges facing comprehensive, multi-sectoral initiatives, which will be elaborated through later sections of the Topic Guide.

Case Study 1: Integrated Child Development Services (ICDS), India

Integrated Child Development Services (ICDS) is the Government of India’s flagship child welfare programme which began in 1975 as a national comprehensive programme, delivered through community-based, local and often quite small Anganwadi centres (‘Courtyard Shelter’), typically led by a local woman who has received basic training in ECD (Streuli et al. 2011). Numerically, ICDS is still the largest early childcare programme in the world, with 1.4 million Anganwadi centres operational by December, 2010. The number of child beneficiaries nearly doubled between 2003-04 and 2008-09 (from 377 million to 725 million) (DESI, 2010).

The first goal of ICDS has been to improve nutrition in a country which even in 2013 still had alarmingly high rates of malnutrition and stunting, affecting 61.7 million, or 48% of all under-5s in India. But ICDS has always been holistic, as currently expressed through five ambitions (Programme Evaluation Organisation, 2011):

  • Improve the nutritional and health status of children below the age of 6 years and that of pregnant and lactating mothers as well as of adolescent girls.
  • Lay the foundations for proper psychological, physical and social development of the child.
  • Reduce the incidence of mortality, morbidity, malnutrition, and school dropout.
  • Achieve effective coordination of policy and implementation among various departments to promote child development.
  • Enhance the capability of the mother to look after the normal health and nutritional needs of the child through proper health and nutrition education.

Anganwadis aim to deliver on these goals via supplementary feeding of children under 6 and growth monitoring; immunisation; health check-ups; referral services; antenatal and postnatal care of mothers; nutrition and health education; and non-formal preschool education for 3 hours a day for children aged 3-6 years.

At constant prices (1999), budgetary allocation to ICDS by the central government increased nearly three-fold between 2003-04 and 2008-09, and by 2010-11 was INR 87 billion. A Programme Evaluation Organisation study (2011) of ICDS covered 19,500 households across 100 districts in 35 states and estimated ICDS’s coverage of children aged 6 months to 72 months as 31%.

Main findings on the impact of ICDS are:

  • ICDS has had a significant impact on improving the rates of breastfeeding immediately after birth. The percentage of children breastfed within an hour of their birth is 10% higher in the case of ICDS beneficiaries than children not covered by ICDS.
  • The proportion of underweight children in India declined from 51.5% in 1992-93 to 40.4% in 2005-06. ICDS had a positive effect on nutritional status in some states but not in others.
  • Overall, ICDS has had a positive but marginal impact on immunisation rates of children. It has had a significant impact in the case of measles immunisation.
  • Nationally, the preschool component of ICDS has had a small positive impact on enrolment at primary school and reduced dropout. 5% more ex-ICDS children attend primary schools, than children who haven’t been enrolled in ICDS.
  • There is considerable variation in preschool provision between states. A Ministry of Women and Child Development report (2013, p. 16) states there is, “Overwhelming evidence that the preschool education component of the ICDS scheme is particularly deficient in quality, and almost non-existent in anganwadis, in some parts of the country.”

Recently, high parent demand for preschool education has led to an increasing yhhtrend in many states of India for parents with sufficient resources to abandon Anganwadis in favour of enrolling their children in the lower kindergarten classes of ‘low-fee’ private primary schools, that offer early initiation into academic learning, with the added attraction of English-medium teaching (Woodhead and Streuli, 2013; James and Woodhead, 2014).

These evaluations draw attention to many of the challenges of delivering an integrated programme on such a massive scale. Many Anganwadi centres are insufficiently resourced to deliver the ambitious goals of ICDS. In many cases, they are operating in a totally inadequate building, without safe drinking water, nor space for children to play. Regulations to govern basic infrastructure are weakly implemented. Anganwadi workers are often overburdened, underpaid and have only very basic training, and learning materials are generally inadequate (Programme Evaluation Organisation, 2011). The scale of ICDS places a huge financial burden, and as a rule, Anganwadi centres are under-resourced in practice. Moreover, the Programme Evaluation Organisation report (2011) identifies a big discrepancy between reported expenditure and actual resources at programme level. For example, only 40% of reported expenditure on supplementary nutrition could be accounted for in service delivery, and a large proportion of funds intended for supplementary nutrition were siphoned off, which highlights the absence of a results-oriented monitoring mechanism in ICDS.

Adequate interdepartmental cooperation has also been a challenge for ICDS, especially coordination among providers of complementary services such as health facilities and water and sanitation. Finally, delivering on the core goals of ICDS has been hampered by inequities in access. The Anganwadi model is celebrated for being able to reach remote and marginalised communities, led by local women who are respected within the community. But overall the states with the greatest need for the programme, the poor northern states with high levels of child malnutrition, have the lowest programme coverage and the lowest budgetary allocations from the central government (Programme Evaluation Organisation, 2011; Lokshin et al., 2005).

In conclusion, DESI (2010) calls for evaluation of the trade-off between “Universalization with thin spread of inadequate resources” and “targeting ICDS to the needy with quality public spending and effective implementation.”

2.2          Building effective integrated ECD systems

The pioneer example of ICDS offers evidence of what can be achieved, as well as the challenges. Many other comprehensive integrated programmes are reviewed in this Topic Guide, including ambitious reforms initiated by governments. But central government-driven, system-level reforms are only one starting point. Identifying more modest sectoral ‘entry points’ and effective delivery platforms for more integrated services may pragmatically achieve ‘quicker wins’ than full-scale integration reform, as will become clear in later sections.

There is scope for more localised and modest innovation, especially in countries where policy engagement is relatively recent, with infrastructure and capacity gaps, in terms of service delivery systems, professional and para-professional training, etc. Many priorities for integrated ECD are in relatively low resource, but high need contexts, where populations are large (and may be widely dispersed), governance systems can be relatively weak and professional capacity scarce. Governance, resourcing and logistic challenges can result in a patchwork of provision, made more complicated by the co-existence of multiple providers, from the state, NGO and private sectors. One of the consequences is “…a wide gap in enrolment between the richest and the poorest…Part of the reason is that governments have yet to assume sufficient responsibility for pre-primary education: as of 2011, private providers were catering for 33% of all enrolled children” (UNESCO, 2014, p.2).

Governance weaknesses can have serious consequences in terms of equity in access and quality, representation of girls and boys, the most disadvantaged children, ethnic minorities and isolated communities, and inclusion of children with special needs.

In recent years, in spite of the expansion of services for young children and families, many of which have been accompanied by rigorous evaluations demonstrating effectiveness, a majority of the world’s youngest children still lack access to quality early childhood development (ECD) services. This is due in part to poor systems-level coordination, and sometimes to the chaotic and unsystematic approaches used to scale up programs. It is the capacity or ability of the system, therefore, that creates the opportunity to achieve desired outcomes. Understanding the operations, strengths, and feasible entry points of ECD systems can help to ensure more effective service delivery, sustainability, and scalability.

In summary, the goal of achieving more integrated ECD systems can be articulated in terms of relatively modest objectives that involve specific community-based innovations, or initiatives that encourage greater collaboration amongst policymakers, service providers and professionals concerned with ECD (WASH, nutrition, health, education, social protection etc.).

Figure 4 depicts some steps towards more integrated ECD as rungs on a ladder, with the extent of integration varying from very modest ‘softer’ coordination (e.g. inter-professional communication and sharing) through to much ‘harder’ integration (e.g. physical and organisational merger), and ultimately fully-integrated ECD systems from global and national policies through to service delivery.

Rungs of an integrated ECD ladder image 5. Full integration of governance, finance, service delivery, training etc.; at all levels through to service users, led by national policy and/or lead ministry
4. Partial integration, joint policies and/or combined services, including national, municipal or community-based initiatives
3. Active inter-sectoral collaboration e.g. via joint planning office, shared training, quality standards, inspections, etc.
2. Basic coordination of roles, goals and delivery, with effective inter-sectoral communication at ministry and municipal levels
1. Sector based services with minimal connection between policies, services, professionals, etc.
0. Fragmentation amongst sectors and providers at all levels.

Figure 4: Rungs of an integrated ECD ladder

Figure 4 is a useful starting point, although in practice, operationalising integration is rarely so uni-dimensional or straightforward, for several reasons:

Integrated ECD is not ‘a one size fits all’.

Operationalising a more ‘joined up’ ECD approach can take many different forms. Evaluation strategies should not assume there is a single most cost-effective way to deliver ECD, nor that full integration is realistically attainable, nor necessarily even considered desirable in societies that value local innovations, and community initiatives that may not fit neatly into a uniform, centrally-controlled ECD system.

Integrated ECD rarely starts from a ‘blank canvas’.

Unless there is strong political engagement and consensus, it can be challenging to carry out ‘root and branch’ reform towards integration within systems that are founded in strong sectoral and professional traditions and infrastructures, each linked to strong organisational and budgeting hierarchies from central government through to local provider. More modest, pragmatic steps towards ‘joined up’ services may be more realistic.

Integrated ECD systems are ‘complex and context specific’.

While general principles and key indicators are transferable, any ‘integrated ECD toolkit’ will need to be adapted case by case. Cautionary lessons can be learned from the well articulated parallel field of ‘integrated care systems’:

… Understanding outcomes… is like a ‘multiple simultaneous equation’ – it requires appreciation and consideration of the combination of factors that occur at multiple levels, over time, and in different contexts. Generating transferable and practical lessons for future strategies in different country contexts requires an appreciation of this complexity.(Goodwin and Ferrer, 2013, p.1)

On a more positive note, low- and middle-income countries with shorter histories of ECD programming may be at an advantage and more open to exploring innovatory and sustainable approaches to service development, delivery and evaluation. For example, Colombia adopted a national integrated care strategy for ECD in 2010 known as De Cero a Siempre (From Zero to Forever), which is led by the office of the President and backed by a ‘Decree for Comprehensive ECD’ and administered via an inter-sectoral commission (World Bank, 2013). Vargas-Baron (2013) discusses building national ECD systems.

Sections 3, 4, 5 and 6 of the Topic Guide look in more detail at sectoral and age specific entry points for more integrated ECD, based around both traditional and more innovatory delivery platforms and including examples of comprehensive national programmes, as well as smaller scale initiatives. Section 7 revisits the concept of more holistic ECD and offers ten general conclusions relevant to planning for more integrated – or at the very least more coordinated – ECD services.

Before conception to earliest infancy – interventions for the mother, father and newborn
Figure 5: Before conception to earliest infancy – interventions for the mother, father and newborn

The ‘critical period’ for ECD begins long before the infant is born, and arguably, even before the infant is conceived. A comprehensive framework extends to the health, well-being, readiness and ultimately, the survival of the mother as well as father and/or other caregivers on whom the newborn infant(s) will depend: to survive, thrive and develop (or otherwise) throughout their childhood and beyond. A comprehensive framework also takes into account the cultural context, belief systems and behavioural patterns that shape the ways birth is prepared for and anticipated, including the birth of an infant girl versus boy.

Beginning this Topic Guide by focusing on the mother before and during pregnancy is an important extension of the scope of a holistic ECD, which conventionally begins at birth. Focus on the young woman and mother-to-be should be set within a life cycle and gender-based analysis of family, social and economic systems as these can be reformed in ways that enable, empower and support parenting, and promote development of the next generation of girls and boys (Girl Hub, 2014; Taylor and Pereznieto, 2014; Cornwall and Edwards, 2014).

This section includes the social protection available to the young mother; their preparation for pregnancy; health, nutrition and WASH risks and interventions during pregnancy, birth and earliest infancy; as well as the significance of early developmental stimulation and parent support, and the impact on neo-natal survival, growth and development. This section includes interventions through to the very earliest weeks of life. Section 4 picks up on these themes for the full period from birth to 2 years old. The significance of this earliest period is signalled by the campaigns around ‘the first 1,000 days’ (conception to the child’s second birthday) (1,000 days, 2014).

To date, the policy priority has been on maternal and child survival, health, and nutrition, with significant progress made in recent years (The Lancet, 2013). As under-5 mortality has reduced, so the proportion of child deaths that occur in the first month increased from 37% in 2000-3 to 41% in 2008, reinforcing the priority of effective interventions during this brief period (DFID, 2011). Latest figures estimate 44% of child deaths occur in the first month. Progress has been made in reducing these high levels of newborn mortality by 2% each year between 1990 and 2012 – from 33 to 21 deaths per 1,000 live births (Samarasekera and Horton, 2014). UNICEF global estimates are that 34% of deaths amongst newborns result from complications associated with pre-term births; 24% result from complications at labour and delivery, including birth asphyxia and a third of newborn deaths are due to infections acquired during delivery or after birth (Wright et al., 2014). The global statistics conceal significant diversity within as well as between countries, related to gender, poverty, urban versus rural location and other factors (see Figure 6).

Global distribution of deaths of newborns, by cause pie chart
Figure 6: Global distribution of deaths of newborns, by cause (2012)
(Source: Wright et al. (2014), p. 9; citing: UNICEF (2013). Committing to Child Survival: A Promise Renewed – Progress Report. (Note: Due to rounding, percentages do not add up to 100).)

Margaret Chan, Director General of the WHO, comments that, “the health sector… has a unique responsibility, because it has the greatest reach to children and their families during pregnancy, birth and early childhood,” (Chan, 2013). Health workers are well placed to implement many of the health, nutrition and WASH interventions during pregnancy, birth and earliest infancy, which are crucial to child survival and development.

Mother and infant survival and health are particularly important during this earliest phase, but survival is not sufficient, with all sectors having a role to play in promoting children’s holistic development:

The agenda to improve child survival and health is indivisible from the agenda to improve ECD. That is, taking a developmental perspective on the early years provides a comprehensive framework of understanding that subsumes issues of survival and health.

The Lancet ‘Every Newborn Series’ from 2014, reinforces the message that these interventions for women, mothers, and newborn babies are best planned as a “…continuum of care (pre-conception, antenatal, intrapartum, postnatal) and in the community” (Samarasekera and Horton, 2014, p. 107).

Nine entry points for integrated ECD are identified for this earliest phase (see Figure 5):

  • social protection and poverty reduction
  • family planning
  • health and nutrition for adolescent girls and mothers-to-be
  • antenatal preparation
  • mother-to-child infection prevention
  • birthing practices
  • newborn care
  • breastfeeding
  • early interactions and ‘stimulation’

3.1          Social protection and poverty reduction

Biological and psychosocial risk factors associated with poverty lead to marked inequalities in ECD (Walker et al., 2011). These risks begin long before the baby is conceived, notably affected by the education levels; the living conditions of young women; livelihoods and household poverty levels; risks and shocks; and access to information and services. Data from 66 developing countries show that child mortality rates for under-5s among the poorest 20% of households are almost double those in the richest 20%. In all countries with relevant data, child mortality rates are highest in households where the education of the mother is lowest (WHO, 2009a). The poorest women are generally least likely to access healthcare services. For example, women in the poorest households are least likely to have a skilled birth attendant with them during childbirth (WHO, 2009b). Adolescent pregnancy is more common in adolescents who live in poverty and in rural areas, and it is more likely to occur among the less educated. Perinatal deaths are 50% higher among babies born to mothers under 20 years of age than among those born to mothers aged 20–29 years, and babies of adolescent mothers are more likely to be of low birthweight (WHO, 2008).

Social protection programmes can alleviate the impact of poverty on pregnant women directly, through cash transfers, as well as through providing antenatal preparation and other services. Britto et al. (2013) review the potential of social protection within an integrated strategy (see also Attanasio et al., 2005; Macours et al., 2012). One long-standing and well researched example is Oportunidades in Mexico (see Case Study 2).

Case Study 2: Oportunidades, Mexico

Oportunidades is a large-scale Federal programme, introduced in 1997. It combines conditional cash transfers with coordinated health, nutrition and education interventions. Beneficiary families are identified through a socio-economic and demographic survey, which screens families’ poverty conditions and vulnerability. Major components of the programme are:

  • Direct cash transfers, which increase household income by 20-30%, are paid every two months to the female head of household. These transfers are conditional on children attending school; family members accessing preventative medical care and attending communal educative self-care workshops. Evidence indicates that families use about 70% of their payments on improved diets, including more meat, fruit and vegetables. They also invest in farm animals.
  • For pregnant women, one condition of cash transfers is attendance at five prenatal visits to monitor the pregnancy’s progression – and prevent, detect and control obstetric and perinatal risk factors. They are required to attend meetings about prenatal care, maternal nutrition and reproductive health and receive milk-based nutritional supplements.
  • Nutritional supplements are provided for all infants between 6 and 23 months old, undernourished children between the ages of 24 to 59 months old, and pregnant or breastfeeding women.
  • Educational grants are provided for school age children. Families receive about 13% more for keeping a girl in middle and high school than a boy, because fewer girls traditionally stayed in school beyond the elementary grades. The grant amount also increases with the child’s grade, as the family are potentially losing the child’s earnings by sending them to school.
  • Records from health centres and schools are used to monitor whether families are meeting their ‘co-responsibilities’.

In 2012, the budget granted to Oportunidades by the federal Government was 70 thousand million pesos (approximately US$5.3 billion dollars). The programme’s cost of operation is less than 5 cents of each invested peso, including the cost of cash transfer. Oportunidades benefited 5.8 million families in 2012.

An evaluation of the programme from 1997-2007 (Government of Mexico, 2012) identified a range of cross-sectoral outcomes:

  • Anemia incidence for children under 2 years was reduced from 61% to 35.8%.
  • The prevalence of low height for under 2s was reduced from 35% to 23.9%.
  • Children under 2 showed less general morbidity than those who were not in the programme (35.5% vs 39.9%).
  • There were lower rates of teenage pregnancy among women whose families had been part of the programme over a long period.
  • Sexually-reproductive beneficiary women 15 to 49 years old increased their use of birth control from 36% in 1998 to 57% in 2007.
  • Children up to 3 years old showed fewer social-emotional and behavioural problems and greater language and speech development skills.
  • An increase of 10 percentage points on mathematics achievement was observed for Oportunidades´ beneficiaries (1998-2003).
  • Girls and female teenagers obtained better school results, compared to male beneficiaries for elementary and junior high school levels, for both mathematics and Spanish.

Barber and Gertler (2008) reported a study of 840 women which found that participation in Oportunidades predicted birthweight 127.3g higher and a 4.6% decrease in the odds of having a low birthweight baby compared to a control group. Fernald et al. (2009) conducted a study of the effect of Oportunidades on child growth, cognition, language and behaviour after 10 years. They found that the amount of cumulative cash that had been transferred to households during their participation in the programme was significantly associated with children having higher verbal and cognitive scores; height- for-age scores and reduced behavioural problems at ages 8-10 years.

Oportunidades was one of the first nationwide programmes of this kind, and the principles have been widely replicated, especially within Latin America. Currently, the largest coverage conditional cash transfer programme is Bolsa Familia in Brazil (Lindert, 2006).

 3.2          Family planning

One specific strategy to combat the impact of poverty on child development is improving access to family planning. Effective family planning can reduce pregnancy rates amongst adolescents living in poverty and encourage later first pregnancies. Having fewer, healthier children can reduce the economic burden on poor families and allow them to invest more in each child’s care and schooling, helping to break the cycle of poverty (UNFPA, 2005). Spaced births and fewer pregnancies improve child survival and health. Babies are more likely to be born prematurely, have low birthweight, be small for gestational age, die in infancy, and suffer from malnutrition when they are closely spaced (Norton, 2005; Rutstein, 2005; Zhu, 2005). Short birth intervals may also harm older siblings by reducing the duration of breastfeeding (Marston and Cleland, 2004). See the HEART Topic Guide on Family Planning (Cleland et al., 2014). Breastfeeding for longer is also likely to increase birth spacing as ovulation is delayed (Howie and McNeilly, 1982).

3.3          Health and nutrition for adolescent girls and mothers-to-be

Maternal undernutrition impacts the infant’s birthweight, and may affect growth and development. Between 10-19% of women are affected across low- and middle-income countries. A woman’s body-mass index and weight gain during pregnancy predicts the birthweight of their infant. Infections, such as malaria, and high blood pressure can also affect birthweight (Hendrix and Berghella, 2008). In low- and middle-income countries, 16% of births are low birthweight with rates as high as 27% in south Asia, most of these births being intrauterine growth restriction (IUGR). IUGR is associated with early developmental risk (Walker et al., 2011). For example, a Guatemalan study showed associations between birth size adjusted for gestational age and development at 6 and 24 months (Kuklina et al., 2006). Evidence for longer-term effects of IUGR on cognitive and social skills is less consistent (Walker et al., 2011).

Recent research points to specific epigenetic pathways from maternal nutrition at the time of conception through to long term development via ‘fetal metabolic programming’. Much of the evidence relies on animal research (Wu et al., 2004) but one study investigated the consequences of predictable seasonal variation amongst communities dependent on own-grown foods in rural Gambia. Dominguez-Salas et al. (2014) were able to link indicators of food availability for mothers-to-be to DNA extracts from hair follicles of their infants, demonstrating that maternal nutritional status during early pregnancy caused persistent and systemic epigenetic changes in babies, with potential long-term consequences for health and development (Hivert and Bouchard, 2013).

Bhutta et al.’s (2013) review of maternal nutrition interventions recommends folic acid, multiple micronutrient, calcium and balanced energy-protein supplementation for pregnant women and women of reproductive age. Balanced energy-protein supplementation of pregnant women benefits birthweight and reduces births that are small for their gestational age. Analysis of 12 randomised controlled trials from low- and middle-income countries show that supplementation with multiple micronutrients in pregnancy leads to increased birthweight (Walker et al., 2011). Trials of supplementation with multiple micronutrients during pregnancy in Bangladesh, and in pregnant women infected with HIV in Tanzania, suggest small benefits to infants’ motor development (Tofail et al., 2008; McGrath et al., 2006; Li et al., 2009).

3.4          Antenatal preparation

Antenatal services can address many of the factors that impact upon infant survival and development by detecting and addressing obstetric risks during pregnancy; providing important health and nutritional interventions, and educating mothers in antenatal and newborn care. A systematic review of 18 trials of community-based intervention packages of antenatal and newborn care, reported a 24% overall reduction in deaths of newborns. These studies were mostly conducted in developing countries including India, Bangladesh, Pakistan, Gambia, Nepal and Indonesia. A significant impact on newborn deaths was found for community support/women’s groups that focused on antenatal education and preparedness for newborn care; and for packages including home visits by community health workers; community mobilisation and education strategies. Interventions delivering antenatal newborn care and breastfeeding education to mothers doubled rates of initiation of breastfeeding (Lassi et al., 2010; Dyson et al., 2005).

3.5          Mother-to-child infection prevention

HIV infection affects brain development, leading to cognitive impairments. Detrimental effects of HIV infection on neuro-cognitive development were identified in 36 of 43 studies from low-income, middle-income, and high-income countries (DFID, 2011). Studies of the development of children younger than 5 years infected with HIV from low- and middle-income countries show they have significantly lower motor and mental development scores (Walker et al., 2011).

Health workers can implement interventions to prevent mother-to-child transmission (PMTCT) of HIV during pregnancy, labour and the immediate newborn period (Wright et al., 2014; WHO, 2014).

Preventative measures such as maternal tetanus immunisation and screening and treatment for syphilis can reduce the risk of newborn death due to infection. Postnatally, health workers’ early identification of severe infections and treatment with antibiotics dramatically increases survival chances (Wright et al., 2014).

3.6          Birthing practices

Birth and the first 24 hours after birth are the most dangerous for both child and mother – accounting for almost half of maternal and newborn deaths. More than 40% of maternal deaths (total about 290,000) occur around the time of birth (Samarasekera and Horton, 2014). Every year, 2.6 million infants are stillborn and a further 2.9 million babies die from largely preventable causes during the first 28 days. The highest numbers of newborn deaths per year are in South Asia and sub-Saharan Africa, with India (779,000), Nigeria (267,000) and Pakistan (202,400) leading. Rwanda – alone among sub-Saharan African countries – halved the number of newborn deaths since 2000.

WHO and UNICEF launched an ‘Every Newborn Action Plan’ in 2014 (WHO/UNICEF, 2014), building on the most recent evidence (Lawn et al., 2014). Safe birthing practices can prevent maternal and newborn deaths, with skilled care from midwives or other health professionals. They can prevent newborn deaths due to complications during delivery by monitoring foetal heart rate and signs of distress in labour; providing assisted delivery and caesarean section if needed, and resuscitating newborns with difficulty breathing at birth (Wright et al., 2014).

Adequate access to water and hygiene is very important as a means to ensure safe delivery and to prevent infection and sepsis. In a study from Nepal, maternal and birth attendants’ hand-washing behaviour was strongly associated with infant survival (Rhee et al., 2008). In a review on the effect of hygienic birth practices Blencowe et al. (2011) found evidence for a strong effect on tetanus and sepsis affecting newborns.

3.7          Newborn care

Health workers play a crucial role in supporting the care of newborns, and ensuring intervention and referral where necessary. While both lay and professional workers have a role to play, The Lancet 2014 series on midwifery (The Lancet, 2014) draws attention to potential for professional midwives to serve as ‘the essential link in the continuum of care’ which begins with family planning, includes birthing as well as newborn care:

…the midwife addresses the continuum of care from the community through to complex clinical care whereas the medical specialist may not. Midwives are potentially the facilitators—the essential link—to bring the woman into the health-care system at the most effective and efficient time and level. Effective referral is often hampered by practical considerations such as lack of finance, transport services and lack of services and access to specialist medical care once in higher-level facilities. Again, this highlights the need for midwifery, and midwives more specifically, to be situated as part of a team within a functional and enabling health system that has a skilled health workforce with the appropriate competencies, and is based in the community as well as in the hospital or health facility.
 

Early newborn care is crucial to reducing the risks of morbidity affecting long term development, for example, delayed treatment of asphyxia leading to permanent brain impairment; untreated retinopathy of prematurity leading to impaired vision/blindness; inappropriate dosing of premature newborns with oxygen leading to the same risk; premature babies not receiving antenatal corticosteroids leading to impaired lung development. The authors of a Lancet series paper on newborn health note:

The first worldwide burden estimates of neonatal morbidities have drawn attention to 19 million neonates with life-threatening conditions (including intrapartum related brain injury, severe bacterial infection, pathological jaundice, and preterm birth) who need specific and special care, many of whom do not receive even basic warmth and feeding support.

Kangaroo Mother Care (KMC) is a low cost, low technology intervention for strengthening infant care that has proven effectiveness in low-resource contexts (see Case Study 3).

Case Study 3: Kangaroo Mother Care (KMC)

Mothers/caregivers provide skin-to-skin contact for low birthweight infants (under 2,500g) by carrying the babies in upright positions. The mothers are used as ‘incubators’ to maintain the infants’ body temperature and as the main source of food and stimulation while they mature enough to face extrauterine life in similar conditions as those born at term. Exclusive or nearly exclusive breastfeeding and attempt of early discharge from hospital are also prioritised. This intervention is used in many low- and middle-income settings in which resources (e.g. incubators) are limited (Irwin et al., 2007).

A Cochrane Review of randomised controlled trials of Kangaroo Mother Care found that: Kangaroo mother care (KMC) is an effective and safe alternative to conventional neonatal care for low birthweight (LBW) infants mainly in resource-limited countries.” (Conde-Agudelo and Díaz-Rossello, 2014, p. 2)

Compared with conventional neonatal care, KMC was found to reduce:

  • mortality at discharge or 40-41 weeks’ postmenstrual age and at latest follow up
  • severe infection/sepsis
  • nosocomial infection/sepsis
  • hypothermia
  • severe illness
  • lower respiratory tract disease
  • length of hospital stay.

KMC was to found to improve outcomes for mother and baby:

  • increased weight
  • head circumference
  • length gain
  • breastfeeding
  • mother satisfaction with method of infant care
  • some measures of maternal-infant attachment
  • some measures of quality of home environment.

The studies in the review included a range of low- and middle-income countries: India, Malaysia, Indonesia, Madagascar, Ethiopia, Mexico, Columbia and Ecuador. Evaluations show that KMC use is also effective in high-income settings, suggesting that skin-to-skin care may have advantages over incubators even where cost is not such a significant issue (Renfrew et al., 2009).

The website for research and resources on kangaroo care is available here: http://skintoskincontact.com/home.aspx

3.8          Breastfeeding

Midwives, and other trained health workers, both professional and lay, can help women to establish exclusive breastfeeding which is widely considered good practice, wherever feasible. Breastfeeding reduces the risk of infection (Wright et al., 2014) and fosters strong maternal-infant attachment, as well as providing a natural context for early interactions. Early feeding is an intimate opportunity for early ‘dialogue’ initiated by the infant as well as by the mother, and providing strong foundations for emotional, social, language and cognitive development (UNICEF, 2013). The potential for linking infant nutrition goals with wider ECD goals is elaborated in Section 3.9.

A systematic review showed that professional and lay support for breastfeeding women is effective (Dyson et al., 2005). For example, a large cluster-randomised trial in Belarus which implemented breastfeeding promotion increased the rates of exclusive breastfeeding at 3 months and any breastfeeding up to 12 months. At age 6.5 years, intervention children had significantly higher scores on verbal and full-scale IQ and teacher ratings for reading and writing (Kramer et al., 2008). Health workers can support the mothers of premature and underweight babies to establish exclusive breastfeeding and to keep the baby warm through skin to skin contact. An effective technique for this is Kangaroo Mother Care (see Case Study 3).

3.9          Early interactions and ‘stimulation’

The focus of interventions in the period after birth has typically been on health and nutrition, and where infants are being screened as special needs or at risk in other respects. But early breastfeeding, nurturing and care are also the contexts within which infants, mothers and others establish positive relationships, including engaging in early interactions, which foster emotional security, brain development and early learning. While interventions are sometimes described in shorthand as ‘infant stimulation’, which may be appropriate for low birthweight infants (Walker et al., 2010), decades of research suggest a more nuanced understanding of early learning processes, involving early emergence of mutually engaging mother-infant interactions. Babies typically seek out stimulation via facial expressions, sounds and gestures, as much as their mothers (or other caregivers) are providing stimulation (Schaffer, 1996). More recently, the concept of ‘serve and return’ interactions has been used to emphasise that early development is a two-way process within which the normally functioning infant is actively engaged from the beginning of life in seeking out developmentally-appropriate interactions and experiences (Center on the Developing Child, 2011; see also age phase 0-2, Section 4.6).

There is evidence that supporting mothers to interact with their low birthweight and premature babies has an especially positive impact on their development. In India, mothers of 800 at-risk infants (75% low birthweight, premature, or both) were randomly assigned to receive training to provide stimulation at home over 12 months. Following intervention, children’s mental development and psychomotor development scores were significantly higher than the control group at both 12 months and 2 years (Nair et al., 2009).

In Jamaica, 109 low birthweight, term-born children were randomised at birth to a psychosocial intervention or control group. The intervention was delivered during weekly home visits by community health workers, for the first 8 weeks and again from 7 to 24 months. In the first phase, visits focused on improving the mothers’ responsiveness to their infants. Mothers were encouraged to ‘converse’ with their infants, respond to their cues, show affection, and focus their attention on the environment. The second phase focused on play techniques and positive interaction. At 6 years, the intervention group had higher IQ, higher visual-spatial memory scores and fewer behavioural difficulties than children in the control group (Walker et al., 2010).

Case Study 4: Support for women with newborns

A systematic review of seven cluster randomised controlled trials in rural, low-resource settings in Bangladesh, India, Malawi and Nepal, covering a total of 119,428 births, found that participatory women’s groups were associated with a 23% reduction in neonatal mortality. The groups aimed to increase appropriate care-seeking (including antenatal care and institutional delivery) and appropriate home prevention and care practices for mothers and newborns. They used a participatory learning and action cycle which included four phases:

  • identifying and prioritising problems during pregnancy, delivery and post-partum
  • planning locally feasible strategies to address priority problems
  • implementing the strategies
  • assessing the activities.

Women’s group facilitators were local women who were not health workers. They received 7-11 days of basic training in maternal and newborn health and participatory facilitation techniques. The trials that reported the behavioural mechanisms through which the birth outcomes may have been achieved, reported effects on health, nutrition and WASH behaviours. Significant effects were reported on clean delivery practices for home deliveries, especially hand-washing and use of clean delivery kits; exclusive breastfeeding for at least the first 28 days and uptake of antenatal care. Although the cost per neonatal death differed widely between trials, according to WHO-recommended standards, participatory women’s groups were a highly cost-effective intervention (Prost et al., 2013).

There is also evidence that psychosocial interventions in high risk and unstable contexts can improve infant development. A study in northern Uganda offered mother and baby group sessions and home visits for mothers, which led to improved infant stimulation and maternal mood. Mothers in the intervention group had greater involvement with their babies, more availability of play materials, and less sadness and worry at follow-up (Morris et al., 2012).

3.10        Summary for age phase ‘Before conception to birth’

During the period before conception to earliest infancy:

  • Family planning and social protection strategies can help to alleviate the impact of poverty on ECD.
  • Antenatal services can provide a range of interventions to address maternal nutrition and health during pregnancy, which have a powerful impact on child survival, growth and development.
  • Skilled care at birth and hygienic birth practices can prevent newborn deaths.
  • Establishing and maintaining breastfeeding is important, especially exclusive breastfeeding for the first six months with breastfeeding continuing thereafter with appropriate weaning foods.
  • Parents’ early stimulation of low birthweight or premature infants may have positive effects on their development.

Table 2: Evidence strength assessment for ‘Before conception to birth’

Quality of evidence: Size of body of evidence: Consistency of results: Context
High Medium/Large Consistent Global
Birth to 2 years – interventions for parent and infant
Figure 7: Birth to 2 years – interventions for parent and infant

A healthy environment, support for parents, good infant nutrition and developmental checks all build on the ingredients identified for the age phase ‘conception to birth’ in Section 3, as the foundation for physical and neurological, cognitive and social development. The emphasis of policy is traditionally on health, WASH and nutrition, but fostering positive relationships, attachment and providing opportunities for early play and learning are also crucial at this stage, and research points to the benefits of integrated delivery platforms, notably combining nutrition interventions with support for parents in promoting play-based learning (Black and Dewey, 2014). Interventions specifically targeting mothers and infants within their household and community are best framed against broader social policy that includes social protection, as at the age phase ‘conception to birth’ (and indeed at all age phases).

Specific entry points in this section are:

  • birth registration
  • parental leave, childcare and social protection
  • infant nutrition
  • reducing disease
  • healthy environments
  • parenting interventions
  • community-based programmes including day care.

4.1          Birth registration

Birth registration is a first step to ensure entitlement and access to basic services for all children (girls and boys, disadvantaged and minority groups). In their guidance to States parties the UN Committee on the Rights of the Child affirm:

…The Committee notes that provision for registration of all children at birth is still a major challenge for many countries and regions. This can impact negatively on a child’s sense of personal identity and children may be denied entitlements to basic health, education and social welfare. As a first step in ensuring the rights to survival, development and access to quality services for all children (art. 6), the Committee recommends that States parties take all necessary measures to ensure that all children are registered at birth. This can be achieved through a universal, well managed registration system that is accessible to all and free of charge.

It is estimated that in 2007, about 51 million children’s births were not registered, about half of them in South Asia (Engle et al., 2011).

The impact of strengthening birth registration systems is highlighted by the example of Democratic Republic of the Congo. The 2010 UNICEF Multi Indicator Cluster Survey (MICS) revealed that only 28% of births had been registered. UNICEF report that “action plans developed and implemented with community involvement led to a surge in birth registration – in one district, from 6% in June 2012 to 41% in December 2012. Pregnant women also benefited from this community based initiative: 58% received at least four antenatal care visits, up from 16% six months earlier” (UNICEF, 2014, pp. 10-11).

4.2          Parental leave, childcare and social protection

The quality of care available during infancy is crucially dependent on the time and capacities of parents (especially mothers) to provide that care, with financial and psychological security. In many contexts, early childhood programmes respond to family demand for childcare as much as to young children’s need for quality spaces that promote healthy development and learning whether in domestic settings or in a preschool centre. Childcare policies and services are strongly shaped by employment opportunities (and constraints) for mothers with newborns through to school age, and their entitlements to paid (or unpaid) parental leave (for both mothers and fathers). Realities of the childcare economy are also conditional on poverty levels, resources to pay childcare fees, informal household or community-based childcare traditions (e.g. by grandparents, extended family, or childminders) and the ability of mothers to negotiate decisions about their (and their children’s) well-being.

In these respects, the well-being of children is closely tied to legal and policy frameworks to promote gender equity and women’s labour market participation, availability of parental leave, adequate social protection, and availability of quality childcare. In a review of Latin America, Pautassi and Rico note:

The regulation of childcare in labour laws or codes tends to be limited to the protection of working mothers during pregnancy, childbirth, postpartum and breastfeeding, but does not consider the child-rearing and care needs of children at this stage. It also disregards or minimizes men’s responsibility for their young children. Legislation thus shows heavy gender biases and the measures adopted do not necessarily consider the needs of care receivers. Crucially, labour regulations are targeted: they exclude from the respective benefits anyone who is not a formal-sector waged worker, to the detriment of informal-sector, independent, part-time and rural workers—and their children. Special mention is warranted by domestic service —the foremost economic activity among poor women— since these workers receive discriminatory treatment in much of the region.

Entry points for empowering women and strengthening children’s development during the earliest months and years involve ensuring mothers, fathers and others are able to balance quality care with adequate livelihoods. In life cycle analyses, households are generally at their poorest when children are at the youngest phase of life (Dornan and Woodhead, 2014 forthcoming).

Early childcare services are expanding rapidly in low- and middle-income countries, but they are highly variable in quality, resourcing and regulation. At best, they can be an important entry point for delivering quality ECD, which can take the form of family day care, children’s centres or workplace nurseries (Hein and Cassierer, 2010).

Social protection measures (already discussed in Section 3) are also important for this age phase. For example, an evaluation of the Child Support Grant, introduced in South Africa in 1998, concludes:

…Child Support Grant (in the first two years of life) increases the likelihood that a child’s growth is monitored and improves height-for-age scores for children whose mothers have more than eight grades of schooling. Since children’s cognitive development depends on receiving appropriate nutrition in the first few years of life, this result provides important evidence of the Child Support Grant’s role as an investment in human capabilities – a critical determinant of multi-dimensional poverty reduction. This also suggests that a mother’s education complements the Child Support Grant in strengthening important impacts.(DSD, et al., 2012, p. 105)

4.3          Infant nutrition

In the period from birth to 2 years, promoting good nutrition for all girls and boys is vital to prevent stunting and promote healthy growth and development. Bhutta et al.’s (2013) review of nutrition interventions that are effective in reducing child mortality recommends promotion of exclusive breastfeeding, complementary feeding, vitamin A supplementation, preventative zinc supplementation and management of moderate and severe acute malnutrition for infants and children.

Stunting is estimated to affect 34% of children younger than 5 years in low- and middle-income countries and is associated with lower cognitive ability, education outcomes (Glewwe et al., 2001) and poorer adult economic outcomes. Timing of growth faltering may be important. In Guatemala, growth and development were related up to age 24 months but not from 24 to 36 months (Kuklina et al., 2006). Five longitudinal studies identified that an increase in weight gain from birth to 24 months was associated with increased schooling and reduced grade failures, whereas growth from 2 to 4 years had little effect (Martorell et al., 2010). While policy correctly emphasises early nutrition, recent evidence also draws attention to the scope for catch up by initially-stunted children, as well as the risks of growth faltering in middle childhood (Fink and Rockers, 2014).

Breastfeeding remains the single most effective intervention to improve infant and young child nutrition (see also Section 3). The WHO recommends six months of exclusive breastfeeding and up to two years of continued, partial breastfeeding (Meeker et al., 2013). There is good evidence for the benefits of breastfeeding to development and educational attainment. In Brazil, boys breastfed for at least 9 months attained 0.5-0.8 school grades more by 18 years than boys breastfed for less than one month (Victora et al., 2005).

Reducing micronutrient deficiencies is a specific priority for infant nutrition. Globally, deficiencies of vitamin A and zinc were estimated to have resulted in 157,000 and 116,000 child deaths respectively in 2011; deficiencies of iodine and iron, together with stunting, can contribute to children not reaching their developmental potential (Black et al., 2013). Studies in Chile, India and Mexico identify evidence of delayed brain maturation in infants with iron-deficiency anaemia. Additional evidence shows poorer cognitive, motor, and social-emotional development associated with iron-deficiency anaemia in infancy, or the preschool period (Walker et al., 2011). Randomised controlled trials of macronutrient supplementation to promote better growth consistently show concurrent developmental benefits. Follow-up of a cluster randomised trial in Guatemala showed benefits to reading comprehension and reasoning at 25-42 years in participants supplemented from birth to 24 months, but not those supplemented later (Stein et al., 2008). While these findings point to the first 1,000 days as a critical window, later nutritional supplementation can also bring benefits (Singh et al., 2014; Section 6.7).

Providing nutrition information and support to parents is an important pathway to improved nutrition, and multiple benefits, as demonstrated in a randomised controlled trial with 2,500 women distributed across 24 other sites in Malawi. The study was linked to an established home visiting programme in central Malawi called MaiMwana (‘Mother and Child’), delivered at relatively low cost by local ‘peer counsellors’ with personal experience of infant nutrition. The study demonstrated that a sustained intervention during the earliest years improved mothers’ knowledge, translated into improved household nutrition and delivered improved child growth. Interestingly, the greater awareness of the importance of nutrition appeared to have a systemic impact on household functioning, such that parent employment rates increased to help pay for improved food consumption (Fitzsimons et al., 2014).

This study demonstrates intervention efficacy of nutrition awareness and support for poor families, although parenting and home visiting interventions for mothers and babies are often integrated within a social protection programme (see Sections 3.1 and 4.2) and/or involve broader child development interventions, including promoting early relationships, play and learning (Section 3.9; Section 4.6; Black and Dewey, 2014).

4.4          Reducing disease

Undernutrition has a pervasive impact on young children, undermining all aspects of their development, and leaving them more vulnerable to infectious diseases. The relationship between undernutrition and infectious disease is a vicious cycle: infections result in decreased dietary intake and malabsorption of nutrients, which leads to undernutrition, and undernutrition reduces children’s resistance to infection, increasing the likelihood of them contracting infections and diminishing their ability to successfully fight these infections off (Katona and Katona-Apte, 2008).

Infectious disorders are the leading cause of child mortality, causing 64% of deaths in 2010. The most important single causes of death were pneumonia (18%), diarrhoea (10.5%) and malaria (7.4%) (Liu et al., 2012). Jones et al. (2003) showed that there are effective interventions for all the major causes of child mortality, including preventative interventions such as breastfeeding, vaccinations, insecticide-treated bednets and the availability of WASH as well as treatment interventions including antibiotics, antimalarials and oral rehydration therapies. Infectious disorders not only have an impact on child survival, but also on growth and development.

In many regions, malaria is a continuing risk. Cerebral or severe malaria can have serious neurological sequelae, including seizures, and language and cognitive deficits. In Uganda, cognitive training interventions improved the function of affected children (Bangirana et al., 2009). New evidence suggests that repeated uncomplicated attacks and asymptomatic parasitaemia (experienced by millions of children annually) also affect children’s development (Walker et al., 2011).

Studies of the development of children younger than 5 years infected with HIV from low- and middle-income countries show they have significantly lower motor and mental development scores (Walker et al., 2011). A study of the use of highly active antiretroviral therapy in the Democratic Republic of Congo noted benefits to motor and cognitive development after one year, with greater benefits in younger children (Van Rie et al., 2009).

In South Africa, a randomised controlled trial of 122 children with HIV aged less than 2 years and 6 months assessed the effectiveness of a home-based stimulation programme. The programmes were individualised and were structured around play and activities of daily living. They included activities to promote motor, cognitive, and speech and language development. Outcomes were assessed at 6 months and 12 months. Children in the experimental group showed significantly greater improvement in cognitive and motor development over time than children in the comparison group (Potterton et al., 2009).

4.5          Healthy environments

WASH interventions are elaborated in this section, but are a priority for all age phases in the Topic Guide. They play an important role in creating healthy and safe environments for parents and young children in their homes, neighbourhoods and in due course in play spaces, preschools etc.

Children’s material conditions, with their capacity to undermine health, well-being and opportunities for learning, constitute one of the major expressions of poverty. Hundreds of millions of children live in physical environments that fail to support their health, their optimal development and their well-being. At issue here is the adequacy of housing, the availability and quality of water and sanitation, drainage and waste removal, and the quality of neighbourhood conditions.(Bartlett, 2012, p. 4)

The scale of the problem was highlighted by a study of child poverty in low- and middle-income countries (Gordon et al., 2003). Deprivation was defined in terms of the circumstances most likely to affect children’s health and development. Most of these circumstances were related to their material conditions or their access to services. Half of the children in these countries were found to be seriously deprived on at least one count. Over a third lived in dwellings with more than five people to a room or with mud floors; almost a third lacked access to any toilet facilities at all; while 20% lacked adequate access to safe water.

The impact of insanitary living conditions is illustrated by research into diarrhoea and other diseases. Studies in Brazil show associations between the number of diarrhoea episodes before age 2 years, late school entry and intellectual performance (Lorntz et al., 2006; Patrick et al., 2005). A multi-country study showed that each episode of diarrhoea in the first two years of life contributes to stunting, suggesting that associations between diarrhoea early in life and school age performance might be through the same processes that cause stunting (Checkley et al., 2008).

Studies of infants’ faeces disposal practices have found that unsafe disposal increases the risk of diarrhoea by 23%, highlighting the importance of the safe disposal of infants’ faeces (Mara et al., 2010). During weaning, good hygiene could help to prevent diarrhoea. A recent intervention study found both high baseline faecal contamination of weaning foods and large reductions in contamination following a targeted hygiene intervention (Cairncross et al., 2013).

An approach which integrates health, nutrition and cognitive stimulation interventions is the Integrated Management of Childhood Illness and Care for Development which was developed by the WHO and UNICEF (see Case Study 5).

Case Study 5: Integrated Management of Childhood Illness (IMCI) and Care for Development

IMCI is an integrated approach to child health developed by the WHO that aims to reduce death, illness and disability, and to promote improved growth and development among children under 5 years of age. In health facilities, IMCI promotes the accurate identification of childhood illnesses in outpatient settings, appropriate treatment, rapid referral and counselling of carers. In the home setting, it promotes improved nutrition and preventative care, and the correct implementation of prescribed care.

A multi-country evaluation of IMCI, conducted in Brazil, Bangladesh, Peru, Uganda and Tanzania, found that IMCI can reduce under-5 mortality and improve nutritional status, if implemented well.

Care for Development is an intervention developed by WHO/UNICEF for health workers to provide information and recommendations for cognitive stimulation and social support to parents of young children, through sensitive and responsive caregiver-child interactions. It can be delivered as part of IMCI or other child health initiatives.

A controlled trial of 0-2 year olds who received the Care for Development intervention as part of IMCI in Turkey, found positive effects on the home environment, more home-made toys were observed (42.5% vs 10.6%), and more caregivers reported reading to their children (20.0% vs 3.5%) (Ertem et al., 2006). A study of the use of Care for Development as part of IMCI for 0-2 year olds in rural China, found that children in families who received Care for Development counselling had significantly higher development scores in cognitive, social, and linguistic domains, six months after the intervention (Jin et al., 2007).

4.6          Parenting interventions including home visiting

Interventions to enhance mother-child interactions and increase developmental activities can build on those that begin during the perinatal period (see Section 4.3), and can be effectively integrated with nutrition programs or health check-ups. They can be distinct programmes or delivered as part of an integrated social protection scheme for the poorest households. Parenting interventions are especially important to support care and development of infants with special needs or at risk in other respects.

Harvard Center on the Developing Child see these interactions as “…one of the most essential experiences in shaping the architecture of the developing brain …. Young children naturally reach out for interaction through babbling, facial expressions, and gestures, and adults respond with the same kind of vocalising and gesturing back at them. This back-and-forth process is fundamental to the wiring of the brain, especially in the earliest years” (Center on the Developing Child, 2011, film).

Engle et al. (2011) reviewed 15 assessments of parenting interventions which promote parent-child interactions to improve responsiveness in feeding infants and young children; increase attachment; and encourage learning, book reading, play activities, positive discipline and problem-solving related to children’s development, care and feeding. Substantial positive effects were identified in relation to children’s cognitive and social-emotional development, parent knowledge, home stimulation, and learning activities with children. The most effective interventions were those with systematic training methods for the workers, a structured and evidence-based curriculum, and opportunities for parental practice with children with feedback.

Rao et al. (2013) reviewed 27 parent-focused interventions in developing countries and 26 of these showed positive effects on cognitive development. Most of these interventions were designed to promote sensitive and responsive caregiver-child interactions through psychosocial stimulation to improve cognitive and language abilities of infants and toddlers. Almost all of them focused on teaching parents to stimulate children through play, often utilising home-made toys or other readily available household items. Parent-focused interventions were often delivered through home visits, community groups, and a combination of home visits, group sessions, community activities, and primary health care and nutritional services. Interventions which involved guided interactions and practice involving both parent and child were more effective than parent-only or information-based interventions. Those conducted at least partly in group settings had a slightly greater effect than home-based interventions alone.

Interventions to support early interactions have been shown to have particular benefits for children with risk conditions such as severe malnutrition, low birthweight, iron-deficiency anaemia and HIV infection (Walker et al., 2011).

The evidence base for holistic interventions that integrate a nutrition programme with support for early interactions and learning during infancy is growing in number, quality and geographical contexts. Case Study 6 in Jamaica is one of the earliest reported inter-sectoral home-based interventions that is now yielding follow-up data over two decades, with impressive evidence of economic returns as well as child development outcomes. The study reinforces the importance of looking beyond single sector approaches to early development. Nutrition is important, but nutrition plus early learning is a great deal better!

Interventions combining play and learning with nutrition have now been replicated in several other countries. For example, randomised trials have already been conducted in Bangladesh with malnourished children (Hamadani et al., 2006). Whereas the Jamaica study involved health workers from local clinics making weekly home visits (Powell et al., 2004), new models are now being explored that can reach more children, including mothers and children coming to the local clinic for individual play sessions every two weeks (Nahar et al., 2012). A large randomised trial in Bangladesh is working with the staff at local health clinics and asking two mothers and children at a time to visit the clinic for a joint play session every two weeks. This study run by Walker and colleagues is also exploring working with groups of mothers and children, as well as showing child development videos to mothers while they wait to see the nurse during clinic visits (Grantham-McGregor, personal communication).

A randomised controlled trial in Colombia harnessed a national social protection programme (Familias en Acción) to deliver scaleable integrated nutritional supplementation (Sprinkles) combined with psychosocial intervention to stimulate playful interactions for mothers and infants. The sample of 1,420 children aged 12-24 months was draw from 96 municipalities across Colombia. The initial results show benefits for cognition and language, but less clear evidence for the benefits of nutrition supplementation (Attanasio et al., 2014)

Case Study 6: Long term evidence from an integrated psychosocial stimulation and nutrition intervention, Jamaica

A randomised controlled trial carried out in Jamaica in 1986-1987 measured the benefits of two years of psychosocial stimulation combined with nutrition supplementation. A total of 129 stunted children aged 9-24 months were assigned to one of four groups – control, supplementation, stimulation, or supplementation and stimulation. Supplementation comprised 1kg of milk-based formula per week. Stimulation comprised weekly 1-hour home visits by community health workers, with the objective of improving mother-child interactions through play; mothers were encouraged to talk with their children, to label things and actions in the environment and to play educational games with their children. Low cost, often home-made toys and books were provided. Emphasis was put on cognitive and language development as well as improving the self-esteem of mother and child. Both interventions significantly benefited development. Most interestingly, the development of children who received both treatments caught up with that of a group of 32 matched non-stunted children (Grantham-McGregor et al., 1991).

These children have now been followed up with, in order to track long-term outcomes. Small benefits from nutritional supplementation seen at 7 years were not detected at 11 years. When they were assessed aged 17-18 years, those who had received the stimulation intervention had higher scores on a range of cognitive and educational tests (Walker et al., 2005). Participants’ psychosocial functioning was also assessed and those who had received stimulation had significantly less anxiety, depression, attention problems and higher self-esteem than the control group (Walker et al., 2006).

Twenty years after the intervention was conducted, we find that the earnings of the stimulation group are 25% higher than those of the control group and caught up to the earnings of a non-stunted comparison group. These findings show that a simple psychosocial stimulation intervention in early childhood for disadvantaged children can have a substantial effect on labor market outcomes and can compensate for developmental delays. The effects for female earnings are substantially higher than for males. The estimated impacts are substantially larger than the impacts reported for the U.S.-based interventions, suggesting that ECD interventions may be an especially effective strategy for improving long-term outcomes of disadvantaged children in developing countries.

 

Delivery of integrated programmes for mothers and babies is a rapidly growing field for well designed research, especially focusing on nutrition and psychosocial interventions (Grantham-McGregor et al., 2014; Yousafzai and Aboud, 2014; Black and Dewey, 2014).

4.7          Community-based programmes including day care

Finally in this section we briefly review implementation of community-based models within various national programmes delivered at scale. Much of the evidence from earlier sub-sections is relevant to these programmes which are typically based in caregivers’ homes or small community facilities by para-professionals or experienced community mothers. Note that many of these programmes aim to be comprehensive in terms of sectors and age groups, and are equally relevant to the preschool years (Section 5). The primary goals of these programmes varies, with some prioritising child development goals for children, and others established primarily to serve the needs of working parents (usually referred to as ‘day care’).

The ‘Educa a Tu Hijo’ (Educate Your Child) programme in Cuba has been one of the most influential Ministry of Education-directed (but multi-sectoral) initiatives. It is a community-based programme that places the family at the center of programme activities, with home visiting as a feature for 0-2s, followed up by group sessions from 2 years old held once or twice a week in a community space. Importantly, at least one of the child’s parents or daily caregivers participates in the in-home and group sessions, which serves the dual purpose of involving them fully in children’s learning and providing support and training in the knowledge and skills to promote the development of their children. Seventy per cent of Cuban children under the age of 6 years participate in the programme (Tinajero, 2011). These specific activities are embedded within a much broader, integrated vision for social cohesion, illustrated by Figure 8.

The 'Educa a Tu Hijo' programme and coordination with the local network of ECD programmes
Figure 8: The ‘Educa a Tu Hijo’ programme and coordination with the local network of ECD programmes
(Source: Tinajero, A.R. (2010). Scaling-up Early Child Development in Cuba – Cuba’s Educate Your Child Program: Strategies and Lessons from the Expansion Process, p.16.)

 

 

 

 

 

One lesson … offered by Educate Your Child is that it is important to integrate health 
and education programmes in a universal early human development programme. Integration required the training of health and education professionals in child development (health, learning, and behaviour), the formation of integrated health and education working teams, and the provision by community polyclinics and family doctors of healthcare and development services during pregnancy and the entire early child development period.

Peru also has a long history of community-based programmes for very young children, notably ‘Wawa Wasi’ (Children’s House). It started in the 1980s and become a national programme in 1993. Evaluation of Wawa Wasi was inconclusive about positive benefits, even though the programme was highly valued by families (Cueto et al., 2009). Wawa Wasi has now been incorporated into a new social programme ‘Cuna Mas’ initiated by the Ministry of Development and Social Inclusion in 2011 (Cuna Mas, 2014). Cuna Mas aims to improve child development of children under 3 years of age in areas of poverty and extreme poverty, to promote their cognitive, social, physical and emotional development. Providing quality childcare is one of the goals of the programme currently serving more than 60,000 children aged 6 to 36 months of age who are living in areas of poverty and extreme poverty. Besides offering childcare, the programme includes components on nutrition, health care, early learning and working with families.

Other well established comprehensive programmes for mothers and babies during the first 1,000 days include, ‘Crece Contigo’ (Grow Together) in Chile (Delpiano and Vega, 2011), Hogares Comunitarios de Bienestar in Colombia and ‘Mãe Coruja’ (Mother Owl) programme in Brazil (Bernard van Leer Foundation, 2013). Finally, integrated initiatives described in other sections of the Topic Guide all encompass this age range, and have community-based components, for example, Integrated Child Development Services (ICDS), India (Case Study 1, Section 2); and Ilifa Labantwana, South Africa (Case Study 9, Section 5).

Community-based programmes for the very youngest age group also include day care programmes for babies and infants mainly planned around the needs of working parents. These are very widespread in industrialised societies (and growing in low- and middle-income countries) especially in urban centres. They vary from informal ‘childminding’ arrangements provided by other mothers or older community women through to large scale, centre-based childcare businesses, catering for large numbers. Quality can be highly variable, depending on whether standards and regulative systems are applied. There is a long history of concern about possible adverse effects of extra-familial care for the very youngest infants, especially in low quality settings where staff ratios do not allow for continuity in individualised care and attention. Research evidence about the impacts of day care services is very weak for low- and middle-income countries (Brown et al., 2014).

4.8          Summary for age phase ‘From birth to 2 years (infancy)’

In the period from birth to 2 years:

  • Birth registration helps to establish entitlement to quality services.
  • Support for parents includes adequate parental leave, social protection and quality childcare in the early years.
  • Good infant nutrition is vital to child survival: to prevent stunting and to promote healthy growth and development. Effective nutrition interventions include breastfeeding and nutritional supplementation.
  • Infectious disorders are the leading cause of child mortality and also have an impact on growth, motor and cognitive development.
  • Effective interventions include preventative measures such as vaccinations, insecticide treated bednets and the availability of WASH as well as treatment interventions.
  • Sanitary living conditions contribute to a healthy environment for infant well-being.
  • Parenting interventions which promote parent-child interactions and child development have positive effects on children’s cognitive and socio-emotional development.
  • Successful interventions have been developed which integrate early learning and psychosocial stimulation with nutrition and health interventions.
  • Community-based programmes offer an alternative model to centre-based care, especially for very young children.

Table 3: Evidence strength assessment for ‘From birth to 2 years (infancy)’

Quality of evidence: Size of body of evidence: Consistency of results: Context
High Medium/Growing rapidly Mostly consistent Increasingly global with some gaps
3 to 5 years old: inclusive and holistic ECD programmes
Figure 9: 3 to 5 years old: inclusive and holistic ECD programmes

The earlier age phases reviewed in this Topic Guide have illustrated a range of entry points for ECD, including health, nutrition and WASH, as well as parenting, community-based care and social protection. Many of these programmes cover the full age range through to starting school. But in terms of policy priority and scale of programmes and research, there is a marked shift in emphasis, at around 3-4 years, with much stronger engagement from the education sector. This shift partly reflects young children’s growing skills and capacities, but it is strongly shaped by the anticipation of transition into formal school (by around 5-7 years, varying between countries); and specifically with concerns about reducing inequalities in children’s school readiness (see Section 6).

A holistic, integrated framework for ECD requires some re-balancing of these age-linked priorities. Section 4 (birth to 2 years) included evidence on the importance of including early learning within interventions for the youngest children and their families. In the same way, this section draws attention to the continued importance of health, nutrition and WASH interventions being coordinated or integrated with preschool services that mainly focus on providing quality early education. ‘Preschool’ is a conventional term used to refer to this period, but actual age boundaries are blurred, including when very young children begin attending centre-based programmes, as well as children starting formal school as young as 4.

Many of the interventions highlighted in Section 4 have continued relevance in this age phase, but are at risk of being given less attention: for example, the prevention and treatment of infectious disorders; the need for immunisation; WASH interventions to reduce diarrhoea and continued nutritional supplementation. Adequate social protection systems are also of continued importance to support families living in extreme poverty, hazardous or difficult circumstances.

A summary of evidence on strategies for enhancing resilience to nutritional shocks acknowledges the evidence for the first 1,000 days as a critical window, but also proposes a more balanced approach to nutritional and other interventions, throughout early childhood:

Nutrition interventions need to begin prenatally and continue during the first two years of life. Child development interventions also need to begin early, within the first two years. But they must also be continued up to and through school age. While the early years are the most effective time for establishing a foundation for later education and development, there are times that households are overwhelmed and a child falls behind. It is clear, however, that disadvantaged children benefit from additional stimulation and that programs that target psychosocial development help them to make up deficits. The earlier interventions dominate in terms of efficiency, but when these are insufficient or lacking, later interventions are needed for equity.

Rapid global expansion of childcare and preschool services provides new opportunities for more effective intervention via more integrated cross-sectoral services. The percentage of children worldwide who are enrolled in pre-primary education has increased from 33% in 1999 to 50% in 2011, although the enrolment rate for low-income countries is only 17% (UNESCO, 2014). Despite rapid expansion, half of the world’s children still don’t attend preschool, and those with greatest need are at greatest risk of missing out (including disabled, ethnic minority, poor, rural children). Ensuring equity and inclusion for all girls and boys is also urgent for some regions (UNESCO, 2014; see also Sections 5.6, 6.4 and 7.5)

Many health, nutrition and WASH interventions for 3-5 year olds continue to be delivered ‘stand-alone’ through household and community-based services, but this section also describes interventions that are integrated into daily preschool provision, for example, promotion of hand-washing as part of the daily routine; provision of clean water and toilets; and meal times as an opportunity for nutritional supplementation. Many steps towards integrated ECD are about greater coordination and referral of children between separate services. This section also includes programmes which integrate two components of early childhood development (e.g. preschool provision and nutritional supplementation) as well as initiatives aiming to provide a continuum of integrated ECD services.

Entry points in this section include:

  • centre-based preschool interventions
  • home and community-based programmes
  • parenting support and training
  • integrating nutrition, health and WASH within early childhood programmes
  • comprehensive, scaleable initiatives
  • inclusive programmes and equity.

Social protection programmes (included as entry points in Section 3 and Section 4) are equally relevant throughout early childhood.

5.1          Centre-based preschool education

The most compelling economic case for investment in ECD originally came from research with this age group, notably long-term follow-up from preschool interventions in USA, which were carried out around the time that the US Federal programme Head Start was introduced in 1964 (Zigler and Styfco, 2004). Economic analyses of the Perry Pre-school Project (Ypsilanti, Michigan) were already published by the mid-1980s (Berrueta-Clement et al., 1984) but the influence of these analyses received a strong boost 20 years later through the engagement of leading economists (Heckman, 2006; Heckman et al., 2013). For example, the widely disseminated ‘Heckman curve’, vividly conveys evidence that the highest returns on investment are during the earliest years (Figure 1 in Section 1).

Since the 1960s, the evidence base for preschool provision has grown, strengthened and broadened to include evidence from low- and middle-income countries, but with many significant evidence gaps remaining, especially for more integrated programmes, and programmes in low resource contexts. The strongest evidence is for preschool education programmes with ‘school readiness’ goals (see Section 6). Engle et al. (2011) reviewed the effects of formal centre-based preschools and non-formal community-based preschool provision. In eight of nine studies comparing preschool attendees with non-attendees, those who attended preschool had higher scores on measures of child development, including literacy, vocabulary, mathematics, quantitative reasoning and teacher assessments of performance. Two of four studies that assessed the effects of preschools on social and behavioural development reported positive effects. The effects of non-formal provision were generally weaker than those of formal preschools. Greater benefits of preschool attendance were shown for higher risk or more disadvantaged children. In some reports, preschool attendance was associated with improved school performance in Grades 2 and 3 and effects were shown into adolescence.

More recently, Rao et al. (2013) carried out a review for DFID of 32 studies of child-focused educational interventions in developing countries, most of which were conducted in preschool settings with children aged 3 or over, with specific focus on benefits to children’s cognitive development. It is not just participation in preschool programmes that matters, but the quality of the interventions provided. Rao et al. (2013) found that child-focused interventions with higher quality of stimulation resulted in significantly higher levels of cognitive development for participating children. Quality was associated with the qualifications and training of change agents (early childhood educators, teachers, childcare workers), programme structure and child-appropriate curricula and instruction. Formal preschool programmes typically have better qualified educators. Engle et al.’s (2011) review also found that enrolment in higher quality or improved preschool programmes was associated with better learning outcomes than standard, non-improved programmes. Evidence on effective programmes also includes: structured pre-reading programmes in Bangladesh (Opel et al., 2009) and Costa Rica (Rolla San Francisco et al., 2006); formal rather than informal preschools in China and Cambodia (Rao et al., 2012a; 2012b); child-centred and interactive instruction methods in Bangladesh (Moore et al., 2008) and East Africa (Mwaura et al., 2008).

It is important to note that the positive impacts of a preschool programme on children’s long term outcomes, are not only or even mainly via improved cognitive skills. The dynamic transmission processes that produce long-term effects were recognised many decades ago, when researchers were faced with the apparent mystery that short-term cognitive benefits from US interventions ‘faded out’, but later re-emerged as significant outcomes later in life (Schweinhart et al., 2005). The longitudinal pattern of findings points to the significant role of psychosocial, attitudinal and motivational influences on children’s readiness for school, most recently reinterpreted within an economic analysis of cost effectiveness of investing in early childhood (Heckman, 2006; Heckman et al., 2013). Recognising the ways school organisation impacts the transmission of preschool effects, and the significance of differential treatment of children perceived as more or less ‘ready for school’, is important within a life course framework. The long term impacts of a preschool programme are dynamic, shaped by the school systems into which children transfer (Woodhead, 2004). These analyses reinforce the case for a holistic framework for ECD which avoids viewing development through narrow sectoral lenses and seeks to maximise the synergies between children’s economic and household security, their environment, nutrition, health, learning, and well-being. For example, early childhood programmes can benefit child and adolescent mental health, including social skills and conduct problems (Baker-Henningham, 2014; Baker-Henningham, et al., 2012).

Case Study 7 is a notable example of a successful preschool programme in a low resource context, rural Mozambique, which was evaluated through a randomised controlled trial. It includes some components of an integrated intervention (WASH, health and nutrition). The programme is now being rolled out at scale.

Case Study 7: A randomised evaluation of a preschool programme, rural Mozambique

A randomised control trial evaluated the impact of a preschool programme for 3-5 year olds run by Save the Children in 30 rural communities in Mozambique from 2008-2010.

Communities provided space, labour and some materials to build preschool classrooms. Save the Children provided materials for playgrounds, child-sized toilets and safe water for drinking and hand-washing. Classes were run by volunteer teachers, chosen by community committees who managed the preschools. Teachers received training on learning techniques and monthly mentoring. Monthly parenting meetings were held with the preschool teachers and community health activists, focusing on nutrition, health and literacy. Self-care practices such as hand-washing were strongly promoted as part of the preschools’ daily routine. The cost of running the programme was US$2.47 per child per month.

The evaluation identified that primary school enrolment rates among children in the treatment group were 24% higher than those in the control group. Children attending primary school who had been to preschool spent an average of 7.2 hours more a week on homework, classroom time and other school related activities than the control group. The time they spent working on the family farm and attending community meetings was reduced. Children who had attended preschool showed a 12.1% increase in cognitive development compared to the control group. They also showed increases in communication skills, problem-solving, fine motor development and emotional maturity compared to the control group.

The only nutrition component of the programme was the parenting meetings which included nutrition and health topics. The baseline survey found that stunting was present in over 42% of children and the programme showed no impact on stunting or wasting. There was a significant reduction in skin problems and a reduction in diarrhoea (although this did not reach significance) which are likely to have resulted from the WASH interventions included in the preschool programme. However, there was a 10% increase in the probability of preschool attenders having symptoms of ill health in the previous 4 weeks, largely coughs and colds, probably caused by increased daily exposure to other children. The study authors propose that in addition to preschool, children in poor, rural settings may benefit from complementary health, nutrition and early stimulation interventions starting much earlier in life.

Based on the results, Mozambique’s Ministry of Education are expanding the community-based preschool model to 600 communities in the 2013-2015 period (World Bank Human Development Network, 2012; Martinez et al., 2012).

5.2          Home and community-based programmes

Home and community-based programmes offer an alternative model to the centre-based preschool, and build on programmes in Section 4.7). For example, the Hogares Comunitarios de Bienestar in Colombia serves 800,000 low-income children under age 6. This is a model of childcare provided to up to 15 children by a ‘communitarian mother’ in her home. It includes promotion of children’s physical growth, health, social and cognitive development and the provision of supplemental nutrition (50-70% of the daily allowance). An evaluation included 10,173 children aged 3-6 years. Participation for more than 16 months was associated with a trend for positive effects on receptive language, mathematical reasoning, general knowledge and verbal ability compared to control children. Children older than 49 months who participated in the programme for more than 16 months showed a trend for higher height for age scores compared to control children (Bernal and Fernandez, 2013; Attanasio et al., 2013).

5.3          Parenting support and training

The potential of parenting interventions during the first two years of an infant’s life has already been reviewed in Section 4, but support for parents is equally important during the preschool years, and can take many different forms, including encouraging positive parenting, providing advice and counseling, as well as offering practical advice and training on how best to support children’s learning for all children, but especially for children with special needs (Oates, 2010).

Of 38 parenting interventions included in Rao et al.’s (2013) review, 8 targeted parents of children 3 years or above. One parenting intervention aimed at the mothers of children aged 3 to 5 years that has been found to have significant long-term positive effects is the Mother-Child Education Programme in Turkey (see Case Study 8).

Case Study 8: Mother-Child Education Programme, Turkey

The Mother-Child Education programme began as a research project in 1982. Over a two year period, mothers of children aged 3 to 5 years from low-income families received weekly training in a programme to stimulate their children’s cognitive skills including language, sensory and perceptual, problem-solving, pre-literacy and pre-numeracy skills. They also participated in fortnightly group discussions designed to support mothers in their parenting and spousal roles and provide them with better coping and communication skills. Topics included nutrition, child health, child development, play activities, discipline and parent-child communication. Seven years after the intervention, sustained effects were found in terms of school attainment, higher primary school grades and vocabulary scores, more favourable attitudes towards school and better family and social adjustment (Kagitcibasi et al., 2001). Follow up after 19 years demonstrated higher levels of university attendance and higher status employment for children who had participated in the programme (Kagitcibasi et al., 2009).

This programme has developed into a national NGO, the Mother-Child Education Foundation, which implements a range of ECD interventions (http://acev.org/en).

Investing in new services may not always be feasible, nor a cost-effective route to stronger integration. Quick wins can be achieved by building on existing services for mothers and children, for example, incorporating parenting education into a maternal health programme, ensuring play and learning activities are provided within community or work place childcare services, and employing new media to reach parents and children alike (for example, a local adaptation of Sesame Street has been broadcast in India since 2006).

One quick-win solution to increase learning opportunities for preschool children is by providing kindergarten or preschool classes within primary schools, using existing buildings, management structure and professionals. The potential benefits (and challenges) are discussed further in Section 6.

5.4          Integrating nutrition, health and WASH into preschool programmes

In their recent systematic review of the effects of integrated child development and nutrition interventions, Grantham-McGregor et al. (2014) note that there is an evidence gap regarding the use of centres for early learning to deliver health and nutrition interventions for children 3-6 years of age. However, there are some examples of integrated programmes.

An early study in Colombia evaluated the effectiveness of a centre-based programme for 301 children aged 3 to 7 years which provided education supporting language development, social abilities and psycho-motor skills and a nutritional intervention consisting of children being fed 75% of their daily recommended allowance of protein and calories and being given micronutrient supplements. There were four treatment periods of approximately 180 days each. Children who began the programme at a younger age and participated for longer, showed higher cognitive scores than those who began later and participated for a shorter time. Compared with the group who received just one treatment period, the children who received four treatment periods gained 0.6 standard deviation in height-for-age and 0.7 standard deviation in weight-for-age (Perez-Escamilla and Pollitt, 1995).

In their discussion of opportunities for integrating ECD and nutrition programming, DiGirolamo et al. (2014) identify that a low-cost strategy can be to enhance existing services in a target community to offer children access to child development, health and nutrition services. One example cited is an intervention being conducted in Malawi by Save the Children, the World Bank and the Government of Malawi (DiGirolamo et al., 2014), where 200 existing community-based childcare centres are being enhanced to provide additional health and nutrition interventions. Community health and nutrition volunteers have been trained to provide health and nutrition messages and to ensure children receive nutritious meals. Impact data on health, nutrition and cognitive outcomes is not yet available.

An initiative which aims to develop WASH interventions in early childhood settings is ‘WASH from the START’ (http://www.worldomep.org/en/wash-from-the-start/), run by OMEP and UNICEF. This aims to extend UNICEF’s successful WASH in Schools programmes and services into early childhood settings, including homes, communities, health centres, and preschools. UNICEF is currently developing a publication of case studies about WASH activities in early childhood settings.

5.5          Comprehensive, scaleable ECD initiatives

This age phase of 3 to 5 years has been been a major target group for some of the most ambitious, large scale, multi-sectoral initiatives, notably the Government of India’s Integrated Child Development Services (ICDS), which began in 1975 (see Case Study 1 in Section 2). The Opportunidades programme in Mexico also targets this age group with comprehensive initiatives built around social protection (see Case Study in Section 3). Both these – and many other examples in this Topic Guide – originate from government initiatives. But government policies and programmes aren’t the only entry point. For example, the Government of South Africa developed a National Integrated Plan for Early Childhood Development 2005-2010 which built on existing public programmes with the aim of ensuring a comprehensive range of quality services. Biersteker (2011) summarised the challenges that have been experienced of effectively coordinating multiple departments at central and provincial level, arguing that:

…it is extremely difficult to coordinate and integrate the services offered by several departments. It is doubtful whether national and provincial interdepartmental coordinating structures have achieved more for young children, it has not been active in interdepartmental structures. International experience shows that it is at local level that integration is most effective, but there is little coordination in most municipalities. A further complication is lack of legislative clarity on the role of local authorities in regard to early childhood services, other than environmental health and safety.

Against this background, a partnership of donor organisations established a new initiative, Ilifa Labantwana, with the aim of supporting the process of moving towards effective integration (see Case Study 9).

Case Study 9: Ilifa Labantwana (Children's Heritage), South Africa

Ilifa Labantwana is a partnership of donor organisations that aims to influence South African policy implementation on integrated, scalable ECD interventions in a sustainable manner. Their strategy proposes a progressive cycle of research, advocacy, capacity building, finance modeling and support for government and providers.

Strategy cycle of Ilifa Labantwana
Figure 10: Strategy cycle of Ilifa Labantwana
(Source: Ilifa Labantwana (2013b). Into the Future. Ilifa Labantwana Phase II 2013-2016 Strategy. Cape Town: Ilifa Labantwana, p.5.)

Ilifa Labantwana has developed strong working partnerships with government and civil society stakeholders. At national government level this includes the Departments of Social Development, Basic Education and Health, the Treasury, the National Planning Commission and the Office of the Presidency. At provincial level, partnerships have been created in the North West, KwaZulu Natal, Mpumalanga and Eastern Cape which have the dual aim of testing a population coverage approach to ECD services and supporting the development of effective government management systems.

Partnerships with civil society organisations is key to Ilifa Labantwana strategy, given that ECD services in South Africa are currently largely provided by the non-profit sector with about 70 Resource and Training Organisations (RTOs) whose coverage can be fragmented. Ilifa Labantwana is working to develop the capacity of these organisations, including supporting training of middle-level managers, developing the curriculum for an ECD practitioner qualification and completing an audit of the RTO sector in 2013.

Ilifa has conducted implementation and outcome evaluations of home visiting, community playgroup and centre-based programmes in mainly rural low resource communities. Effects on cognitive and language development of preschool children have been measured. Children who received one or other intervention were followed up on into school. The effects of home visiting interventions on caregiver stimulation of language and cognition were assessed, and the effects of training preschool teachers on the quality of care and learning environment were also assessed (More information can be accessed at: http://www.ilifalabantwana.co.za/ilifa-publications/publication-archive/).

Ilifa is also funding a randomised trial to test the effectiveness of a parenting programme in increasing affectional care and reducing harsh punishment among caregivers and their children who are resident in poor urban community.

In 2010, Ilifa conducted an indepth study on government funding to the ECD sector, using three municipalities as case studies – Eastern Cape, North West and Western Cape. This aimed to trace the flow of public funds for ECD and identify policy and administrative obstacles to accessing funding. This has informed Ilifa’s dialogue with the national treasury in advocating for revision of the ECD funding framework, particularly to provide support to home and community-based (not just centre-based) programming. Ilifa will support a costing exercise for ECD provision as part of the modelling of an Essential Package of ECD services at provincial level.

The ‘Essential Package’ covers the period from conception to 5 years, with ECD services seen as a continuum of interventions, in which the family at household level is the primary level of care and support. It focuses primarily on prevention and early interventions with referrals for more intensive support where necessary. The five components included in the Essential Package are:

  • nutritional support
  • primary level maternal and child health interventions
  • social services
  • support for primary caregivers
  • stimulation for early earning.

Service delivery indicators and measures of success have been defined for each of these components, using indicators which are already used by the relevant government department as far as possible (see Figure 11).

Essential Package services and support for ECD
Figure 11: Essential Package services and support for ECD
(Source: Ilifa Labantwana (2013c). The Essential Package: Early Childhood Services and Support to Vulnerable Children in South Africa. Cape Town: Ilifa Labantwana, p.7.)

Along with its government and NGO partners, Ilifa Labantwana plans to implement the modelling and testing of the Essential Package from 2013-16 at provincial level in the Northwest, KwaZulu Natal, Mpumalanga and Eastern Cape. Ilifa will support the development and testing of the management, human resources and financing systems needed for ECD scale-up (Ilifa Labantwana, 2013b).

For examples of initiatives to scale up ECD programmes across several world regions, see Bernard van Leer Foundation (2011).

5.6          Inclusive programmes and equity

Attendance at preschool has growing significance in shaping life course trajectories for children. But there is large gap between the evidence of what can be achieved, and realities of what is actually happening, or not happening for young children and families. In the absence of state obligations to deliver services (as in a compulsory school system), huge variation is found in the extent of policies and services and the adequacy of finance and governance, with community-based, NGO-led, faith-based and private sector initiatives playing a key role in many countries. Since for the most part, services for the 3-5 age group are neither statutory nor compulsory, there is a serious risk of disadvantaged, disabled, and socially marginalised groups being excluded (Britto et al., 2013, Chapters 14-16).

Woodhead et al. (2009) analysed equity issues in accessing preschool provision for 6,000 children in Ethiopia, Peru and Andhra Pradesh, India. They identified that in Ethiopia, 50% fewer children from the poorest households attended preschool, compared to children from more advantaged homes. They report a 25% difference in access in Peru and 10% difference in Andhra Pradesh. Rural children were less likely to access preschool than urban children. Children with more highly-educated mothers were more likely to have attended preschool than those with low parental education levels. Although overall statistics do not suggest gender per se is a major factor affecting access, compared to the influence of poverty or location. Disaggregating gender data is informative of the specific groups at risk of being excluded. For example, the sample of 2,000 children in Peru was widely dispersed: 89% urban children compared with 73% rural. While overall gender disparities were small, rural girls show the lowest enrolment, at 69%. In a small qualitative research sub-sample, all the children without access to preschool were girls:

Rural girls who experience delays in their school trajectories (such as late entry to first grade or repetition during primary years) are more at risk of dropping out of primary school early, or of completing primary education only… If more rural girls than any other group are entering school without pre-school experience, which may cause delays or repetitions in their school trajectories, this will have significant consequences for their ability to finish their primary education and go on to attend secondary school.

In some countries, a growing, often unregulated, private sector has also increased inequalities, notably in India (Streuli et al., 2013; Woodhead and Streuli, 2013). These trends risk perpetuating intergenerational poverty and inequalities.

Woodhead et al. (2009) recommend several strategies to work towards addressing these equity issues including:

  • Positive equitable government policies on ECD, especially targeting most disadvantaged groups.
  • More effective governance, including of the private sector.
  • Integration of early childhood care and education initiatives with national poverty alleviation strategies and with health and welfare policies.

In some regions, gender-norms about socialisation of girls versus boys shapes access to early childhood programmes and transition to primary school. By the time they enter preschool, most children have adopted socially-accepted gender roles and beliefs about what is appropriate, which impact on the way they respond to school, as well as the ways they are treated by their teachers, their parents and their peers. Gender discrimination is not just about unequal access to education, but can involve more subtle decisions about which school boys versus girls attend, and more generally, the level of household investments in their education at various phases through childhood, as revealed for example, by the impact of growth in private schools on gendered decision-making in India (Streuli et al., 2011; Woodhead et al., 2013).

Monitoring for equitable, inclusive services recognises that children’s gender is a major factor in some societies, while in others the challenge is marginalisation faced by ethnic minorities and other disadvantaged groups; and of course these disadvantages often coincide (see also Section 6. 4).

In emerging national systems, the needs and rights of disabled and special needs girls and boys are especially at risk of being overlooked. Scherzer et al. (2012) note that with increased infant survival rates:

…it is estimated that more than 200 million children have developmental delay or disability. The components of this enormous problem have been studied from many angles. Studies of survivors of HIV/AIDS and malaria, for example, show that they have a high prevalence of neurodevelopmental delays, cerebral palsy, and intellectual disability. In essence, there is an emerging new population of children in low- and middle-income countries with developmental delays and disabilities whose existence must be recognised and dealt with in all health practice and planning.

Disabled children are seriously under-represented in early childhood programmes, their needs may not even be recognised, and overcoming stigma may be a first step towards inclusion (WHO, 2012; Section 6.4).

5.7          Summary for age phase ‘3 to 5 years’

  • There is strong evidence for the positive impact of centre-based preschool provision on cognitive, educational and other child development outcomes from low- and middle-income contexts as well as high-income countries.
  • Home and community-based programmes as an alternative to centre-based preschool can improve education and health outcomes.
  • Parenting interventions can also be effective for 3 to 5 year olds.
  • Integrated ECD programmes include those which integrate limited components of ECD provision (e.g. preschool provision and nutritional supplementation) and those which aim to provide holistic ECD services.
  • Challenges to implementing large scale integrated ECD programmes in low resource contexts include the funding required to provide adequate infrastructure and resources; development of effective monitoring and evaluation and the challenge of effective coordination between services.
  • Pro-poor policies and service delivery must be actively pursued to address equity issues in accessing preschool and ECD services and avoid the perpetuation of intergenerational poverty and inequality.

Table 4: Evidence Strength Assessment for ‘3 to 5 years’

Quality of evidence: Size of body of evidence: Consistency of results: Context
Medium/High Larger for education than for other sectors; gaps for informal and private sector Mostly consistent Increasingly global, but with country specific applied studies a priority in some regions
6 years onwards – interventions for the transition to school
Figure 12: 6 years onwards – interventions for the transition to school

Rapid progress towards the MDG and EFA targets to achieve universal access to basic education means that enrolling in primary school is now a major transition for the majority of the world’s children.

A first issue is ensuring access to quality education for all the world’s children. UNESCO (2014) reports that the numbers of primary school age children not in school fell by half between 1999-2011, but still remains at 57 million. Regional differences are very significant, with 22% of children in sub-Saharan Africa still not in school in 2011. Globally, girls are over represented in the out-of-school statistics, making up 54% of those out of school, with the Arab States accounting for a significant share, along with South and West Asia.

A second issue (which is a major focus for this section) is about school readiness. The concept of ‘school readiness’ is often assumed to be about ‘children’s readiness for school’. But this disproportionately emphasises children’s ability to adjust to the demands of school: the curriculum, pedagogy and expectations of prior learning; the physical, social, language and cultural environment of school; the expectations for their behavior and teachers’ use of physical punishment; etc. The flip side of the coin is about ‘schools’ readiness for children’. Or as Kagan puts it, readiness is “the match between the child and the institutions that serve the child” (Woodhead and Moss, 2007, p. 22). Evaluating schools’ readiness is important as a starting point for policies and reforms designed to ease children’s (and parents’) transition, ensure access and quality, promote inclusion and respect for diversity and children’s individuality, strengthen their progress, develop skills and academic achievement and reduce dropout.

As with previous sections, this age phase is approximate: age of entry to school varies between countries according to organisation of preschool services, legal requirements and actual admission practices. Readiness issues don’t just apply to the transition to school, but the whole age span of ECD as in earlier sections.

Britto (2012), proposes three dimensions of school readiness (the interaction between them is illustrated in Figure 13):

  • Ready children: focusing on children’s learning and development.
  • Ready schools: focusing on the school environment along with practices that foster and support a smooth transition for children into primary school and advance and promote the learning of all children.
  • Ready families: focusing on parental and caregiver attitudes and involvement in their children’s early learning and development and transition to school.
Building competency/capacity for transition to school
Figure 13: Building competency/capacity for transition to school
(Source: Britto (2012). School Readiness: a Conceptual Framework, p. 7.)

All of the factors discussed in relation to ECD in previous sections have an impact upon the readiness of individual children and families for school, for example, poverty, children’s health, nutrition, living in a healthy environment, parental stimulation and support and experiences of childcare or preschool. The impact of these factors on their readiness will vary according to their gender, ethnicity, disability, and a host of other factors, including individual differences.

This section will also focus on schools’ readiness for children, recognising that primary school attendance is now a near-universal experience in most countries of the world, with potential to build on healthy development and learning during earliest childhood, strengthen skills, capacities and long-term outcomes and further reduce inequalities established early in life. Well established school systems provide opportunities that extend beyond children’s educational development to include WASH, nutrition and health interventions, within the school environment as well as in the wider community. These may be delivered as stand-alone interventions or as integrated initiatives.

Entry points for intervention in this age phase include:

  • children’s readiness for school
  • families’ readiness for school
  • schools’ readiness for children
  • inclusive practices in the transition to school
  • WASH in schools
  • school-based health interventions
  • school-based nutrition interventions

6.1          Children’s readiness for school

All of the factors that have influenced children’s development during their early childhood have an impact on their preparedness for school and their ability to participate in learning. Lack of antenatal care, poor nutrition, low birthweight and lack of routine immunisations have all been linked with poorer school outcomes and performance (Britto and Limlingan, 2012). A holistic definition of children’s school readiness given by Kagan et al. (1995) includes five domains: physical well-being and motor development; social and emotional development; approaches to learning; language development; and cognition and general knowledge, including mathematics.

One major gap in planning and monitoring school readiness issues, as well as evaluating programme effectiveness, has been the shortage of appropriate measures for monitoring and assessment of children’s capacities at this stage. One global initiative has identified a global framework of learning domains:

Entry to primary school is a key milestone in a child’s learning trajectory, and measuring competencies across multiple domains at this point or in the years before entry to primary school can help drive improvements in early childhood education, health, family services, and other sectors serving young children. Given the complexity of child development, a holistic measure across several domains is the best way to capture learning at this stage. This typically includes aspects of learning related to five of the seven domains: physical well-being, social and emotional, literacy and communication, learning approaches and cognition, and numeracy and mathematics.
Global framework of learning domains diagram
Figure 14: Global framework of learning domains (Source: UNESCO-UIS/Brookings Institution (2013). Towards Universal Learning: Recommendations from the Global Metrics Task Force, p. 11)

Save the Children has also been working towards similar goals with its new International Assessment of Development and Early Learning. In the first phase of the process, which included Bangladesh, Bhutan and India, more than 60 items have been tested covering five developmental domains with a goal to narrow these down to the most reliable and feasible items that can be used across countries and contexts with 3.5-6 year old children. Continuous modifications and improvements have been made through trials in Ethiopia, Pakistan, Rwanda, Zambia and Mozambique in 2012. By early 2013, a consolidated 20-item version of the original tool had solidified and further testing began in Bangladesh, Egypt, Indonesia, Malawi and Mali (Save the Children, 2014).

In the absence of systematic developmental assessments, successful adjustment into the early school grades is a widely used readiness indicator. For example, Mingat (2005) estimated the impact of preschool on the numbers of children persevering to Grade 5 of primary education. Data was available from 40 countries, 24 of them in sub-Saharan Africa. A positive association was found between preschool enrolment and low school dropout, and a negative association between preschool enrolment and repeating grades.

However, early childhood experts express concern about trends to ‘schoolify early education and care’, especially a risk when preschool classes are integrated into primary schools, and taught by primary trained teachers, and narrowly focused on early literacy and numeracy (Bennett, 2006). In many countries, creating a ‘Grade 0′ in primary schools has become a practical, relatively low-cost solution to extending preschool opportunities, which can rapidly increase access (Biersteker, 2008). In other countries, enrolling children as young as 4 into formal kindergarten classes in private-for-profit English medium schools is a popular response to poor parents’ high aspirations for children to get a headstart in a competitive school system, as for example in India (Streuli et al., 2011; Singh and Bangay, 2014).

Leaving aside these general issues surrounding the relationship between the early childhood programmes and school readiness, Britto (2012) identifies where specific school readiness interventions can help children enter school ‘ready to learn’, and so more likely to stay in school and achieve learning and academic success:

  • Reduced drop-out rates: Initial test results from school readiness interventions in several developing countries demonstrate reduction in primary school drop-out rates. For example, the Government of Cambodia piloted a school readiness programme in the first two months of Grade 1 of primary school that demonstrated positive results for student learning and a reduction in drop-out rates (Nonoyama-Tarumi and Bredenberg, 2009).
  • Reduced grade repetition: For example, in Nepal, participation in school readiness programmes was linked with a substantially lower repetition rate in Grade 1 for children compared to the national average (Save the Children, 2003).
  • Secondary/high school completion: Data from several developing countries, including Brazil, Jamaica and the Philippines, indicate a strong association between early skills and later high school completion, controlling for a host of influencing factors such as family income and education (Grantham-McGregor et al., 2007).
  • Academic achievement: Data from several studies in developing countries, including Guatemala and South Africa, have demonstrated a positive association between school entry ability and academic performance in primary school and later academic achievement (Liddle and Rae, 2001; Stith et al., 2003).

6.2          Families’ readiness for school

Families prepare their children for school right from birth, and even before birth, in multiple ways. As discussed in earlier sections, all of the following interventions have an impact on the child’s development: the health and nutrition of the expectant mother; breastfeeding in infancy; living in a healthy environment and early stimulation. Yet the extent and nature of impact may vary according to the cultural significance attached to their gender, and other factors. Poverty is strongly related to parenting practices and children’s development. Some evaluations suggest that children from disadvantaged backgrounds could already be years behind their economically-advantaged peers at school entry (Brooks-Gunn et al., 1999).

Supportive parenting and stimulating home environments have been shown to be among the strongest predictors of school performance during primary school and beyond. Britto (2012) identifies the following aspects as important for school readiness:

  • parents’ beliefs, attitudes and goals regarding their children’s education
  • the learning environment provided in the home
  • supportive and responsive relationships within the family which are the building blocks of children’s social and emotional development
  • parents’ commitment to on-time school enrolment.

The Mother-Child Education Programme in Turkey (Case Study 8, Section 5) illustrates interventions with the specific aim of helping mothers prepare children for early literacy and numeracy skills. Family focused initiatives don’t just target mothers, fathers or other adults. The Child-to-Child Trust has pioneered work involving older siblings and peers in supporting young children’s development. For example, ‘Getting Ready for School’ resources originally designed for parent programmes (Hayes et al., 2006), have been adapted for use by children (Kanji and Landers, 2009). In Ethiopia, child-to-child has been incorporated within the framework policy for early childhood education in 2010, as a cost-effective way to increase access to early education. This is done by setting aside primary school classrooms, with older children supporting preschool children’s learning, in ways that may be considered mutually beneficial (Orkin et al., 2012).

6.3          Schools’ readiness for children

The challenges of ensuring high quality developmentally-appropriate primary school are widely recognised. MDG and EFA priorities to increase access have now shifted to re-prioritisation around ‘achieving quality for all’ (UNESCO, 2014). The impact of low quality schooling on pupil experience, low achievement and early drop-out are relevant to this Topic Guide because of the impact on young children’s successful transition to school. The quality of the school environment is linked with higher rates of student retention and lower drop-out rates, especially for girls (Lloyd et al., 2000). For example, Young Lives research in a large sample of schools in Ethiopia reported that only around 50% of schools had access to water on site. Fewer than 50% of schools provided toilets for girls with an acceptable degree of privacy. Delayed enrolment and early dropout was commonplace, for boys as well as girls, but the reasons for dropping out varied by gender, with boys more likely to be expected to take on agricultural labour. The most common reason for girls to leave school was that they were needed to look after their siblings. The second most common reason for girls dropping out of school was that the direct costs of schooling were considered to be too high (Frost and Rolleston, 2013).

Although schools cannot influence most of the factors that have affected children’s development before they enter the school system, there are many ways in which they can increase their readiness to enable children to access school and to develop to their full potential through the opportunities that school provides. School readiness factors are not just about basic quality issues (the physical environment, resources, teacher qualifications, etc.). They also include location, accessibility and admission practices that shape which children are included and which are excluded (Woodhead and Moss, 2007).

Preschool and primary school settings are often very different in relation to rules, routines, structure, curriculum, teachers’ expectations and styles of interacting. Instruction in primary school is often more structured. Early childhood curricula often focus on domains of learning (cognitive, physical, social, etc.) whereas primary school curricula are often subject-based (reading, mathematics, science, etc.). If children have attended preschool, they may find it difficult to adjust to these changes. Some countries have developed strategies to provide greater continuity to ease children’s transition between these settings (Britto and Limlingan, 2012). For example, projects in Jamaica and Guyana have developed an integrated curriculum for pre-primary and primary school, organised around the child’s developmental cycles (UNESCO, 2007). The Step by Step Transition to Primary School Programme, run in a number of Central Eastern European and Commonwealth of Independent States (CIS) countries, uses strategies including students from Grade 1 talking with preschool students about their experiences; preschool children participating in role play; preschool teachers and parents reviewing the primary school curriculum and discussing the skills children will need and primary and preschool teachers training using the same pedagogic framework and core modules (Arnold, 2006).

The concept of schools’ readiness for children can include not only how they support children’s transition to school and their educational development but, more widely, how they support children’s holistic development. This is illustrated in Case Study 10.

Case Study 10: UNICEF Child-Friendly Schools

The concept of ‘ready schools’ shares characteristics with UNICEF’s Child-Friendly Schools initiative which focuses on improving the quality of the school environment to support children’s holistic development and comprehensive learning. It aims to be child-centred in teaching and learning, health, hygiene, safety (regulating school construction and playgrounds), protection (banning punishment, abuse or violence), gender sensitivity and inclusion, aiming to reach marginalised children and involve families and communities (Britto, 2012). Child-Friendly Schools take an inter-sectoral approach which is, “concerned as much with the health, safety, security, nutritional status and psychological well-being of the child as… with teacher training and the appropriateness of the teaching methods and learning resources used for schooling” (UNICEF, 2009, p. 3).

Inter-sectoral interventions carried out as part of Child-Friendly Schools include:

  • working to improve water supply; gender-sensitive sanitation facilities and hygiene promotion
  • provision of school health interventions including de-worming, malaria prevention and vaccination programmes
  • provision of school nutrition interventions including school feeding and micronutrient supplementation

For example, Malawi’s Child-Friendly Schools model stresses the importance of inter-sectoral partnerships. UNICEF, the World Food Programme, the Government, non-governmental organisations and other civil society organisations collaborate to provide quality primary education. This includes teacher training on child-friendly methods, school feeding for children attending primary day schools, and take-home rations for girls and orphans. Schools are provided with furniture, teaching materials and water and sanitation facilities, along with life skills training, deworming services and micronutrient supplementation (UNICEF, 2009).

A study in the Siraha region of Nepal provides clear evidence of the role that child friendly preschool can play in improving school participation amongst marginalised groups, and especially girls. At the time of the study, only 30% of children from dalit communities (a low caste traditionally defined as ‘untouchable’) were in school, compared to 80% for the country as a whole. And the percentage of dalit girls attending was half that of their brothers. A Save the Children programme included making the schools more child-friendly and provided community-based ECD to dalit children. The findings indicated that 95% of participants in the ECD programme continued on to primary school, compared to 75% of children who had not attended ECD centers. Moreover, the increased participation rates was much more striking for girls (Bartlett et al., 2004).

6.4          Inclusive practices in the transition to school

As part of a school’s readiness to receive all girls and boys, inclusive practices address the inequities that persist in enrolment, attendance and learning outcomes based on gender, poverty, geographical location, ethnicity, health status, and disabilities (Britto, 2012). Educational exclusion and inequity often begins at preschool stage (see Section 5.5) placing already disadvantaged children even further behind their peers. This is then all too often amplified at school (Woodhead et al., 2013), contradicts the stated goals of school systems, and is not inevitable, as studies of school effectiveness confirm (Rolleston et al., 2013). Some major inclusion issues relate to the following three areas:

Mother tongue education

Many schools teach in the ‘official language’ rather than children’s first language. This is an issue that particularly effects children from ethnic minorities. When the language used in school is not a child’s first language, particularly in environments characterised by poverty and with high rates of illiteracy, the chances of dropout increase substantially (Villegas and Lucas, 2002). Children who learn in their first language for the first six to eight years perform better in terms of test scores and self-esteem than those who are taught in the official language (Thomas and Collier, 2002). Once a child can read and write in his or her first language, the skills are transferable to other languages. Evidence from Bolivia, Guinea-Bissau, Mozambique and Niger shows that parents are more likely to communicate with teachers and participate in their children’s learning when local languages are used (Benson, 2002). Researchers who conducted classroom observations across 12 countries in Africa, found that the use of unfamiliar languages led primary teachers to use teacher-centred methods which undermined students’ learning (Alidou et al., 2005).

Gender sensitive practices

Just 20% of low-income countries have achieved gender parity (equal enrolment of girls and boys) at primary level. Equal enrolment is only the first step towards gender equality on education. Other starting points for schools include making sure the school environment is safe; improving facilities to provide, for example, separate toilets for girls and boys; training teachers in gender sensitivity; achieving gender balance among teachers and rewriting curricula and textbooks to remove gender stereotypes (UNESCO, 2014).

Teaching in children’s first language is also important to promote gender equality. In some societies, girls are less likely than boys to be exposed to the official language, because they spend more time at home. Girls who are taught in their first language tend to stay in school longer, have less grade repetition and achieve more academic success than those who are not (UNESCO, 2005).

Inclusion of children with disabilities and special educational needs

A literature review on inclusive education for children with disabilities and special educational needs identified the following qualities of successful inclusive schools in developing countries (Peters, 2003):

  • early intervention when children are in the formative stage of development
  • small classes
  • well trained and valued teachers
  • multi-ability groups
  • positive learning environments with a sense of community
  • strong parental involvement.

An evaluation of a Save the Children project which provided inclusive training for teachers and parents of young children in Mongolia, found an increase in the percentage of children with disabilities enrolling in preschool and primary school from 22% to 44% (Save the Children, 2008). An inclusive education project which ran from 1993-2009 in Lao, focused on changing the educational pedagogy from being teacher-centred to child-centred. Teachers received training in inclusive education; actively supported children with disabilities in class; enabled other children to provide peer support; used resources to support learning and collaborated with parents to encourage them to support learning at home. The number of children with disabilities in the schools increased. The percentage of children with special needs passing grades increased in 2004-2007 to 78% and the percentage of all students passing grades also increased to 86% (Grimes, 2009).

As well as enabling children to access opportunities for their educational development, schools are well placed to provide opportunities for children’s healthy development through WASH, health and nutrition interventions (WHO, 2012).

6.5          WASH programmes in schools

 

WASH and health

Many of the WASH risks for school age children and the interventions targeted at them are related to health outcomes.

The impact of diarrhoea on school entry and intellectual performance has been discussed in earlier sections. A campaign promoting hand-washing with soap in 30 primary schools in Egypt reduced diarrhoea-related absenteeism by 30% (Talaat et al., 2011). Similar results have been found in China (Bowen et al., 2007) and Colombia (Lopez-Quintero et al., 2009). Each of these studies also demonstrated a significant reduction in absenteeism related to respiratory-illness as a result of improved hand hygiene (Mooijman, 2012).

Intestinal worm infections include hookworm, whipworm, roundworm and schistosomiasis. Worm infections are spread through unhygienic environments in soil or water and unhygienic behaviour via food or hands. School age children have the highest infection prevalence of any group; an estimated 47% of children ages 5-9 in the developing world suffer from a worm infection (Mooijman, 2012). These are associated with impaired learning, increased absences from school, and decreased future economic productivity (Bethony et al., 2006; Clasen et al., 2010). Children enduring intense infections with whipworm miss twice as many school days as their infection-free peers (WHO, 2005). Children with heavy-intensity hookworm infections have shown to suffer from growth retardation, as well as intellectual and cognitive impairments. A worm reduction programme in Kenya reduced absenteeism by a quarter (Miguel and Kremer, 2004).

WASH and school attendance

Many of the studies cited here report the negative impact of WASH-related illnesses on children’s attendance at school. There are other aspects of WASH which have an impact on school attendance, particularly that of girls. In many countries, girls bear more responsibility for water collection for the family than boys. A study in Ghana showed a significant relationship between water collection time and girls’ school attendance. A 15-minute reduction in collection time increased the proportion of girls attending school by 8 to 12%. The impact of hauling time on school attendance was stronger above a 30-minute round trip (Nauges and Strand, 2011). A World Bank study in four countries showed that girls’ school attendance increased significantly for every hour reduction in water collection. In Nepal, attendance improved by over 30% (Koolwal and van de Walle, 2010).

The lack of toilets or separate toilets in schools for girls is a major reason for girls not attending school (LaFraniere, 2005; MacIsaac, 2006).

WASH interventions

WASH interventions in schools include the provision of safe water, toilets, hygiene promotion and education, cleaning and food hygiene practices.

Hygiene education can be provided through participatory education by teachers in school or by children’s involvement in youth hygiene clubs. It aims to develop children’s knowledge and understanding, attitudes and practical skills in relation to hygiene. Mooijman (2012) identifies the following key areas for children’s life skills to be developed in relation to WASH: safe use of toilets; personal hygiene; hand-washing with soap; waste management and water drainage; water treatment, handling and storage and food hygiene. School-based studies have demonstrated potential for influencing hand-washing behaviour through membership in safe water clubs, peer-to-peer teaching, classroom sessions with focused training materials and role-playing or songs (O’Reilly et al., 2008; Bowen et al., 2007; Onyango-Ouma et al., 2005).

Mooijman (2012) includes implementation guidelines for WASH in schools, including location and design of facilities, WASH standards and indicators, hygiene education, community linkage, teacher training and monitoring and evaluation. WASH standards include the following areas: water quality, quantity, facilities and access, hygiene promotion, toilet provision, control of vector-borne disease, cleaning and waste disposal, food storage and preparation.

6.6          Health programmes in schools

Malaria, waterborne diseases, parasitic infestations, diarrhoea, cholera, dehydration and HIV and AIDS are just some of the health risks to school age children. WASH-related illnesses, including diarrhoea and worm infections, and interventions targeting them, have already been discussed. Other health issues also have an impact on school readiness, in terms of children’s cognitive ability, attendance, academic performance and school completion.

In a survey of 3,000 children at 20 schools in Ethiopia, the second most common reason for dropping out of school (after the need for the child to undertake domestic/agricultural work) was for health reasons: illness or disablement. Qualitative findings indicate that some children dropped out repeatedly, or experienced long periods of absence due to a variety of health problems. Illness of a family member also caused children to drop out if it caused a shortage of family labour, including labour for domestic tasks (Frost and Rolleston, 2013).

A history of malaria attacks was associated with poorer cognitive function at school entry in Sri Lanka (Fernando et al., 2003). Longitudinal studies with school aged children from Brazil and Mali have shown associations between attacks of clinical malaria or asymptomatic parasitaemia and poorer cognitive scores and academic performance. In a cross-country analysis controlling for education quality and other confounders, grade repetition and primary school completion rates were related to malaria exposure (Thuilliez, 2009). Randomised clinical trials of chemoprophylaxis in school children showed significant benefits to language, mathematics and attendance in Sri Lanka (Fernando et al., 2006), and to attention in Kenya (Clarke et al., 2008). Skills-based health education can give children the ability to recognise the signs and symptoms of malaria and to recognise the need to seek treatment. Skills-based health education through schools can also help promote a community-wide understanding of malaria with particular emphasis on the need for community-based control measures such as the use of impregnated bed nets (World Food Programme/UNICEF, 2005).

Schools can work to combat health risks by providing a healthy school environment that provides access to safe WASH facilities; by implementing life skills-based health, hygiene and environmental education; and by providing health services as an integral part of schooling. Schools can be used as appropriate venues for health interventions, including vaccination programmes, malaria prevention and systematic deworming (UNICEF, 2009). The World Food Programme/UNICEF Essential Package and the Focusing Resources on Effective School Health (FRESH) framework are examples of large-scale, comprehensive school health initiatives that incorporate WASH and nutrition interventions (see Case Study 11).

Case Study 11: Focusing Resources on Effective School Health (FRESH)

FRESH is a shared framework agreed upon by WHO, UNESCO, UNICEF and the World Bank in 2000 to strengthen school health, hygiene and nutrition programmes. The four core components of the FRESH framework are:

  • health policies in school that advocate and facilitate the teachers’ role in promoting good health practices and helping to make schools healthy learning environments
  • adequate sanitation and access to safe water to reduce disease, worm transmission and waterborne illnesses in the school environment
  • skills-based health education that promotes good hygiene, avoidance of disease, prevention of worm infection and other illnesses
  • access to health and nutrition services that include school meals and deworming

(UNICEF, 2009).

The Essential Package consists of 12 interventions to improve the health and nutrition of school age children, implemented by the World Food Programme and UNICEF in the context of the FRESH framework (World Food Programme/UNICEF 2005). The 12 interventions are:

  • basic education
  • food for education, including take-home rations targeted to girls, orphans and other vulnerable children who attend school regularly; in-school meals or snacks
  • promotion of girls’ education
  • potable water and sanitary latrines
  • health, nutrition and hygiene education
  • systematic deworming
  • micronutrient supplementation
  • HIV and AIDS education
  • psychosocial support
  • malaria prevention
  • school gardens
  • improved stoves

 6.7          Nutrition programmes in schools

School-based nutrition interventions include school meals and snacks; take-home rations which are often targeted to girls and other vulnerable children, and micronutrient supplementation. These can have an impact on a range of physical, cognitive and educational outcomes.

Evidence from a meta-analysis shows that school feeding programmes have small effects on school age children’s anthropometry, particularly in low-income settings (Ruel and Alderman, 2013). A systematic review found that the highest quality studies (randomised controlled trials from low-income countries indicated that children who were fed at school gained an average of 0.39kg more than children from control groups over 19 months; in lower quality studies (controlled before and after trials), the difference in gain was 0.71kg over 11.3 months. For height, results from low-income countries were mixed; in randomised control trials, differences in gains were important only for younger children, but results from the CBAs were large and significant overall (Kristjansson et al., 2007).

School meal programmes can also improve micronutrient status either through increasing diet diversity or through fortified foods. A review of randomised evaluations of iron-rich school meals (fortified or providing animal-source foods) documents that three of four studies improved iron status (Ruel and Alderman, 2013). A study of the effects of providing biscuits fortified with iron and iodine found that rates of absenteeism were reduced as well as improvements in some dimensions of cognitive function compared to a control group provided with a similar snack without fortification (van Stuijvenberg et al., 1999).

According to Alderman and Bundy (2011), a limitation of school feeding programmes, and related research, is that their focus is not on the most vulnerable period for malnutrition, from pregnancy to 2 years. However, school feeding can also benefit other members of the household when the food provided is shared or when the school age child’s intake at home is reduced. A few studies have included younger siblings of students in their impact evaluations. For example, in Burkina Faso, weight-for-age increased by 0.38 standard deviations for children aged 12-60 months whose sisters were eligible for a take home ration compared to a control group (Kazianga et al., 2009). In Uganda, younger siblings of beneficiaries of a school feeding programme had a significant improvement in height-for-age of 0.36 standard deviations.

In relation to educational and cognitive outcomes, Kristjansson et al.’s (2007) systematic review identifies that children who were fed at school attended school more frequently than those in control groups; this translated to an average increase of four to six days a year per child. Children who were fed at school gained more than those from control groups on mathematics achievement, and on some short-term cognitive tasks. Numerous studies show that in-school feeding has a positive impact on school enrolment or participation in areas where initial indicators of school participation are low (Jukes et al., 2007; Adelman et al., 2008). Alderman and Bundy (2011) also report evidence that school feeding programmes can have a positive impact on cognitive ability and academic achievement (see also Singh et al., 2014).

6.8          Summary of age phase ‘6 years onwards’

  • Multiple factors related to ECD have an impact on children’s readiness for school. These include poverty, health, nutrition, environment, parental stimulation and experiences of preschool, which in turn may vary according to children’s gender, ethnicity, disability, etc.
  • Schools can improve their readiness for children through strategies to ease the transition to school and through inclusive practices as well as provision of a quality learning environment.
  • School readiness can have a positive impact on drop-out rates, grade repetition, school completion and academic achievement. Schools can provide opportunities beyond children’s educational development to address their holistic development, including through WASH, health and nutrition interventions.
  • WASH interventions in schools can reduce the incidence of WASH-related illnesses, including diarrhoea and worm infections, and associated absenteeism.
  • Schools can work to combat health risks by providing a healthy school environment, implementing health education and providing health interventions including malaria prevention, deworming and vaccination programmes.
  • School feeding programmes can have an impact on children’s physical, cognitive and educational outcomes.

Table 5: Evidence strength assessment for ‘6 years onwards’

Quality of evidence: Size of body of evidence: Consistency of results: Context
Moderate Medium, especially education sector focussed Mostly consistent Strongly shaped by national education system quality and priorities

Previous sections have drawn attention to more age-specific entry points for strengthening ECD. This final section revisits the overarching question introduced in Section 2, about moving from a multi-sectoral to an inter-sectoral system, of more integrated – or at the very least better coordinated – ECD services.

7.1          Holistic early childhood development

Integrated ECD recognises that young children’s lives (and their parents’ lives) are lived holistically, not sectorally. Ensuring quality services are ‘joined-up’ at the point of delivery is a first indicator of progress.

Fostering an enabling environment that comprehensively addresses the development of every girl and boy through childhood cannot be adequately addressed through interventions via any single sector (World Bank, 2013). The starting point for any integrated ECD reform is an appreciation of the interdependencies and interactions between different aspects of ECD that have traditionally been siloed in terms of nutrition, health and education (Naudeau et al., 2011). Household poverty and health affect education and personal well-being – and vice versa. For example, physical growth or ‘stunting’, as an indicator of undernutrition, is linked to later height gain, to children’s learning and to their self-esteem. Achieving objectives within a sector, requires acting beyond it (Dornan and Woodhead, 2014).

Ecological models of development (outlined in Section 1) are useful for identifying the complexities of early human development systems, and as a starting point for articulating risks and potential entry points for intervention: via specific ‘micro-system’ settings (household, health clinic, preschool, school, etc.); as well as more indirect influences to improve child development via macro-system focused public policy (employment laws, social protection programmes, etc.) (Bronfenbrenner, 1979). Whereas coordination efforts are mainly focused on specific service delivery sectors, integrated child development objectives are achieved through attention to wider systems, for example, economic policies, social protection provisions, housing and environmental policies, employment law and parental leave entitlements.

7.2          Multiple entry points and delivery platforms

 

Full-scale systemic integration may not always be feasible, nor cost effective. Building on sector-specific delivery platforms may be a cost-effective and pragmatic way forward.

Concern about fragmentation of service delivery, ‘sectoral silos’, and weak coordination is the most common starting point in making the case for integration. While sectoral programming and expertise can ensure delivery on key child development targets, tight boundaries between sectors are unsatisfactory to the consumer (children and parents), they do not capitalise on the synergies between goals for development and they can be inefficient in their use of resources. Case studies in earlier sections illustrate the full range of sectoral and professional starting points, as well as delivery platforms linked to health clinics, midwifery and nutrition services, home visiting, centre-based preschools and primary schools. While the Topic Guide has included examples of ‘root and branch’ integrated systems at ministerial and service-delivery levels, steps towards integration can be more modest. Training health workers to deliver early learning as part of home visits, or providing good nutrition and health checks within a preschool or school programme are relatively simple and well proven steps, which may be more cost effective than attempting full integration at every level.

7.3          Horizontal integration

 

Horizontal integration coordinates social protection, health, nutrition, WASH, education, child protection, etc. An added challenge is to ensure integration within a sector.

Advocates for greater integration within ECD generally assume the main priority is to strengthen coordination between social protection, health, nutrition, WASH, education, etc. The added challenge of ensuring integration even within sectors is often overlooked. For example, integration within health care systems is a major focus for research, organisational and professional development. Goodwin and Ferrer (2013) identify five distinct types of horizontal integration within care systems, which are here adapted to ECD services:

  • functional (e.g. resources, planning, accounting and monitoring systems)
  • organisational (e.g. between different institutions or programmes)
  • professional (e.g. amongst various specialists at different grades, as well as with para-professionals)
  • programme/practice (e.g. between different components of an ECD service, each with distinct goals, methodologies and procedures)
  • focus (e.g. image of the child’s needs and rights, and inclusion of parents and others as clients)

7.4          Vertical integration

 

Effective vertical integration links central government policies with local services, with clear lines of responsibility and effective two-way communications.

While integration initiatives can be triggered at any level, from local community programme to President’s office, large-scale systemic change generally requires central government engagement and coordinated delivery systems. A national ECD policy is crucial in making goals, objectives and strategies visible, with the responsibilities of different actors or agencies clearly identified and financial, human, and material resources allocated. Having clear policy is necessary… but it is not sufficient.

Given typical ambiguities surrounding ministerial responsibilities and bureaucracies surrounding implementation, identifying a lead ministry or agency (and in practice an influential and charismatic leader) may be the best way forward. With political will to drive forward both horizontal and vertical coordination, and clarify the roles of agencies at national regional and local levels. A review of laws and regulations is also important, given the multiple areas of government that affect young children both directly and indirectly (Neumann and Devercelli, 2012).

The World Bank Systems Approach for Better Education Results (SABER) initiative reviews many of these issues, and offers case studies of how sectoral coordination is achieved in Jamaica, Chile and Tanzania. Figure 15 is an example for Tanzania, based on policy drafted in 2010.

ECD national coordination plan for Tanzania diagram
Figure 15: ECD national coordination plan for Tanzania
(Source: World Bank (2013). What Matters Most for Early Childhood Development: a Framework Paper, p. 27.)

7.5          Integration at all levels of governance

 

Vertical integration includes middle level governance and finance streams which can be a barrier to effective reform.

A study of ECD governance in four low- and middle-income countries (Britto et al., 2014) reports examples of strong coordination being achieved at national level in terms of multi-sectoral policy planning and coordination; and at local level, where for example, village councils made decisions about range of local services. But they note that the weakest area of governance was often at the middle level where within-sector vertical compliance was often a major preoccupation: “…the rhetoric of integration in the national policies did not appear to translate into integrated or even multi-sectoral governance functions…” (Britto et al., 2014). Some of the recognised weaknesses of the ICDS in India are about governance and finance weaknesses at state level, in the local delivery of a national programme (Case Study 1 in Section 2).

7.6          Effective coordination beyond public services

 

Effective coordination extends to non-state actors, the private sector, NGOs, community groups, etc.

Concerns about integration frequently begin and end with the state sector, overlooking the significant (and in many regions growing) importance of non-state actors (private-for-profit, NGOs, community-based services). All too often these services are outside effective governance systems, or weakly regulated, with the extent of integration highly variable between countries (Woodhead and Streuli, 2013). Besides effective regulative systems, integration can be promoted by including networks of non-state actors on National and local coordination groups, along with key government officials (World Bank, 2013).

7.7          Inclusive and equitable

 

Integrated ECD systems are inclusive, with careful monitoring for equity, and especially targeted to the most marginalised, disadvantaged as well as disabled children.

As already noted, in many countries, ECD policies are not fully articulated, and even less implemented, services are not universally accessible, nor are they adequately monitored and regulated. The evidence that ECD programmes can transform opportunities and outcomes for disadvantaged children is one of the major arguments for investment in early childhood (Siraj-Blatchford and Woodhead, 2009). Yet, access data for early childhood care and education (ECCE) programmes by socio-economic groups (Figure 16) highlights the serious equity challenge, which in some countries, is also linked to gender, ethnicity and disability (see also Section 5.5). Ironically, unless very carefully targeted, one of the risks of investing in high quality integrated ECD programmes is that resources will be diverted to support ‘gold standard’ provision, most often in urban centres, further skewing access away from those most in need. UNESCO (2014, p. 49, Figure 1.1.3) also has more recent data on the equity challenge.

Poverty and inequality of access to ECCE programmes chart
Figure 16: Poverty and inequality of access to ECCE programmes
(Source: UNICEF Multi Indicator Cluster Survey (2005). 3&4 year old preschool attendance x poverty quintiles, cited in Engle et al. (2011).

7.8          Continuity across age phases

 

Integrated ECD is about ensuring continuity between age phases and smooth transitions between age-linked services.

A holistic child-focused framework is sensitive to the discontinuities that are linked to key transitions (Vogler et al., 2008). These begin with the earliest phases of the life course, notably: the young mother becoming pregnant, preparing for the birth, giving birth, beginning breastfeeding, early care routines, etc.; and in turn, the infant engaging with their environment, establishing key attachment relationships, experiencing vaccinations, attending an ECCE programme, making the transition to school, etc. A combination of developmental priorities and sectoral traditions means that different programmes, professionals and associated ministries are more prominent at each age phase, notably health services dominating the earliest period and education services increasingly significant later. For parents and children, these transitions can seem abrupt and even stressful, and can be smoothed as part of an effective coordination strategy. Greatest attention has been given to successive educational transitions into preschool and into school (Kagan and Tarrant, 2010).

Integrated ECD identifies entry points for strengthening early learning within health services, and health interventions within school systems, as illustrated by previous sections on specific age phases.

7.9          Capacity building

 

Building capacity is a priority at every level. Training of sector specialists remains a priority, but with a shared vision for integrated ECD.

One of the biggest obstacles to progress across the whole field of early childhood is the skill shortage at every level, including sectoral experts. In a thought-provoking essay, van Ravens (forthcoming) makes two important points. Firstly, cross-disciplinary working is not an alternative to specialist skills:

In many sectors of the economy – not just in ECD – we can find both specialists and all-round workers. But if we need a carpenter and a mason, we probably prefer to hire one of each above hiring one person who claims to be excellent in carpentry and masonry at the same time. Mastery of a craft requires intensive learning before and on the job, so the specialist will generally deliver higher quality than someone who does a little bit of all. The single carpenter and the single mason may have to cooperate with each other, but that should be no problem if they are sensible people. People and organisations that deliver integrated ECD programs – encompassing multiple disciplines – can never deliver the same quality as specialists(van Ravens, forthcoming)

Secondly, one of the consequences of capacity shortages in a low-resource setting is that training programmes typically take recruits with low educational levels, and offer only a very brief training, measured in days and weeks, not years. Faced with this reality, van Ravens (forthcoming) questions whether it may be preferable to train indepth for specific skills, rather than offer very general and superficial training that in practice prepares trainees to deliver relatively little.

Building specific ECD expertise is essential, but wider capacity building is also needed, including of those with responsibility for driving forward ministerial and municipal change, including politicians, civil servants and the research community. Building understanding of ECD amongst parents, communities and civil society is also part of the process of engineering systemic change in the best interests of all young children. Harnessing the resources and influence of the media and advocacy groups, using social media and other new technologies, is all part of the process of building a well informed movement for better understanding about ECD.

7.10        Pragmatic, innovative and sustainable

 

Implementing more integrated ECD involves being context sensitive, pragmatic and innovative, as well as working in partnership with other stakeholders, including families and communities as well as children.

There is a risk that the current enthusiasm for holistic integrated ECD initiatives could overwhelm initiatives with modest resources or sideline well proven sectoral programmes. Equally, centrally driven system reform can risk overlooking local, practical entry points and cost-effective delivery platforms that build on informal community systems.

There is now a good deal of pressure on governments to take a holistic approach. And while the overall frameworks should indeed be looking at the whole child, international agencies might do better to acknowledge that ministries ARE sectoral. There has perhaps been too much pressure for ECCD projects at the level of implementation (and especially the ECCD centres) to do everything. … Policy and programme decisions need to be made in collaboration with families and communities in order to be relevant, affordable, and jointly owned. The good intentions of government as they expand services are laudable and should be acknowledged. However, government cannot do it all. Family and community members are also duty bearers and offer indispensable and complementary contributions towards realising a government’s desire to ensure a good start for all children.

Well governed, well resourced, evidence-based, fully implemented, fully integrated ECD services are a distant goal for many countries. But along the way, many low cost ‘quick-wins’ may be possible, achieved by looking creatively at ways to harness resources of one sector to achieve goals of another, provide supplementary training of sector specialists, ‘piggy-back’ specific innovations within large well established programmes, and build on the capacities for supporting ECD within communities and nations. There is also a risk that over-governed, centralised systems could stifle community-based initiative and innovation which are a hallmark of ECD. Amongst various stakeholders, children themselves also have a role to play in the planning of their learning environment (Clark, 2010). Finally, ECD solutions may involve looking beyond conventional delivery platforms, as illustrated by the potential for video and digital technologies to enhance ECD via television, internet and mobile phones (Ba and Bangura, 2011; Blanchard and Moore, 2011; NAEYC, 2012).

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Educational technology /topic/educational-technology/ Mon, 06 Oct 2014 11:47:50 +0000 http://www.heart-resources.org/?post_type=topic&p=24963 Read more]]>
‘At a Glance’ SummaryExecutive Summary1. Introduction2. Methodology3. Findings4. Discussion5. Conclusion and Recommendations

Introduction

This guide aims to contribute to what we know about the relationship between educational technology (edtech) and educational outcomes by addressing the following overarching question:

What is the evidence that the use of edtech, by teachers or students, impacts teaching and learning practices, or learning outcomes?

It also offers recommendations to support advisors to strengthen the design, implementation and evaluation of programmes that use edtech.

We define edtech as the use of digital or electronic technologies and materials to support teaching and learning. Recognising that technology alone does not enhance learning, evaluations must also consider how programmes are designed and implemented, how teachers are supported, how communities are developed and how outcomes are measured  (see http://tel.ac.uk/about-3/, 2014).

Findings

Effective edtech programmes are characterized by:

  • a clear and specific curriculum focus
  • the use of relevant curriculum materials
  • a focus on teacher development and pedagogy
  • evaluation mechanisms that go beyond outputs.

These findings come from a wide range of technology use including:

  • interactive radio instruction (IRI)
  • classroom audio or video resources accessed via teachers’ mobile phones
  • student tablets and eReaders
  • computer-assisted learning (CAL) to supplement classroom teaching.

However, there are also examples of large-scale investment in edtech – particularly computers for student use – that produce limited educational outcomes. We need to know more about:

  • how to support teachers to develop appropriate, relevant practices using edtech
  • how such practices are enacted in schools, and what factors contribute to or mitigate against successful outcomes.

Recommendations

  1. Edtech programmes should focus on enabling educational change, not delivering technology. In doing so, programmes should provide adequate support for teachers and aim to capture changes in teaching practice and learning outcomes in evaluation.
  2. Advisors should support proposals that further develop successful practices or that address gaps in evidence and understanding.
  3. Advisors should discourage proposals that have an emphasis on technology over education, weak programmatic support or poor evaluation.
  4. In design and evaluation, value-for-money metrics and cost-effectiveness analyses should be carried out.

Introduction

Purposes of this guide

There is enormous interest and investment in the potential of educational technology (edtech) to improve the quality of teaching and learning in low and lower-middle income countries. The primary aim of this Topic Guide is to contribute to what we know about the relationship between edtech and educational outcomes. Taking evidence from over 80 studies, the guide addresses the overarching question: What is the evidence that the use of edtech, by teachers or students, impacts teaching and learning practices, or learning outcomes? It also offers recommendations to support advisors to strengthen the design, implementation and evaluation of programmes that use edtech.

Methodology

The research involved three distinct stages:

  • an online literature search identifying 83 studies (45 research documents, 20 literature reviews and 18 grey literature reports) on edtech use in schools in select low and lower-middle income countries
  • an appraisal process, against DFID’s agreed criteria (including transparency, rigour, validity), to identify key findings and rate the quality of the evidence
  • a written analysis addressing the overarching and subsidiary research questions.

Definition: What is edtech?

Definitions of edtech are contested and changing, but for the purposes of this guide, and in line with emerging DFID policy, we define edtech as the use of digital or electronic technologies and materials to support teaching and learning. Implicit within this definition is the recognition that:

Technology of itself doesn’t enhance learning! It depends how the technology is designed and implemented; how teachers are supported to use it; how outcomes are measured; what communities are in place to support it.

Findings

Use of edtech among reviewed studies

These findings come from a wide range of technology use including:

  • interactive radio instruction (IRI)
  • classroom audio or video resources accessed via teachers’ mobile phones
  • student tablets and eReaders
  • computer-assisted learning (CAL) to supplement classroom teaching
  • computer suites
  • one laptop per child.


For the purpose of this guide, we distinguish between edtech use by teachers (e.g. IRI, where the teacher uses technology in class) and edtech use by students (e.g. CAL or eReaders, where the students have hands-on access to technology).

Examples of effective edtech programmes

It is now widely acknowledged that while the Millennium Development Goals prompted improvements in access to education, quality remains a challenge. This issue is also reflected in edtech programmes. Reports of programmes that move beyond access to technology (both in programme design and evaluation) are emerging, but as yet relatively few programme evaluations focus on adequately capturing improvements in the teaching and learning process or measuring improvements in learning outcomes. The findings below are drawn from those that do.

The following uses of edtech by teachers were associated with positive changes in learning outcomes and classroom practice:

Interactive radio instruction (IRI). Several studies reported positive impacts on learning outcomes from IRI, particularly with early primary students. A World Bank review showed average effect sizes of +0.5 (World Bank, 2005, p. 16), while a subsequent review found effect sizes ranging from -0.16 to +2.19 (Ho & Thrukal, 2009). The variability in effectiveness was attributed to factors including quality of programme implementation, monitoring, and local human resources. The greatest effect sizes were seen at Grade 1, suggesting IRI is particularly effective for early primary years.

Improvements in classroom practice from IRI were evidenced by two studies in which IRI was used in the context of teacher professional development. Sous le Fromager in Guinea supplemented IRI with radio programmes for school staff and face-to-face professional development to instill respectful behaviour of teachers towards students. Qualitative classroom observations suggest teachers hit students less often and allowed more time for students to develop understanding (Burns, 2006, p. 9). Similarly, an IRI programme in Mali supplemented IRI with radio-based, in-service training. Systematic classroom observations showed year-on-year improvements in the percentage of observed lessons demonstrating select classroom practices (e.g. brainstorming, group work, total physical response) (Ho & Thrukal, 2009, p. 10).

Mobiles for classroom audio and teacher development videos. Several studies arising from one programme (English in Action [EIA], Bangladesh) reported positive impacts from mobile use on English language teaching (ELT) practices and student learning outcomes. EIA is primarily a teacher development (TD) programme. The approach has some similarities to IRI, in that mobile phones provide access to audio resources for classroom use, particularly for primary teachers. Mobiles are also used to provide access to TD materials, including videos of classroom practice, which underpin the programme. Materials are not broadcast, or downloaded, but provided as a library of digital resources, on a small memory card.

Several large-scale systematic observations of classroom practice (EIA, 2011b, 2012b, 2014b) showed significant increases in students’ talk time (including talk in pairs and groups), and students’ and teachers’ use of English (the target language), compared with baseline studies (EIA, 2009). Associated improvements in student learning outcomes were also evidenced, most recently with 35% more primary students achieving Grade 1 or above, and 20% more primary achieving Grade 2 or above, on recognized international frameworks of English language competence (Graded Examinations in Spoken English (GESE), Trinity College London, 2013, which map onto the Common European Framework of Reference, Trinity College London, 2007, EIA, 2014b).

Mobiles for classroom video. The BridgeIT programme (India and Tanzania) provided evidence of improved learning outcomes from teachers’ use of smartphones to play video lessons for their classes via flat-screen TVs or data-projectors. Teachers also had activity guides to support or extend the video lessons. In Tanzania, students showed average gains of 10–20% over control groups for maths and science. However, while some groups of students excelled, others showed modest gains if any (Enge, 2011). In India, there were average gains of 10% over control groups for science, but no gains for English (Wennerstan & Qureshy, 2012). BridgeIT also carried out systematic classroom observations pre- and post-intervention in India. These showed a 31% increase in the proportion of lessons identified as ‘high quality’, with a corresponding 24% drop in the proportion of (traditional) ‘direct instruction’ lessons (Wennerstan & Qureshy, 2012, p. 32).

Among the studies reviewed, the strongest evidence of changes in learning outcomes and classroom practice came from the use of mobile devices (such as eReaders) and CAL programmes to support improvement in mathematics:

eReaders and tablets to support early literacy. Several programmes presented evidence of improved learning outcomes (in terms of increased reading fluency in the mother tongue or English) that combined provision of eReaders and eBooks for students with TD programmes on phonics-based literacy instruction (Worldreader, 2012, 2013; Murz, 2011; Piper & Kwayumba, 2014).

Remedial CAL programmes in mathematics. Although CAL programmes in maths as a replacement for regular teaching were found to have limited impact (Banerjee et al., 2007, p. 1,240) or lower learning outcomes (Linden, 2008, p. 26), there is some evidence of improved learning outcomes from remedial CAL programmes as supplements for under-privileged students (Banerjee et al., 2007, p. 1,238) or under-performing students (Lai et al., 2011).

In addition, several studies presented evidence of students working more independently and collaboratively using online or offline digital resources to support project work. This was usually in the context of a teacher development programme, with clear curricular and pedagogic focus (for example: Light, 2009; Were et al., 2009; Leach et al., 2005). In two studies, students expressed a view that group work was better than individual work with a computer, as peer learning was valued. Young students suggested an optimum group size of three, four (Haßler,et al., 2011, p. 42) or five (Leach, 2008, p. 20).

The effective edtech programmes described above are characterized by:

  • a clear and specific curriculum focus (e.g. communicative language learning, early literacy or remedial mathematics)
  • the use of relevant curriculum materials (classroom audio, video, eBooks, research resources, radio programmes)
  • a focus on teacher development and pedagogy
  • evaluation mechanisms that go beyond outputs to look at outcomes in terms of changes in teaching and learning practices, or learning outcomes.

Finally, while value for money (VFM) analysis is non-existent in most studies, the PRIMR study stands out for its strong focus on cost-effectiveness. The programme in Kenya implemented and compared the effectiveness of three different interventions – tablets for tutors (teacher educators), tablets for teachers, and eReaders for students. Similar gains in student learning outcomes were shown for all three treatments, with no statistically significant difference between treatment groups (Piper & Kwayumba, 2014, p. 2). Further analysis showed that while the outcomes were similar, the costs for teacher or tutor tablets were much lower than for class sets of eReaders, making the cost-effectiveness of teacher or tutor tablets approximately an order of magnitude greater (Piper & Kwayumba, 2014, p. 3).

Examples of less effective uses of edtech 

Among the studies reviewed, 21 reported on students’ use of computers, but very few of these presented evidence of measurable improvements in learning outcomes. Three that did were CAL programmes in maths, as discussed above.

Several studies showed that increasing students’ access to computers of itself has little discernable impact on teaching or learning practices. For example:

  • computers are often not used for teaching and learning purposes’ (EdQual, 2011, p. 3)
  • while 98% of publicly supported schools in Chile have increased access, ‘ICT is not frequently used at school’ (Hinostroza et al., 2011, p. 1,360)
  • although NEPAD provided schools with 20 suites of desktop computers, satellite connectivity, wireless networks, smartboards, and health software, ‘teachers are not in general using the Healthpoint software for purposes of health promotion’ (Rubagiza et al., 2011, p. 42)
  • in Myanmar, 33,497 schools were provided with ICT facilities in 2009, but evaluation showed ‘the frequency of use of ICT for teaching and learning was considered to be very low’ (UNESCO, 2013a, p. 45)
  • despite increasing student-computer ratios in Peru, the One Laptop per Child (OLPC) programme ‘did not seem to have affected the quality of instruction in the class…a substantial share of laptop use was directed to activities that might have little effect on educational outcomes’ (Cristia et al., 2012, p. 3).

These examples illustrate that even the most substantial investment in edtech can have limited impact. A common explanation for this is that:

“Provision of ICT in schools is only the first step. For ICTs to become a tool for improving teaching and learning…they need to be supplemented by teacher professional development.” (EdQual, 2011, p. 12)

There is scant evidence of this being done successfully (for example: Light, 2009; Were et al., 2009; Leach et al., 2005). More broadly, across the studies reviewed, detailed accounts of how edtech is used in classrooms are very rare. Relatively few studies examine classroom practice beyond teacher self-reporting.

Recommendations

Edtech programmes should:

  • be designed to focus on enabling educational change, with an emphasis on curriculum, pedagogy, teaching and learning, not on the technology
  • provide adequate programmatic support to enable implementation of change in classrooms and schools (see for example, Westbrook et al., 2013)
  • develop systematic monitoring and evaluation procedures, that capture changes in teaching and learning practices and learning outcomes, as well as participants’ experiences and perspectives.

Advisors should encourage the development of proposals that:

  • further explore and develop practices for which there is evidence of a positive impact on teaching and learning (see Examples of effective edtech programmes)
  • address gaps in evidence including:
    • effective approaches to teacher development that enable improved teaching and learning practices with edtech;
    • understanding how such practices are enacted, and in what contexts, at school and classroom level.

Advisors should discourage the development of proposals that have an emphasis on technology over education, that have weak programmatic support or poor evaluation.

Before the design stage, the costs of programme inputs should be estimated, key cost drivers analysed and forecast, value-for-money metrics developed, and a cost-effectiveness analysis (Economy, Efficiency and Effectiveness) carried out.

Checklist for reviewing edtech programmes or proposals

Conceptual clarity

Programmes should have a design focused on enabling educational change, with an emphasis on curriculum, pedagogy, teaching and learning, not technology.

Does the programme including the use of technology have clearly articulated educational outcomes?
Does the theory of change explain how the outputs (of technology, materials, training and so on) will contribute to improved educational outcomes?
Is the programme design, including the use of technology, supported by credible theories of student learning and teacher development?
How well does the functionality of the planned technology fit with the desired teacher development and curriculum practices it is intended to support?
How appropriate is the technology to the context? (Consider requirements of infrastructure, technical support, technical training, cost, durability, retrofitting etc.)
Are there alternative technologies (or non-technological approaches) that might be more effective, more cost-effective or more appropriate to context?

Programmatic support

Programmes should provide adequate support, to enable implementation of change in classrooms and schools.

Is the programme design including the use of technology likely to deliver the desired educational outcomes?
Is there a reasonably even balance between a) technology b) materials for classroom and teacher development use c) support to teachers and schools, and d) monitoring and evaluation, reflected in programme activities and budgets?
Do plans for teacher development and support focus primarily on curriculum and pedagogy, not technology (e.g. ‘pedagogy first’ principle for edtech (UNESCO, 2013c, p.13))?
Do plans for teacher development and support align with known best practices (e.g. Westbrook et al., 2013)?
  • Is professional development aligned with classroom practice?
  • Is follow-up support and monitoring adequate (in service training), after initial training (pre-service training)?
  • Are there formal and informal mechanisms for teacher peer support?
  • Are there mechanisms for engaging support of headteachers, school management committees, local education officers and wider school communities?

Research, monitoring and evaluation

Systematic monitoring and evaluation procedures should capture changes in teaching and learning practices and learning outcomes, and participants’ experiences and perspectives.

Does programme research deepen understanding of what happens in classrooms and schools, participants’ experiences or relevant contexts?
Does programme monitoring track implementation of new activities and/or technology use in classroom practice?
Does programme evaluation move beyond outputs and access to technology?
Does programme evaluation evidence changes in teaching practice or learning outcomes?

Value for money (VFM)

Before the design stage, the costs of programme inputs should be estimated, key cost drivers analysed and forecast, and VFM metrics developed.

Are key cost drivers understood?
Are VFM metrics in place?
Are Economy, Efficiency and Effectiveness analysed?
Given expected or probable learning outcomes, does the programme offer VFM?

1.1 What is edtech?

Definitions of educational technology (edtech), or the use of technology for educational purposes, are contested, and have changed frequently over the last 40 years or more. Typically, current definitions go beyond merely defining what is meant by ‘technology’, but include reference to educational purposes and practices. For example:

Educational technology is the study and ethical practice of facilitating learning and improving performance by creating, using and managing appropriate technological processes and resources.
A historical review of the literature on educational technology reveals that the definition of technology use varies widely across research studies…Too often, however, studies focus on technology access instead of measuring the myriad ways that technology is being used. Such research assumes that teachers’ and students’ access to technology is an adequate proxy for the use of technology.
Technology Enhanced Learning (TEL) research aims to improve the quality of formal and informal learning…Technology of itself doesn’t enhance learning! It depends how the technology is designed and implemented; how teachers are supported to use it; how outcomes are measured; what communities are in place to support it. 

For the purposes of this guide and in line with emerging DFID policy, we define edtech to be the use of digital or electronic technologies and materials to support teaching and learning. As such, edtech does not refer simply to hardware (radio, TV, mobile phones, computers, and tablets) or software (applications and learning resources). Rather, the definition encompasses an understanding of the technologies as tools, used by communities, in the social practices of teaching and learning, directed towards educational goals.

1.2 Research questions

These issues led the authors to focus their research on the following key questions:

  • What is the evidence that the use of edtech byteachers impacts teaching practice or learning outcomes?
  • What is the evidence that the use of edtech by students impacts teaching and learning practices or student learning outcomes?

Two other areas of evidence were also considered (but as these relate to an emerging field, there was not sufficient literature to include these as full research questions):

  • Is there any evidence that the use of edtech in schools represents value for money?
  • What are the enabling factors that inhibit or support integration of edtech?

1.3 How is edtech used?

There is a broad range of different ways that edtech can be used in schools. The studies reviewed included the following ways:

  • interactive radio instruction (IRI)
  • classroom audio or video resources accessed via teachers’ mobile phones
  • student tablets and eReaders
  • computer-assisted learning (CAL) to supplement classroom teaching
  • computer suites
  • one laptop per child.

For the purpose of this guide, we distinguish between edtech use by teachers (e.g. IRI, where the teacher uses technology in class) and edtech use by students (e.g. CAL or eReaders, where the students have hands-on access to technology).

1.4 Policy background: a shift from access to quality

Historically, programmes that incorporate edtech have focused on the distribution of hardware and programme evaluations have measured the number of devices in the hands of teachers or students. This approach is very limited. It fails to measure to the extent to which edtech has changed the process of teaching and learning, or the impact on learning outcomes, and thus prevents decision-makers evaluating the effectiveness and cost-effectiveness of edtech.

Programmes that move beyond access to hardware both in programme design and evaluation are still relatively rare. Equally, few programme evaluations focus on capturing improvements in the teaching and learning process or measuring improvements in learning outcomes.

This may be partly because measuring the impact of edtech is complicated by many contextual factors, such as access to appropriate infrastructure or local socio-cultural dynamics. It may also be because the role of edtech in many programmes is to supplement teaching and so isolating its impact can be a challenge. It is necessary to change the nature of learning activity, and the pedagogy, if you are to introduce edtech meaningfully.

The effective use of any learning technology is bound up in pedagogy, curriculum, purpose, roles and activities. If new technologies are introduced without changing any of the other aspects, nothing different is happening.

While most of the studies appraised for this paper did not present evidence of impact of edtech on learning outcomes, those that did often painted a much broader picture of how edtech was integrated into the programme design and the success of doing so. It may well be that programmes that have clearly thought through how edtech will support and change teaching and learning will find it easiest to design evaluations that will show whether such changes are taking place.

2.1 Literature search

A clear methodology was planned for this Topic Guide, beginning with searching the literature using electronic databases, key journals, websites, reference lists and advice from key contacts. Sources included: 3ie Systematic Review Database, 3ie database of impact evaluations, Google Scholar, World Bank IEG, The Campbell Library, Centre for Education Innovations, R4D and documents provided by DFID advisers, members of HEART and academic leads.

A two-stage process followed: firstly a screening and coding of studies according to four thematic questions identified by the authors, which were then analysed and narrowed down to two key research questions, and two sub-questions; secondly a screening and rating of studies for critical appraisal of the quality of the evidence.

2.2 Screening and coding of studies

Inclusion criteria were first applied to screen out the studies that did not contribute sufficiently to answering the thematic questions. Papers meeting the criteria were read and stratified by question and, for each, titles, weblinks and abstracts were collated.

An extensive data extraction process was then followed to draw out the key data in each paper. Some documents were relevant to more than one thematic question; these were cross-referenced for ease of navigation through the document.

The authors then analysed these tables and once they had an overview of the evidence available, narrowed the focus to the key questions and sub-questions outlined in 1.2 Research questions.

2.3 Screening and rating of studies for critical appraisal

Research papers that met further inclusion criteria (relating to relevance and clarity of reporting) were then selected for critical appraisal by a team of experts and research officers working in the field of education. Both quantitative and qualitative research methods were considered. The studies were rated for the evidence they provided on a number of principles of quality: conceptual framing, openness and transparency, appropriateness and rigour, validity, reliability, cogency, overall key findings and relation to thematic questions.

As this guide is evidence focused, information from a number of source types was appraised, including programme evaluation reports, peer-reviewed published academic papers, internet reports and other grey literature. Information from literature reviews was included in the text of the guide, however these documents were not critically appraised, as this would have resulted in an appraisal of the reviews’ methodology rather than an appraisal of the programmes mentioned in the review. Additionally, some grey literature was not suitable for appraisal but the key findings were drawn out during the data extraction stage.

3.1 Use of edtech by teachers

What is the evidence that the use of edtech by teachers impacts teaching practice or learning outcomes?

 3.1.1 Introduction

This section looks at the evidence of changes in classroom practice or improved learning outcomes as a result of edtech use by teachers.

Among the 45 research studies reviewed, 15 referred to use of edtech by teachers. Among these, three forms predominated:

  • interactive radio instruction (IRI)
  • video materials (displayed on a large screen monitor, for viewing by the whole class), or audio materials (played on a rechargeable speaker, for listening by the whole class), played from the teacher’s mobile phone
  • teacher development (TD) materials and activities (online and/or offline, print and/or audio-visual), related to curriculum and pedagogy, sometimes including how to use edtech for curriculum purposes.

Of these, IRI was by far the most common form of edtech use by teachers in the studies reviewed. This is in part because IRI is a well-established, low-cost, large-scale approach, with a much longer history than, for example, the use of mobile phones. Although IRI could be considered old technology, the simple fact of it being around for so long means that it has the greatest amount of evidence and evaluations available.

The video lessons evidence all comes from evaluations of BridgeIT projects, though in two different programme contexts (Tanzania and India).

The evidence around the use of edtech for teachers’ continuing professional development (CPD) is illustrated by studies from Sub-Saharan Africa (TESSA), and South Asia (EIA). In the TESSA study, the teachers’ CPD programme included use of open educational resource (OER) materials. In EIA, the teachers’ CPD programme included structured, peer-supported use of offline teacher development videos, and also use of offline audio resources in class (in a manner similar to IRI) via media players. In the eGranary programme, teacher educators in a primary teacher-training college in Uganda accessed offline copies of internet resources (either on a dedicated server or a memory stick) to use with student teachers.

3.1.2 Evidence of changes in classroom practice

When teachers use technology, they are well placed to positively impact classroom practice. Changes in teaching and learning practices are usually described by teachers’ testimonies from interviews or focus groups (although there are few detailed accounts of the nature of these changes). Evidence indicates that teachers use edtech for a number of purposes and with a variety of results.

Access to resources

In the eGranary report, teacher educators positively recount their experiences of being able to access new teaching resources from their offline repository, with the implication that these are used in practice:

My participation in the use of ICT has changed my attitude and ways of teaching language. I realised that I don’t need to go to the library to read each day and every book related to a topic which may not even be there, but there is a simple and quick way of getting the ‘wanted’ information on the net.

Improving lesson delivery

A study performed by Egerton University in Kenya about the use of TESSA OERs to promote changes in teacher pedagogy found that headteachers perceived improving pedagogy, increased student motivation, and the creation of good learning environments, which they attributed to teachers’ use of the TESSA OERS in their CPD (Cullen et al., 2012).  Headteachers were asked an open question about whether learning had improved: all those surveyed reported improved lesson delivery by teachers and 8 out of 11 reported that students’ mean scores increased. However, while headteachers reported these changes – and valued them highly – no hard supporting evidence was given.

Using technology in a disability-specific programme

The evaluation of the USAID Tikwere IRI programme in Malawi reported positive impacts on classroom dynamics among blind children. The qualitative evidence reports that a small class of 17 blind or visually impaired students sat quietly waiting for the Tikwere lesson to begin; students then noticeably brightened and engaged in a very lively lesson, led by a capable teacher using the Tikwere radio broadcast and accompanying materials in Braille (Method et al., 2009).

Although the programme did not survey student perceptions of the programme, the results demonstrate that certain types of technology can be incorporated into a disability-specific programme without huge changes to the overall programme design, to bring significant changes in practice. This study also illustrates the value of direct field observations of practice, to validate teachers’ accounts.

Improve classroom management and more active learning strategies

Another IRI and TD programme, the Fundamental Quality in Education Level programme, includes a number of interventions – classroom-based IRI (Sous le Fromager), a radio programme aimed at teachers, principals and other staff (Pas à Pas) and face-to-face professional development sessions integrating audio-taped recordings of Pas à Pas. The IRI broadcasts were specifically designed to instil respect towards students in teachers and qualitative observations showed that teachers hit students less often for incorrect answers after their introduction. Following the programme, it was considered that teachers took a more developmental approach to learning, with field staff reporting more active learning strategies and a move away from transmissive approaches (Burns, 2006, p. 9).

Improved classroom practice and continuous professional development (CPD)

Looking at three programmes, quantitative observations of improvements in practice were reported, most notably through programmes that combine media for classroom practice, with teacher professional development. These include IRI in Mali, the BridgeIT video lessons in India, and classroom audio and teacher video in the English in Action (EIA) programme, Bangladesh.

First, the following was reported as evidence of impact when using IRI in Mali:

In Mali, teacher training was introduced via IRI as a delivery mechanism built to overcome long distances, reaching educators at the school and classroom level. Radio-based in-service training complemented school-based ‘communities of learning’ and face-to-face trainings…Results from teacher observations indicate real improvements in instructional practice over the course of the project…Each evaluation shows steady gains in teachers’ familiarity with, and use of, all key techniques emphasized by the program.

Second, BridgeIT was implemented in India as part of the Nokia Education Delivery system, aimed at improving both teaching practice and educational outcomes. Selected English and maths teachers were given a mobile telephone and a TV cable. The phones were connected to a TV or projector, and educational videos were broadcast over the 3G network. Activity guides suggesting teaching strategies accompanied the videos. Observed lessons were rated as ‘high quality’ or ‘direct instruction’ (didactic teacher-led practice). Before the intervention, almost three-quarters (74%) of lessons observed were categorised as ‘direct instruction’, whereas after the intervention almost three-quarters (74%) of lessons were rated as ‘high quality’ – an increase of 31% from the baseline (some lessons were rated as being both ‘high quality’ and ‘direct instruction’ in both sets of observations).

Third, EIA is a professional development programme for English language teachers in Bangladesh, which focuses on using audio-visual materials and peer support to improve teaching. The EIA pilot programme, which ran with 600 teachers from 300 schools, specifically assessed whether there were changes to students’ learning processes that could be attributed to the intervention, which consisted of professional development videos, activities for teachers and audio resources (all available offline), along with other learning materials to be used as part of interactive lessons.

The EIA programme pilot study (Walsh et al., 2013) reports teachers’ views on changes in practice, but – unusually among the studies reviewed – these are also triangulated against students’ views (EIA, 2011a). Further, the evaluations also report large-scale, systematic observation of objective features of practice (timed observations of student-talk time, teacher and student use of English, the target language) and instances of classroom organisation for pair and group work (EIA, 2012b).

Teachers indicated that the programme was very effective in changing the learning processes of the students. They considered that the students were more motivated and engaged in the lessons, and concentrated more on what was being taught:

Before engagement with EIA, it was hard to keep my students’ concentration for the whole class. Now they request me to take the English class for more time.

3.1.3 Evidence of changes in learning outcomes

Although there is some hard evidence of improved learning outcomes from video lessons (Enge et al., 2011) and programmes where edtech is used for CPD and classroom use (EIA), there are relatively few programmes that specifically set out to gather this evidence and most of the evidence found comes from IRI programmes.

IRI programmes

Many IRI programmes that have measured student learning outcomes have compared the effectiveness of IRI between out-of-school learners using IRI to in-school learners without IRI: in other words, looking at IRI as an alternative to school, in contexts of chronic shortages of teachers or schools. Comparatively few programmes have measured learning outcomes associated with IRI for in-school learners. Additionally, IRI has often been implemented as part of a wider set of educational interventions, making independent assessment of its effectiveness difficult (World Bank, 2005).

Where IRI has been assessed, students in IRI classes outperform students in control groups with an average effect size of 0.5 standard deviations.

Post test data on achievement of students in selected IRI projects
Post-test data on achievement of students in selected IRI programmes conducted in the early to mid–1990s in six countries. Source: World Bank, 2005, p. 16

A more recent review, with a strong methodology, looked at 37 IRI programmes. The review found average effect sizes ranged from -0.16 to +2.19 across a variety of subject areas, projects and countries, suggesting that several factors (including availability of qualified local resources, quality of project implementation and monitoring, and extent to which students participate) affect the degree to which IRI can improve student achievement (Ho & Thrukal, 2009). Mathematics effect sizes were measured in Zambia, Sudan and Haiti, and local language literacy was measured in Zambia, Sudan, Somalia and Haiti; in both measurements the greatest effect size was seen at Grade 1, which was attributed to the effectiveness of IRI for this grade level.

Finally, there is some evidence that IRI can help to reach more disadvantaged students. Firstly, historical data indicated that IRI can be a mechanism for narrowing gender-based achievement gaps (World Bank, 2005), although more recent data (e.g. Ho & Thrukal, 2009) appeared mixed. Secondly, analyses of student assessment results revealed that rural IRI students enjoy approximately the same boost in achievement over their non-IRI peers as do urban IRI learners. This was particularly the case in Pakistan, where results for English Grades 1 and 2 showed significant large effect sizes for isolated students (Ho & Thrukal, 2009). Thirdly, there is also some limited evidence that IRI improves student learning outcomes in the context of fragile states, such as Sudan and Somalia: students who participated in IRI classes had a distinct advantage over their non-IRI peers, and this advantage was consistent across subjects (Ho & Thrukal, 2009).

Other forms of edtech

As well as IRI, there is also emerging quantitative evidence of impact on student learning outcomes from video lessons and mobile-enhanced CPD with classroom audio.

Test scores of students in BridgeIT and BridgeIT+LifeSkills in both maths and science showed significant gains during the 2010 academic year in comparison to those of students who did not benefit from BridgeIT. On average, test scores for students in BridgeIT schools were 10–20% higher. However, analysis shows that these increases were due to groups of students who excelled, while others showed more modest or no gains. Students in the BridgeIT schools with the added Life Skills curriculum performed the best academically (Enge, 2011).

These results show again that edtech works best within the context of a wider programmatic and pedagogic context. They also show the challenges of data collection and analysis to evaluate the success of edtech programmes, given the natural variation within study populations.

BridgeIT in India gave teachers in the programme access to educational videos and an activity guide. The impact assessment found statistically significant improvements (10%) over control groups in science, although there was no statistically significant impact on English test scores (Wennerstan & Qureshy, 2012).

In Bangladesh, where teachers were also provided with SIM cards, classroom media, activity guides and regular follow-on support, EIA found improvements in students’ spoken English language competence. 50% of primary students achieved a Grade 1 or above in 2011 (compared to just 35% in 2010); for secondary students, 90% achieved a Grade 1 or above in 2011 (compared to 75% in 2010) and an improvement was found across all grades compared to those achieved in 2010. These improvements were found to be statistically significant for both groups (EIA, 2012c).

Finally, the Primary Math and Reading Initiative (PRIMR) in Kenya, explored the use of teacher tablets (preloaded with enhanced teachers’ guides, instructional materials such as flashcards, other literacy materials, and the Tangerine:Class continuous assessment software), in 20 schools. This was compared to other interventions (using tablets for tutors (teacher educators) only, and eReaders for students only). Baseline and endline Early Grade Reading Assessments (EGRAs) in Class 2 were carried out with samples of 20 students (10 boys and 10 girls) from each class, giving a sample size of over 1,500 students. The results showed statistically significant gains in learning outcomes over control students, of 0.47 standard deviations, for the use of teacher tablets (Piper & Kwayumba, 2014, p. 2).

3.1.4 Summary

In summary, among examples of edtech used by teachers, there is some evidence that edtech contributes to changes in classroom practice or improves learning outcomes.

Teachers perceive significant changes in practice that they attribute to edtech (eGranary, Tikwere, BridgeIT, EIA, TESSA). However, across studies reviewed, there is an overreliance on teacher self-reporting.

It is perhaps not coincidental that the programmes that have gathered the most systematic evidence of changes in practice (e,g. BridgeIT, EIA) are characterized by the use of audio or video media to support professional development and classroom practice. These programmes, evaluated with medium-to-large scale systematic classroom observations, suggest significant changes in classroom practice, for a majority of teachers observed.

In these studies, the use of edtech by teachers is bound up with curriculum, pedagogic intent and an enabling programmatic context. The technology alone is not a ‘magic bullet’ or a ‘quick fix’, but is rather a tool used both within teacher development and to support improving teaching practice.

Among the examples of edtech used by teachers, there are relatively few accounts of measured changes in student learning outcomes. However, for all three approaches to teachers’ use of edtech identified here, there are examples that provide statistically significant evidence of improvements in student learning outcomes (World Bank, 2005; Ho & Thrukal, 2009; Enge, 2011; EIA, 2012c & 2014c). Of these, EIA might also be seen as an example of statistically significant improvements in student learning outcomes from edtech-enhanced CPD (EIA).

3.2 Use of edtech by students

What is the evidence that the use of edtech by students improves teaching practice or learning outcomes?

 3.2.1 Introduction

This section looks at the evidence of changes in classroom practice or improved learning outcomes as a result of edtech use by students.

In general, among the studies reviewed, there is little conclusive evidence of measurable changes in teaching and learning practices, through students’ use of edtech. Of 45 research documents, 17 (39%) measured learning outcomes in some way. However, changes are generally self-reported by teachers or students, rather than reported by observation or via objective indicators of practice.

There is some indication that where the focus is upon computers and ICT hardware, rather than subject curriculum and pedagogy, this may do little to improve students’ active learning (Rubagiza et al., 2011). When it is poorly introduced it may reinforce existing teacher-centred practices and when teachers are not supported in its use it may simply have no contribution to subject teaching (EdQual, 2011). An additional flaw with this approach is that current policy initiatives appear to be disadvantaging particular groups, such as girls and those living in rural communities.

Engagement with ICT could be reconceptualized as access to the capability of what Jenkins calls ‘participatory culture’, i.e. how ICT can be used ‘‘to enable young people to become full participants in the social, cultural and political future of society’’ (Rubagiza et al., 2011, p. 43).

3.2.2 Evidence of changes in classroom practice

Improved access but limited impact

The NEPAD e-schools Initiative in Rwanda aimed to equip both primary and secondary students with ICT skills. The provision of edtech was extensive and comprehensive, but the effect on teaching and learning practices was negligible. The study found that many teachers couldn’t access the software or had never used it (Rubagiza et al., 2011) and students felt they were not trained in practical use of the equipment.

Similarly, national survey data from Chile showed that the national ICT in education policy (Enlaces) had been very successful in reach (over 98% of the almost 11,000 publicly supported primary and secondary schools had participated by 2009), but found that ‘ICT is not frequently used at schools’ (Hinostroza et al, 2011).

Therefore, when introducing edtech in schools, it is key to plan how it will integrate with pedagogy and the curriculum. Simply providing equipment is not enough to improve teaching.

One Laptop per Child (OLPC) seeks to provide a laptop to every student, preloaded with learning software and materials. The first large-scale study of the effects of OLPC, carried out in primary schools in Peru, found that despite increasing access to computers by an order of magnitude (from 0.12 computers per student, to 1.18 computers per student), and substantial increases in computer use at home and at school, there was little effect on motivation (as indicated by enrolment or attendance), time spent on homework, or student reading habits. Computer logs suggested most computer activities were not directed towards educational outcomes, and a qualitative observation suggested, at best, modest changes in pedagogical practices. This is attributed to a lack of curriculum-related materials and no clear pedagogic guidance for teachers (Cristia et al., 2012, p. 3).

In Rwanda, tens of thousands of laptops had been deployed by 2011, with plans to distribute half a million by 2017 (OLPC, 2011, p. 4). Despite the impressive scale of implementation, a case study from Rwanda provides scant evidence of changes in practice, illustrating just two examples of project-based learning carried outside of the classroom (OLPC, 2011, p. 6).

An absence of curriculum-related materials and inadequate technical and pedagogic support were also identified as key reasons for very low levels of use of computers provided to rural schools, from a survey of over 250 participating science teachers in Namibia (Ngololo et al., 2012, p. 11).

Similarly, the UNESCO review of ICT in Education in selected ASEAN countries highlighted Singapore as ‘a global leader in the use of technology in education’ but presented little evidence of the nature of changes in practice:

…advanced technologies can in fact mask low levels of student comprehension. The numerous projects being piloted for innovative ICT usage in schools would do well to maintain an evaluative focus on learning outcomes.

Strong pedagogy enables more positive outcomes

There is some evidence that positive changes in practice are more likely where there is a strong pedagogical – rather than technological – focus, supported by appropriate teacher development and subject-specific resources. For example, the evaluation of the Intel ‘Teach Essentials’ course in India, Turkey and Chile found that appropriate pedagogical context is key to successful ICT integration (Light, 2009).

Teachers and students spoke positively about three types of new learning activities:

  • project-based work, which gave students a chance to collaborate, use multiple resources, and direct their own learning
  • independent internet research, which gave students autonomy and a chance to develop and share their own perspectives
  • schoolwork that was more relevant to students’ lives outside school, which made learning more meaningful.

Although only based on case studies from six schools, these findings show that it is the changes in lesson structures, learning materials and teaching practices that drove the observed improvement in learning outcomes. Access to the internet was a central part of this, but as an enabling tool or context for the new pedagogic practices.

Similarly, EdQual found some examples of changes in students’ learning activities where ICT was used in support of curriculum-focused activities (particularly in biology and maths). Students noted that they were no longer dependent upon what the teacher knew and told them, but they were able to do their own research and discover new areas beyond what the teacher taught; they also felt computers assisted understanding, accuracy and kept their interest better (Were et al., 2009).

In addition, a small but in-depth study in Zambia aimed to identify how mobile technologies could be used to embed more interactive teaching and learning activities within classroom practice. Much of the evaluation focused upon technical issues, but there were some interesting observations on the classroom use of the various technologies explored:

  • “eBook readers…were not that successful at stimulating interactive activities in class…teachers found it difficult to bring e.g. the WikiReader into the lesson fairly dynamically…the devices can be quite idiosyncratic…the students did not find this easy…
  • The webcams we had hoped to use as document cameras…the concept of using a document camera is fairly extraneous to the current Zambian teaching, so it was hard to introduce this idea…
  • The battery powered [pico] projectors…are not bright enough for use in Zambian classrooms…
  • When children go into the local community with cameras, through which interactive learning becomes visible to the community…the school standing is improved
  • Generally speaking, there appears to be little awareness and experience of the benefit of mobile equipment in Zambian schools. When ICT in schools is discussed, for instance within government or within schools, there is generally a push towards putting equipment into computer rooms. Educationally speaking, we consider this to be outdated…

 (from Haßler et al., 2011)

In the context of a deliberate shift in pedagogy (“In this project, we were concerned with inquiry-based approaches…”), all six teachers were unanimously positive about the way the edtech had facilitated student collaboration and independent work (Haßler et al., 2011).

Finally, in Ghana, the Worldreader programme focused on introducing phonics-based literacy instruction; teachers were given training in this pedagogic approach and students were provided with eReaders. Subsequent teacher focus groups all reported that their students were reading more than they had previously, although they also thought it took a considerable amount of time for students to become proficient with the eReaders.

Another finding was that teachers who regularly used paper textbooks in their classrooms prior to the Worldreader intervention were generally more motivated to learn about and use the eReaders in their classrooms. Teachers who had not used textbooks frequently found it cumbersome to learn the new skills required to operate the eReaders and coach the students to use them.

This suggests that individual teachers’ prior values, attitudes and practices may significantly shape their responses to, and experiences of, edtech programmes.

Student focus groups uncovered additional project results, including increases in the reading of supplementary materials and storybooks, reading outside of school, and reading for pleasure among students at treatment schools. Nearly every Worldreader student interviewed indicated he/she was reading ‘a lot’ more and better at the time of the interview (compared to the start of the school year), whereas the majority of control school students felt they were reading about the same amount and slightly better (Worldreader, 2013, p. 18).

Quality without quantity

In the Digital Education Enhancement Project (DEEP) in Egypt and South Africa, teachers from schools serving disadvantaged communities were provided with a laptop and printer/scanner (shared between a pair of teachers), a handheld ‘pocket-computer’ each, and a digital camera and video camera (shared between several local schools). These were used in the context of professional development and participatory research, with supportive curriculum materials and ongoing peer-support (Leach et al., 2005). The combination of edtech, CPD and support led to significant changes to teaching practice and the nature of students’ learning activities. For example, a majority (77%) of DEEP participants reported that ICT had a ‘high’ impact on their ability to plan lessons. Within classrooms, ICT facilitated collaborative working (74%), presentation of material (54%), independent learning (31%) and new classroom practices (Leach, 2008).

Teachers also reported that having a very limited number of devices – while challenging in one way –actually promoted them to adopt new classroom practices: firstly, because they could not stand at the front and show the whole class something on the small screens of the mobile devices, they had to put the ICTs in the hands of the students; secondly, because only a few students could use the ICTs at a time, they had to adopt approaches where one group would use the mobile technology, but other groups (or the rest of the class) would do other, non-ICT activities, on rotation.

Students also recommended sharing in reasonably large groups, rather than providing edtech for individual or pairs of students:

One pupil commented: ‘…helping each other learn makes it much easier; children only learn from other children’. When asked, ‘what do you think is the ideal computer set up for a class of 40+, supposing there were unlimited resources?’ she replied ‘I would go for a mix. Sometimes what you get from a laptop or handheld is different. If you use all of them together you just come up with something brilliant. One laptop for 5 people…that would be 8 laptops… Questioner: ‘Not two to a laptop or even one per learner?’ ‘No, that would be selfish. And we learn to work together. Because that is what we should be doing, working together.

3.2.3 Evidence of changes in learning outcomes

In general, there is sparse evidence to indicate measurable changes in learning outcomes. Among the 45 research studies reviewed, only a few found hard empirical evidence of learning outcomes from students’ use of edtech. The strongest of these related to students using mobile devices (TeacherMates or eReaders), in the context of support from teachers who had participated in teacher development programmes, with a strong and very specific pedagogic focus.

One Laptop per Child (OLPC)

The first large-scale RCT of OLPC, evaluated its implementation in Peru (Cristia et al., 2012). As discussed on page 20, despite the lack of evidence of large-scale impacts on learning practices or outcomes, investment in and planned roll-out of OLPC continues at enormous and accelerating pace, for example in Rwanda.

Computer suites

A comparative analysis conducted in Jordan, Oman, Palestine and Qatar found evidence of improvement in learning outcomes associated with use of computers was weak and mixed, and could possibly be attributed to variations in socio-economic status:

Data…demonstrate somewhat higher achievement in science amongst 8th graders who use computers, but not in mathematics. Moreover, no difference was found amongst 4th graders in either subject…It should also be recognized that in the four countries under examination, schools that are well-equipped with ICT also tend to be from regions of a higher socio-economic status (SES). Therefore, unless the effect of SES can be discounted, correlations between availability of technology and learning outcomes should be approached with caution.

Similarly, a Jamaican study into the effectiveness of school improvement plans, in which computers in schools was one of nine interventions implemented in programme schools, found some positive association between computers and student learning outcomes, but again the authors suspected these improvements were due to correlation between computers and another variable (in this case, school leadership), rather than a causal relationship between computers and learning outcomes (Lockheed et al., 2010). In principle, RCTs should account for variations such as socio-economic status, provided enough is known about the variables that need to be controlled.

Using CAL programmes to improve mathematics

An RCT study was carried out on the effects of CAL for improving mathematics in India. The programme was implemented in two forms: as a replacement for regular teaching methods and also as an ‘out of class’ supplement to ‘in school’ lessons (Linden, 2008). The findings showed that when implemented in school, as a replacement for normal lessons, students learned significantly less than they otherwise would have:

Compared to the apparently productive learning experience students encounter in the normal…curriculum, the Computer Assisted Learning program is a poor substitute… students receiving the program performed on average 0.57 standard deviations worse in math than students who did not receive the program.

However, when CAL was implemented outside of school as a supplementary programme, it did report positive gains in the ‘weakest’ students (0.4–0.69 standard deviations).

Strong gains in learning outcomes from supplementary CAL programmes in mathematics were shown from a Pratham-led project in India. In this RCT, Grade 4 students were offered two hours of shared computer time per week, during which they played games that involve solving maths problems.

The computer-assisted learning increased math scores by 0.35 standard deviations the first year, 0.47 the second year, and was equally effective for all students. Such large gains are short-lived, although some effect persists over time…

Lai et al. (2011) also reported mixed findings from a large-scale RCT exploring the effects of CAL for mathematics, with 4,000 third-grade students from Bejing, from 43 schools predominantly serving poor migrant families. The results showed improvements of 0.14 standard deviations from standardized maths scores, but again reported that low-performing students, or those with less-educated parents, showed the biggest improvements.

In summary, there is little evidence that as a replacement for regular teaching CAL is of benefit; indeed, there is some evidence that it may be detrimental. However, there is some evidence that supplemental CAL lessons may improve learning outcomes in mathematics, especially for disadvantaged or underperforming students.

Mobile devices

The TeacherMate Differentiated Instruction System was used in Rwanda by 620 students in Grades 2 and 3. It was developed with a strong phonics component. Students were intended to use TeacherMates for half of each of their regularly scheduled English periods each day (20 minutes). However due to the heavy demands placed on teachers to cover specific material from the national curriculum, students eventually ended up using the TeacherMates for an average of 40 minutes per week plus a total of 10 nights of home use (Murz, 2011, p. 9).

The results showed an average increase of 36% among standardized measures of verbal skills for students using it over the school year. This compared with average increases of 14% in each of two control groups (Murz, 2011, p. 12).

Source: Murz, 2011, p. 11
Source: Murz, 2011, p. 11

The Primary Math and Reading (PRIMR) Initiative in Kenya consists of an RCT of three ICT-based literacy initiatives. The three interventions are:

  • using tablets to bolster the Teachers’ Advisory Centre (TAC) Tutor instructional support system
  • using teacher tablets with classroom pedagogical support
  • using eReaders to help pupils practise literacy.

All three initiatives are supported by PRIMR with provision of books, lesson plans, supplementary readers, and instructional aids alongside teacher training and supervision support.

In terms of oral reading fluency (ORF), evaluations of all three groups showed gains over the baseline, for both English and Kiswahili fluency, with the strongest gains in English:

Gain over baseline in ORF
Gain over baseline in ORF. Source: Piper & Kwayumba, 2014, p. 32.
The ongoing support from the TAC tutors was identified as essential in realizing the potential contribution of edtech in improving literacy and numeracy findings across Kenya. This echoes the findings of Westbrook et al. (2013), which show follow-on support for teacher training, and modelling new classroom practices, to be a key aspect of improving teaching quality.

The Worldreader programme in Ghana also reported learning outcomes for students using eReaders. Each Grade 1–3 student received a reader with approximately 140 books (15% textbooks, 85% age-appropriate storybooks). Students were also supported through extra-curricular activities that focused upon reading. Evaluation was carried out using a quasi-experimental design, with control and experimental groups, and random selection of students. Early Grade Reading Assessments (EGRA) were used as the basis of evaluation.

Improvements in reading scores of primary school students who received eReaders increased by 7.6% in a seven-month period, compared with control classrooms (Worldreader, 2012, p. 5). After one year, students showed substantial gains over control groups, as measured by the English subject examinations. The effects were particularly strong for girls.

eReaders
Source: Worldreader, 2012, p. 8

The gains in mother tongue reading (Akuapem-Twi), in terms of correct words per minute (CWPM), provides a general indicator of progress, with Worldreader students learning to read almost twice as fast as students in the control group (see figure below). The authors attributed these gains to the programme’s focus on teacher training, and the emphasis on Twi phonics within this.

Improvements in average words correctly read per minute, Twi.
Improvements in average words correctly read per minute, Twi. Taken from Worldreader, 2013, p. 9.

Using mobile devices to close achievement gaps

When disaggregated by gender, girls and boys in the Worldreader programme improved the same amount in terms of ORF in the local language, whereas girls in control schools improved only half as much as boys.

Similarly, the PRIMR study provided evidence that rural students show greater gains in learning from eReader access than their peri-urban counterparts. In control schools, there was a larger increase in literacy outcomes in peri-urban zones compared to rural zones between January and October 2013. But for the PRIMR Kisumu ICT intervention schools, an improved fluency of 9.7 CWPM was observed in rural schools as a result of treatment, compared to a 3.2 CWPM improvement that was observed for peri-urban schools (Piper & Kwayumba, 2014, p. 41).

Taken together, the Worldreader evidence on gender and the PRIMR evidence on rurality may suggest that students’ direct access to eReaders might mitigate against some of the effects of discrimination or disadvantage on learning outcomes.

The studies reviewed may suggest that mobile devices (such as eReaders and TeacherMates) may be better positioned to address issues of equity than suites of desktop computers. Perhaps surprisingly, none of the research studies evaluated provided evidence of students’ use of mobile phones for learning. This was the topic of a review focused on Asia, which found that while there was important evidence of mobile phones facilitating increased access to technology, there was much less evidence relating to whether or how this resulted in new learning (Valk et al., 2010, p. 1).

However, caution should be exercised when generalizing more broadly, from students’ use of mobile technologies such as eReaders and TeacherMates, to students’ use of other forms of edtech, such as computers. The EdQual programme found that home and community environments determine the quality of education, particularly for the most socio-economically disadvantaged groups. Attending a school where a substantial proportion of the pupils share one or more of these disadvantage indicators is also strongly and negatively associated with learning achievement, independent of the individual’s background (EdQual, 2011, p. 9).

The variability between rural and urban schools, with urban schools having relatively more computers, Internet connectivity and other ICT equipment than rural schools, could be as a result of the support that some urban schools get from parents’ contributions towards school development, with some of these funds being used to purchase ICT equipment…When the MOE supplied us with these computers they did not provide us with extra funds for maintenance of the computers. Now we spend a lot on repairs whenever they break down, we have to bring private technicians from town and they are very expensive. So we have to restrict student access to them…

3.2.4 Summary

In summary, among the examples of edtech used by students, there are relatively few accounts of whether changes in practice occur, and if they do, what the nature and extent of such changes are. As well as this, most accounts are also based on self-reporting rather than quantifiable metrics. Additionally, more focus needs to be on curriculum and pedagogy rather than simply supplying equipment, as there is some evidence that this leads to positive changes in practice.

Evidence of measurable impacts from students’ use of edtech on student learning outcomes, from the research studies reviewed, is sparse. Three of the research papers showed improvements in student learning outcomes, in terms of reading speeds, fluency, or literacy, in the mother tongue and the English language (Piper & Kwayumba, 2014; Worldreader, 2012; Murz, 2011).

Again, providing computers without thinking about pedagogy produces no measurable improvements (UNESCO, 2013a; Linden, 2008). There is some evidence that CAL in mathematics, as a supplement to, not replacement of, other teaching, may be of some benefit, especially for disadvantaged (Banerjee et al., 2007) or underperforming (Light, 2009; Lai et al., 2011) students.

3.3 Is there any evidence that the use of edtech in schools represents value for money?

Surveying the studies reviewed for this guide, there was a dearth of cost data and cost-effectiveness analysis for the edtech interventions assessed. Only a tiny number presented breakdown of costs, provided value for money (VFM) indicators, reported key cost drivers or conducted a cost-benefit analysis linking the input costs of the edtech interventions with their impact on pupil learning outcomes. None compared the cost of edtech interventions to non-edtech interventions, which is a key VFM comparison.

This is problematic, because without cost data it is difficult to assess the VFM of edtech interventions, or make comparisons between edtech and non-edtech interventions that could deliver the same outcomes.

Edtech should only be used if it is affordable and can really add value that is better or different in comparison with other possible inputs.

Cost-effectiveness analysis determines how much impact (e.g. on teaching practice or learning outcomes) an intervention achieves relative to the inputs invested in it. Before the design stage of edtech programmes, the costs of programme inputs should be estimated, key cost drivers analysed and forecast, VFM metrics developed, and a cost-effectiveness analysis carried out. These cost indicators should be revisited throughout the project cycle, and be used when evaluating the effectiveness of interventions. The 3 Es (Economy, Efficiency and Effectiveness of edtech interventions should be clearly analysed. A lack of clear information about key cost drivers or of a robust cost-effectiveness analysis indicates that issues may arise around the transparency and accountability of funds put towards edtech interventions, and the impact these interventions may have.

Case study: Analysing cost-effectiveness

One study of the Primary Math and Reading Initiative (PRIMR) programme in Kenya provided an excellent example of cost-related data and cost-effectiveness analysis for edtech interventions (Piper & Kwayumba, 2014). The main objectives of the PRIMR programme were to assess the impact on pupil outcomes of three ICT interventions implemented at different levels of the education system, and their cost-effectiveness against each other. The three interventions were:

  • Teachers’ Advisory Centre (TAC) tutor tablets to bolster instructional support to students
  • teacher tablets, with enhanced teachers’ guides and PRIMR materials
  • eReaders for students, used during language lessons and after-school clubs.

To measure cost effectiveness, the unit costs per student (comprising the total of student books, teachers’ guides, teacher training, classroom observations and TAC tutor training) were analysed, in the context of the intervention and level it was applied at (student, teacher, school). The basic cost of the PRIMR model was $2.28 per student, slightly less than the control group costs. Per student, the eReader cost $40, the teacher tablet $3, and the TAC tutor tablet $0.10 (Piper & Kwayumba, 2014, p.34-5). Given that the impact of the three interventions on learning outcomes was similar, per-student cost-effectiveness analysis makes a significant difference. In the figure below, the ORF gains over the baseline results per dollar spent are shown. The TAC tutor tablet programme was nearly two times more cost-effective than the teacher tablet or control groups, and ten times more cost-effective than the student eReader. The teacher tablet programme was marginally more cost-effective than the control group. The student eReader group was six times less cost-effective than the control condition. Therefore, while PRIMR’s ICT programs were all effective, the per-student costs of each treatment were remarkably different.

Measuring cost is important so we can ensure programmes focus on the lowest-cost interventions that are proven to improve learning outcomes, whether these involve using technology or not.

Oral reading fluency gains over baseline per dollar spent
Oral reading fluency gains over baseline per dollar spent (Piper & Kwayumba, 2014, p. 4)

The PRIMR study found no statistically significant difference in the improvements between the three treatment groups (tutor tablets, teacher tablets, and student eReaders), but given that the numbers requiring the edtech grew progressively larger from one group to another, PRIMR did find that the cost-effectiveness of teacher and tutor tablets to be orders of magnitude greater than that of student devices.

Increase in numbers of pupils at emergent reader benchmark, per $100 spent.
Increase in numbers of pupils at emergent reader benchmark, per $100 spent. Source: Piper & Kwayumba, 2014, p. 36

Unfortunately, these cost issues are rarely mentioned in the majority of studies.

3.4 What are the enabling factors that inhibit or support integration of edtech?

 

3.4.1 Inhibiting factors

In several of the appraised studies, authors identified issues that they felt had inhibited the effective implementation of edtech, or limited effects on teaching practice or learning outcomes. Such issues typically fall into one of the following categories:

  • inadequate support for curriculum-related uses
  • limited access to edtech resources for curriculum purposes
  • difficulty in identifying appropriate curriculum content
  • equity issues.

Inadequate support for curriculum-related uses

One issue is inadequate or inappropriate support for curriculum-related uses of ICT. For example, the Myanmar ICT Master-plan 2011–2015 includes several action steps relating to e-Education, including incorporation of ICT training into the school curriculum, teacher training in the use of ICT and the development of teaching materials for ICT training (UNESCO, 2013a, p. 44). But, in practice, the focus appears to have been on technology (LAN installation and internet connection for high schools) and satellite broadcast audio resources, rather than on the development of curriculum-related materials or teacher development; “the frequency of use for teaching and learning was considered to be very low” (UNESCO, 2013a, p. 45).

Similarly, one of the summary findings of the EdQual research programme was that “computers are not often used for teaching and learning purposes and that schools and teachers need to be supported in their use” (EdQual, 2011, p. 3). EdQual went on to draw out important policy implications:

For ICTs to become a tool for improving teaching and learning across the curriculum, they need to be supplemented by teacher professional development. The form of professional development found to be most effective in previous research in UK and Chile as well as in Rwanda, consists of: (i) workshops in which teachers experiment and collaborate with available software in schools to develop resources and lesson plans; (ii) class-room based support from a trainer, who regularly observes and discusses practice with the teachers and (iii) encouraging teachers at the same school to develop their classroom practice as a team.

In Chile, the long-running, large-scale Enlaces ICT policy has been highly successful in introducing computers and ICT infrastructure into huge numbers of schools, and has also provided training on computer use to 82% of teachers, yet “critical results are narrow in terms of classroom learning, and no additional competencies have been observed” (Sanchez & Salinas, 2008, p. 1,621). It has been found that that “school principals think that the integration of computers into classroom pedagogical practices is the most difficult task at the school level” (p. 1,629).

An over-emphasis on (and over-funding of) ICT equipment and infrastructure, at the expense of adequate provision (and funding) of effective support for implementation is central to this problem.

To be effective, support for implementation at school should include both professional development and classroom resources, with a clear focus on curriculum and pedagogy, rather than generic ICT skills. Yet such aspects are often overlooked at policy level.

Gulbahar & Guven (2008) also point to the need for high-quality materials, developed in authentic classroom contexts, to support teacher professional development and classroom practice.

Teachers must be part of the decision making process with respect to the implementations of ICT innovations in schools, so that they may commit to the innovation with conviction.

Limited access to edtech resources for curriculum purposes

After problems related to lack of teacher support and curriculum-related materials, one of the most frequently mentioned inhibiting factors is lack of access to IT facilities or internet services, particularly for subject teaching.

A field survey in Rwanda found that 52% of students had access to computers for a period of one hour per week and less than 30% of the respondents had accessibility of up to three hours a week (Rubagiza et al., 2011). The author suggested computers were prioritized for administration purposes.

While governments and donors fund ICT equipment, schools are often expected to maintain them out of their own funds. This can lead either to equipment falling into disrepair, or to use being restricted.

…many of the principals kept the ICT classrooms under lock and key to protect against theft, damage, or improper use of the computers, printers…other problems reported by the computer coordinators were a lack of telephone lines for internet connection…

A study in Namibia found low usage of ICT in rural science classrooms due to poor ICT infrastructure, lack of technical and pedagogical support, and the shortage of digital learning materials (Ngololo et al., 2012).

While it is hoped that mobile internet use may offer an alternative to overcome some of the difficulties of wired access in rural areas, none of the studies appraised reported on this. It may be that this is because wireless data networks are only just becoming available in rural areas, and therefore there hasn’t yet been sufficient time to implement and report research studies. Alternatively, it may be that in many contexts, wireless connectivity currently remains too slow, unreliable or expensive for realistic use in schools. This is likely to be a rapidly changing landscape over the current decade.

Difficulty in identifying appropriate curriculum content

In some cases, curriculum materials are provided but are not felt to be appropriate by end-users. For example, in the case of the Rwandan NEPAD schools, EdQual reported that materials developed for a particular cultural context in South Africa went against the cultural values of teachers in Rwanda:

Almost all teachers (93%) in all the Rwandan NEPAD schools surveyed in 2008 were of the view that some of the information contained in the health program was too lurid and that it would not be appropriate to expose learners to the stark facts of say reproductive health and HIV/AIDS transmission. This position was strongly held by a school in Southern Province. In fact, all learners in the school had not had the chance to use the programs at school. Even teachers found it a ‘waste of time’ or ‘against cultural beliefs’…These sentiments point to the fact that digital content needs to be culturally sensitive and locally generated.

Equity issues

UNICEF (2013) caution on the use of ICTs, particularly with children, noting that ICTs often serve to exacerbate pre-existing areas of inequality for children, rather than reduce them. As such, inequality needs to be addressed intentionally in any project: technology will not be spread equitably by default.

3.4.2 Supportive factors

Across the appraised studies, a number of features were identified that seemed to be common to studies reporting implementation of edtech with positive effects on classroom practice or learning outcomes. These included:

  • a focus on curriculum, teaching and learning throughout programme design
  • mobile technologies with appropriate curriculum resources
  • appropriate programmatic support for teachers
  • sufficient time to develop new teaching and learning practices
  • opportunities to harness ICT outside school.

Focus on curriculum, teaching and learning throughout programme design

Several studies showing impact on teaching practice or learning outcomes, have used relatively simple mobile technologies (for example eReaders, TeacherMate devices, teachers’ iPods or mobile phones) loaded with relevant curriculum materials. These technologies are typically deployed with a very clear pedagogic intent and curriculum purpose (such as teaching phonics, early literacy or engaging model language).

There is some evidence that teachers find task-orientated mobile technologies simpler to use than complex computers, both for professional development and for classroom use. For example, EIA in Bangladesh found “the iPod touch is playing a great role in this intervention for teachers’ professional development” (Shohel & Banks, 2010). Students also stated that they felt this equipment aided their pronunciation and teachers felt it helped keep their attention in class and made the lessons more enjoyable (Shohel & Banks, 2010, p. 5,490).

Mobile technologies with appropriate curriculum resources

Mobile technologies can potentially overcome barriers of access, particularly in rural areas, and also provide relevant, appropriate, contextualized learning materials:

The programmes that use these technologies are among those that present the strongest evidence of impact on learning outcomes (Ho & Thrukal, 2009; EIA, 2012c; EIA, 2014c; Piper & Kwayumba, 2014; Worldreader, 2012), among studies reviewed.

Appropriate programmatic support for teachers.

A recent DFID-funded rigorous literature review identified four key findings that characterize teacher education programmes that improve teaching practice and learning outcomes:

  • professional development aligned with classroom practices, with follow-up support and monitoring (including lesson modelling, constructive feedback on practice and discussion)
  • peer support (formal and informal, in clusters or schools; focused on introduction of new classroom practices; joint observations, lesson planning and resource sharing)
  • headteacher support (awareness of, and support for new methods of teaching, from headteacher and community)
  • assessment (teaching development/student formative and summative) aligned with the curriculum.

The need for edtech programmes to offer such programmatic support is underlined by several of the appraised studies, either as a recommendation to bridge a gap where outcomes have been sparse or as a strength of current practice, where outcomes have been positive.

The need to engage the support of school leadership for implementation of edtech interventions has also been noted. Teachers surveyed in Kenya agreed that headteachers created a positive and supportive school culture towards web-based educational materials. “26 out of the 35 teachers describe their headteachers as what might be termed ‘lead learners’, role modelling the use of the [resources]” (Cullen et al., 2012).

A study of the use of the TeacherMate learning system in Rwanda found teachers needed monitoring and assistance to get into routine usage (Murz, 2011). EIA found teachers benefited from school visits and feedback, which kept their focus to practise their learning in classrooms (Shohel & Banks, 2010).

Sufficient time to develop new teaching and learning practices

Even with simple mobile technology, it can take time for teachers to become familiar in finding their way around resources (Shohel & Banks, 2010). Similarly, students may need a lot of time to become familiar with eReader operation (Worldreader, 2013, p. 7).

The Intel Teach Essentials Course includes 40 to 60 hours of training “to prepare teachers to integrate ICT across the curricula as a tool for learning and to design and implement inquiry-driven, project-based learning activities” (Light, 2009). Fieldwork looked at the changes in classrooms where this training had been used. Schools were found to have developed “new beliefs about learning and new practices, new ways to engage with content, changing relationships, and new ICT tools for learning”. EIA also provided ongoing support to teachers, over a period of a year or more, to enable them to introduce significant changes in practice (Walsh et al., 2013).

Programmes should not expect ‘quick wins’ from the introduction of edtech, or changes in practice to arise from brief ‘one-off’ training events, but should provide ongoing support, and allow teachers and students significant time to develop new practices, before conducting evaluations.

Opportunities to harness ICT outside school

Although, as previously noted, differentials in access to ICT outside school may raise several issues of equity, some students who may have very poor experiences of ICT in schools, may have rich ICT experiences outside schools (Rubagiza et al., 2011). Teachers also have been found to use internet cafes and other opportunities to access professional development OERs outside school (Cullen et al., 2012). There may be opportunity for considering how these external ICT opportunities, experiences and skills could be drawn upon to enrich in-school learning or in-school uses of ICT.

Technology can be a powerful education multiplier, but we must know how to use it. It is not enough to install technology into classrooms – it must be integrated into learning. Nothing can substitute for a good teacher.

The overall picture that has emerged from this review is that the use of edtech in practice remains a complex challenge. With some notable exceptions (e.g. DEEP, EdQual and EIA), this guide has indicated the lack of evidence on how teaching practice changes as a result of edtech and found clear gaps in the research on the relationship between edtech use by students and improved learning outcomes. Thus, the review has highlighted the need for supportive and relevant curriculum materials, teacher CPD, clear understandings of the pedagogic context and the development of stronger evaluation strategies of ongoing changes in teachers’ practice.

Looking at the evidence explored in this guide through a more analytical lens, the following broad issues need to be considered before edtech implementation:

1. There is lots of research on teachers’ use of edtech

Much research has shown that teachers’ use of technology is contextual. Research has been undertaken to determine how teachers use technology on a day-to-day basis (e.g. preparing notes, using the internet for research purposes), the challenges they face (e.g. limited computer literacy, resource constraints) and understanding how the school setting impacts on their ability to undertake their teaching (e.g. power outages, limited infrastructure). Much of the work focuses on administrative issues such as the motivation to purchase equipment and resource constraints. While this research is worthwhile, it is not deeply related to the practice of teaching.

2. However, use is different to practice and we don’t know enough about practice

How do teachers use technology in the practice of teaching? Two key (and interrelated) points are:

  • the pedagogy related to the subject being taught is often overlooked
  • how the technology can support practice is not addressed.

Subject-specific pedagogy. There are good examples of how to investigate changes in classroom practice but these have yet to be directly linked to technology use. For example, in EIA there is a very clear focus on the importance of supporting subject-specific pedagogy, in this case communicative language teaching (CLT) in English language learning. The researchers were able to demonstrate very clearly the important changes in teaching practice, including the use of spoken English in the classroom (EIA, 2012b; EIA 2014b).

Teachers also used the project technology outside of the classroom to help them reflect on and improve their practice. This is a great first step as it highlights how technology use by teachers (often in their spare time) can impact upon changes in their practice. Moreover, many projects have shown how technology can support teachers to increase their subject knowledge (e.g. Leach et al., 2005, p. 61). The question is: can we go further?

The functionalities of the technology are important. One of the key motivations for governments to invest in technology in education is to provide students with new insights into particular phenomena. One example from maths is using dynamic geometry software to allow students to view the relationship between angles in a triangle visually, and manipulate the various parameters to get a better understanding of these relationships. This is an important alternative to using equations. The key point is that the functionalities of the technology linked to an appropriate pedagogy provide new ways of learning that can only be achieved with technology.

Therefore, an important way to think about edtech in developing countries is to look for examples of how technology is providing these new avenues for learning, thereby justifying investment. If technology is being used in the same manner as pen and paper, then what justifies its use?

Mobile learning (Pachler et al., 2010) provides a good example of this. The functionalities of the technology provide numerous opportunities for learning, including geographical reach, communication, information storage and internet access. However, how these functionalities are used depends upon the pedagogical design and underpinning model of learning (Valk et al., 2010; Haßler et al., 2011). Where an intervention has been well designed, innovative uses have been documented. For example, as early as 2002, teachers on the DEEP project were using mobile devices for “creating images and movies for use as ongoing classroom resource; capturing classroom activity to document student progress; recording programme activity for self-assessment/portfolio” (Leach et al., 2005, p. 57).

Thus, change in practice derives from paying close attention to the interplay between pedagogical and technical innovation.

However, the challenge of designing and supporting this interplay should not be underestimated. From previous research, we know that teaching practice often doesn’t change with the introduction of technology. Also, our findings suggest that it can be difficult to analyse and review the specifics of practice with technology, as what software was used and how teachers used it in their practice is often not presented in sufficient enough detail. This makes the justification question, as outlined above, very difficult or even impossible to answer.

So more research is required to better understand the relationship between the design of edtech and teaching practice in low-resources settings. This goes to the heart of the question of what it means to embed technology in teaching practice.

While this is a complex issue, there are important starting points. The 2009 TALIS study on practice, although carried out mainly on OECD countries, showed that teachers engaged in teaching strategies in the following order: “structuring of lessons, followed by student-oriented practices and finally enhanced learning activities such as project work. This order applies in every country [in the project]” (OECD, 2009, p. 121). Interestingly, studies reviewed for this guide also found little evidence of student-oriented practices and project work, illustrating that the pedagogical challenges discussed are not resource-specific but are deeply related to the values that teachers (in whichever country they are working) place on classroom practice.We need to know more about teachers’ values and their perspectives on their preferred teaching strategies across low and middle-income countries. Only then can we think about developing evaluations of subject-specific pedagogies. Designing project evaluations in this way will allow for the development of deeper understandings of the specific nature of the change in teacher and student practice when using technology.

3. Programmes must be explicit about their conceptual framework

The conceptual framework underpinning many of the research projects was not clear.

A clear description of the framework used in any project is important because it “provides an understanding and definition of education quality and identifies the key inputs and processes necessary to implement a good quality education for disadvantaged learners in low-income contexts

This leads to defining the principles of the project, which in the case of EdQual were inclusivity, relevance and democracy. The implications for this are clear: including a focus on all learners, with learning outcomes determined through consensus.

The DEEP project was also clear about its theoretical principles, which primarily focused on teacher learning as a social practice, where developing teaching practice is a process of collaborative knowledge construction. This enabled the project to position technology as “an essential component of human agency…[helping] communities learn about, respond to, act on and manage their experience of the world” (Leach, 2008, p. 4).

While different projects may take different approaches to the design and use of edtech, a strong conceptual framing allows for a better understanding of the underpinning motivations of the researchers and practitioners. Furthermore, it makes their rationale for the role technology can play in education transparent. This is absolutely critical in development but is often not made explicit enough.

4. Teacher training is critical, but more attention must be paid to its design and focus

The importance of teacher training cannot be emphasised enough. Across the studies, this took a variety of forms, with many projects providing training via workshop models. However, these were often too focused on developing basic competencies regarding the use of technology. Instead, a key to the success of many of the larger and more longitudinal projects was the importance of ongoing support and training directly related to pedagogy. Both the DEEP and TESSA projects strongly promoted school-based teacher training, where partnerships and communication were seen as very important. Where there were few opportunities for this, it was seen as problematic. For example, in the Tikwere IRI project: “…there appears to be no systematic way for teachers to provide feedback to the Tikwere production unit on the errors they observe and the specific difficulties they experience” (Method et al. 2009, p. B1-4). Interestingly, more recently, the latest OECD TALIS Report (2014) emphasised the need for a stronger emphasis on teachers’ ongoing professional development and the DFID-funded research by Westbrook et al. (2013) stressed that professional development must be aligned with classroom practice, with follow-up support and monitoring (including peer and headteacher support) being of critical importance.

5. The challenges of generating evidence

The use of edtech in a development context is increasing, resulting in a growing interest in determining the role of technology in educational attainment. This raises a number of fundamental issues regarding what counts as evidence in this context.

There are no simple answers here. Every stage of the role of technology in education in developing countries is fraught with complexity. As such, education technology can be considered a “complex intervention”, i.e. one that has several interacting components and is very sensitive to features of the local context (Craig et al., 2008). While there is increasing recognition of the need for rigorous evaluation of complex interventions, this is sometimes framed in an overtly simplistic manner, where evidence-based practice – often in the form of an RCT – is sought to justify the promotion of technology in education. While we are not saying that there is not a role for RCTs, we emphasise caution in doing so. The complexities outlined in points 1–4 are not trivial and can seriously undermine any RCT, if not accounted for correctly.

…statements about programme effectiveness that are based solely on traditional methods of programme evaluation, in contrast with programme in context evaluation, may be misleading.

6. More peer-reviewed evidence is needed

Of the 45 research documents including in this topic guide, only 17 were peer-reviewed journal articles. It is clear from this that the field, although a nascent one, needs to place more effort on opening its research up for peer review.

In the context of enormous global challenges to improve the quality of education, particularly in low to lower-middle income countries, governments, donors, schools and communities often seek to explore or exploit the potential of edtech. The studies reviewed for this guide provided some compelling examples of evidence that this potential can be realized, to produce educationally significant impacts on practice and outcomes. In particular, there is some evidence that mobile technologies (radios, mobile phones, and tablets) – used for curriculum-specific purposes in a context of appropriate support – can be particularly effective. There is also tentative evidence that such approaches may contribute to addressing issues of equity, in relation to gender and rurality.

But there are also many studies that either stopped at the point of identifying the difficulties and challenges experienced, or described what was done, but failed to provide adequate evidence of what difference was made to the educational experiences of the teachers, students and communities involved. There is therefore a pressing need, both to improve the quality of design and implementation of edtech programmes in order to raise their effectiveness in improving educational quality, and also to improve the evidence base on ‘what works, in which contexts, why and how’.

Education Advisors may have a critical role to play in helping governments, donors and implementers challenge the rigour of proposed or actual programmes in three critical areas:

Conceptual clarity

  • What are the educational purposes of the intervention?
  • How does the planned use of edtech support the practice of teaching and learning, in the particular subjects and age ranges being targeted?
  • To what extent does the functionality of the technology support or enable the desired curriculum practices?
  • To what extent is the technology appropriate to context; is the technology likely to overcome or exacerbate existing inequities?
  • Are there other technologies or approaches that might be more effective in achieving the educational goals?

Programme design

  • How is the clarity of educational purpose reflected in programme design?
  • To what extent is expenditure and effort balanced between education (e.g. curriculum materials, teacher education and development activities) and technology (e.g. equipment, infrastructure and IT training) in programme design and budgets?
  • How are teachers, students and school communities supported in exploring and establishing new teaching and learning practices through edtech, and to what extent is programmatic support in line with known best practices (e.g. Westbrook et al., 2013)?

Evaluation and evidence

  • To what extent does programme evaluation move beyond access to edtech to help better understand whether or how that technology is being used to support teaching and learning practices, and the extent to which such use contributes to educational outcomes that schools, communities, donors and policy makers have reason to value (Tikly & Barrett, 2011)?
  • What quality of evidence will programme evaluations produce, and in what ways might this be strengthened, within the constraints of programme budget, capacity and scope?
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Inclusive learning /topic/inclusive-learning/ Sun, 07 Sep 2014 23:40:22 +0000 http://www.heart-resources.org/?post_type=topic&p=24961 Read more]]>
Introduction1. Key concepts in inclusive learning2. Evidence on inclusive learning3. Inclusive societies4. Toolkits relevant to inclusive learning
Inclusive learning is the result of effective teaching practice, an adapted learning environment and teaching approaches which ensure that all children are included, engaged and supported.

This HEART Topic Guide brings together evidence on what works in inclusive learning for children aged 3 to 12 years with disabilities and/or difficulties in learning in low and middle income countries, and explores the role of inclusive approaches in contributing to inclusive societies and ultimately inclusive growth. The Topic Guide addresses some of the contested and debated issues around terminology, labelling, and segregated, integrated and inclusive schooling; reviews the limited evidence that exists from low and middle income countries around the outcomes of inclusive learning; and identifies future research directions.

The evidence underpinning inclusive learning in low and middle income countries is weak and fragmented. In the absence of systematic reviews of high quality, the body of evidence cited here includes empirical studies and conceptual research considered to be of good quality. The evidence is summarised for each section, and includes a range of sources from UN agencies, international non-governmental organisations and academic studies.

Although the primary focus of the Topic Guide is on inclusive learning for children who are at risk of failure and educational exclusion due to their disability or their difficulties in learning, the approaches and evidence discussed have the potential to benefit the learning of children from all disadvantaged or marginalised areas or groups, such as children from remote or nomadic populations, children living in conflict-affected states, malnourished children, and children from linguistic, ethnic or cultural minorities. It has often been said that by meeting the needs of children with disabilities, the needs of all children will be met.

The broader context

Unprecedented progress has been made in addressing barriers to universal basic education, including the achievement of a large proportion of primary school enrolment in East Asia and North Africa and gender parity in enrolment in Latin America and the Caribbean, South Eastern and Southern Asia (UNESCO, 2013). The abolition of school fees has rapidly accelerated progress in many countries, ensuring that the number of children out of school around the world almost halved between 2000 and 2011, dropping from 102 million to 57 million.

Strategies to achieve mass access to education have made schooling a reality for boys and girls from urban centres, high income households and for those fortunate enough to live in countries where supply and demand side factors have created opportunity for equitable and meaningful access to quality education (CREATE, 2008). For example, in the period 2006-2009, Lao People’s Democratic Republic (PDR), Vietnam and Rwanda all reduced their out-of-school populations by 85% (UNESCO, 2014) and considerable progress was made in increasing net enrolment by more than 25% in Benin, Bhutan, Burkina Faso, Ethiopia, Guinea, Mali, Mozambique and Niger between 1999 and 2009 (UN, 2011). Such gains come as a result of the transformative momentum brought to bear by international commitment, government policies, civil society engagement and economic growth (UN, 2013b).

However, factors affecting disadvantage rarely act in isolation. Gender often interacts with poverty and geographical location to create even greater disadvantage in learning opportunities within countries. In 2011, in Ethiopia, wide disparities were evident between the proportions of girls and boys who had ever been to school. In Addis Ababa, almost all children from rich households had been to school, while 43% from the pastoralist region of Afar had never done so. These disparities become amplified when comparing the situation of girls and boys from the poorest households living in Afar, where two thirds of poor girls (65%) had never been to school compared with around one half of poor boys (53%) (UNESCO, 2013: 4). Gender also interacts with disability to create disadvantage for girls with disabilities, for example, Lynch et al. (2014) reported that the number of girls with albinism attending resource centres in Malawi is significantly lower than boys.

Progress has stalled

Global net enrolment increased at a slower rate than in previous years, from 87% in 2005 to 89% in 2011 (UNESCO, 2013: 1). Between 2008 and 2011, the number of out-of-school children fell by only 3 million (UN, 2013a), a rate too slow to achieve the Education for All (EFA) target of 97% enrolment by 2015. Sub-Saharan Africa is the region which is furthest behind. No progress has been made since 2011, when 22% of primary school age children were still out of school. On current rates of progress, 53 million children across the world are expected to remain out of school in 2015 (UNESCO, 2014: 52-53). This is in spite of a number of landmark reports which raised the alarm on the failure to reach marginalised girls and boys, including the Education for All Global Monitoring Report 2010 (UNESCO, 2010), the Millennium Development Goals (MDGs) progress report in the same year (UN, 2010) and the first ever World Report on Disability (WHO, 2011).

Fee-free schooling has not been a panacea for the achievement of universal enrolment and many social, cultural, geographic, linguistic and economic barriers remain to be able to include all children. Of the 57 million children currently out of school, 49% will never enter school, 23% have dropped out and 28% will start late (UNESCO, 2013:3), and at least 250 million children cannot read or count, even if they have spent 4 years in school (UNESCO, 2012). Millions of children remain untouched by the benefits of economic growth and the gains brought by progress towards the MDGs.

Children living in countries affected by armed conflict make up more than half of the out-of-school population, but little is known about those who have disabilities, either prior to, or as a direct result of, the conflict. Afghanistan, the Democratic Republic of Congo, Somalia and pre-secession Sudan all have out-of-school populations over 1 million (UNESCO, 2014: 55). Girls, whose education is often considered of less value than boys’, make up 54% of those out of school. That figure increases to 60% in Arab states, a proportion that has remained unchanged since 1999 (UNESCO, 2014). Faced with the prospect of social stigmatisation and schooling in a language that is not their own, children from ethnic minorities can face insurmountable barriers to education, while ‘wealth based inequalities are a universal source of disadvantage’ (UNESCO, 2010: 140).

Access to good quality basic education drives down poverty and improves livelihoods, as well as enabling people to fulfil their potential and contribute to open, inclusive and economically vibrant societies (DFID, 2013). The costs of exclusion are high. In Bangladesh for example, foregone income due to lack of schooling and employment, both of people with disabilities and their caregivers, is estimated at US$1.2 billion annually, or 1.74% of Gross Domestic Product (GDP) (World Bank, 2008: 14). The economic costs of out-of-school children is estimated to be ‘greater than the value of an entire year of GDP growth’ in nine countries, namely Burkina Faso, Cote d’Ivoire, Gambia, Lesotho, Liberia, Mali, Nigeria, Senegal and Yemen (Thomas and Burnett, 2013: 38). Even for large middle income countries with low out-of-school populations, such as Brazil and Indonesia, the costs of having children out of school outweigh the additional public spending required to enrol them, making it an equitable and cost effective investment (Thomas and Burnett, 2013).

Recognising the continuing scale of the challenge, the Report of the High Level Panel of Eminent Persons recommended that the post-2015 development agenda ‘leaves no one behind’ by ensuring that the new goals are designed to reach the excluded, incorporating social protection measures and tracking progress at all income levels (UN, 2013b). By building on the renewed global focus on learning, this Topic Guide responds to growing concerns about the estimated 250 million children who are unable to read and count after 4 years of schooling (UNESCO, 2012), many of whom are likely to have disabilities and/or difficulties in learning which could be addressed through inclusive learning. It also highlights the importance of ensuring that global strategies prioritise the diverse learning needs of the most marginalised children, many of whom have disabilities and/or experience difficulties in learning.

The most marginalised

Disability continues to be one of the primary causes of educational disadvantage and exclusion, creating the largest single group of girls and boys who remain out of school. Even in those countries close to achieving universal primary enrolment, children with disabilities continue to miss out on education and opportunities to access meaningful employment and sustainable routes out of poverty. The lack of political will and commitment needed to drive improvements in data availability and management to date has been insufficient (UNICEF, 2014), and this has limited the ability of governments, donors and others to assess, monitor and address the situation of children with disabilities (UNESCO, 2010).

The Topic Guide outlines new survey tools, guidelines, toolkits and capacity building programmes, led by the Washington Group and UNICEF. A lack of evidence of learning outcomes in low income settings more broadly, as well as for girls and boys with disabilities and difficulties in learning in particular, presents a further challenge to our understanding of how school systems can better respond to children’sindividual learning needs. Inacknowledging the tensions and complexities in the global discourse on inclusive learning, this Topic Guide has sought to bring greater conceptual clarity to inform policy and practice.

Systemic challenges, such as divided ministerial responsibility for children with disabilities – across education, health and social protection – have shifted the focus on to social welfare and ‘special’ treatment, rather than inclusion and equity (WHO, 2011). The absence, or inadequacy, of legislation, strategies and targets prevents the inclusion of children with disabilities in education, along with school-level barriers including physical access, inflexible and inappropriate curricula and pedagogy, inadequate teacher training, labelling and discriminatory attitudes that reinforce marginalisation (WHO, 2011).

The complexities in addressing the specific needs of children who have disabilities and/or difficulties in learning have challenged policymakers, as their needs tend not to be met by interventions designed for other marginalised groups, such as those living in slums or remote rural areas. Extending education opportunity to all children needs more than the general expansion of education provision and the improvement of average learning achievement (UNESCO, 2010). Policies and other system-wide interventions that directly target children with disabilities and the underlying causes of disadvantage require political support and leadership to be effective. However, one size does not fit all. All countries face their own specific constraints, challenges and opportunities. Action to ensure the inclusion of children with disabilities and/or difficulties in learning works best when it is tailored to local and individual circumstances.

Most of the literature focuses on concepts and definitions of ‘inclusive education’, access to basic education, policy recommendations, and on teacher attitudes, but evidence on implementation and on learning outcomes is scattered and inconclusive. The Topic Guide provides illustrative examples from the limited evidence that exists which highlight the urgent need for further research – for example, teachers’ difficulties in adapting their classroom practice and differentiating curricula without adequate human resources to support their ongoing capacity development (Johnstone and Chapman, 2009).

Provision of even the most low-cost and relatively straightforward assistive devices, such as spectacles, is often inadequate or unaffordable, especially in rural areas, and, when made available in Gansu, China, social stigma had a negative impact on their uptake (Glewwe et al., 2012). Peer-to-peer approaches have assisted learning and built self-esteem and friendship networks in some contexts (Grimes, 2009), but little is known about their impact on learning outcomes. Similarly, there is evidence to suggest that parent engagement in learning and community-based support services, can promote engagement in learning (Deng and Holdsworth, 2007). The evidence gaps in inclusive learning highlighted in this Topic Guide are considerable, and high quality research is urgently needed to inform future developments.

The Topic Guide begins by discussing key concepts associated with inclusion and inclusive learning, terminology related to disability, and the difficulties faced in collecting appropriate data (Section 1). Section 1 also addresses some of the dilemmas of the twin-track approach, which involves providing specialist support for children with disabilities, while at the same time promoting generic inclusive strategies. The main body of evidence on inclusive learning is presented in Section 2, and is divided into four broad areas: classroom practice; teacher education; school leadership; and community engagement. Finally, Section 3 explores the relationship between inclusive learning and the development of inclusive societies and inclusive growth.

Inclusive learning is a relatively new concept which draws attention to the need for more flexible approaches to support the learning of girls and boys who have traditionally been excluded from formal learning, and those whose individual learning needs are currently not being met in formal education. Although this Topic Guide focuses on the diverse educational needs of children with a disability, and those with difficulties in learning, it raises issues of broader relevance to improving the quality of teaching and learning for all.

Research on disability, inclusion and education has been neglected in developing country contexts, and the evidence base is both scattered and scarce. This is arguably due to the predominance of a rights agenda, and a strong focus on advocacy. The little research that has taken place has tended to be small scale, and has focused on teacher attitudes, rather than classroom practice and learning outcomes. However this is beginning to change, and there are signs of a shift taking place to including children in a developing country context who have a disability or difficulties in learning.

This section of the Topic Guide summarises the following: definitions of key terms, concepts and debates related to inclusive learning; current efforts to strengthen the collection of statistics on the number of learners who experience difficulties in learning, and on learners with a disability; the various forms of specialist provision, including special schools, and resource rooms; and a review of the ‘twin-track’ approach which ensures both specialist and mainstream provision. In acknowledging the tensions in global debates about inclusion, this section seeks to bring greater conceptual clarity to these complex debates in order to inform policy and practice.

The concept of inclusive learning

 

Inclusive learning focuses on the capacity of educational institutions to understand and respond to an individual learner’s educational requirements and entitlements, and girls and boys are seen as individuals who learn in different ways. In this way, the labelling and stigmatising of learners is avoided, and instead, priority is given to the creation of appropriate and responsive educational environments. Diversity in education is simply a reflection of diversity in society.

The aim of inclusive learning is to move beyond simply focusing on ‘access’, to understanding ways of increasing active participation and engagement in learning. Achieving the optimum level of participation of all girls and boys, and introducing gender-sensitive and learner-centred approaches to suit diverse learning styles, has implications for the way schools are organised, such as: curriculum change; teaching, learning and assessment adjustments; and a shift in emphasis of school leadership. Inclusive learning moves beyond providing individuals with support to fundamental changes being made to the way teaching and learning is organised.

Inclusive learning can be seen as ‘a principled approach to education'(Ainscow and Miles 2008: 5) which involves:

  • the process of increasing the participation of students in, and reducing their exclusion from, the curricula, cultures and communities of local schools
  • restructuring the cultures, policies and practices in schools so that they respond to the diversity of students in their locality
  • the presence, participation and achievement of all students vulnerable to exclusionary pressures, not only those with impairments or those who are categorised as ‘having special educational needs’ (Ainscow and Miles, 2008: 5).

The Salamanca Statement and Framework for Action (UNESCO, 1994) called for a broad approach to the inclusion of all marginalised groups of children in education, and claimed that inclusive learning is the most effective means of tackling discrimination, building inclusive societies, achieving education for all, and improving the efficiency and cost effectiveness of the entire education system. It put forward three justifications for inclusive learning:

  • Educational: It is a way of producing higher quality schools.
  • Social: Inclusive learning is the basis of a just and non-discriminatory society.
  • Economic: It is less costly to establish and maintain schools which educate all girls and boys, rather than funding a complex system of different types of schools.

Salamanca also called for ‘a major reform of the ordinary school’ (UNESCO, 1994: iii-iv), arguing that inclusive learning, ‘has to form part of an overall educational strategy and, indeed, of new social and economic policies’.

In summary, inclusive learning is concerned with a significant proportion of learners who experience educational difficulties and who subsequently fail and drop out of school. In developed countries, the percentage of children in mainstream schools who have, at some point, been identified as having difficulties in learning (often referred to as ‘special educational needs’), including those who have a disability, is estimated to be between 15% and 20% (WHO, 2011: 209). It seems likely that a similar proportion of children will experience difficulties in learning at some stage in their school career in low and middle-income countries.

A focus on disability

Although reliable, comparable data is difficult to obtain, an estimated 15% of the global population, or more than 1 billion people, are currently living with a disability and prevalence rates are set to rise (WHO, 2011). Of these 1 billion, around 93 million children under the age of 14 years old have a severe or moderate disability, and 4 out of every 5 children with disabilities live in developing countries, with the highest levels of moderate and severe disabilities being found in sub-Saharan Africa (UNESCO, 2010). Poverty, undernutrition, poor health and an unsafe, or insanitary, home environment may increase a child’s cognitive, motor and social and emotional development, putting them at greater risk of disability and educational exclusion (WHO, 2011).

Just as there are greater challenges in ensuring that all girls complete a full course of primary education, there are additional challenges associated with ensuring that all girls identified as having a disability attend school. In Vietnam, for example, Nguyen and Mitchell (2014: 10) found that, ‘girls with disabilities have been much more disadvantaged than boys with disabilities and more disadvantaged than girls without disabilities in terms of opportunities and access to education’. While both girls and boys with albinism are ‘at risk of violence on the way to school’ (Nguyen and Mitchell , 2014: 8), girls with disabilities face the increased risk of sexual abuse.

Progress in stepping up efforts to support enrolment, learning and progression has been slow, in spite of a number of internationally-agreed conventions and statements relevant to inclusive learning, which are summarised in Box 1.

Milestones and momentum for inclusive learning: Conventions, statements and major reports
1989: UN Convention on the Rights of the Child expresses the right of all children to quality education (Article 28) and the responsibility of all governments to ensure children with disabilities also enjoy that right (Article 23).

1994: Salamanca World Conference on Special Needs Education 1994 was attended by 92 governments and 25 organisations who endorsed the Salamanca Statement and Framework for Action. The Framework for Action contains guidance on the development of inclusive schools which is still relevant today. It argues for changes to be made to school structures, classroom practice, school leadership and national education systems which make schools more effective and raise teachers’ expectations for all children. Governments were called upon to give the highest legislative, policy and budgetary priority to improve education systems to ensure inclusive enrolment.

2000: World Declaration on Education For All states that, in addition to active commitment to other marginalised groups, the learning needs of children with disabilities ‘demand special attention’ and specific steps must be taken to ‘provide equal access to education to every category of disabled persons as an integral part of the education system.’

2006: UN Convention on the Rights of Persons with Disabilities (UNCRPD) calls on States Parties to ensure inclusive education systems at all levels and lifelong learning, the right of persons with disabilities to a free, inclusive, quality primary education and the provision of ‘reasonable accommodation of the individual’s requirements’ and effective individualised support (Article 24). The UNCRPD stresses the importance of international cooperation ‘in support of national efforts’ and measures aimed at ensuring accessibility of development programmes, facilitating capacity building, research, and technical and economic assistance (Article 32).

2010: UNESCO EFA Global Monitoring Report highlights how failure to put inclusion at the heart of the Education for All agenda is holding back progress and singles out disability as ‘one of the least visible but most potent factors in educational marginalisation.’ The Millennium Development Goal Report (2010) notes that even in countries that are close to achieving universal primary education, children with disabilities ‘are the majority of those excluded.’

2011: First ever World Report on Disability focuses on systemic and institutional changes needed to remove barriers to the participation of disabled learners.

2013: UN High Level Meeting on Disability and Development considers a disability inclusive development agenda towards 2015 and beyond.

Box 1: Milestones towards inclusive learning.

Data challenges

The World Report on Disability (WHO, 2011) highlights the substantial variations between prevalence rates of children with disabilities, due to differences in definition and measurement of disability. The report provides in-depth insights into the difficulty of generating data on disability, given the lack of international consensus on definitions, and the difficulty of generating comparable data sets.

The number of children aged 0–14 years experiencing “moderate or severe disability” [is] 93 million (5.1%), with 13 million (0.7%) children experiencing severe difficulties. In 2005, the United Nations Children’s Fund (UNICEF) esti­mated the number of children with disabilities under age 18 at 150 million. A recent review of the literature in low- and middle-income countries reports child disability prevalence from 0.4% to 12.7% depending on the study and assessment tool,’ (WHO, 2011: 36).

One of the challenges faced in collecting reliable and comparable data is the changing nature of this population, due to the continued disabling impact of preventable childhood diseases; the consequences of armed conflict, disasters and emergencies; and advances in medical science. This is coupled with social, cultural and economic developments, leading to greater recognition of educational difficulties. Children who are malnourished are not only likely to be stunted in their physical growth, but are highly likely to experience cognitive difficulties and delays in learning. In countries affected by conflict, boys face distinct risks, as they are more involved in outdoor activities such as herding livestock, gathering wood and food or collecting scrap metal. They are more likely than girls to come across mines or explosive remnants of war, placing them at increased risk of injury.

A lack of disaggregated data, by sex and by type of disability and level of functioning, makes educational planning for inclusive learning extremely difficult. Furthermore, evidence on the number of children identified as having a disability which affects their learning, and those who may have an unidentified difficulty in learning leading to poor outcomes, is scarce.

The difficulties associated with the lack of consensus on definitions have slowed progress, but this is starting to change. Mont (2014) has been influential in arguing for the development of data collection tools that help countries to better understand how children with different types of impairment interact with their school environment. Some of the problems with current survey instruments for collecting data on disability and education are as follows:

  • asking if a child has a disability – only identifies children with the most severe impairments
  • asking if a child is receiving special support – problematic because the answer relates to both the function of the child’s disability, the policy and how the policy is implemented
  • asking about diagnoses – problematic because many children do not have a diagnosis; children can have very different abilities and needs, yet have the same diagnosis; the list of diagnoses is never complete (Mont, 2014).

Mont (2014) has also recommended that information is collected about the school environment, not just about the children in schools. This includes:

  • physical accessibility (school grounds, entrance, classrooms, toilets, etc.)
  • human resources (e.g. teacher training)
  • materials (e.g. aids and appliances, such as magnifying glasses, wheelchairs)
  • services (e.g. physiotherapy, orthopaedic support, speech therapy).

These recommendations have been acted upon by UNICEF (2014: 1) with positive results for more reliable data collection in the future:

UNICEF and the Washington Group are developing a new survey module to measure the school environment and children’s participation in education. The module will measure the barriers and facilitators to education by children with/without disabilities. This module will complement the module on child functioning and disability. Together, they will provide a comprehensive measurement of disability – assessing activity limitations, as well as children’s interactions within their environment. The module will cover: attitudes, accessibility, getting to school, and affordability. Once finalized, the module will undergo cognitive testing and field testing. It is expected to be ready for actual data collection and use by countries in early 2015

This represents a major step forward in providing governments with a useful tool to establish the particular difficulties facing both individual learners, and the education system. The tool will be relevant regardless of the stage of development in a particular country, and will impact upon children with a disability as well as those who experience difficulties in learning. However, improvements in data collection will only lead to improved policy and practice if there is a greater understanding of the principles of inclusive learning.

Croft (2013: 240) has argued for a ‘bottom-up’, ‘service-based’ approach to the ethical collection of quantitative data which would simultaneously deepen the understanding of educational practitioners and planners of ‘the kind of information that is needed to improve education for disabled children.’ Learning lessons in this way from existing educational, Croft (2013: 240) argues, could help, ‘inform broader analysis of national needs so that education can play a positive role in breaking the link between disability and poverty’. Collecting data about disability prevalence in contexts where learners with disabilities are already enrolled in schools, would provide a higher quality of data on the barriers experienced (as proposed by Mont, 2014), than in contexts where children with disabilities have been excluded from education (Croft, 2013).

Approaches to educating children who have a disability

Children tend to be either seen as ‘normal’, with common characteristics, and so educated in a mainstream school; or ‘special’ because of their particular individual or group characteristics, and educated in a special school, or in a specialist unit attached to a mainstream school (see EENET, 2006: 27, for an illustration of these different forms of provision). Alternatively, all learners are seen as having a common educational aim, and so the quality of teaching and learning is regarded as the main priority, with additional support being provided, where necessary, as part of an inclusive learning approach. The inter-relationship between common, individual and group characteristics is illustrated in a diagram entitled Inclusive Pedagogy (see Figure 3).

The arguments about the most appropriate location for the education of children with disabilities are influenced by culturally defined and evolving concepts and by the availability of educational options, but in many countries there is only one option – that of attending the local school. Alternative options include special, residential or day schools, resource rooms or special units, specialist support from a visiting itinerant teacher, and home-based education (sometimes in preparation for formal education), supported by community-based rehabilitation (CBR) workers, where available.

Special schools

Special schools can be a source of specialist expertise and facilities, and provide education for those with profound and complex disabilities. When they are well managed and resourced, they are an efficient way of concentrating resources in one location. No statistics are available on special school attendance in developing countries, but in the European context 2.3% of learners are educated in segregated settings, either in separate classes in mainstream schools, or in a special school (WHO, 2011: 210). The number of special schools has increased in India, in line with the development of inclusive education (Singal, 2008), but they tend to be urban-based, and so this does not necessarily involve separation from families and communities, as would be the case with attendance of a residential special school.

Special schools for deaf learners provide a focus for the development of sign language. The employment of deaf teachers and support staff further strengthens such specialist provision. This is difficult to achieve in a resource room or unit attached to a mainstream school (due to the smaller number of learners with just one specially trained teacher), and much more difficult to achieve in an inclusive setting with limited resources. Similar arguments are posed from the perspective of specialisms, such as autism, deaf-blindness and profound and complex disability. Indeed, in some countries, those with severe impairments are often considered to be ‘ineducable’, and so are excluded from both mainstream and special school settings.

Special schools tend to be perceived to provide a superior form of education for girls and boys with disabilities. Disabled people’s organisations and parents’ groups in Uganda reported that their preference was for special school provision, partly because of the overcrowding and poor resourcing of mainstream schools, together with their conviction that special schools provide a higher quality of education, leading to employment (Lang and Murangira, 2009). Similarly, parents of girls and boys with albinism in Malawi expressed a strong preference for education to take place in a specialist resource unit because they believed that the quality of learning and support far exceeded that to be found in a mainstream school (Lynch and Lund, 2011). Both deaf students and those with intellectual impairments have argued that mainstreaming is not always a positive experience, due to the low quality of specialist provision (WHO, 2011: 211). Yet there is also evidence of poor quality specialist provision in a study of special schools in Uganda, where some of the teachers had little or no specialist expertise, and specialist equipment was not available (Kristensen et al., 2006).

Singal et al. (2011) report the experience of 30 Indian young people with disabilities (from communities with few resources, whose parents had little education) in attending both special and mainstream schools. The young people benefited from attending special schools, particularly in the early years, as they were able to learn basic life skills; access appropriate specialist equipment; have exposure to positive role models, such as blind teachers; and develop friendships in a safe space. They appreciated the opportunity in later years to broaden their educational opportunities by attending mainstream schools, but some experienced high levels of frustration due to the lack of appropriate resources, a narrow and irrelevant curriculum, teachers’ inability to engage them and their lack of friendships.

Residential settings not only separate children from formal learning, but also separate them from opportunities for social learning in their families and communities. Children with disabilities are vulnerable to physical and sexual abuse in all settings (and girls are more vulnerable than boys), but residential special schools can be particularly unsafe in this respect.

These arguments and examples highlight the difficulties involved in comparing special school provision with mainstream settings. Poor quality education is bad for all children, not just those with a disability. The challenge is to raise standards of teaching and learning for all children in all schools and this involves ensuring that all schools are effective and promote quality education, regardless of the location.

Resource rooms

Resource rooms are sometimes referred to as ‘special units’, and as ‘transitory classes’ in French speaking countries. They enable the provision of specialist support within a mainstream educational setting, ideally as close to learners’ homes as possible. However, they can either reinforce the principles of inclusive learning, or they can be exclusionary – as is the case with any form, or location, of educational provision. Usually, a resource room is staffed by one specially trained teacher, who manages the learning of a multi-grade classroom of approximately 8 to 10 learners with sensory and/or intellectual disabilities. The initial purpose of locating a resource room adjacent to a mainstream school was to enable opportunities for inclusive learning and/or socialising, and to support team teaching and whole school approaches to inclusive learning for the benefit of all children. However there is a tendency for resource rooms to become small special schools, and for there to be few links with the host school. For examples of the use of resource rooms, see Section 2 and Stubbs (2008: 104-105).

The shift from segregated to inclusive learning

There are discernible patterns of development in all country contexts in the way school systems across the world have responded to children who have disabilities and/or experience difficulties in learning. This has involved a gradual move from exclusion and segregation, to an emphasis on integration, through to inclusion, but the pace of change varies enormously. The cartoon in Figure 1 reflects two contrasting approaches: a school making theoretical preparations for including children with disabilities; and a school willing to learn from experience.

Figure 1: A tale of two schools (Giangreco, 2007)
Figure 1: A tale of two schools (Giangreco, 2007)

Evidence of the impact of attending special or mainstream schools for learners who have a disability is not conclusive, even in developed countries, due to inconsistencies in the methodologies used to study both the settings, and the type and intensity of specialist services provided (WHO, 2011: 211-212).

The little research that has been conducted in low and middle income country contexts tends to focus on the most visible impairments, such as physical and sensory impairments, for which there are straightforward technical solutions, while relatively little attention is paid to learners who experience difficulties in learning, but have no visible disability (Section 2). In high income countries, by contrast, advances in medical science have led to a rise in the numbers, and complexity, of learners who require high levels of specialist knowledge and support, as reflected in the literature which is dominated by studies of girls and boys with autism and with severe intellectual impairments in a range of educational settings (Bakhshi et al., 2013).

Even where research exists, drawing the appropriate conclusions is challenging. A review of studies on inclusion (pre-1995) found that there were slightly better academic outcomes for students with learning disabilities in special education settings, and higher numbers of learners with emotional difficulties dropping out of mainstream schools (WHO, 2011: 211). Similarly, there is some evidence that the acquisition of communication, social and behavioural skills is superior in inclusive classes or schools, and that the inclusion of students with disabilities is generally not considered to have a negative impact on those without disabilities (WHO, 2011: 212). Again, these results cannot be used to draw conclusions about location and type of provision, where the mainstream schools in question have not made a conscious effort to promote inclusive learning – in terms of presence, practice, achievement and participation.

‘Global inclusionism’, Le Fanu (2014) argues, has led to the withdrawal of support for, and ultimate closure of, special schools by some large international non-governmental organisations , without first investing in the development of support systems for inclusive learning. The closure of specialist facilities has had a devastating impact on the lives of people with disabilities, especially those children with complex educational needs, as alternative forms of educational support and social protection have not been provided by national governments (Le Fanu, 2014).

The twin-track approach

The twin-track approach advocates removing the environmental, attitudinal and institutional barriers to addressing inequalities in education, while recognising that girls and boys with disabilities have additional individual needs which need to be addressed (see Figure 2).

DFID's twin-track approach to disability, poverty and development (adapted from DFID, 2000)
Figure 2: DFID’s twin-track approach to disability, poverty and development (adapted from DFID, 2000, cited in Yeo and Moore, 2003: 582)

Bines and Lei (2011) suggest that the continuation of some specialised provision through the twin-track approach is advisable in developing country contexts until more inclusive practice has been developed. They also argue that since special schools in developing countries tend to be located in urban areas, different models may need to be developed in remote rural areas, and suggest that the twin-track approach could support rural schools in developing specialist expertise.

‘In Southern countries, special provision is very limited, and the policy choice centres on whether to develop inclusive regular schooling and/or provide some interim specialist provision, as a twin-track approach’ (Bines and Lei, 2011: 422).

In India, twin-track approaches are commonplace, with the number of special schools having doubled between 1992 and 2002 at the same time as financial incentives being made available for the inclusion of girls and boys with disabilities into mainstream schools (Singal, 2008).

Individualised education plans are used widely in developed country contexts, and to a limited extent in developing countries (WHO, 2011: 218), with varying degrees of success to support learning in a range of settings. The aim of an individualised education plan is to ensure that learning needs are understood by all professionals involved, and that changing learning needs are constantly reviewed. They have been reported to be useful for those who need individualised learning support, but more research is needed on the implementation of individualised education plans in promoting inclusive learning in countries with few resources and limited teacher education.

As with all the concepts discussed here, the twin-track approach can be misrepresented and misunderstood unless it pays attention to the underlying principles, practices and ethos of inclusive learning. It can lead to an increased reliance on specialist support, which, in turn, can undermine teacher confidence and capacity. However, it has great potential to promote fully resourced and supported inclusive learning.

Conclusion
This section has discussed the concept of ‘inclusive learning’ developed for the writing of this Topic Guide. It has also discussed the difficulties faced in generating accurate and comparable data (disaggregated by sex and by type of impairment or difficulty), rather than simply collecting quantitative data on prevalence of disability and of school attendance and the potential for collecting service-based data at the same time as deepening teachers’ understanding of difficulties in learning. The provision of specialist facilities and the widely recommended twin-track approach for ensuring that the educational needs of specific groups of learners are met alongside efforts to promote an inclusive learning environment have been discussed in this section. In Section 2, evidence is presented of the practical difficulties involved in developing ‘grounded’ and contextually specific approaches to inclusive learning.
This section brings together the available evidence on inclusive learning in low and middle income countries, with a particular focus on children with disabilities and those who experience difficulties in learning, for the first time. It seeks to identify practices and approaches from low and middle income countries that have made efforts to include all girls and boys in learning. The research methodology is outlined, along with its limitations. Thematic research questions are addressed across four key areas: teacher education; classroom practice; management and administration of educational leadership; and beyond school factors. The section highlights the key challenges, identifies knowledge gaps and suggests agendas for future research on equitable and inclusive learning.

Part A: Research methodology and its limitations

Summary of the limitations of the evidence

The evidence base on inclusive learning for children with disabilities and difficulties in learning focuses largely on high income countries, particularly the US and UK, and there are challenges in identifying good quality evidence from low and middle income countries. These include:

  • There is a lack of reliable data on prevalence of disability and difficulties in learning in school-age populations.
  • There is a lack of reliable data on attendance at pre- and primary schools.
  • Evidence focuses on concepts and definitions of ‘inclusive education’, access to basic education and policy recommendations but evidence on implementation and on learning outcomes is patchy.
  • The most substantial body of literature focuses on teacher attitudes towards disability, but findings are varied and inconclusive.
  • Much of the available evidence has been generated by international non-governmental organisations, but this often lacks academic rigour and sample sizes are small.
  • Little evidence is available on inclusive learning in early childhood education

The evidence summarised here on inclusive learning in low and middle income countries was identified through a rigorous review of literature from five education databases linked to ProQuest, using a set of relevant search terms. A total of 60 journal articles were identified through this process, 23 of which focused on teacher attitudes. Only eight articles were deemed to be of direct relevance to the practice of inclusive learning, and so included in this review. Further searches were conducted of literature recommended by key stakeholders in the international non-governmental organisation (NGO) and UK-based research community. Only three systematic literature reviews have been included: access to education for children with disabilities (Bakhshi et al., 2013); teacher attitudes (de Boer et al., 2011); the economic costs of exclusion and gains of inclusion (Morgon Banks and Polack, 2014). The majority of the literature is drawn from small-scale studies conducted by international agencies and academics based in the North.

The issues of teacher attitudes and self-efficacy in relation to inclusive education are over-represented in the literature identified for the review (23 out of 60 articles identified in the initial review of the literature). There is a clear gap in the literature in relation to inclusive learning processes, strategies and outcomes at both teacher education and classroom level. The preoccupation with the barriers created by negative attitudes towards inclusion has arguably led to a lack of resourcing of research into classroom-based inclusive learning strategies. It is also indicative of the current phase of global advocacy around inclusive education. There has been a predominance of policy advocacy in the grey literature which has been primarily concerned with developing and delivering key messages from the inclusive education discourse to influence decision makers and mobilise popular campaigns. However, this has not translated into investment in research and the absence of evidence on learning outcomes for learners with disabilities reflects the dearth of evidence on the topic in general.

Further reviews of literature generated in developing country contexts highlighted gaps in the knowledge base. Such reviews tend not to be included in international databases. However they are likely to be identifiable through consultation with practitioners and academics in those contexts, but this approach requires additional resources. For example, as part of the consultation with UK-based academics, a national achievement survey was identified that had been conducted on the learning outcomes of students in Class 5 (around age 10) of Indian elementary schools, including learners with physical difficulties (National Council of Educational Research and Training, 2012). This more complex process of literature searching was beyond the scope of this review.

The first systematic review of the literature which focused on the accessibility of education for people with disabilities in both developed and developing countries found that:

there have been virtually no studies in the academic literature that have looked at the impact of an intervention to improve accessibility of children with disabilities to formal school settings in low- and middle-income countries in the past decade
(Bakhshi et al., 2013: 28).

They also found that the literature from low and middle-income countries on the issue of education of children with disabilities consists primarily of ‘commentaries, discussion papers, opinion pieces or reviews’, and that there is an absence of evaluations of effectiveness (Bakhshi et al., 2013: 28).

Most of the studies identified by Bakhshi et al. focused on learning disabilities and autism (reflecting research trends in the US and UK) and there was a notable lack of attention to blindness, visual impairment or physical disabilities, which are ‘very prevalent impairments in low-income countries’ (Bakhshi et al., 2013: 28). Of those studies identified, the implications for policy and programming lacked substance:

…although these studies present a picture of what and how well children with various disabilities can do within classrooms, these measures alone do not provide the required information for making recommendations in terms of policy and programming; in other words although most studies might hold scientific validity, their external validity is not very strong
(Bakhshi et al., 2013: 24)

The implications of the Bakhshi et al. (2013) review are that:

…some of the questions about education for children with disabilities in middle- and low-income countries are still unanswered;
(Bakhshi et al., 2013: 29).

They conclude that ‘it is not possible to draw any formal conclusions about the most effective approaches (in terms of impact or indeed cost) to increase the accessibility of education for children with disabilities’ in developed or developing countries (Bakhshi et al., 2013: 34).

A rigorous literature study was conducted in 2012 to identify projects in low and middle income countries in the preceding 10 year period which aimed to make education more inclusive, and to identify the effects of these projects (Srivastava et al., 2013). Of the 157 references identified in 30 databases and from international organisations, 11 studies and 4 reports were selected for review, and only 2 projects reported positive effects in terms of increased attendance of children with disabilities; these were: Deng and Holdsworth (2007) and Villa et al. (2003), studies identified for review in the process of writing the Topic Guide.

Much of the evidence on inclusive learning in low and middle income countries which was reviewed for this Topic Guide focuses on girls and boys who have more prominent, often physical, impairments and who are already attending school. The findings presented in this section reflect the conclusions of the Bakhshi et al. (2013) and Srivastava et al. (2013) reviews, and further expose the limited evidence available on the effectiveness of inclusive learning for children with disabilities, and for those who experience difficulties in learning. There is an emerging body of literature focused on the education of learners with visual impairments, including those with albinism. Many girls and boys who experience difficulties in learning and who would benefit from more inclusive forms of education, tend to go unrecognised in developing country contexts (Villa et al., 2003). This reflects the ways in which impairments, disability and difficulties in learning are defined in particular contexts, as discussed in Section 1. The research questions addressed in this section of the Guide focus on some of the limited evidence that does exist, and its practical implications.

Part B: What forms of teacher education enable teachers to promote inclusive learning for girls and boys aged 3 to 12 years old?

Summary of evidence

Teacher attitudes and confidence

Numerous studies have focused on teacher attitudes in both pre-service and in-service teacher education. Findings are varied and include:

  • Teacher attitudes are important to the reduction of stigma and discrimination and the active participation of learners with disabilities and difficulties in learning
  • Teachers who perceive their school to be supportive of inclusive learning, and teachers who have had contact with students with disabilities, tend to have more positive attitudes than those who have had little contact.
  • Teachers with the least experience of teaching have more positive attitudes than those who have been teaching for a longer period of time.
  • Teacher confidence can be low among the newly qualified who tend to feel they do not have the requisite skills and experience to teach inclusively.

Approaches to teacher education

  • In-service teacher education plays a key role in tackling stigma, reducing discrimination and raising teachers’ expectations of learners with disabilities and those with difficulties in learning.
  • Inadequate human resources at ministry level to support the ongoing development of teacher capacity is one of the major reasons for teachers’ difficulty in differentiating their teaching.
  • An extensive range of generic toolkits and manuals have been produced to prepare teachers for, and promote, inclusive education.

Teacher attitudes, confidence, knowledge and expectations, in relation to teaching girls and boys with diverse learning needs, are inextricably linked and can be affected, both positively and negatively, by pre-service and in-service training, by teaching experience, and by social and cultural values. In the absence of national policies, strategies or statutory teacher education on inclusive learning, much of the training available in low and middle income countries is fragmented and inconsistent. Many of the examples cited here involve sustained efforts to provide in-service teacher education. However, there are challenges in sustaining such efforts due to a shortage of experienced advisory level staff, as well as leadership commitment. Yet, teacher education is one of the most urgent priorities and most sustainable investments, given expectations placed on teachers to deliver inclusive learning.

Teacher attitudes

The negative attitudes and behaviour of teachers towards children with disabilities and those who experience difficulties in learning can inhibit academic progress. Numerous studies have focused on teachers’ attitudes towards inclusion, and on the impact of attitudes on the effectiveness of inclusive teaching practices, and the findings are varied.

When universal primary education was first introduced in Uganda, initiating a large influx of previously excluded groups, schools were overwhelmed. They reported problems with discipline, performance and drop-out rates, and teachers who were opposed to inclusion made little or no effort to support students with impairments (Arbeiter and Hartley, 2002). A systematic literature review covering a range of countries, including China, India, Iran, Palestine and Zimbabwe, found that ‘teachers with the least general teaching experience had more positive attitudes than those with longer service’ (de Boer et al., 2011). Teachers who are better educated or have personal experience of people with disabilities tend, unsurprisingly perhaps, to take a more supportive approach to inclusion (Parasuram, 2006).

A study of 738 teachers working in 293 government primary schools in Bangladesh found that ‘perceived school support for inclusive teaching practices’ and a range of demographic variables including successful contact and experience of teaching students with disabilities were associated with more positive attitudes of the teachers towards inclusive education more generally (Ahmmed et al., 2012).

Similarly, in Lao PDR, teacher attitudes were found to be fundamental in developing innovative and inclusive practice. In particular:

… where teachers engage with the idea of changing lessons so that all children are participating and achieving, then their attitudes begin to change. As well as enjoying their teaching more and becoming increasingly motivated, they are also enabled to understand how children with disabilities and special needs can be included in ordinary lessons in mainstream schools.

Approaches to in-service teacher education

International and national NGOs have a long history of working in parallel and in partnership with government initiatives to provide teacher training for inclusive learning, through differentiated approaches to teaching style and content. These programmes can be small scale and unsustainable (Le Fanu, 2014) due to high transaction costs and short-term project financing from donors. This fragmented approach makes it harder to introduce, consolidate and sustain more inclusive approaches to learning at classroom level and, while it can provide scalable, contextualised models of practice, is thus not sustainable on a national basis in the longer term.

In Rwanda, 19 of the 25 NGOs working with children with disabilities have developed their own inclusive teacher training for both mainstream and special schools (Karangwa, 2013). This training is not recognised by the Ministry of Education because it ‘does not follow the nationally recognised accreditation and qualification frameworks’ (Karangwa, 2013: 4) and is therefore not rewarded with increases in salaries or promotion. This can disincentivise teachers from engaging in these development programmes. Karangwa suggests that many such courses tend to be ‘specialist’ by design, inadvertently discouraging teachers from taking responsibility for the learning of all children. In order to address the problems arising from this fragmentation in Rwanda, Handicap International has supported the development of a government recognised Diploma programme on inclusive education, developed by the ‘Task Force for the Development of Inclusive Education in Rwanda.’ This programme is now working with a range of education stakeholders including 40 model schools, 8 district education offices, education inspectors, the Rwanda Education Board, the Ministry of Education and Kigali Institute of Education (Handicap International, no date)

In Lao PDR, in-service training was prioritised by teachers and policymakers as a central pillar of the national inclusive education programme that began in 1993 with initial support from Save the Children Fund UK. However, it was found to be ineffective as a stand-alone initiative and failed to improve classroom practice (Grimes, 2009). A subsequent phase of in-service teacher training, which took place for 60 days over a 2 year period, was introduced in combination with ongoing advice and guidance at school level, an approach that proved to be more effective. This advice and guidance was provided through a range of initiatives, designed to support teachers: resource centres; cluster schools; itinerant teachers; support for leadership; inclusive school development; governance programmes; mentoring; peer-to-peer support for pupils and staff; and continuing professional development training and events.

A national in-service teacher education programme was initiated in 1991 in Lesotho, with support from Save the Children Fund UK and UNICEF. It prioritised the in-service training of all 77 teachers in 10 pilot schools across 8 districts, led by Ministry of Education staff (Khatleli et al., 1995). The training of all teachers was a deliberate strategy to avoid the difficulties that can arise when one teacher is perceived as the ‘specialist’ in disability issues. The training was conducted in the school holidays by a wide range of education stakeholders, all based in Lesotho, including disabled people’s organisations, parents’ organisations, specially trained teachers from the special schools, and rehabilitation professionals. Follow-up visits were made on a regular basis to support the teachers in pilot schools, which subsequently became a regional resource for neighbouring schools.

In 2005, a doctoral study analysed the impact of this national teacher education programme in Lesotho. The study was conducted in 21 of the 82 primary schools (Johnstone and Chapman, 2009: 139), some of which had been involved in the training described by Khatleli et al. (1995). It found that, ‘Many of Lesotho’s teachers can adequately (informally) screen student academic and sensory functioning, and do care deeply for students with disabilities’. As a result, many teachers are able to adequately, though informally, screen students’ academic and sensory functioning. However, the training had not prepared them to differentiate or accommodate the educational needs of a diverse range of learners in the context of large classes. Inadequate Ministry capacity to provide sustained support to ongoing teacher development was identified as one of the major barriers to the development of teachers’ skills in differentiation.

Deluca et al. (2014) present evidence from a school-based survey in four districts in the north of Zimbabwe of knowledge, attitudes and beliefs, barriers, concerns and daily practices related to disability and inclusive education. Their findings demonstrate the need for further specific training on inclusive approaches for teachers and head teachers in order to improve the quality of teaching and learning outcomes for girls and boys with disabilities. Although attitudes and beliefs were generally positive, the long distances between home and school, a lack of assistive devices and lack of adequate transport continued to be major barriers to school attendance, as were the direct and indirect costs of schooling, suggesting the need for a variety of support mechanisms to make inclusive learning a reality. Large class sizes and poor sanitation arrangements were additional barriers.

Five strategies for training, recruiting and supporting inclusive teachers have been identified by the International Disability and Development Consortium (2013), and these include: ensuring that all teachers receive training on inclusion in their initial teacher training; balancing theoretical understandings of inclusive learning with practical experience; ensuring that teacher trainers have a good grasp of inclusive principles; involving people with disabilities in teacher education processes; recruiting a diverse range of people as teachers.

Teacher expectations

Raising teacher expectations and challenging negative attitudes through high quality in-service teacher development programmes are critical for inclusive learning to succeed.

In Vietnam two pilot projects were set up in 1995, one in an urban and the other in a rural district. Within 4 years, 1,000 of the 1,078 girls and boys with disabilities identified in their homes with mild, moderate and severe disabilities had gained access to their local schools (Villa et al., 2003). The evidence reviewed only provides details of the process of identifying the girls and boys, and supporting their access to school, it does not provide information about the nature of their engagement, or their learning outcomes. ‘Prior to the project there had been minimal in-service training of any sort’ (Villa et al., 2003: 27), but through the process of in-service education, teachers’ expectations of learners’ abilities were raised.

Research directions

The evidence reviewed indicates the following gaps in the literature, which are worthy of attention in future research:

  • the content and impact of pre-service training on inclusive learning
  • the knowledge and skills that teachers need to support, develop and sustain inclusive learning
  • learning needs of teachers at different stages of their career about teaching inclusively and managing the diverse learning needs of children
  • the role of inclusive learning in early childhood education in preparing children for formal schooling and in preventing future difficulties in learning
  • training needs of educational leaders, including at ministry and local government level.

Part C: What forms of classroom practice can promote inclusion in participation and learning?

Summary of evidence

  • The economic benefits of providing girls and boys with eye glasses outweigh the costs while also improving test scores, but social stigma and lack of access and affordability can impact negatively on uptake.
  • Teachers’ positive attitudes and ability to screen for disabilities and diverse learning needs does not necessarily translate into adapted classroom practice or an ability to provide differentiated curricula and learning opportunities.
  • Peer-to-peer approaches have assisted learning and built self-esteem and friendship networks in some contexts, but little is known about their impact on learning outcomes.
  • Multi-grade teaching has potential benefits in promoting inclusive pedagogy and teacher awareness of learner diversity.

Effective teaching practice is important for inclusive learning. This includes differentiation and accessibility of lessons. Adaptations need to be made to the learning environment and to the pedagogy, according to the variable needs of the learners. Sometimes learners require individual assistive devices to support their learning and ensure that they can access the curriculum. Effective teaching ensures that all girls and boys are included, engaged in learning and supported to achieve their potential. Similarly, gender-sensitive teaching approaches can help to ensure that the learning outcomes of girls and boys with disabilities are not adversely affected by gender-prescribed roles and expectations.

Inclusive classroom practice

In Lao PDR, girls and boys with mild to moderate disabilities were successfully included in classrooms by teachers who actively supported them using skills they had learnt in their training, which included:

  • actively providing additional classroom support to help children with specific skills and comprehension
  • enabling peer-to-peer support, which not only assisted learning but built self-esteem and friendship networks
  • using locally-produced resources (e.g. stones/chopsticks for maths, flashcards for literacy), often produced by community members
  • actively engaging parents to support children’s learning at home (Grimes, 2009: 106-107).

Similarly, the DFID supported Gansu Basic Education Project (GBEP) in China introduced ‘measures to ensure good learning opportunities for children with special educational needs’ (Deng and Holdsworth, 2007: 507). Baseline data revealed that, prior to GBEP’s launch, approximately 30% of children with mild physical or sensory disabilities had been accepted for enrolment in schools ‘out of sympathy,’ but were ‘found in the corners of the classrooms’ and received no extra help, effectively being excluded in an ‘inclusive’ setting. Parents reported fears of sending their children to school due to bullying and doubts about the value of their education. Within 2 years of the project’s inception, enrolment of girls and boys with disabilities and difficulties in learning had risen to about 60% as a result of improved parent and community awareness.

A study of teachers in Lesotho observed that there was a lack of emphasis on differentiation or accommodation of learners’ needs in large group settings, in spite of in-service training provided by the Special Education Unit at the Ministry of Education. This highlights inadequacies in teacher education, discussed above, which leave teachers ill-equipped to teach girls and boys with specific learning needs in an inclusive classroom. At the same time, the Lesotho study found that teachers had positive attitudes, and some offered lessons in their spare time to girls and boys with disabilities and those who experienced difficulty in learning (Johnstone and Chapman, 2009).

Peer-to-peer learning and child-friendly approaches

Encouraging cooperation between students through peer-to-peer learning (also referred to as child-to-child approaches), has the potential to maximise participation as well as achieve high learning standards for all. A study in India found that:

‘A common practice adopted by all teachers was to involve other children in helping the child with disabilities. This was done primarily through making changes to the classroom seating arrangement. Teachers made the child with disabilities sit with a ‘good’ student, who was then instructed to help her/his partner’ (Singal, 2008: 1523).

However, concerns were raised by teachers that a great deal was expected of the most able students, who sometimes became proxy teaching assistants. As with any inclusive learning strategy, the quality of the intervention varies considerably and a great deal depends on the quality of the teachers involved.

In Pakistan, a 2007 pilot programme to introduce inclusive schools in Balochistan found that child-friendly teaching and learning methodologies improved average academic performance of all children, including those with disabilities (Acedo et al., 2011). This pilot led to the Islamabad Commitment on Inclusive and Child-Friendly Education and the establishment of 3,000 child-friendly schools targeting 700,000 children with disabilities. The Commitment is supported by the Ministry of Education and UNICEF.

In contrast to this confidence in the child-friendly approach, a recent survey of 12,576 government schools in rural India found that child-friendly approaches, though ‘well intentioned’ and designed to increase inclusion in learning environments, had insignificant effects on test scores (Das, 2014: 1). The study was the first quantitative evidence of the impact of child-friendly approaches in India and looked at pedagogical practices through high quality classroom observations. Das (2014) found that the popularity of child-friendly approaches in policy discourse was disproportionate to their actual impact on learning outcomes, thus highlighting potentially substantial flaws in the available evidence base on child-friendly approaches. However children with disabilities and/or with identified difficulties in learning were not included in this study.

Specialist support to mainstream schools

This section reviews a range of specialist interventions including the deployment of itinerant teachers, resource rooms, sometimes referred to as special units, and the provision of assistive devices and learning materials.

Itinerant teachers

In Kenya, Uganda and Malawi specialist support is provided to children with visual impairments and their teachers in mainstream classrooms through the employment of ‘itinerant’ teachers. This model was first introduced in Kenya by Sightsavers in the 1980s, and more recently has been introduced to support children with hearing and intellectual impairments in Malawi.

In Malawi, itinerant teachers work full-time in their role as specialist itinerant teachers, whereas in Kenya and Uganda they are employed as mainstream class teachers with permission to conduct itinerant teacher duties. Kenya has the most well-developed and successful system of itinerant teachers. Evidence of the progress of itinerant teacher programmes has been studied by researchers based at the Visual Impairment Centre for Teaching and Research (VICTAR), established in 2001 at Birmingham University, (see for example, Lynch et al., 2011). Trained in inclusive or special education, itinerant teachers aim to ensure that assistive devices are working, provide advice, support and resources to children, families and teachers about the importance of education for children with disabilities (this includes attending church services and village elders’ meetings to raise awareness in Uganda; Lynch et al., 2011), and liaise with teachers to strengthen inclusive classroom learning and practice.

Itinerant teachers are considered to have a key role to play in supporting participation and learning in the classroom. They may provide technical one-to-one support (e.g. teaching numeracy with an abacus, teaching sign language, transcribing tests into Braille), support transitions from home to mainstream classrooms and enable girls and boys with disabilities to engage with the curriculum. They may also provide regular advice and guidance to mainstream teachers on inclusion issues and challenges, such as best placement of pupils within the classroom, basic adaptations of learning materials and so on.

One of the limitations of the itinerant teacher approach is that caseloads tend to be very large and distances too great, preventing teachers from making regular school visits and meaning that coverage can be patchy. The difficulty of balancing regular teaching responsibilities with the demands of the itinerant teacher caseload is another limitation (Lynch et al., 2011).

Resource rooms

Resource rooms (sometimes referred to as ‘special units’, ‘support rooms’, or ‘transitory classes’ can facilitate the inclusion of girls and boys with disabilities in mainstream schools by providing additional specialist services, with a view to supporting transition into a mainstream class, although children often remain in the resource room setting. In Rwanda, resource rooms have been developed and equipped with locally-made educational resources in over 27 schools in order to ensure access to, and support for, the education of students with disabilities, including those who are deaf. Parents work with teachers on a rota basis in the resource rooms to develop educational materials (Karangwa, 2013).

Mainstream primary schools in El Salvador similarly have ‘support rooms’ which provide assessments of needs, individual or small group instruction, support for regular teachers, speech and language therapy, and work closely with parents, receiving a budget from the Ministry of Education. By 2005, 10% of all primary schools had such support rooms (WHO, 2011: 221).

In Uganda, a total of 123 deaf children are supported by 14 units attached to primary schools in Bushenyi District – this amounts to around 8% of the deaf school-age population in the district being registered as attending school, compared to only 2% nationally (Miles et al., 2011). Prior to these units, early identification of children with disabilities and formal education was provided by Danida-funded resource centres (1984-2000, after when external funding ceased). The later, less resource intensive initiative, focusing on deaf children, was supported by Deaf Child Worldwide and VSO and paid particular attention to teaching parents, teachers and pupils Ugandan Sign Language, and on addressing the negative attitudes in the community to the inclusion of deaf girls and boys in primary schools. The first cohort of teachers to receive training was exposed to good practice, learned sign language, and went on to teach a second cohort of teachers using a cascade model. An evaluation found that the language competency of this second cohort was weak and as a result children’s own language acquisition and development was constrained (Wapling, 2010). The evaluation recommended that opportunities be created for deaf girls and boys to meet with deaf adults or students with advanced sign language competence to enhance their language development.

While there are clear benefits to enhancing access and inclusion of disabled learners in mainstream settings, the establishment of resource units and rooms in low and middle income countries is fraught with challenges. Stubbs (2008) does not recommend resource units as a strategy for inclusive learning, and has identified the following barriers to implementation:

  • Substantial additional funding for resource rooms can lead to resentment among teachers who have under-resourced classrooms and large class sizes.
  • Teachers with additional qualifications in special education tend to receive higher salaries, which can also fuel resentment.
  • Teachers who do not have specialist qualifications often struggle to teach ‘problem’ children, and so label them as having ‘special needs’ in order to shift responsibility for them to the resource room teachers.
  • Children with a wide range of impairments tend to be grouped together according to their characteristics, rather than their learning needs.
  • Stigma and separation are perpetuated, as some girls and boys remain in the resource rooms on a permanent basis.
  • Children and teachers in regular classrooms do not receive adequate support (Stubbs, 2008: 44-45).

Assistive devices and learning materials

Recognising the diversity of educationally significant impairments and providing assistive devices, where possible, is a critical component of support for inclusive learning. Ensuring the provision of the right assistive devices (spectacles, magnifying glasses, telescopes, hearing aids, mobility aids) and adapted materials (Braille textbooks, large print materials) is an essential part of well-supported inclusive learning. There can, however, be considerable logistical challenges in providing such additional resources, especially in rural and low income settings. Limited finance, lack of collaboration between ministries of health, education and social welfare, social stigma, and the need to train and deploy professionals to monitor, maintain and evaluate these devices (Lynch and Lund, 2011) are some of the key barriers.

Eye glasses are one of the most straightforward and least expensive assistive devices and in China’s Gansu province the economic benefits of giving glasses to children has been shown to outweigh the costs, as well as to improve test scores:

‘A randomized control trial was implemented in 25 townships of two counties in Gansu, which included about 19,000 children in 165 schools, of whom about 12% had poor vision. The results indicate that offering eyeglasses to children with poor vision increases their test scores (averaged over three subjects) by between 0.11 to 0.16 standard deviations of the distribution of those test scores, depending on the estimation method used’ (Glewwe et al., 2012: 34-35).

In spite of these results, around one third of children or household heads refused the glasses because of social stigma associated with having an impairment, and a larger number of boys (74%) than girls (66%) accepted the prescription of eyeglasses (Glewwe et al., 2012). The Gansu province experience helps explain why so many disability-focused organisations prioritise awareness raising and the addressing of negative attitudes, and why there is so little evidence on the impact of inclusive learning initiatives in developing countries.

Programmes in southern Africa which address the particular needs of children with albinism routinely address extreme stigma, alongside delivering practical help to address poor eye sight and reduce the risk of skin cancer. In Malawi, it is reported that:

‘The most effective, cheapest and most accepted form of ‘aid’ is a wide brimmed hat and dark glasses. If children with albinism are allowed to wear a hat both inside and outside the classroom, this will help protect their very sensitive eyes from bright light and improve their vision. Hand held magnifiers are also useful, but compliance may be low. Prescription spectacles will correct some visual problems such as astigmatism, which will improve visual performance, but these are relatively expensive, may get broken and require regular check-ups at optometrists’ [italics added] (Lynch and Lund, 2011: 38).

Lynch et al. (2011) found that itinerant teachers in Kenya were making effective use of local materials to support the learning of children with low vision. However, high pupil-to-textbook ratios were found to be problematic, when students had to share texts and those with visual impairments struggled to access the materials. As a result some itinerant teachers transcribed textbooks by hand into large print during the holidays, but this is clearly neither an efficient use of their time, nor a sustainable approach (Lynch et al., 2011). Girls and boys with severe visual impairments also need specialised assistance: brailling of textbooks is essential and these books must be made durable; video magnifiers (also known as closed circuit television systems, or CCTVs) have been made available in some Nairobi resource centres but are impractical in rural primary schools which do not have electricity supplies, and so are rare outside of urban contexts (Lynch et al., 2011).

In a study of the barriers to full educational access for learners with albinism in central and southern Malawi, Lynch et al. (2014) reported that, ‘Although albinism affects both genders equally, the number of girls attending resource centres is significantly lower than boys’, and that one of the possible explanations is parental concerns about girls attending centres managed primarily by male staff. This observation is indicative of many other studies reviewed here, where occasional observations are made about gender inequality, but gender analysis was not built into the study design. This indicates a need for a greater awareness of intersectionality and more gender-sensitive approaches to research and development work, as UNICEF (2013) suggests, ‘Integrating age, gender and diversity awareness, including paying special attention to the multiple discrimination faced by women and girls with disabilities is critical for disability-inclusive programming’.

Regular breaks

Inclusive classroom practice recognises the importance of play and breaks during lessons. Play fosters critical skills, such as problem solving, planning, turn taking and sharing. Wapling (2010) argues that children with disabilities have often not been given the freedom to play and socialise because they may have been rejected by their peers or kept at home by overprotective parents. Breaks between activities are particularly helpful for all girls and boys, but particularly those with hearing impairments who can find transitioning between lessons and subjects a challenge, and need time to prepare for a new topic or activity. Deaf children find learning tiring, due to the level of concentration required, and so benefit from short breaks in between lessons, with opportunities to play and interact with their peers. This can help them concentrate better, develop essential social and linguistic skills and maximise their time in class (Wapling, 2010).

Pedagogy

In many classrooms, teaching and learning is aimed at the majority, who are perceived to have common characteristics and common learning needs. The concept of ‘inclusive pedagogy’ is relatively new in high income contexts, and virtually non-existent in low and middle income countries. There are ongoing debates about the extent to which learners with disabilities require a specific, adapted ‘special’ pedagogy, sensitive to the needs of sub-groups (such as visually-impaired learners) while other scholars argue that it is sufficient to promote the development of pedagogies that treat all children as individuals (Croft, 2013).

See Figure 3 for an illustration of inclusive pedagogy: as a dynamic relationship between responding to learners as having common characteristics; as sharing the characteristics of a sub-group; and as a way of understanding individuals. Most children have a complex mixture of individual, group and common characteristics, and inclusive pedagogy aims to address the diverse educational needs arising from the children’s characteristics and their personal circumstances (e.g. orphaned, displaced).

Inclusive pedagogy (adapted from Croft, 2013)
Figure 3: Inclusive pedagogy: a response to learner’s common, group and individual characteristics and situations (adapted with permission from Croft, 2013: 235)

The way teachers understand and conceptualise ‘difference’ in broad terms (gender, disability, ethnicity, culture) is integral to inclusive pedagogy, as are the repertoires, or range of techniques that teachers use to respond to those differences, and in particular to those who experience difficulties in learning.

‘Inclusive pedagogy … accepts that learners have individual differences but sees pedagogically significant differences as located in the interaction between the learner and the school and therefore within the teacher’s influence and responsibility’ (Croft 2010: 28).

Pedagogical practice that labels girls and boys ‘special’ or ‘slow’ can lead to stigmatisation, exclusion and low expectations of learners by their teachers. In Mpika, Zambia, ‘Most of the teachers believed that inclusive education was not their responsibility. They saw it as a specialist issue associated with ‘special needs’ and disabilities’ (Miles, 2009: 616). Teachers in Mpika collaborated in a process of problem-based learning, involving reflective writing and regular after-school discussions led by an in-service teacher educator, and they began to realise that they already had significant skills in managing large inclusive classes, and in responding to children with diverse needs such as those who were poor attenders, orphans and teenage mothers (Miles, 2009). Engaging in this process helped the teachers to appreciate their existing skills, grow in confidence, and take risks in developing greater competence as inclusive teachers.

Multi-grade teaching

Multi-grade teaching is challenging even for the most committed and well trained teachers, though it has often been presented as the only viable approach for governments wishing to expand access and deliver Education for All (Croft, 2006). Where teachers and schools have successfully adapted to multi-grade teaching this has been recognised as potentially beneficial in promoting greater teacher awareness of learner diversity, an appreciation of the importance of differentiating learning. It also has a wider impact on progression through grades, transition from primary to secondary and better learning outcomes (Croft, 2006).

Multi-grade teaching approaches can help teachers better understand that ‘difference’ is not something that only applies to learners with disabilities or with obvious physical impairments. However, this understanding also needs to include recognition of diversity within sub-groups of learners. Many specialised resource units attached to mainstream schools cater to girls and boys of different ages and grade levels. In a study of units catering to deaf Ugandan girls and boys, Wapling (2010: 11) found that ‘whilst staff were generally very good at differentiating work according to assumed primary grade level there was much less attention being paid to the children’s varying abilities within those grades’. This had particular consequence for language acquisition and demonstrates the complexity of the challenges faced by teachers in their classrooms day to day.

Research directions

The evidence reviewed indicates the following gaps in the literature, which are worthy of attention in future research:

  • the impact of low-cost aids and appliances on learning outcomes (wide-brimmed hats, dark glasses, regular eye glasses, magnifiers, mobility aids, adapted furniture, accessible toilets)
  • the role of technology in supporting inclusive learning (personalised computer-based learning for learners with visual difficulties and cognitive impairments, hearing aids)
  • resource modelling for assistive devices, including education workforce development and deployment
  • the impact of education offered in resource rooms on learning outcomes, and on progression to secondary education, and employment
  • effectiveness of peer support strategies in promoting inclusive learning and improving learning outcomes
  • differentiated teaching strategies and flexible classroom practices for responding to children with diverse learning needs
  • studies of inclusive learning disaggregated by gender and type of disability and difficulty in learning.

Part D: What does the move towards more inclusive learning mean for school organisation and leadership, and what are the implications for financing, curriculum and assessment?

Summary of evidence

Accountability mechanisms can play a potentially useful role in identifying challenges to inclusive learning.

  • Various models exist for the financing of inclusive learning.
  • Leadership teams can play a role in sustaining inclusive learning.
  • Building physically accessible schools is more cost effective than making subsequent adaptations.
This section summarises the limited evidence available on some of the practical school management considerations in the implementation of inclusive learning approaches. This includes the physical accessibility of the learning environment; the adaptation of curricula and assessment structures; and financing and investment for inclusion.

School leadership and organisation

The World Report on Disability underlines the importance, and ‘cost-neutral’ nature, of ‘strong and continuous leadership at the national and school levels’ of an inclusive education system (WHO, 2011: 216). Experience from China shows that commitment from local leadership and working groups made up of representatives from county, prefecture and province, can underpin and ensure successful implementation of inclusive learning approaches. Ten ‘outstanding’ individuals were identified from the Gansu Basic Education Project to become members of a team tasked with developing locally relevant special education training materials (Deng and Holdsworth, 2007). Supported by international and national consultants, they became ‘local experts in special education’ and played a leadership role in cascade training, consultation and mobilisation.

The Special Education Needs Division of the Ghana Education Service has recently developed a monitoring tool to enable mainstream schools to self-assess their progress on the inclusion and learning of girls and boys with disabilities. Supported by UNICEF, this was implemented across 12 districts in the 2013/14 academic year and there are plans to expand nationally. The Inclusive Education Management Tool enables the collection of data on access, participation and academic success, and consists of:

  • a checklist of 25 indicators plus a comment box
  • a list of 15 statistical items on children with disabilities, data disaggregated by impairment/needs
  • a guide for monitoring process (scoring, weighting, frequency, school visits, etc.).

While it is too early for a detailed assessment of the tool’s effectiveness, initial testing suggests that it successfully highlights challenges to inclusion, such as teacher shortages, absenteeism and poor teaching methodologies (Otaah et al., 2013).

Based on their review of education sector planning and provision in 28 low and middle income countries, Bines and Lei (2011: 423) suggest that it is important to identify a ‘local service delivery unit which can then be developed as a locus for both resources allocation and capacity development in relation to inclusion’. At school level they recommend the development of whole school policies, with the employment of ‘at least one trained specialist teacher per school’ (Bines and Lei, 2011: 423).

A focus on school management, and greater links between leadership and improving the quality of education for all learners, led to positive educational outcomes (such as grade passing, primary retention and completion rates) in inclusive schools in Lao PDR (Grimes, 2009). Teachers became more actively engaged, motivated and positively committed to their work, as a result of these improvements.

Figure 4 is an example of a tool which can be used in a relatively straightforward way by teachers and educational administrators to analyse in a systematic way the reforms that are needed in a given context to develop a more flexible, responsive and inclusive education system.

Level of education system
Type of access International National Region District School Department (in larger schools) Class/Teacher Students: Individuals or groups
Physical and bureaucratic access to school, within the school, within the classroom
*Access to teaching, learning and assessment

* Relevant curriculum and materials, motivation and emotional security, teaching and learning in a comprehensible language, participation in constructing and applying knowledge, fair assessment for pedagogic and social purposes

Figure 4: Sites of possible educational interventions to support the access of disabled children and youth to schooling (Croft, 2013: p236).

Financing inclusive learning – what works?

The World Report on Disability summarises three ways of financing inclusive learning (WHO, 2011: 218):

i.            national: through sector budgets

ii.            institutional: through materials, teaching aids, operational support

iii.            individual: through support to specific needs of learners.

Many countries use a blend of financing methods. The WHO report (2011: 219) concludes that whichever approach is taken, funding models should be easily comprehensible, flexible as well as predictable, provide adequate resource, be ‘cost-based and allow for cost control,’ embed special education within general education provision and ‘be neutral in identification and placement’. Furthermore:

‘While the costs of special schools and inclusive schools are difficult to determine it is generally agreed that inclusive settings are more cost-effective. Inclusion has the best chance of success when school funding is decentral­ized, budgets are delegated to the local level, and funds are based on total enrolment and other indicators’ (WHO, 2011: 220).

This is reflected in findings from a study in Vietnam which found that the, ‘per pupil cost … has averaged US$58 per year, as compared with the US$400 average for services in segregated schools and the US$20 average for general education students’ (Villa et al., 2003: 25-26). While this clearly shows that the cost of including a disabled child within the mainstream classroom is higher than that of ‘general education students,’ inclusion is not only cost effective but less costly than segregated forms of education, and exclusion. This finding is mirrored at the macro-economic level, and is illustrated in Section 3 (Thomas and Burnett, 2013).

Common approaches to the financing of inclusive services are highlighted by Bines and Lei (2011) in their review of education sector plans submitted to the Fast Track Initiative (now Global Partnership for Education). The following three approaches are indicative of the recent trend to decentralise education systems:

  • funding tied to individual pupils identified as having a disability or special educational need and distributed through a mediating local authority or directly to the school/institution
  • funding based on services provided, for example providing additional resources to schools which include children with disabilities. This resource-based approach can incentivise inclusion. In Uganda, schools are being provided with direct grants to enhance inclusion without ‘much increase in transaction costs’ by supporting accessible infrastructure, curricula and teaching methodologies.
  • output-based models which provide funding on the basis of student attainment and outcomes exist, but are unpopular and ‘difficult to implement fairly’.

The Bushenyi District Education Office in Uganda built units for deaf children in response to demands from parents (Miles et al., 2011). The financing is built into the general education planning and budgeting system. Increased demand for services has put pressure on the government to provide more specially trained teachers through the main education budget. Demand has risen steadily, providing educational administrators with numbers of children needing more specialist provision.

Curriculum

An inclusive curriculum which accommodates all learners’ needs requires structure with flexibility. It must have the capacity to accommodate a range of learning styles, to emphasise the acquisition of relevant knowledge and skills, and be structured around varying levels of entry skills to enable assessment of progress in ways that allow all learners to experience success (Acedo et al., 2011).

In India, the National Curriculum Framework for School Education made recommendations for modifications to the content, presentation and transaction strategies to enable children with special needs to enter inclusive schools. This included preparing teachers and developing learning-friendly evaluation procedures. However, these have not yet been addressed in any sustained way (Singal, 2009: 28).

Teachers in Lao PDR found the provision of differentiated curriculum activities for children with disabilities a significant challenge, as was developing more complex classroom management strategies to maintain the engagement of children in their work. Teachers struggled to develop the skills needed to deliver a differentiated curriculum in maths and science in particular. Older students with visual impairments reported loss of motivation because of the challenges of accessing the curriculum at Upper Secondary Level (Grimes, 2009: 99).

Malaysia’s Curriculum Development Centre produced an alternative ‘Integrative Curriculum’ in 2008 that focused more on the ‘life skills’ thought appropriate for children with disabilities (Acedo et al., 2011). Achieving a balance between high teacher expectations in relation to children’s learning, and the development of relevant and meaningful curricula suitable for children with diverse learning needs, is a major challenge to developing inclusive learning.

Evidence from developing countries suggests that blind children may present particular challenges for teachers and curricula in mainstream settings as these learners require an expanded core curriculum that includes the development of orientation and mobility skills, self-help and independence skills, Braille literacy, and listening skills (Lynch et al, 2011).

Extra-curricular activities, including after-school and holiday clubs, have been found to be useful in supporting the learning and skills acquisition of children with disabilities, particularly in their pre-school years, and in the early stages of their enrolment in formal education. Wapling (2010) recommends the introduction of extra-curricular activities for deaf children’s language development in Uganda to enable children to become fluent enough in a first language (oral or sign) before they are placed into the first grade to enable their access to the mainstream syllabus. Lynch and McCall (2007) suggest that ‘Braille schools’ could be provided during the holidays for teachers and children, to enable the development and refinement of Braille skills, and exposure to additional reading materials.

Curriculum changes to promote inclusion were introduced in Papua New Guinea with the support of the Australian Aid Programme. Designed to respond to the diverse needs of students, the curriculum has been critiqued for being shaped by Western educational ideology, rooted in pedagogical ideals which conflict with local or school level understandings of education, and inappropriate for the national context. As a result, the ‘stakeholders were unable and unwilling to adopt many of the precepts of the new curriculum’ (Le Fanu, 2013: 139). These findings have led Le Fanu (2013) to emphasise the importance of contextualising the concept of inclusive learning, to critique ‘global inclusionism’, as promoted by UNESCO, and argue instead for ‘grounded inclusionism’, rooted in, and sensitive to, local realities.

Assessment: Recognising and addressing individual differences

There is debate about how best to assess and measure learning outcomes for girls and boys who experience difficulties in learning, or who need adaptations to be made to the assessment process. Learner-centred approaches recognise individual differences and ways of learning and therefore curricula, teaching methods and materials, assessment and examination systems, and classroom management need to respond to this. There is still a long way to go: a 2008 survey in Tanzania found that children with disabilities who attended primary school progressed to higher levels of education at only half the rate of children without disabilities (UNICEF, 2013).

The World Report on Disability (WHO, 2011) suggested that assessment practices can facilitate or hinder inclusion. Streaming by ability and focusing on academic attainment promotes exclusion, while mixed ability and multi-grade teaching has the potential to be more inclusive. The WHO Report suggests that:

  • Assessment procedures should promote learning for all students.
  • All students should be entitled to be part of all assessment procedures.
  • The needs of students with disabilities should be considered within all general assessment policies, as well as within policies on disability-specific assessment.
  • The assessment procedures should complement each other.
  • The assessment procedures should aim to promote diversity by identifying and valuing the progress and achievements of each student.
  • Inclusive assessment procedures should explicitly aim to prevent segregation by avoiding – as far as possible – forms of labelling. Instead, assessments should focus on learning and teaching practices that lead to more inclusion in a mainstream setting (WHO, 2011: 220).

Evidence of the learning outcomes of children with disabilities is uncommon because they tend not to participate in assessments, and because data is not yet disaggregated in this way (UNESCO, 2014). Sample sizes are often too small to allow analysis even when they are broken down. In Uganda, literacy rates of young people with different types of impairment have been compared in a rare example of the sample size being sufficiently large:

‘In 2011, around 60% of young people with no identified impairment were literate. By contrast, only 47% of young people with physical or hearing impairments were literate. Those with mental impairments were least likely to be literate: only 38% could read or write a simple sentence. Other sources confirm the scale of this disadvantage. In the United Republic of Tanzania, a survey on disability found that the literacy rate for people with a disability was 52%, compared with 75% for people without a disability’ (UNESCO, 2014).

Inclusive and accessible design

Building schools which are physically accessible is cost effective. Research has demonstrated that the cost of accessibility is generally less than 1% of total construction cost, but the cost of making adaptations after a building is completed is far greater (Steinfield, 2005). While the design of accessible school buildings (such as wide, wheelchair accessible doorways, ramps, large windows, and painting classroom walls white) may be beyond the control of many teachers, there are some straightforward adaptations that can be made to the physical structure and furniture of the classroom which can, in turn, make a big difference to the quality of teaching and learning for all children. See INEE (2009; 2010) for some practical examples of ways that teachers can overcome the common challenges of poor quality lighting, inadequate or inflexible furniture, and noisy, over-crowded classrooms. See Figure 5, which illustrates an inclusive (modern and well equipped) classroom environment.

Inclusive classroom environment (Illustration by Dave McTaggart)
Figure 5: Inclusive classroom environment (Illustration by Dave McTaggart www.davemctaggart.co.uk, reproduced from Global Campaign for Education, 2014) – click to enlarge

Research directions

The evidence reviewed indicates the following gaps in the literature, which are worthy of attention in future research:

  • the relationship between leadership and inclusive classroom practice
  • measuring and assessing learning outcomes of learners with disabilities
  • the relationship between learning metrics and inclusive learning
  • flexible arrangements for children with disabilities and difficulties in learning to participate in examinations
  • finance models for inclusive learning
  • the cost of providing assistive devices to facilitate inclusive learning.

Part E: What evidence is there of the importance of broader links to families, community, primary health care and early identification?

Summary of evidence

  • Engagement with parents and local communities reduces stigma and discrimination and can improve enrolment, attendance and learning outcomes.
  • Community-based rehabilitation (CBR) services can provide important linkages between families, schools and the wider community that tackle discrimination and promote engagement in learning.
  • Local communities can play an active role in producing resources and promoting inclusion.
  • Extra-curricular activities can support inclusive learning, but are often NGO dependent and difficult to sustain.
Children and young people need to feel supported within a wider network of family and community in order for inclusive learning to be effective and is an essential component of the broader process of social inclusion. Similarly, integrated planning and cooperation between health, education and social care sectors can ensure appropriate rehabilitation support is provided, and improve identification, management and prevention of disabilities.

Community engagement

The importance of community ownership and support for inclusive learning to be successful is recognised in the literature. Villa et al.’s (2003) study from Vietnam identifies this as a key lesson for the international community to adopt. Religious leaders, representatives from the Farmer’s and Women’s Unions, district education staff, the Communist Party and other stakeholders were brought together to learn about the benefits of inclusion. The group went door-to-door in each commune (made up of 5,000 to7,000 residents) to identify girls and boys with disabilities who were being left at home and encourage parents to send them to school. In addition to advocacy and awareness-raising, the group carried out practical tasks that helped to cement and sustain inclusion within the community, or as the researchers put it:

‘This is the group that finds an old tricycle that a kindergartner can use as a wheelchair substitute when no resources exist to fund a wheelchair. This is the group that guts and renovates an abandoned downtown office to create an inclusive pre-school, so the commune’s pre-schoolers with and without disabilities can be educated together. This is the group that can talk to the leadership down the road about their commitment, creative solution finding and success’ (Villa et al., 2003: 31).

Research by the DFID-funded EdQual consortium into educational disadvantage more broadly suggests that home and community environment can be an important influence on learning outcomes, especially for those children who are most socio-economically disadvantaged (EdQual, 2010a). ‘Living outside of a stable family environment, lacking basic resources, poor nutrition, and learning in a language not commonly used outside of school are all predictors of low levels of literacy and numeracy’ (EdQual, 2010b). EdQual (2010b) research indicates the positive benefits of an enabling home and community environment that promotes learning needs, parental support and education; community voice and stakeholder engagement in governance; the provision of resources and a place to study at home; links between home and school; and the availability of school meals to aid concentration as well as cognitive development.

Community-based rehabilitation (CBR) services include early identification and prevention, referrals of children to appropriate schools, advocacy, supporting teachers and bridging gaps between home and school (WHO, 2011: 247). Like itinerant teachers, CBR workers can advise on accessibility, galvanise community support in building low-cost ramps for wheelchair access, provide assistive devices, campaign for inclusive sanitation, arrange medical treatment, and secure training and employment as learners prepare for the transition to employment

Inter-sectoral collaboration, especially between health, social care and education, is essential to ensure that rehabilitation programmes are accessible and supportive of education. It is recommended that stronger links are developed between efforts to promote inclusive early childhood education and screening and intervention services for children with disabilities (Yousafzai et al., 2014). Basic health prevention measures such as awareness of, and treatment for, middle ear disease (otitis media), for example, can be critical in preventing children from losing their hearing and so staying in school.

As indicated already, parents have a key role to play in facilitating their children’s learning and there are precedents in Lebanon, Panama and Zanzibar of parents actively engaging with governments through legal processes to deliver inclusive school-based learning and community-based teacher development programmes (WHO, 2011: 249). Children of parents who are involved in their education do better, offering a low-cost solution to educational exclusion (WHO, 2011: 251).

Training for parents and communities is a common approach of inclusive initiatives aimed at reducing stigma and discrimination. In Afghanistan, in 2009-2011 a pilot inclusive education programme led by the Ministry of Education, UNICEF and UNESCO saw the training of 100 teachers and 350 parents in inclusive approaches (Acedo et al., 2011). In the slums of Kolkata, India, the Institute of Cerebral Palsy has trained parents (particularly mothers) and others in communities to help teach children and provide training for others using a bespoke package (Bines and Lei, 2011: 423). In this way, parents and communities have supported the capacity of education systems and schools to deliver good quality inclusive education.

In Uganda, parents of deaf children overcame their initial scepticism and resistance to their children’s enrolment in school through attending sign language classes (Wapling, 2010). Parents have played an important role in identifying their children’s deafness and supporting their education in a wide range of countries and this has been documented by Deaf Child Worldwide (Wilson et al., 2008).

In Lao PDR, Save the Children found that inclusive schools with good working relationships with local communities were more likely to be successful; they had demonstrable reductions in grade repetition and improved attendance (Grimes, 2009). Community members were, for example, drawn upon to produce resources to support classroom learning.

In Mongolia, a teacher education programme developed a community outreach component for which sign language classes were provided to parents and classmates of deaf children. Sign language was subsequently used in class to support the learning of deaf children. A review by Save the Children found that such processes led to significant attitudinal shifts, reducing stigma and discrimination of children with disabilities within their communities (Save the Children, 2008).

In Bangladesh, local and national networking has helped to support and promote access to and retention in local schools for children with disabilities. Blind adults belonging to self-help groups, with links to CBR programmes, have played a key role in this process (Miles et al., 2012). This complex web of networking relationships includes government departments concerned with health, education and social welfare, disability-focused NGOs, and mainstream development agencies and networks.

Disabled people’s organisations, though often poorly resourced, have a key role to play in promoting education, encouraging parents to send their children to school, building confidence and providing role models which address stigma and discrimination. The Southern Africa Federation of the Disabled, for example, has been running programmes for 15 years to promote the inclusion of disabled children in education (WHO, 2011).

Education in humanitarian contexts can help protect children with disabilities from risks and reduce vulnerability, as well as building their resilience and empowering them to develop knowledge of health, communications technologies and politics. Failure to reach these children and their parents, however, has been shown to be the norm for a range of humanitarian interventions in conflict-affected countries and has unintentionally recreated the experience of exclusion already felt by children with disabilities and their families (Trani et al., 2011). Interventions in these circumstances have the opportunity to ‘build back better’ by encouraging parents of children with disabilities to engage with parent-teacher associations or school management committees to ensure they have a voice in creating an enabling environment for their children and that schools provide a channel for medical, social, nutritional and developmental resources, as well as education (Trani et al., 2011: 1200).

Research directions

The evidence reviewed indicates the following gaps in the literature, which are worthy of attention in future research:

  • links between CBR programmes and inclusive learning initiatives
  • parent engagement in, and support for, inclusive learning
  • children’s experience of inclusive learning
  • protective benefits of inclusive learning in humanitarian emergencies
  • benefits of, and models for, effective inter-ministerial collaboration, including education, health, social welfare/protection, and finance.
Conclusion
Section 2 has summarised the available evidence from low and middle income countries on the types and effectiveness of approaches to inclusive learning. It identifies clear gaps in the literature on the impact of teaching and classroom strategies on learning outcomes for children with disabilities and difficulties in learning, contrasted with an over-representation of evidence on teacher attitudes towards inclusion. Although the evidence base does not allow for conclusive or substantive recommendations to be made on the most enabling approaches to inclusive learning, it is clear that some strategies do have a positive impact on children with disabilities and those who experience difficulties in learning. These include enabling policy environments, targeted financing, multi-sectoral coordination, compulsory and accredited teacher development programmes which enable teachers to differentiate and adapt the classroom environment to improve accessibility, inclusive curricula and assessment and outreach to parents and communities that breaks down stigma and discrimination and strengthens relationships. Research in education, disability and inclusion now needs a clearer, more focused agenda drawing on both qualitative and quantitative approaches – including case study-based research – to establish attendance rates and learning outcomes of children with disabilities, disaggregated by sex and impairment, in low and middle income countries. This will help national governments and donors better understand how investments can deliver good quality inclusive learning for all.
This section considers how educational exclusion creates poverty and impacts on GDP. It also explores the ripple effect of inclusive learning on wider communities. The evidence shows that to be more inclusive, societies must ensure that all citizens have the opportunities they need to fulfil their potential, and that of their communities. It is also critical that transitions from education to the workplace are nurtured and supported, as this can have economic and social benefits for individuals, families, communities and the state.

Summary of evidence

  • One in five of the world’s poorest men and women are thought to be living with disabilities.
  • Education has social and economic benefits for girls and boys with disabilities, their families and communities.
  • Education has a role to play in encouraging acceptance of diversity and creating more tolerant and inclusive societies.
  • The costs of maintaining large out-of-school populations are greater than the economic benefits to GDP of universal primary enrolment.
  • The economic and social costs of disability are significant but hard to quantify.
  • Children and young people with disabilities can benefit from early childhood education and tertiary provision – not just primary education.
  • Teachers with and without disabilities can influence others by modelling inclusive practice in the classroom and community.
  • Better educated individuals earn more, have greater job security and experience less unemployment.
  • Environmental and attitudinal barriers can block transitions to employment.

Inclusive societies and inclusive growth

Economic growth does not automatically lead to benefits for poor and marginalised people. Discrimination and ill health, along with low levels of formal and vocational education, prevent poor women and men from enjoying the advantages of expanded economic opportunities. Sustainable inclusive growth requires the active removal of structural barriers that prevent poor and marginalised people, including men and women with disabilities, from finding jobs and increasing their incomes (DFID, 2014).

It is estimated that around one in five of the world’s poorest people are living with disabilities (Elwan, 1999). Poverty is both the root cause, and result, of disability, and ‘Disabled people have a higher likelihood of experiencing poverty because of the institutional, environmental and attitudinal discrimination faced, from birth or the moment of disablement onward (Yeo and Moore, 2003: 572). There is ‘a worrisome vicious cycle of low schooling attainment and subsequent poverty among people with disabilities in developing countries’ (Filmer, 2008: 141).

Inclusive growth is equitable, offers equality of opportunity to all as well as protection in market and employment transitions (Commission on Growth and Development, 2008). A necessary precondition for inclusive growth is a society which does not exclude or discriminate against its citizens on the basis of disability, caste, race, gender, family or community, a society which ‘levels the playing field for investment’ and leaves no one behind (Lanchovichina and Lundstrom, 2009: 3; UN, 2013b). In a study in Zambia of young adults who had been exposed to inclusive learning a decade previously, Serpell et al. (2011) found that their education could be attributed to civic participation, a greater appreciation of diversity, nurturing younger members, and helping those in need. Increased confidence, respect in the family and new friendships were attributed to inclusion in education in Nepal, as well as economic independence resulting from employment (Lamichhane, 2012). Although education did not always lead to economic benefits in India, young people with disabilities reported that it had boosted their social capital, enabling them to manage social relationships beyond the household (Singal et al., 2011).

Economic benefits of inclusion

According to UNESCO Institute of Statistics data, nearly 58 million children of primary school age were not enrolled in 2012 (UIS, 2014). While the cost of investments for universal primary education may be considerable, the costs of educational exclusion can be substantially higher in some countries. A study of 20 low and middle income countries found that enrolling children in primary education is a productive investment and that many economies suffer greater losses from maintaining large out-of-school populations than they would from increasing public spending to enrol those children in primary school (Thomas and Burnett, 2013).

The estimated costs of exclusion vary across countries, ranging from 1% of GDP in Thailand to 10% of GDP in Gambia. In nine countries with high out-of-school populations, the economic benefits of including all children in primary education are greater than multiple years of economic growth (Thomas and Burnett, 2013: 13). This includes Nigeria and Mali where the cost of out-of-school children is estimated to be more than ‘two years of average GDP growth’ (Thomas and Burnett, 2013: 13). Even in countries such as Brazil and Indonesia, where there are relatively low out-of-school populations, the economic gains of including marginalised groups in education are still greater than the public spending costs of enrolment (Thomas and Burnett, 2013).

Exclusion from education – and the economic opportunities that schooling creates for individuals – pushes people into poverty. Yet educating children with disabilities reduces welfare costs and future dependence; releases other household members from caring responsibilities, allowing them to engage in employment and other productive activities; and increases children’s potential productivity and wealth creation which in turn helps to alleviate poverty (Peters, 2003).

Filmer (2008: 141) found that ‘adults with disabilities typically live in poorer than average households: disability is associated with about a 10 percentage point probability of falling in the two poorest quintiles’ and that ‘each additional year of schooling is associated with about a 2 to 5 percentage point reduction in the probability of being in the two poorest quintiles’ (Filmer, 2008: 150). Children with disabilities are less likely to attend school and acquire the human capital that will enable them to earn higher incomes than other children, suggesting that disability is associated with long-term poverty (Filmer, 2008).

They are also less likely to start school, and in some countries they have lower transition rates. The school participation disability deficit is typically larger than deficits associated with characteristics such as gender, rural residence, or economic status

Filmer (2008) argues that, since the attainment gap between children with and without disabilities begins in Grade 1, and the disability deficit widens each year, efforts need to be made to increase enrolment and ensure retention in the early years of schooling.

Research from a wide range of economic contexts indicates that better educated individuals earn more, have greater job security, stronger social networks and experience less unemployment than their less well educated counterparts (Lamichhane, 2013). Education exerts a significant influence on wages, with one study from Nepal estimating returns to education for people with disabilities ranging from 19.3% to 25.6% (Lamichhane and Sawada, 2013: 86).

A similar study in the Philippines found that higher earnings among people with disabilities were associated with increased schooling, generating returns of more than 25% (Mori and Yamagata, 2009); and in China each additional year of schooling results in wage increases for people with disabilities of around 5% for rural residents and 8% for urban (Liao and Zhao, 2013). Lamichhane and Sawada (2013) found that the benefits of education to children with disabilities can be higher than those to people without disabilities, but they also found that returns diminish when learners with particular impairments (such as hearing impairments) do not receive the required support.

The findings of a systematic literature review on the economic costs of exclusion (focusing on health, education and employment) provide ‘a robust empirical basis to support the theorised disability-poverty link’, as a link between poverty and disability was reported in 80% of the studies (Morgon Banks and Polack, 2014: ii). The review also suggested that promoting inclusion in education can potentially offer social as well as financial gains to individuals, families, communities and the state as well as positive impacts on health, child and maternal mortality, population growth, gender empowerment, citizenship and crime, but ‘further empirical research is urgently needed to understand the extent, magnitude and scope of exclusion costs and the impact of inclusive interventions’ (Morgon Banks and Polack, 2014: v). Figure 6 highlights the broad impact of being included in education upon health, wealth and employment.

Education pathway 2 (Morgon Banks and Polack, 2014)
Figure 6: Education pathway 2 – non-employment costs and benefits (Morgon Banks and Polack, 2014: 32)

It is not just primary education that can benefit children with disabilities, but also education from early childhood through to tertiary provision for young people. Portage-based interventions, jointly delivered by professionals and community volunteers in Zambia and in Vietnam, assisted young children with disabilities to develop motor, communication and daily living skills, and simultaneously increased the cohesion and resilience of their families (Le Fanu, 2014). Lamichhane (2012: 471) found that access to higher education influences the likelihood of people with disabilities achieving gainful and satisfying employment, and reports findings from studies conducted in Turkey and South Korea which found that higher education was a good predictor for employment success for people with visual impairments (Lamichhane, 2012: 472).

Men and women with disabilities face many barriers in accessing employment, even if they have completed higher education and jobs are available due to inaccessible physical environments. A survey of 400 adults with physical, hearing, and visual impairments in Nepal conducted by Lamichhane (2012), a blind Nepali researcher, revealed that employment opportunities would remain limited due to the inaccessibility of buildings, toilets and roads.

The role of teachers in inclusive societies

Teachers have a powerful role to play in modelling inclusive attitudes and expectations through the classroom, influencing not only the children that they teach, but also their colleagues, leadership teams, parents and the wider community. Teachers with disabilities, as well as those who have been sensitised to inclusion, can be instrumental in tackling stigma and discrimination, ‘promoting positive identities in children with disabilities and in breaking down prejudices of non-disabled children’ (Mpokosa and Ndarahutse, 2008: 47).

There can be challenges to the recruitment of teachers with disabilities. Young men and women with disabilities can face barriers to achieving the requisite level of education needed to train as a teacher. The University of Delhi, India, created 1,300 places for students with special educational needs but was only able to fill 300 of those places due to the limited number graduating from secondary schools (Le Fanu, 2014). Le Fanu (2014) suggests that flexible policies for entry into teacher training colleges, along with supportive resources and scholarships may offer one solution. In Bangladesh allocating ground floor hostel rooms, adapted seating and classroom assistants had promoted the inclusion of students in tertiary institutions (Ehsan, 2011: ix).

Following the lobbying efforts of the organisation of people with visual impairments in 1989, the Ministry of Education in Nepal introduced ‘a quota-based system, allocating a certain number of teaching jobs for people with visual impairments. At present, there are nearly 350 teachers with visual impairments’ working in mainstream schools all over the country (Lamichhane, 2012: 481). An employment survey of adults with disabilities found that 43% of the visually impaired respondents worked as teachers in mainstream schools in Nepal whereas a smaller number of teachers with hearing impairments were employed in special schools for deaf students (Lamichhane, 2012). It is unusual for such a large number of teachers with disabilities to be employed in any country, and it is significant that it was a national disabled people’s organisation that spearheaded this initiative.

Conclusion
The economic and social costs of exclusion are high. Many low and middle income economies suffer greater losses from maintaining large out-of-school populations than they would from increasing public spending to achieve universal primary enrolment. It is clear that enrolling all children in basic education is a productive investment and it is a smart investment. The economic benefits of education are well established and the inclusive growth to which it can contribute is by definition grounded in societies which are open, equitable, tolerant and just. This section provided some examples of inclusive approaches to education that have contributed to inclusive societies and inclusive growth, providing social and employment opportunities for children and adults with disabilities. While there are significant attitudinal and environmental barriers to be overcome in accessing education and employment, enrolling children with disabilities in school has the potential to lift individuals and their families out of poverty.
This section summarises a selection of available toolkits on inclusive education with a particular focus on guides to classroom practice. These toolkits have been identified through the online disability and inclusion resource centres – Enabling Education Network (EENET) and Source (Handicap International) [as well as recommendations from professionals].

Ainscow, M. (2004). Special Needs in the Classroom: a Teacher Education Guide. Paris: UNESCO Publishing. http://unesdoc.unesco.org/images/0013/001351/135116e.pdf

This is an updated version of UNESCO’s training pack developed for teachers’ learning about inclusivity in the early 1990s. The guide has been used in over 50 countries and adapted to different country contexts. It provides ideas for educators to improve teachers’ skills in dealing with pupil diversity in mainstream schools. It offers advice on teacher education methods, including accounts of initiatives already undertaken around the world. The book emphasises the importance of teacher development, both pre-service and in-service, and demonstrates how pupil diversity in mainstream schools can be a positive influence on the life of the school.

Booth, T. and Ainscow, M. (2011). Index for Inclusion: Developing Learning and Participation in Schools. Third Edition, Bristol: CSIE. http://www.csie.org.uk/resources/inclusion-index-explained.shtml

This resource is designed to support inclusive school development, offering schools a process of self-review and development that brings in all education stakeholders and examines how barriers to learning and participation can be reduced. Although ostensibly designed for high/middle income settings, this third edition of the index has been translated and used in 39 countries and substantially revised with developing countries in mind. The index is written in an accessible style and encourages schools to ask questions of inclusion that are valuable and relevant to any context.

Handicap International (2014, forthcoming). Inclusive Teacher Training Toolbox. Lyon:Handicap International.

Developed in response to many requests for clearer guidelines within Handicap International inclusive education projects across 16 countries, this toolkit is based on an analysis of existing teacher training to improve access to quality education for children with disabilities in mainstream learning environments. The document takes the reader through the different stages necessary before, during and after training to achieve sustainable teacher training outcomes. The resource offers guidelines on how to develop teacher training programmes and manuals and provides both a coherent representation of inclusive education and advice on practical implementation.

INEE (2009). Education in Emergencies: Including Everyone. INEE Pocket Guide to Inclusive Education. Geneva: Inter-agency Network on Education in Emergencies (INEE). http://www.eenet.org.uk/resources/docs/IE_in_Emergencies_INEE.pdf

This short accessible guide outlines useful principles for an inclusive education approach in emergencies and provides advice for planning, implementing, and monitoring. The guide also looks at the issue of resistance to inclusion, and highlights ways in which organisations can support their emergency staff to develop more inclusive education responses. It is available in Arabic, Bahasa Indonesia, English, French and Spanish.

INEE (2010). INEE Pocket Guide to Supporting Learners with Disabilities. Geneva: The Inter-agency Network on Education in Emergencies (INEE). http://www.eenet.org.uk/resources/docs/INEE_Supporting_Learners_with_Disabilities.pdf

This short, accessible guide offers practical ideas and suggestions for including children and young people with disabilities in education before, during or after crises. The activities are designed to strengthen teacher practice in both government and non-government contexts and are adaptable for education managers and teacher trainers to incorporate into teacher development schemes and resources. The guide outlines inclusive principles, school accessibility, recognising support needs, timetabling and classroom management, planning and assessment.

INEE (2011). Teachers Can Help Everyone Learn. New York: The Inter-agency Network on Education in Emergencies (INEE). http://www.eenet.org.uk/resources/docs/Teachers_can_help_everyone_learn_poster.pdf

This poster provides simple messages designed to empower teachers to make their schools and classrooms more inclusive.

Le Fanu, G. (2000). Inclusive Education for Children with Visual Impairments: A Guide for Non-Formal Schools. Bangladesh: Helen Keller International.

Developed in Bangladesh, this guide considers how children with little or no vision can be included in mainstream, non-formal classrooms. Written in an accessible style, this resource covers the causes of visual impairment, reading and writing in print and Braille, teaching mathematics, orientation and mobility, daily living skills, sports and games.

Mendis, P. (2006). Children who have Disability in Early Childhood Care and Development Centres: A Resource Book for Teachers. Sri Lanka: Save the Children. http://www.eenet.org.uk/resources/docs/ECCD_Disability_Manual.pdf

Developed in Sri Lanka by the Ministry of Child Development and Women Empowerment, the Open University, the National Institute for Education, local NGOs and Save the Children, this handbook is designed to build teacher capacity to support boys and girls with disabilities in pre-school, or early childhood, settings. The resource discusses supporting children with specific impairments, working with parents, communities and referral systems.

McConkey, R. (2001). Understanding and Responding to Children’s Needs in Inclusive Classrooms: A Guide for Teachers. Paris: UNESCO. http://unesdoc.unesco.org/images/0012/001243/124394e.pdf

Designed for teachers with and without experience of inclusion, this practical guide is to support children who have particular difficulties in learning. The guide provides key facts about various impairments and how to overcome common learning difficulties that come with them, suggests classroom adaptations, describes teaching strategies to respond to diversity, including curriculum modifications, and encourages teachers to work with families, community members, health and social care professionals and others.

Perner, D. (2004). Changing Teaching Practices: Using Curriculum Differentiation to Respond to Students’ Diversity. Paris: UNESCO. http://unesdoc.unesco.org/images/0013/001365/136583e.pdf

This manual aims to expand and improve teacher capacities to adapt, modify and differentiate their teaching in contexts of large class sizes and poor resources. Suggestions, strategies and activities to improve inclusion through differentiation are contained in five units: curriculum differentiation and our students; environmental strategies; instructional learning strategies; assessment strategies; and putting it all together. Case studies are used to illuminate approaches and sample lesson plans are provided.

Stubbs, S. (2008). Inclusive Education: Where there are Few Resources. Oslo: Atlas Alliance. http://www.eenet.org.uk/resources/docs/IE%20few%20resources%202008.pdf

This resource booklet takes a wide ranging approach to inclusion but has a practical section on putting inclusive education into practice. It provides step-by-step advice and guidance on planning and implementation tools to overcome resource barriers.

Thomas, P. and Vichetra, K. (2003). Inclusive Education Training in Cambodia: In-Service Teacher Training on Disabilities and Special Needs. Manchester: EENET. http://www.eenet.org.uk/resources/docs/cambodia.php

Written by the Disability Action Council and the Cambodia Ministry of Youth, Education and Sport, this popular training guide comprises six modules for primary school teachers designed to be delivered separately or intensively over five days. The training develops teacher capacity to recognise special needs and understand disabilities; raises awareness of international and national policy context and barriers to education for children with disabilities; introduces ‘eight golden rules for good teaching’; describes practical teaching techniques to aid children’s verbal and written communication, reading and mathematics; and takes a case study approach to offering advice on teaching children with specific impairments.

UNESCO Bangkok (2004-13). Embracing Diversity: Toolkit for Creating Inclusive Learning-Friendly Environments. Bangkok: UNESCO. http://www.unescobkk.org/education/inclusive-education/resources/ilfe-toolkit/

Compiled of a series of booklets, this toolkit provides practical guidance on creating inclusive, child-friendly learning environments. Designed for teachers working from pre-primary through to higher education, including those who are involved in reform processes to enhance inclusion, the guidance offers tools and activities for self-study. Booklets 3, 4 and 5 focus particularly on inclusive classrooms, classroom management, differentiation, resources and assessment.

WHO (2010). Education Component. Community-Based Rehabilitation. CBR Guidelines. Geneva: WHO. http://whqlibdoc.who.int/publications/2010/9789241548052_education_eng.pdf?ua=1

This is one section of a comprehensive set of guidelines for CBR practitioners on the different stages in education from early childhood provision, through to primary, secondary and tertiary education, and finally lifelong learning. The guidelines draw readers’ attention to the low literacy rates among adults with disabilities, cited as being as low as 3% for males and 15% for females, and therefore the importance of engaging CBR workers in the task of education at community level.

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Family Planning /topic/family-planning/ Thu, 29 May 2014 12:11:43 +0000 http://www.heart-resources.org/?post_type=topic&p=23409 Read more]]>
IntroductionAssessment of Evidence Strength1. Overview2. Population growth, economic growth and fertility rates3. Contraceptive methods and prevalence4. Barriers to contraceptive adoption and sustained use5. Health benefits of contraception6. Demand for family planning7. Family planning programmes8. Service delivery options9. Abortive technology10. Value for money
This document presents a summary of family planning. It reviews existing literature, examining carefully what the current knowledge is, where the important issues or problems lie and “what works”. It is divided into ten sections.

This guide was produced as a result of a reading week held for the UK Department for International Development (DFID) advisers in mid-2012. The topics and readings were chosen by experts in the field but are not a comprehensive review of all family planning literature. This topic guide is an update and based on the key readings selected for this week plus updated materials. The main audience for this guide is policymakers, advisers, managers and practitioners.

As part of this topic guide we have assessed the strength of the evidence that we have used. This will enable readers to use evidence responsibly and judiciously. Strong evidence should be of central importance in informing policy and programming decisions. Robust research and evaluation generates the evidence required to form judgements, deliberate options and make intelligent decisions about how to spend scarce financial resources on behalf of taxpayers.

This evidence assessment we have done is this topic guide is based on the DFID How to Note on Assessing the Strength of Evidence which is available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/291982/HTN-strength-evidence-march2014.pdf

For this topic guide we have done a two part evidence assessment:

  • Single study assessment: We have assessed the strength of evidence of each individual paper used. This is based on research type, research design and method and a quality assessment. We used part two of the DFID paper, and the tables on page 9 and 15 to guide our method for this. In order to use the single study assessment, please see the key in the appendix which outlines the use of acronyms for each part. For example, and assessment of (P&E; EXP; H) would mean a study is primary and empirical, experimental and high quality.
  • Evaluating the overall strength of a body of evidence: Assessment of the overall strength is directly linked to the quality, size, consistency and context of the body of evidence. Ideally, this is based on the assessment of all the individual studies that constitute a body of evidence but due to limitations in time and to show the quality of evidence used for this guide, we have based this on the evidence that is used for each section. Therefore this assessment is based on the body of evidence used for this paper, not all the literature. For this assessment we used part four of the DFID paper, and the table on page 20. For the key for this assessment please see the appendix. We have also assessed the overall strength of the evidence in the whole guide below.

Overall Evidence Strength Assessment for the Family Planning Topic Guide

Quality of evidence: Size of body of evidence: Consistency of results: Closely matched to topic: Overall assessment:
Medium/High Medium Medium/High Medium/High Medium/High
Introduction to topic guide

By Professor John Cleland, London School of Hygiene and Tropical Medicine

The origin of state-sponsored family planning programmes can be traced back to the massive improvements in life expectancy, and in particular to child survival, that occurred in the last century. In 1900, global life expectancy was about 25 years. A couple typically had five or six births but only two, on average, survived to adulthood, sufficient to maintain a stable population size but no more (Dyson, 2010). By 1950, life expectancy had risen modestly to 30 years but thereafter the pace of change accelerated dramatically. By 1960, expectancy had leapt to 48 years and has continued to improve to reach 69 years by 2005-10 (UN DESA, 2013). At the global level, it is projected to reach 76 years in 2045-2050 and 82 years in 2095-2100. By the end of the century, people in developed countries could live on average around 89 years, compared to about 81 years in developing regions (UN DESA, 2013).

Birth rates in most of Asia, Latin America and Africa in the 1950s and 1960s remained high and thus the inevitable result of declining mortality was a rapid population growth. Between 1950 and 2000, world population rose from 2.5 to 6.1 billion. The era of peak growth has now passed but a further increase of more than two billion is expected between 2010 and 2050 (UN DESA, 2013). Demographic projections are outlined in section 2.

Two key publications provided the initial rationale for state promotion of contraception. The first was an economic analysis, concluding that rapid population growth and its associated high dependency ratio represented a serious barrier to socio-economic progress because national and domestic funds have to be diverted from investment in manufacturing and the modernisation of agriculture to the support of an ever growing number of children (Coale and Hoover, 1958). The second concerned women’s health and highlighted the need for contraceptive promotion to reduce the large number of illegal and unsafe abortions that were taking a serious toll on the lives and health of women in Latin America in the 1960s (Armijo and Monreal, 1966).

Economic advance and health remain important justifications for family planning investment and the evidence for both is discussed in section 2 and section 4. Other powerful arguments have been added to these original two. The ability and freedom of individuals and couples to choose when and how often to become pregnant is rightly regarded as a fundamental human right (Baird 1965). Exercise of this right is crucial for empowerment of women. In the absence of contraception, a woman’s prime adult years are dominated by incessant cycles of pregnancy, breastfeeding and child care. As the number of pregnancies falls, women are able to participate more fully in public life including paid employment (Bloom et al., 2009).

Environmental concerns provide a further justification for family planning promotion. Growing population together with rapid increases in consumption have led to a realisation that humanity is approaching limits to our exploitation of the planet. Global warming, due to CO2 emissions, ocean acidification, unsustainable depletion of aquifers, land use change and its effects on bio-diversity, are among the concerns. Of course rich nations bear the prime responsibility for these trends; poor countries, where further population increase will be concentrated, have contributed little to CO2 emissions or ocean acidification. However, population growth is the main driver of increased demand for food and the likely consequences of this increased demand include further loss of bio-diversity and natural habitats, degradation of fragile ecosystems due to over-cropping and grazing, and acute problems of fresh water availability (Royal Society, 2012).

Among medical interventions, family planning is unique in its breadth of benefits. It contributes directly or indirectly to the achievement of all the Millennium Development Goals and should be regarded as a central component of development strategy. Moreover, as shown in section 10, it is an extremely cost-effective intervention.

Driven by these considerations, family planning programmes flourished in the era 1960-2000 and many lessons have been learnt. Their key purpose is to reduce the barriers to contraceptive adoption and sustained use, discussed in section 6, and the principles underlying an effective programme can be summarised succinctly. A favourable climate of opinion should be established and this requires high level political commitment and harnessing the support of key constituencies, such as religious and community leaders. Knowledge of methods needs to be disseminated, largely through mass media. Access to a range of affordable methods and services has to be achieved. The options in terms of methods and services are outlined in section 4 and section 8. Health concerns about use of contraceptive methods need to be addressed by medical and paramedical staff. Buttressing these principles are the nuts and bolts of any effective mass programme: adequate funding, clear lines of management and supervision; well trained and competent staff; sound logistics system; and a management information system.

Though the principles are universal, the ways in which they have been achieved vary widely and, in terms of methods and services, no single blueprint for success can be identified. In some countries, for example, India, decisions were made to popularise sterilisation or long acting methods, such as intrauterine devices (IUDs) in Egypt. In others, sub-Saharan Africa, for example, the emphasis was placed on pills or injectables. Once a method becomes familiar, it becomes the desirable choice and this synergy between policy decisions and social influence accounts for the fact that the method-mix in many countries is dominated by one or two methods and method-mix has a major influence on service delivery (Sullivan et al., 2006). For instance, oral contraceptives and condoms, are ideally suited for distribution through commercial outlets, usually at prices that are subsidised by social marketing. Injectables can be provided by mid-level community-based staff. Conversely, sterilisations, implants and IUD insertions are usually performed in medical facilities.

A narrow method-mix has considerable disadvantages. In India, the unpopularity of effective reversible methods is responsible for the fact that short inter-birth intervals, that pose a risk to the health and survival of the newborn, remain extremely common (Rutstein, 2011). In Kenya, where use is dominated by pills and injectables, half of women with an unmet need have tried and stopped one or both of these methods, typically because of side effects and related health concerns (Machiyama and Cleland, 2013). The case for widening choice in these two countries, and many others, is compelling and should be a priority. However, it is not straightforward, because it demands simultaneous attention to supply chains, provider training, and demand-creation. Voucher schemes, discussed in section 8, linked to new methods might make an important contribution to widening method-mix.

Historically, periodic abstinence, other traditional methods and condoms, have rarely been promoted for married couples in family planning programmes because of their high failure rate and difficulty of adherence. The advent of medical abortion (see section 9) and its increasing, albeit often illegal, availability at pharmacies may result in a re-consideration of their roles. Use of these methods, with abortion as back-up, can be an effective way of achieving small family sizes, as shown by the fertility decline in Europe between 1880 and 1930. There is intriguing survey evidence from Ghana, the forerunner of fertility decline in West Africa, that well educated women in the capital city, Accra, are preferring periodic abstinence and condoms over more effective pills and injectables, presumably because they are perceived to pose less of a risk to health (Ghana Statistical Service et al., 2009). Abortion laws in Ghana are liberal and no doubt terminations are easily accessible to women in Accra. This Ghana example illustrates the fact that the story of international family planning is still unfolding and may yet contain surprises.

Evidence Strength Assessment

Quality of evidence: Size of body of evidence: Consistency of results: Closely matched to topic: Overall assessment:
High/Medium Medium High/Medium High/Medium High/Medium
Overview

In 2012, the UN revised its projections for world population growth upwards. The current world population, as of July 2013, is 7.2 billion, which is 648 million higher than in was in 2005, an increase of 81 million people per year. This is projected to increase by nearly one billion people within the next twelve years, reaching 8.1 billion in 2025, 9.6 billion in 2050 and 10.9 billion in 2100 according to medium-variant projections (UN DESA, 2013). Compared with previous projections, this is higher, especially after 2075.

Population growth in the developing world, where numbers will rise from 5.9 billion in 2013 to 8.2 billion in 2050, is driving this increase, and this has been revised from the 2010 prediction of only 8 billion. In contrast, the population of the developed world is expected to change minimally and remain at around 1.3 billion (UN DESA, 2013). Growth is expected to be most rapid in the 49 least developed counties which are projected to double from 900 million in 2013 to 1.8 billion in 2050 (UN DESA, 2013)

Population growth and fertility rates have substantial effects on the economic circumstances of individual regions and countries, partly because they determine the ratio of the working age population to the dependent young and old population. The new UN figures have also adjusted fertility levels upwards as new information has become available. In 15 high-fertility countries of sub-Saharan Africa, the estimated average number of children per woman has been adjusted upwards by more than 5 per cent (UN DESA, 2013). However, there are wider variations in fertility levels with 48 per cent of the world’s population living in low fertility areas, where women have fewer than 2.1 children; a further 43 per cent live in intermediate fertility countries where women have between 2.1 and 5 children, and the final 9 per cent are in high fertility countries where women have 5 or more children. Of the 31 high-fertility countries, 29 are in Africa and two are in Asia (UN DESA, 2013).

Potential adverse effects of rapid population growth and high dependency ratios include slow economic growth and widespread poverty, poor health among women and children, unsustainable strain on existing education, health and employment infrastructure, and the depletion of environmental resources (Bongaarts and Sinding, 2009; Eastwood and Lipton, 2011; UN DESA, 2009). Furthermore, high levels of youth unemployment, exacerbated by rapid rises in the number of school leavers, can contribute to political instability (Bongaarts et al., 2012).

The promotion of family planning reduces unintended births and has thus been the main policy instrument to moderate rapid population growth and affect demographic change for the past half century. An evaluation of the success of family planning programmes can be found in section 7 of this guide.

Figure 1. World Population Growth 1950-2100.
Figure 1. World Population Growth 1950-2100.Source: UN DESA, 2013.

What are the issues?

Globally, total fertility is expected to fall from 2.52 births per woman in 2005-2010 to 2.17 in 2040-2050, which is close to the defined rate for replacement fertility (2.1 births per woman) (UN DESA, 2011). The medium-variant projection for Africa, the area of highest fertility, assumes fertility will fall from 4.9 children per women in 2005-2010 to 3.1 in 2045-2050, reaching the replacement fertility rate by 2095-2100 (UN DESA, 2013).

Future population growth is highly dependent on the path that future fertility takes. Small differences in the trajectory of fertility during the next decades will have major consequences for population size, structure and distribution in the long term. The “high-variant” projection depicted in figure 1, for example, which assumes an extra half of a child per woman (on average) compared to the medium variant, implies a world population of 10.9 billion in 2050 and 16.6 billion in 2100. The “low-variant” projection, where women have half a child less, on average, than under the medium variant, would produce a population of 8.3 billion in 2050. Thus, a constant difference of only half a child above or below the medium variant would result in a global population in 2050 of around 1.3 billion more or less compared to the medium variant of 9.6 billion (UN DESA, 2013).

Population growth until 2050 is inevitable even if fertility rates decrease below what is projected and if fertility remains unchanged the planet’s population is projected to reach almost 11 billion by mid-century and over 25 billion by the end of the century.

The majority of the global population growth will take place in the developing world, where, although fertility rates are projected to fall from 2.53 children per woman in 2005-2010 to 2.24 in 2045-2050 and 1.99 in 2095-2100 according to the medium projection figures (UN DESA, 2013), the total population will continue to increase. The population of the 49 least developed countries is expected to continue increasing by 2.5% per year (Bongaarts and Sinding 2009; UN DESA 2011).

Population transitions from a state of high mortality and high fertility to low mortality and low fertility include a period where fertility per person decreases but the population continues to grow as a legacy of previous high fertility rates (Bongaarts et al., 2012; Eastwood and Lipton, 2011; Higgins and Williamson, 1997). Nevertheless, a sustained decrease in fertility will promote further demographic transition and eventually result in population stabilisation (figure 2).

demographic transition
Figure 2. The Demographic Transition model. Source: Population Reference Bureau, 2004

Family planning is considered a tool to reduce population growth and effect demographic change, and many countries have adopted population policies to encourage this. In Mali, a population reduction policy was adopted in 2003 as part of a poverty reduction strategy (UN DESA, 2009). Likewise, Mauritania seeks to reduce fertility to 4 births per woman by 2015 as a measure to reduce widespread poverty (UN DESA, 2009). Cambodia’s National Population Policy of 2003 acknowledged the negative effects of fast population growth on health, the environment and policy and implemented a National Birth Spacing Programme to reduce total fertility rates (UN DESA, 2009).

There are synergistic effects between longer inter-birth intervals and lower fertility with other development goals, for example health and education targets, and the speed at which demographic transition occurs within individual countries is affected by in-country demographic diversity between educated and uneducated, rich and poor, and urban and rural residents (Eastwood and Lipton, 2011; UN DESA, 2009). Fertility rates are more likely to decline when child mortality is declining and schooling opportunities are expanding; therefore decreases in child mortality and investment in education can help to increase demand for family planning and drive fertility reductions (UN DESA, 2009).

There is a strong correlation between gender equality and family planning, and some evidence shows that sexual and reproductive health projects that integrate gender considerations achieve better outcomes (Rottach et al. 2009 and Barker et al.,  2007 reviewed in UNFPA, 2012). Gender inequity significantly impacts sexual and reproductive health outcomes, including contraceptive use, unwanted and unintended pregnancies and gender-based violence. At the same time high fertility rates and poor family planning lead to reduced opportunities for girls to attend school and for women to join the labour force, which enable them to contribute at both the household and macroeconomic levels. Important obstacles to gender equality include cultural attitudes and expectations around marriage and family roles and dominant concepts of masculinity.

Decreases in fertility deliver defined socio-economic benefits (Eastwood and Lipton, 2012). These include:

  • Potential for higher spending per head on the health and education of children (UN DESA, 2009).
  • Greater educational opportunities for children born into smaller families (UN DESA, 2009)
  • More years of education for girls, leading to an average higher age of marriage (UN DESA, 2009)
  • Higher female workforce participation (Eastwood and Lipton, 2012).

Population growth also effects economic growth through the idea of capital dilution and the ‘carrying capacity’ of global natural resources (Bloom et al., 1998). The rise in prosperity that was seen in the developed world following the industrial revolution was also due to a simultaneous rapid capital accumulation. This also helped to drive recent prosperity in East Asia (Case study 1). However, in the least developed countries of the world, population is increasing rapidly without necessarily any increase in capital accumulation (Pritchett, 1996). The population in the least developed countries is still young, with children under 15 accounting for 40 per cent of the population (UN DESA, 2011). In sub-Saharan Africa, where the majority of the least developed countries are located, there is: a low ratio of reproducible capital to natural capital; rapid population increases; and low net savings as a share of income (Bloom et al., 1998). Therefore there is a large savings gap, which means that the total available capital will be diluted as the population continues to increase (World Bank, 2006).

Case study 1: Demographic transition in East Asia

Between 1970 and 2005, East Asia experienced what has been described as an economic ‘miracle’. The increase in economic prosperity occurred in the wake of rapid demographic transition that began in the 1950s. A dramatic decrease in child and infant mortality in 1965-1970 led to a rapid expansion in the proportion of young dependents in the population, and by 1980 the dependency ratio peaked at 80% of the total population. Post-1980, the dependency ratio fell to less than 50% in 2010 and there was significant growth in labour, human capital per head of population, and the savings ratio. The economic result was an increase in GDP of 6.1% per head between 1965-2005, of which 1.37-1.87% of GDP, and 20% of the increase in the savings ratio, has been attributed to the change in the age structure of the population (Bloom and Williamson, 1998; Schultz, 2004). Therefore, although East Asia can attribute a significant fraction of its increase in economic prosperity to demographic transition, it cannot necessarily be used as a model for other areas of the developing world (Bloom and Williamson, 1998).

Key messages

  • Total world population is expected to surpass 9 billion by 2050 (UN DESA 2011).
  • The population of the 49 least developed countries is the fastest growing in the world, at 2.5% per year (Bongaarts and Sinding 2009; UN DESA, 2011).
  • Projected trends are dependent on an overall decline in fertility in developing countries; small changes in the number of births per woman can have a large effect on total population growth (UN DESA, 2011).
  • Although reductions in fertility have defined economic benefits, for populations to successfully undergo population stabilisation with associated economic prosperity, capital accumulation needs to occur concurrently.
  • The population in the 49 least developed countries is expected to increase by 2.5% per year; there is a savings and capital accumulation gap that threatens future living standards.

Evidence Strength Assessment

Quality of evidence: Size of body of evidence: Consistency of results: Closely matched to topic: Overall assessment:
High Medium Medium/High Medium/High Medium/High
Overview

Globally, an estimated 661 million women of reproductive age who are either married or single and sexually active use modern contraceptives (Singh and Darroch, 2012). The majority of these women are from Europe, North America, Latin America, Asia and North Africa (Singh and Darroch, 2012). Sub-Saharan Africa lags behind and has the lowest prevalence rates of 18% (in 2010) (Singh and Darroch, 2012). Least progress has been seen in West Africa and Central Africa particularly among the poorest, those with no education, and those living in rural or remote areas (Alkema et al., 2013; Singh and Darroch, 2012).

Contraceptive prevalence in individual countries is dependent on access to an adequate mix of contraceptive methods, social acceptability and health concerns (Singh et al., 2009; Singh and Darroch, 2012; Sullivan et al., 2006). The complex barriers that prevent women from using modern contraceptives are discussed in detail in section 4 of this guide. The increase in contraceptive prevalence has stalled since the year 2000 due to factors such as sustainability of funding for supplies, access and cost issues (Alkema et al., 2013).

An estimated 215 million women globally want to avoid pregnancy; however, they are not using contraceptives (Singh et al., 2009). Women with unmet contraceptive needs have 1 in 180 lifetime risk of dying during pregnancy (Singh and Darroch, 2012). The original definition of unmet need has changed over time. Using a revised definition, evidence suggests unmet need is slightly higher compared to the original definition. The average total unmet need across 169 Demographic and Health Surveys between 1990 and 2010 was 21.3% for the original definition and 23% for the revised definition (Bradley S, Croft T & Fishel, 2011). An assessment of the demand for family planning programmes can be found in section 6 of this guide.

Figure 3. World Contraceptive Use and Unmet Need
Figure 3. World Contraceptive Use and Unmet Need. Source: Singh and Darroch, 2012.

What do we know?

Contraceptive prevalence

The global estimate for modern contraception use among married or cohabiting women is 56% (UN DESA, 2011), with a noticeable difference between the more developed (61%) and least developed (25%) countries (UN DESA, 2011). The regions with the highest prevalence are North America and Latin America and the Caribbean (73% and 67%, respectively), and the lowest prevalence is seen in Africa (22%; figures 4 and 5). Prevalence varies within each region and by individual characteristics, for example, wealth, education and age (UNFPA, 2012). The highest levels in Europe are seen in Norway and other Northern European countries and the lowest levels are seen in the countries of the former Yugoslav Republic (UN DESA, 2011). In Latin America and the Caribbean, the highest levels are seen in Brazil and the lowest in Haiti. In Asia, China has the highest levels and Afghanistan the lowest. In Oceania, New Zealand has the highest levels and Samoa the lowest; while, in Africa, Morocco has the highest levels and Chad the lowest.

Although the use of modern contraceptives in the developing world has increased from 10% in 1950 to 57% in 2012, the degree of increase in recent years has all but stopped; from 2008 to 2012 the increase in uptake was only 1% (Singh and Darroch, 2012).

The highest level of unmet contraceptive need is in Africa. A strong link exists between high unmet need, low use of modern contraceptives, and poverty. In India, unmet contraceptive needs were twice as high among the poorest women as among the wealthiest (Singh et al., 2009).

When considering contraceptive prevalence and unmet need, it is important to note that these measures fail to capture the nature of individual’s decisions regarding their sexual activity and the factors that are out of women’s control, such as changing availability and supply of contraceptives over time. Nor does unmet need take into account willingness to use in the future. Many women with unmet need state no intention for future use (Westoff, 2006). UNFPA has stated that it would be useful to monitor progress by additional indicators to capture demand for contraceptives, including ‘proportion of demand satisfied’ to monitor whether women’s stated desires for family planning are being met and the rights based approach is becoming a reality (UNFPA, 2012).

Contraceptive methods

Modern contraceptive methods can be permanent or reversible; permanent methods include surgical sterilisation of men or women, and reversible methods are often divided into long-acting (IUDS and implants) and shorter-acting methods that include the pill, injectables, hormonal patches, barrier methods such as male and female condoms, sponges and diaphragms, and spermicides (Singh et al., 2009). Globally, the most commonly used contraceptives are female sterilisation, the pill and IUDs (Sullivan et al., 2006); however, the popularity of each method varies with geographic region. Female sterilisation is more prevalent in Asian countries such as China (29%) and India (37%) and in Latin America (26%) than in sub-Saharan African countries (1.6%) (Singh et al., 2009; UN DESA, 2011). The highest use of the contraceptive pill is seen in Europe, the Americas and Oceania, and the IUD has its highest prevalence in Asia.

The marked differences between countries in method-choice often reflect past policy decisions to promote specific methods rather than cultural preferences or women’s personal preferences. In many countries, one or two methods account for the majority of use (Sullivan et al., 2006). Widening method choice is a priority but requires considerable investment in logistics, training and demand-creation, expanding access to safe, effective and affordable contraception and making information about different methods readily available.  Additionally, some methods have additional issues which must be factored in to planning. For example, sterilisation has been used in a coercive or persuasive manner at state level, for example in China, and also been used to target women with disabilities, on low income, and other disadvantaged groups. Therefore sterilisation programmes must be planned using a rights based approach (Jones, 2006).

Hormonal contraceptives (the pill, injectable contraceptives, implants, patches and some IUDs) offer up to 99% certainty of control for pregnancies if used correctly (Cleland et al., 2006). There are potential side effects associated with the use of some hormonal contraceptives, including irregular or heavy vaginal bleeding (implants), a delayed return to fertility (progesterone only pills) and an increased risk of cardiovascular disease (combined oral contraceptives); combined oral pills are also contraindicated during breastfeeding (WHO, 2010). Importantly, there are concerns that some injectable methods of hormonal contraception, for example Depot medroxyprogesterone acetate (DMPA), may increase the risk of HIV acquisition (Heffron et al., 2011; Jain, 2012).

Among barrier and/or spermicidal methods, only the male condom is commonly used, accounting for 8% of all contraceptive use among married couples (UN DESA, 2011). The highest prevalence is seen in Hong Kong (50%), Japan (41%), Greece (34%) and Russian Federation (30%) (UN DESA, 2011). It is also the most common method used by sexually-active single women in sub-Saharan Africa and Latin America. If consistently used, condoms are 98% effective and also offer protection against STIs and/or UTIs (Cleland et al., 2006; WHO, 2010). The health benefits of contraception are discussed in detail in section 4 of this guide.

Lesser used methods of modern contraception include the emergency contraception (EC) pill, which is also known as the ‘morning after pill’. Unlike other contraceptive methods discussed above, which are taken before intercourse, the EC pill is usually taken after intercourse to reduce the risk of pregnancy. The use of this method remains relatively low, in part due to a persistent poor understanding of fertility, contraception and pregnancy risk in both the developed and developing worlds (Westley and Glasier, 2010). However, women are also prevented from accessing emergency contraception in the developed and developing worlds by political and social ideologies. For example, the United States currently has age restrictions on the sale of emergency contraception, despite legal rulings compelling their removal (Centre for Reproductive Rights, 2010; FDA, 2013). Where emergency contraception is legal, but not available over the counter, women are dependent on provider willingness for access, which further restricts the use of this method (Ellertson et al., 1995).

Typically, about 40% of reversible method adopters will stop use within 12 months, with the clear exception of IUD adopters who are much more likely to continue use (Ali et al., 2012). The main reasons for stopping pills and injectables are health concerns and side-effects. Many couples do not switch promptly to an alternative method, leaving them at risk of an unintended pregnancy. Accidental pregnancy is the main reason for stopping traditional methods. Traditional methods of contraception include withdrawal and rhythm or calendar or fertility awareness methods. Jointly, these account for 6% of all contraceptive use globally, with highest use observed in Albania (59%), Azerbaijan (38%) and Greece (30%) (UN DESA, 2011). These methods have high failure rates and have not been included in any of the figures for modern contraceptives (Singh and Darroch, 2012).

Figure 6. Prevalence of contraceptive method by region.
Figure 4. Prevalence of contraceptive method by region.Data taken from the UN World Contraceptive Use 2011. NB. ‘Other’ refers to little-used methods of modern contraception and does not include traditional contraceptive methods.

The Couple Years of Protection (CYP) indicator is the estimated protection provided by contraceptive methods during a one-year period, based on the volume of all contraceptives sold or distributed during that period (USAID, 2011). Permanent and long-acting contraceptives such as male and female sterilisation, IUDs and hormonal implants have the highest CYP values, whilst short-acting and single-use methods such as the oral contraceptive pill and condoms have low CYPs (USAID, 2011). Cost per CYP for contraceptive methods varies by region, which is typically due to costs associated with programme setting and mode of delivery rather than regional variations in commodity costs (Levine et al., 2006; Singh and Darroch, 2012). Voluntary sterilisation and IUDs typically have the lowest cost per CYP, whilst hormonal implants and injectables have the highest cost per CYP (Levine et al., 2006; Singh and Darroch, 2012). The cost-effectiveness of family planning programmes is discussed further in section 10 of this guide.

Key messages

  • Contraceptive prevalence is critically low in many areas of the developing world, particularly Sub-Saharan Africa, leading to a large unmet demand for modern contraceptives.
  • Use of specific contraceptive methods varies by region and often reflects past policy decisions that determine access, availability, and the social acceptability of individual methods, as well as lack of choice and women’s poor access to information about/and availability of affordable contraceptive methods.
  • Female sterilisation, reversible hormonal methods of contraception and IUDs are the most widely used contraceptive methods; the male condom is commonly used by married couples in a minority of countries but is often the dominant choice of single people.

Evidence Strength Assessment

Quality of evidence: Size of body of evidence: Consistency of results: Closely matched to topic: Overall assessment:
High Medium Medium/High High Strong
Overview

Barriers to contraception are the constraining factors standing between people’s preferences concerning the number and timing of pregnancies and the adoption of behaviour to achieve these. Barriers can inhibit women’s ability to avoid unintended pregnancy (Campbell et al., 2006). Barriers to family planning occur at multiple levels in government, society and the health system (WHO, 2012). Two dominant reasons for non-use are health concerns and social disapproval. Social disapproval, expressed by women as opposition to family planning, together with lack of information, tends to be more important when contraceptive use is low. Health concerns grow in importance as contraceptive use increases. Effective and targeted actions are urgently needed to improve contraceptive choice and access for women and families globally.

Figure 7 Determinants of FP Use
Figure 5. Determinants of family planning use: a social ecological framework. Source: Adapted from a presentation given by Joanna Busza from LSHTM, 2012.

What are the issues?

Limited method choice and access

Contraceptive use depends on a person’s knowledge of methods and sources of supplies. There is also usually a correlation between travel time from a woman’s home to any health clinic and the likelihood that she will use a contraceptive. Evidence suggests that increasing the number of family planning methods available in a country increases the overall practice of contraception and accelerates fertility reduction (Campbell et al., 2006; Sullivan et al., 2006). It is important to remember that women are not a homogenous group, and that different population groups such as the disabled and ethnic minorities experience different barriers to choice and access, and may face additional barriers to those experienced by other women (UNFPA, 2012).

Financial costs

The prices of contraceptives vary widely in different markets and between branded and generic products. The financial cost of contraceptives may influence choice of method and adoption (Campbell et al., 2006). Evidence from South Africa shows that even when contraceptive services were offered free of charge, teenage pregnancies were not being avoided, suggesting other barriers or pressures were present (Wood & Jewkes, 2006).

Women’s status and perceptions of partner’s views

The social construction of gender and women’s position within society affects many aspects of family planning. Fertility preferences can be derived from the social and economic status gained by conforming to cultural expectations about motherhood rather than through personal choice, for example by having large families, sons or proving fertility by having children straight after marriage (Sills et al., 2012). Additionally, women are often financially dependent on men and may lack access to cash to purchase contraceptives and may also be coerced into making reproductive choices based on the wishes of others (Miller et al., 2002).

The dynamics and prevalence of women’s exposure to intimate partner violence undermines their ability to negotiate safe sex increasing the risk of sexually transmitted infections (STIs), abortion, maternal morbidity and mortality and adverse pregnancy outcomes. As well as this, unplanned pregnancies increase the risk of intimate partner violence and violence increases the risk of unplanned pregnancies (Koenig et al., 2003). Measures to address intimate partner violence should be part of comprehensive reproductive health programmes, including by promoting men’s involvement in programmes (Pallitto and O’Campo, 2004).

Women’s perceptions of societal views can also be a barrier. They may think that their husbands oppose family planning which can be a factor discouraging contraceptive practice in a wide variety of settings, including Egypt, Guatemala, India, the Philippines and Nepal. Data from Pakistan indicate that women’s perceptions of their husbands’ views are not always accurate and that they may perceive their husbands to have more negative views toward family planning than is the case (Casterline et al., 2001). Surveys of men do not reveal widespread opposition. Fears about being thought of as sexually promiscuous have also been mentioned as barriers to using condoms in some settings in the Middle East (Kulczycki, 2004).

Medical and legal restrictions

Practices, derived at least partly from a medical rationale, which result in a scientifically unjustifiable impediment to, or denial of, contraception. For example, women being subjected to unnecessary medical procedures as a prerequisite for gaining access to contraceptive methods may act as a barrier (Campbell et al., 2006). Even where family planning services are physically accessible and economic barriers to access are few, medical barriers to contraceptive services—such as overspecialisation, demanding husbands’ consent, eligibility restrictions and process hurdles—can limit women’s use of services (Speizer et al., 2000). Task shifting, for instance by allowing mid-level providers to insert IUDs and give injectable contraception, has greatly expanded access in many countries. 

Provider bias

Service providers sometimes deny access to a family planning method as a result of their own prejudices about the method or its delivery system or the status of the person asking for family planning (Campbell et al., 2006; Speizer et al., 2000; Sullivan et al., 2006). 

Additionally, another gender dimension of service provision that should be considered is the ‘appropriateness’ of family planning services, including days and hours of operation. This is especially important for services aimed at women as they usually have the burden of care of responsibilities and may find it difficult to travel to access services during the day or may not be able to travel after dark, hence the need for mobile services outlined in section 8 and privacy with separate facilities available for women and men.

Job aides and training for providers can help reduce biases interfering with quality of service. The two most well-known, rigorously evaluated, and effective job aides include the Balanced Counseling Strategy (BCS), developed by the Population Council as part of the FRONTIERS programme, and the Decision-Making Tool (DMT) developed by the WHO (DFID, 2010; Kim et al., 2005).

Misinformation

Side effects, lack of accurate information, and misinformation commonly interact to create a disproportionate fear of fertility regulation methods (Campbell et al., 2006). For example, in Mali, young people were found to be wary of using either the pill or injectable contraceptives because they believed that these methods would make them permanently sterile (Castle, 2003). Limited and inaccurate knowledge of reproductive anatomy and physiology are a serious concern.

Medically inaccurate notions about how conception occurs and fears about the effects of contraception on fertility and menstruation, which were not taken seriously by nurses were found to be barriers to adolescents accessing contraception in South Africa. Nurses’ attempts to stigmatise teenage sexuality, their scolding and harsh treatment of adolescent girls, and their unwillingness to acknowledge adolescents’ experiences as contraceptive users, undermined the effective use of contraception by girls (Wood and Jewkes, 2006).

Youth need better information on reproductive physiology and sexual health, and detailed information on contraception. Tools to enhance the accuracy and availability of knowledge in the clinical setting have a role, but need to be introduced along with initiatives to ensure that services are adolescent friendly and do not stigmatise adolescent sexual activity (Wood and Jewkes, 2006). To make progress, interventions should aim to counter negative perceptions of modern contraceptive methods and the dual role of condoms for contraception and STI prevention should be exploited (Williamson et al., 2009).

Strength of motivation to avoid pregnancy

Some women who indicate a desire to avoid pregnancy are relatively unconcerned about becoming pregnant, whereas others regard it as a highly undesirable outcome and, when asked, admit to numerous concerns and worries. Women who feel ambivalent about their stated desire may be especially susceptible to other factors that act against them practicing contraception (Casterline et al., 2001).

Key messages

  • The presence or absence of barriers to fertility regulation is likely an important determinant of the pace of fertility decline or its delay in many countries. Barriers inhibit women’s ability to avoid unintended pregnancy. Problems of quantifying barriers limit understanding of their importance (Campbell et al., 2006).
  • Effective and targeted actions are urgently needed to improve contraceptive access. The following actions are recommended:
    • Governments and donors need to develop and implement policies to secure access to family planning for all and in particular for vulnerable populations. Funds also need to be committed to pay for it.
    • Mass and other media should be used to enhance social acceptability among men as well as women.
    • Counselling skills should be recognised as key to success in addressing concerns about adverse health effects of methods and in eliminating provider bias in services.
    • Ongoing training and supportive supervision needs to be provided for cadres of family planning providers within the health system and community.

Evidence Strength Assessment

Quality of evidence: Size of body of evidence: Consistency of results: Closely matched to topic: Overall assessment:
Medium/High Medium Fairly Consistent Medium Medium

Overview

The reduction in the number of unintended pregnancies in women is the greatest health benefit of contraception. In 2008, it is estimated that contraception prevented over 250,000 maternal deaths compared with 355,000 deaths that occurred in that year (Cleland et al., 2012). A further 30% of maternal deaths could be avoided by fulfillment of unmet need for contraception (Cleland et al., 2012) By preventing high-risk pregnancies, especially in women of high parities, and those that would have ended in unsafe abortion, increased contraceptive use has also reduced the maternal mortality ratio—the risk of maternal death per 100,000 live births—by about 26% in little more than a decade.

The benefits of modern contraceptives to women’s health, including non-contraceptive benefits of specific methods (such as a reduced risk of transmission of HIV and anaemia), outweigh the risks (Cleland et al., 2012; Warner et al., 2004; Willard et al., 2002).

What are the issues?

Increasing contraceptive use in developing countries has cut the number of maternal deaths by 40% over the past 20 years, merely by reducing the number of unintended pregnancies, particularly in high-risk women. Women with greater than average obstetric risk include those who are younger than 18 years or older than 34 years, those with only one child or more than three, and those whose births are closely spaced. Contraception reduces the risk of maternal death per pregnancy; each 1 percentage point increase in contraceptive use reduces the maternal mortality ratio by 4·8 deaths per 100,000 live births (Cleland et al., 2012).

The use of contraception also reduces maternal morbidity. For every woman who dies of pregnancy and childbirth complications, at least 20 more women suffer long-term illness and disabilities related to unwanted pregnancy or recent childbirth, which affects individual women and impacts on the economic well-being of their families and society (UK Government, 2009).

Unwanted and mistimed births can pose health and socioeconomic risks to mothers and infants (Conde-Agudelo et al., 2007; Singh et al., 2010). In addition to risks to maternal health discussed above, unwanted births threaten maternal psychological well-being that can result from reduced participation in education, social and familial rejection in the case of unmarried women, and being forced to marry or undergo serious physical harm (Singh et al., 2010).

Contraception can also improve perinatal outcomes and child survival, mainly by lengthening interpregnancy intervals. In developing countries, the risk of prematurity and low birthweight doubles when conception occurs within 6 months of a previous birth, and children born within 2 years of an elder sibling are 60% more likely to die in infancy than are those born 3 years or more after their sibling. In early childhood, children who experience the birth of a younger sibling within 2 years have twice the risk of death than other children. In high fertility countries where the majority of children have younger and older siblings, ensuring an interval of at least 2 years between births would reduce infant mortality by about 10% and early childhood deaths by about 20% (Cleland et al., 2012; Hobcraft et al., 1983). Women resolve nearly half of unintended pregnancies through abortion (Singh et al., 2010). Safe and effective abortive technology exists (see section 9 of this guide), but this is not always legal or available, causing women to turn to unlicensed abortion providers (Ahman and Shah, 2011). Legal barriers are a particular issue in Africa and Latin America and in these contexts, induced abortion become the privilege of the rich, while poor women are left with little choice but to resort to unsafe providers (Sedgh et al., 2012). Nearly half of all abortions are considered unsafe (Grimes et al., 2006) and there is a link between countries’ restrictive abortion laws and high rates of maternal mortality and morbidity (Haddad and Nour, 2009). Unlike other causes of maternal death, mortality attributable through unsafe abortion is entirely avoidable through effective family planning and the provision of safe abortion services for accidental pregnancies among contraceptive users and unintended pregnancies among non-users of contraceptives and victims of rape and incest (Ahman and Shah, 2011).

Condoms are the only method of contraception that also reduce the risk of acquiring sexually transmitted infections (STIs) such as HIV, gonorrhoea and chlamydia, although research is currently ongoing to determine whether the female diaphragm can also reduce the risks of some bacterial STIs (Warner et al., 2004; Willard et al., 2002). It is worth noting that condoms are associated with higher risks of pregnancy than some other contraceptive methods that do not protect against transmission of STIs (Willard et al., 2002). The ideal approach to realise the combined health benefits is to use condoms together with a more effective contraceptive method (Willard et al., 2002). Additional benefits to women can include an increase in self-esteem, quality of life, status and decision-making power.

HIV transmission and family planning programmes

Use of contraception reduces unintended pregnancies in HIV-infected women, which reduces the risk of perinatal HIV transmission (Reynolds et al., 2006). Adding family planning aspects to programmes designed to prevent mother-to-child HIV transmission in 14 countries averted 71,000 HIV-positive births in 2007 (Reynolds et al., 2006). However, increasing contraceptive use among women who do not know their HIV status is at least as cost-effective as providing the anti-retroviral treatment needed to prevent perinatal HIV transmission, and also provides clear public health benefits in reduced HIV transmission (Reynolds et al., 2006). It is important to note, however, that these services need to be provided alongside education about choices to avoid issues such as HIV positive women being coerced to give up their right to have children. Additionally, programmes need to be sensitive to local needs and contexts and avoid overbearing approaches, such as providing ‘cash for contraception’. An example of this is in a recent case in Kenya where Project Prevention, a US-based NGO offered HIV-positive women in western Kenya US$40 to be fitted with intrauterine devices (IUDs), which can prevent pregnancy for over a decade.

Key messages

  • Increases in contraceptive use account for about 75% of fertility decline in developing countries in the past six decades and have substantially reduced the proportion of pregnancies in women of high parity, which pose a greater-than-average risk to maternal survival.
  • In 2008, contraceptive use averted over 250,000 maternal deaths worldwide by reducing unintended pregnancies, which is equivalent to 40% of the 355,000 maternal deaths that occurred that year.
  • If all women in developing countries who want to avoid pregnancy use an effective contraceptive method, the number of maternal deaths would fall by a further 30%.
  • Contraceptive use has the potential to improve perinatal outcomes and child survival by widening the interval between successive pregnancies; in rich and poor countries the risks of prematurity and low birthweight are substantially raised by short intervals, and in developing countries, risk of death in infancy (ages <1 year) would fall by 10%, and in ages 1–4 years by 21%, if all children were spaced by a gap of 2 years.
  • The health benefits of specific contraceptive methods far outweigh the health risks, although minor side effects result in high probabilities of discontinuation, particularly of hormonal methods.

Evidence Strength Assessment

Quality of evidence: Size of body of evidence: Consistency of results: Closely matched to topic: Overall assessment:
High Medium/High High High Strong

Overview

Although the world’s total fertility rate has dropped considerably, and contraceptive prevalence is increasing, there is a growing worldwide demand for family planning services (Bongaarts, 1997; UN DESA, 2011; section 2 of this guide). The increase in demand is due to two trends: the burgeoning numbers of young people entering childbearing age and the increasing adoption or desired adoption of contraceptive use (Kent, 2008). In nearly all developing countries, the number of women of reproductive age will grow between 2005 and 2015 because of the large numbers of young people in these countries (refer to section 2 of this guide).

What are the issues?

The absolute number of married women who either use contraception or who have an unmet need for family planning is projected to grow from 900 million in 2010 to 962 million in 2015, and will increase in most developing countries (Alkema et al., 2013). In addition, the demand for contraceptives is projected to grow due to couples’ desires for smaller families (Clifton et al., 2008). Contraceptive use in recent years has risen, but unmet needs remain.

Key concept: unmet need

Women with unmet need are those who are fecund (fertile) and sexually active but are not using any method of contraception, and report not wanting any more children or wanting to delay the birth of their next child. Unmet need for family planning is expressed as a percentage of women of reproductive age who are married or in a union, and is calculated using the following formula:

Unmet need for family planning

=

Women (married or in consensual union) who are pregnant or post-partum amenorrheic and whose current pregnancy/most recent birth was unintended + fecund women who desire to stop childbearing or postpone the next birth for two years or more and who are not using a contraceptive method x100
Total number of women of reproductive age (15-49) who are married or in consensual union

The indicator is widely used to assess progress towards the goal of enabling all couples to implement their preferences for the number and timing of children. The sum of contraceptive prevalence and unmet need provides the total potential demand for family planning. It gives a snapshot measure of the extent of unmet need for family planning at a particular point in time. Unmet need tracked over time can indicate progress towards universal access to reproductive choice. Where survey data are available, unmet need can be disaggregated by whether women have prior experience of a modern method or not and whether they state an intention to use modern contraceptives in the future.

In 2012, 222 million married and sexually active single women worldwide had an unmet need for family planning (Singh and Darroch, 2012). Unmet need is not confined to married women but relevant data for single women are lacking for many countries, particularly in Asia. Typically, use is higher in unmarried sexually active women than married women but unmet need is higher because few single women want a child within 2 years. In Latin America, where relevant data are available, unmarried women account for 28% of all unmet need and the corresponding figure in sub-Saharan Africa is 17% (Cleland et al., 2006).

It should be noted that, even when contraceptive prevalence is rising, unmet need for family planning may sometimes fail to decline, or may even increase, if demand for family planning increases due to declines in the desired number of children. This combination accounts for the small change in unmet need in Eastern Africa despite a large increase in use (figure 6). Changes in the desired spacing of births or changes in the percentage of women who are at risk of pregnancy can also influence the trend in demand for family planning, independently of trends in contraceptive prevalence (UN DESA, 2011).

The factors responsible for high unmet need in particular population groups will differ by context and interventions will need to be modified accordingly. Demand-side subsidies may be required for specific groups; these could include cash transfers or vouchers to reduce the cost of family planning services.

Focusing on the fulfilment of individual aspirations, unmet need remains a sound rationale for the formulation of population policy and a sensible guide to the design of family planning programmes (Casterline and Sindings, 2000). Unmet need accounts for the majority of mistimed and unwanted pregnancies, though contraceptive failure makes an appreciable contribution where less effective methods are commonly used. The main rationale of family planning programmes is to reduce unmet need and such reduction accounts for most of the rise in contraceptive use over recent decades (Feyisetan and Casterline, 2000).

As countries transition from high fertility to low fertility, unmet need will initially be low, and then increase in response to more knowledge about family planning and changing norms. Finally, unmet need will reach a low level because women who want to use family planning are doing so, and relatively few women who want to space or limit childbearing are not using a method (Gribble, 2012). The inverse link between the levels of contraceptive use and unmet need is clearly seen in figure 6.

Figure 9. Percentage of women aged 15-49 years who were married or in a union who used a contraceptive methods or who had an unmet need for family planning in 1990 and 2010, by world, development group and sub-region. (Horizontal lines represent the 95% uncertainty intervals).
Figure 6. Percentage of women aged 15-49 years who were married or in a union who used a contraceptive methods or who had an unmet need for family planning in 1990 and 2010, by world, development group and sub-region. (Horizontal lines represent the 95% uncertainty intervals). Source: Alkema et al., 2013.

Key messages

  • Although global fertility is declining, and contraceptive prevalence is increasing, the absolute number of women with an unmet need for contraception is increasing. This translates into a growing demand for family planning services.
  • Trends in contraceptive prevalence and unmet need for family planning, and the projected growth in the number of potential contraceptive users indicate that increased investment is necessary to meet demand for contraceptive methods and improve reproductive health worldwide.
  • Understanding demand for contraception is vital in the design of projects which aim at improving access to and quality of family planning programmes. It is important to understand the reasons why women are not using contraceptives. 

Evidence Strength Assessment

Quality of evidence: Size of body of evidence: Consistency of results: Closely matched to topic: Overall assessment:
Medium Medium Fairly Consistent Medium Medium

Overview

The implementation of state-sponsored family planning programmes began in the early 1950s as a route to promoting development through population stabilisation (Bongaarts et al., 2012; Finkle and MacIntosh, 2002; Visaria, Jejeebhoy & Merrick, 1999) (see section 2 of this guide for the economic rationale behind population stabilisation). By 1996, the number of countries with official policies to support family planning had increased from 2 in 1960 to 115, and at its peak, donor funding for family planning programmes totalled US$980 million in 1995 (2007 real dollars) (Bongaarts et al., 2012; Cleland et al., 2006).

The greatest reductions in fertility occurred in Asia (58%) and Latin America (62%), and by 1990-1995, the level of childbearing dropped from approximately 5 births per woman to 3 in these regions (Bongaarts et al., 2012). Reductions in fertility were seen in some sub-Saharan African countries, such as Kenya, South Africa and Zimbabwe, and the levels of childbearing in developed countries fell from 2.5 to 1.7 births per woman (Bongaarts et al., 2012).

Despite evidence of success, funding for family planning declined post-1995 (Bongaarts et al., 2012). Several factors can account for this shift, among them a sense that the problem of rapid population growth was largely solved, criticism of the strategies of some early programmes, and the emergence of compelling new priorities such as HIV/AIDS (Bongaarts et al., 2012; Casterline and Sinding, 2000). As a result, much funding was shifted to programmes for reproductive health and HIV/AIDS (Bongaarts et al., 2012).

What are the issues?

Early family planning programmes were characterised by largely economic rationales, as countries sought to combat rapid population growth; however, regional variations occurred, for example in Latin America, where family planning was initiated largely as a response to evidence of an increase in illegal, unsafe abortions (Cleland et al., 2006; Bongaarts et al., 2012). Following the spread of family planning programmes, fertility declined from 5.7 births per woman in 1970 to 2.8 in 2005 in less developed regions of the world (UNDP, 2009). Countries such as Bangladesh (case study 2), South Korea and Taiwan implemented particularly successful programmes that led to rapid declines in fertility levels.

Case study 2: Bangladesh

The Family Planning and Health Services Project was initiated in the late 1970s in Matlab, Bangladesh, at a time when Bangladesh was one of the poorest countries in the world. The region, which had a population of 173,000 in 1977, was divided into experimental and control areas of approximately equal sizes; the control area received the same services as the rest of the country, while a comprehensive high-quality programme aimed at reducing the monetary, social, psychological and health costs of contraception was adopted in the experimental region. Within one year of the programme’s inception, the proportion of women using contraception in the experimental area increased from less than 5% to 28%; a decline in fertility occurred to about 1.5 births less per woman than in the control area. Importantly, both the experimental and control areas saw similar declines in fertility preferences, confirming the impact of the experimental programme of the reduction of unintended births. The success of the programme led to the adoption of it as the national family planning strategy by the Bangladeshi Government.

However, not all programmes were created equal. High pressure, target-led programmes such as those seen in India (case study 3) and some other Asian countries were considered to restrict women’s agency and reproductive choice, and the payment of financial incentives to healthcare providers and individuals for sterilisation created a high risk of corrupt practices (Bongaarts et al., 2012; Casterline and Sinding, 2000).

Case study 3: Family planning in India

The Indian state-run family planning programme was implemented in 1951. Since the mid-1970s, it primarily focused on sterilisation, with little choice of alternative contraceptive methods being offered. Individual health workers were responsible for achieving method-specific targets, with punitive sanctions if these were not met. Although the total fertility rate decreased from 6.5 lifetime births per woman in 1970 to 3.4 per woman in the mid-1990s, various stakeholders including women’s organisations and the donor community, voiced concerns that the programme was coercive and offering limited choice. Since then, the Indian state has shifted to a target-free approach (Bongaarts et al., 2012Visaria, Jejeebhoy & Merrick, 1999).

After the 1994 International Conference on Population and Development in Cairo, narrowly focussed target-driven family planning approaches were largely abandoned (see Box 1). An agenda of women’s rights, health and empowerment was adopted, with fertility reduction achieved through addressing the issue of unmet contraceptive need and a consensus that governments should address social development beyond family planning as part of a broader package of care (Bongaarts et al., 2012; Casterline and Sinding, 2000; Finkle and MacIntosh, 2002; Gillespie, 2004). This was based on an underlying belief that enhancing individual rights would slow population growth. Since this time, funding for family planning has declined by 30%, and there is less enthusiasm for meeting the commitments of earlier years (Bongaarts and Sinding, 2009; Cleland et al., 2006). The London summit on family planning in July 2012 marked the end of 15 years of neglect.

Box 1. Cairo Consensus Programme of Action

A total of 179 governments signed up to the International Conference on Population and Development/Cairo Consensus Programme of Action which set out to:

  • Provide universal access to family planning and sexual and reproductive health services and reproductive rights;
  • Deliver gender equality, empowerment of women and equal access to education for girls;
  • Address the individual, social and economic impact of urbanization and migration;
  • Support sustainable development and address environmental issues associated with population changes (UNFPA, 1995)

The programme of action and benchmarks added at the ICPD+5 review went on to inform the eight Millennium Development Goals.

Assessing the impact of family planning programmes can be difficult because it can be hard to uncouple development progress from the family planning programme. However, there is evidence to suggest that family planning programmes have had significant impact in areas that have experienced poor development progress. Fertility has declined rapidly in a number of countries with unfavourable development conditions, for example, Bangladesh, Nepal, Rwanda and Sri Lanka.

These countries were all largely poor, agricultural and traditional at the time when fertility started to fall, and the unifying factor between them is the priority given by governments to social development and the implementation of family planning and health programmes. In the past 50 years no sustained fertility decline has been observed in a poor and largely illiterate country in the absence of a strong family planning programme (Bongaarts et al., 2012).

Impact can also be assessed by examining the disparity between rates of unwanted fertility in the poorest and richest quintiles of individual countries. Gillespie’s (2004) analysis of unwanted fertility in 41 developing countries found that unwanted fertility was more than twice as high in the poorest quintile than in the richest quintile (1.2 vs. 0.5 births per woman).

This disparity is much smaller in countries with strong family planning programmes, for example, in Indonesia, which has strong family planning programmes, the difference between the highest and lowest quintiles is just 0.1 births per woman, whereas the Philippines (which has weak family planning programmes) has a much larger discrepancy of 1.9 unwanted births per woman between the poorest and the richest (Gillespie, 2004; Bongaarts et al., 2012).

The impact of family planning projects can also be assessed using recently-developed tools that allow individual family planning programmes to be evaluated within national health and demographic changes. These tools can be used for both prospective and retrospective evaluations, and allow detailed assessment of the acceptability of services to clients and providers, and the feasibility and efficacy of different service combinations (Weinberger et al., 2012; Rivero-Fuentes et al., 2008).

There is also considerable evidence to suggest that family planning programmes that intentionally challenge gender norms have a positive impact on use of family planning. The Institute for Reproductive Health implemented programmes in Honduras and El Salvador that specifically targeted men as decision-makers about family planning. The programmes offered sexual and reproductive health education sessions to men at their work sites in water and sanitation and agricultural committees. The messages and materials intentionally challenged gender norms and presented the benefits of family planning. In Honduras, family planning use increased from 37% to 55% throughout the programme duration. The project area in El Salvador also experienced a significant increase in use of family planning (Lundgren et al., 2005; Gribble et al., 2008).

The case for effective family planning programmes: sub-Saharan Africa

Sub-Saharan Africa demonstrates the need for effective family planning programmes. By the time that many African governments accepted the need for population stabilisation programmes, the promotion of family planning was no longer an international development priority. At least partly as a result of this, the fertility decline in most of Africa has been slow: of the 43 countries globally with total fertility rates of 4 or more births per woman, 35 are in sub-Saharan Africa. Continued high fertility, high dependency ratios, and rapid population growth in Africa will make achievement of most of the Millennium Development Goals nearly impossible (Bongaarts et al., 2012; Caldwell, 2002). However, there have been rapid recent increases in contraceptive use in some countries in the wake of political initiatives to promote family planning, including Rwanda, Ethiopia and Malawi, demonstrating the efficacy of targeted family planning initiatives.

Key messages

  • Family planning programmes have been implemented in 115 different countries, often with the explicit aim to achieve population stabilisation and enhance socioeconomic progress. Since 1994, greater emphasis has been placed on the contribution of family planning to women’s health and reproductive rights.
  • Modern tools exist that allow the evaluation of the impact of family planning programmes within national and international frameworks and as part of wider reproductive health programmes.
  • There is clear evidence that family planning programmes can successfully reduce fertility levels.
  • Sub-Saharan Africa has the lowest number of family planning programmes and the highest level of unmet contraceptive need.

Evidence Strength Assessment

Quality of evidence: Size of body of evidence: Consistency of results: Closely matched to topic: Overall assessment:
Medium Medium Medium High Medium

Overview

Service delivery for family planning programmes must be defined in terms of hoped-for outcomes. Policy aims have evolved over time. Since the 1970s, when the policy focus was on slowing population growth, it has been recognised that programmes should focus on choice, rights and responsibilities, health benefits, and helping women decide how many children to have and when to have them (Bongaarts et al., 2012) (see section 2, section 4 and section 6 of this guide). Several options exist in terms of designing effective family planning programmes to deliver these aims, which include interaction between static health services and community-based distribution services, social marketing, social franchising, voucher systems and programmes that focus on increasing equity of access.

What are the issues?

Service delivery faces two key challenges over the coming years:

  • Demand for family planning will increase with global population increases
  • A greater proportion of reproductive lives will be spent using contraception.

Some key principles have been identified which should be adhered to when planning service delivery. Provision of high quality service involves a client-centred approach with informed choice of a range of contraceptive methods, information about alternative methods, competent and caring providers, and offering follow up with well-informed staff. Additionally, voluntarism, counselling, consistent standards, quality assurance and affordable costs through multiple reliable service delivery channels are highly desirable. This should be done alongside infrastructure strengthening of public health systems, and programmes should be flexible enough to adapt in response to changes in the needs of the target population and feedback from users (Mwaikambo et al., 2011; RamaRao and Mohanam, 2003; Simmons et al., 2007).

To achieve these aims, the needs of the target population must first be identified (Mwaikambo et al., 2011). For example, in countries where modern contraceptive method use is very low, such as in much of West and Central Africa, the emphasis needs to be on increasing knowledge and access and defusing social obstacles to contraception. The most effective strategy may be to focus initial efforts on sectors of the population where demand is highest. As programmes mature, the focus should shift to underserved groups, widening the range of services and methods, and cost-effectiveness considerations. A fully mature programme may include the following elements:

  • education, counselling, and contraception for sexually-active young people
  • family planning for the disabled
  • treatment for infertility
  • safe abortion where it is legal
  • post-abortion care wherever abortion is conducted
  • reproductive health needs of peri-menopausal women and those requiring hysterectomies
  • advocacy related to eliminating practices such as female genital mutilation and gender-based and sexual violence (Bongaarts et al., 2012)
  • an understanding of the role of men in family planning decisions and strategies for when and how to involve men in efforts to help women achieve their reproductive intentions (McCleary-Sills et al., 2012) .

What works?

Integrated static services

Although the focus on providing integrated public sector static services such as health centres and hospitals has lessened since the 1970s, these services remain the backbone of service delivery. Improvements to these services can be sought through adapting the service delivery model to local conditions e.g. the number of trained physicians available, and by integrating static services with newer community-based distribution models (Bongaarts et al., 2012).

Education and changing perceptions of family planning through mass media

Education through mass media has been used to promote family planning initiatives for over five decades (Mwaikambo et al., 2011). Communication through mass media has been popular due to the opportunity that it affords to reach a large audience and address issues that are sensitive or culturally taboo in an entertaining and informative manner (Mwaikambo et al., 2011). Studies that have focused on behavioural changes due to mass media family planning campaigns have found that they are most effective when combined with other intervention components such as social marketing or interpersonal communication interventions (Mwaikambo et al., 2011).

Interpersonal communications

Interpersonal communication approaches can include one-on-one discussions, small-group sessions, and facilitator-led curriculum-based programmes. Like mass media campaigns, interpersonal communications are used to influence knowledge, attitudes and intentions regarding family planning. Interpersonal communication interventions can be delivered through healthcare or community-based settings, and have so far been used to target an almost exclusively adolescent audience. A systematic review of interpersonal communication interventions found that 86% reported improved knowledge and attitudes, 63% of those that measured family planning reported increased family planning use and over half of those that measured fertility outcomes found a decline in fertility (Mwaikambo et al., 2011). 

Social marketing

Social marketing schemes are typically run by international organisations, and make contraceptives accessible and affordable through private sector outlets; commercial marketing techniques are used to achieve specific behavioural goals (Cleland et al., 2006; USAID, 2013; DFID, 2010). These methods can help increase availability, and reduce burden on the public sector. Programmes utilising social marketing are most successful when demand for contraception is well established; pills and condoms are popular methods of contraception; a well-developed commercial infrastructure – and a poor public service – exists; coverage of radio and television services are high; and where no restrictions exist on the mass media promotion of family planning (Cleland et al., 2006). At least three systematic reviews of social marketing programmes found that these programmes have had a positive impact on clients’ knowledge of and access to contraceptive methods and on condom use (Chapman, 2003; Madhavan, 2010; Sweat et al., 2012). Evidence also suggests that social marketing increases contraceptive use among adolescents (Agha, 2002). 

Community-based distribution

Community-based distribution involves any programme that is delivered outside of traditional healthcare settings, and can take many forms, including interpersonal communications (discussed above), routine household visits and community meetings (Cleland et al., 2006). These services, particularly in the poorest rural locations, have played an important part in many family planning programmes, and have helped to overcome both poor access and unmet need for contraception, especially in communities where women have limited mobility (Bongaarts et al., 2012; Cleland et al., 2006). A programme in Pakistan that focused on reaching women with impaired mobility and which implemented door-to-door visits, found that women who received visits were 1.5 times more likely to use contraception than women who received no visits (McCleary-Sills et al., 2012).

A further evaluation of community-based distribution found that communities typically saw large increases in contraceptive acceptance and use and that these services are an effective and acceptable way of increasing access to contraceptives, particularly injectables and long acting and permanent methods (figure 7) (Bongaarts et al., 2012). No one model of community-based distribution has yet emerged as best practice, but evidence suggests that these programmes are most successful in countries with sufficient social and political capital to recruit large numbers of volunteers, for example, China, India and Iran (Cleland et al., 2006).

Finally, some community-based programmes are not concerned with the distribution of contraceptives, but with indirectly changing norms and practices around the timing and bearing of children. For example, by keeping girls in school for longer, these programmes hope to equip girls with the skills to advocate for their own reproductive choices whilst also challenging social and community perceptions of what is appropriate for young girls, and therefore effecting long-term community change (McCleary-Sills et al., 2012).

Figure 10. Percentage of women using contraception before and after introduction of community based provision of injectables in selected programmes.
Figure 7. Percentage of women using contraception before and after introduction of community based provision of injectables in selected programmes. Source: USAID, 2013.

Social franchising

A social franchise is a network of private or government health providers whose products and services are standardised and promoted by a single entity. Social franchising aims to increase the number of providers and health services offered, to provide services at an equal or lower cost to other delivery options, to provide services that adhere to quality standards and serve all population groups, especially those most in need, thus addressing equity and quality effectiveness issues. Social franchising has proliferated in recent years, especially for family planning. Many franchises are starting to expand beyond family planning and reproductive health, leveraging their platforms to deliver TB, HIV/AIDS and malaria interventions.

Private sector involvement

The involvement of the private sector in providing family planning services varies among regions, and often dominates in countries with poor public health infrastructure, or where governments have promoted a switch to private sector provision as a cost-containment measure (Cleland et al., 2006; Madhavan et al., 2010). Private sector provision caters mainly to affluent couples, but expansion of this sector does increase choice and reduce costs to government (Cleland et al., 2006). Private sector involvement can include demand-side strategies – such as voucher schemes and conditional cash transfers, or supply-side strategies – such as using microfinance to encourage private midwives and other women’s health providers to improve their services (Madhavan et al., 2010). There is a need for well-designed studies to fully clarify the most effective forms of private sector involvement, but the available evidence indicates that strategies such as voucher provision schemes are well-received and amenable to rapid scale-up (Madhavan et al., 2010).

Vouchers

Voucher programmes aim to increase the use of reproductive health services by distributing vouchers for free or highly subsidised health services and health service providers are reimbursed for seeing voucher-bearing patients. An assessment of reproductive health voucher schemes indicated that voucher programmes increased the use of reproductive health services, improved quality of care, and improved population health outcomes (Bellows et al., 2001; Madhavan et al., 2010).

Service integration

The integration of services is an essential feature of health system strengthening and it is important to continue to strengthen health systems, with particular attention to health equity and accountability to civil society in order to increase responsiveness to the needs of the most vulnerable populations. However, there are significant challenges to implementing integrated systems, such as weak administrative capacity in some countries, the availability of medical support, integrated record-keeping, and the prior existence of established vertical programmes (Hardee and Yount, 1995).

The emergence of new service models, particularly social franchising and voucher schemes, has led to new partnerships with producers, procurers and providers (Bellows et al., 2011). Recruiting community health workers from beneficiary communities and linking health workers to existing health systems is crucial for the success of these programmes (USAID, 2013).

Individual rights and inequity of access

Choice should also be an essential element of family planning service delivery and it must be recognised that choice about family planning is made within a much larger context than the health system. For family planning programmes to have an influence in this process they need the support of key opinion leaders and social networks, including satisfied users, to ensure community support and that cultural norms and barriers to contraceptive use are addressed and potential clients feel secure in their behaviour (Mwaikambo, 2011; DFID, 2010). The most difficult challenge ahead is to reduce inequities in access and use according to wealth, sex, ethnic group, age, marital status and religious affiliation. Part of the difficulty is that there is no shared definition of what constitutes equity in the context of service delivery. However, the Beijing Platform for Action created agreed international standards for equity, and these can be adopted to inform service delivery (Plattner, 1995).

Well-designed programmes can address equity issues. Family planning programmes should focus additional efforts on women under 25 and their families, particularly to decrease high rates of method failure and discontinuation (Bongaarts et al., 2012). The availability of alternative methods and support in switching methods may make a substantial difference for rural and poorly educated users. Increases in spousal discussion about fertility intentions and contraception could lead to decreases in discontinuation and the use of more effective methods. There is no single formula for service delivery though and programmes need to be culturally appropriate, sensitive to clients’ needs, and monitored and modified in response to lessons learned (Mwaikambo et al., 2011; Bongaarts et al., 1990; UNICEF et al., 2010).

Key messages

  • Service delivery of reproductive healthcare has evolved in response to trends in contraceptive use, demographic changes, health transitions and changing perspectives on feasible and appropriate healthcare.
  • Delivery methodologies that show evidence of success are education through mass media, interpersonal communications, social marketing, community-based distribution, voucher schemes and strategies that integrate static and mobile services.
  • The focus of service delivery is increasingly on individual rights, unmet needs and equity of access, as well as beneficial effects on maternal and child health.
  • Family planning programmes should not be stand-alone services or luxuries for only the wealthiest segments of the population; they must become an integral part of health systems that respond to the full range of human needs.

Evidence Strength Assessment

Quality of evidence: Size of body of evidence: Consistency of results: Closely matched to topic: Overall assessment:
High Medium Fairly Consistent High Medium

Overview

Unsafe abortion can be defined as a procedure for terminating an unintended pregnancy, carried out either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both. Unsafe abortions are characterised by the lack of or inadequacy of skills of the provider, hazardous techniques and unsanitary facilities (WHO, 1992).

In 2008, an estimated 21.6 million unsafe abortions took place worldwide, almost all in developing countries. This is an increase from the 19.7 million unsafe abortions in 2003. It was estimated that 14 of 1,000 women of reproductive age (15-44 years) had an unsafe abortion (figure 8).

Figure 11. Estimated annual number of unsafe abortions per 1,000 women aged 15–44 years, by sub-regions, 2008.
Figure 8. Estimated annual number of unsafe abortions per 1,000 women aged 15–44 years, by sub-regions, 2008. Source: WHO, 2011.

What are the issues?

Despite efforts to achieve Millennium Development Goal 5 Target 5A – reduce by three quarters the maternal mortality ratio between 1990 and 2015 – deaths due to unsafe abortion remain close to 13% of all maternal deaths. It is likely that the numbers of unsafe abortions will continue to increase unless women’s access to safe abortion and contraception – and support to empower women (including their freedom to decide whether and when to have a child) – are put in place and further strengthened. Unsafe abortions are preventable, yet they continue to pose undue risks to a woman’s health and may endanger life (WHO, 2011).

Box 2. Women’s rights

Whilst the technology is available to prevent deaths from abortion, the underlying causes of this global pandemic are apathy and unequal rights for women; they suffer and die because they are not valued (Grimes et al., 2006).

Women often don’t have control over their own bodies and are influenced and coerced into making decisions about if and when they want children, when they can or can’t say no to sex, when and where they are subjected to sexualised violence. This takes away women’s fundamental right to decide when she wants a child.Young women and adolescents face higher levels of unwanted pregnancy and unsafe abortions and are particularly at risk because of discrimination based on gender and age.

Tackling wider gender inequalities is needed and this should include work towards eliminating violence against women and girls, closing gender gaps in education, increasing women’s access to decision-making and economic opportunities in addition to fulfilling their sexual and reproductive health and rights.

A total of 99% of unsafe abortions were performed in developing countries and 99% of deaths from these abortions also occurred in those countries (Grimes et al., 2006). Access to safe abortion is limited in many developing countries because of legal restrictions, administrative barriers to access legal abortion services, financial barriers and lack of adequately trained providers (Grossman, 2004).

Figure 12. Unsafe abortions.
Figure 9. Unsafe abortions. Source: Associated Press.

WHO (2011) listed the following as conditions that may (either individually or jointly) characterise an unsafe abortion:

  • no pre-abortion counselling and advice
  • abortion being induced by an unskilled provider, frequently in unhygienic conditions, or by a health practitioner outside official/adequate health facilities
  • abortion is provoked by insertion of an object into the uterus by the woman herself or by a traditional practitioner, or by a violent abdominal massage
  • a medical abortion is prescribed incorrectly or medication is issued by a pharmacist with no or inadequate instructions and no follow-up
  • abortion is self-induced by ingestion of traditional medication or hazardous substances. 

Further hazardous features of unsafe abortion are:

  • the lack of immediate intervention if severe bleeding or another emergency develops during the procedure
  • failure to provide post-abortion check-up and care, including no contraceptive counselling to prevent repeat abortion
  • the reluctance of a woman to seek timely medical care in case of complications because of legal restrictions and social and cultural beliefs linked to induced abortion.

Recommended abortion techniques

Legal abortion in developed countries is one of the safest procedures in contemporary practice, with case fatality rates less than one death per 100,000 procedures (Grimes et al., 2006).

Medical abortion (non-surgical)

Medical abortion is the use of pharmaceutical compounds to end a pregnancy. Any method of medical abortion should have an overall efficacy comparable to that of surgical vacuum aspiration, i.e. a rate of complete abortion of more than 95% and an ongoing pregnancy rate of less than 1% (WHO, 2011).

Any method of medical abortion for the early first trimester should be:

  • effective up to 63 days of gestation
  • easy to administer
  • safe, and have acceptable side-effects
  • blood loss should be similar to, or less than, that associated with vacuum aspiration
  • affordable (WHO, 2011).

The only regimen that meets the efficacy criteria is a combination of mifepristone and a prostaglandin – either misoprostol or gemeprost. Use of mifepristone or a prostaglandin alone does not meet them. Use of methotrexate in combination with prostaglandin can approach the required efficacy, but is not recommended because it is teratogenic (can cause birth defects).

The recommended regimen for medical abortion is 200 mg of mifepristone given orally, followed 36-48 hours later by a prostaglandin – either 0.8 mg of misoprostol or 1 mg of gemeprost – given vaginally. Misoprostol has been studied for use as a sole abortifacient, but success rates are less than 95% (Carbonell et al., 1997). Nevertheless, sole misoprostol is used by women unable to access legal abortions, despite the high rates of unsuccessful complete abortion (Coêlho et al., 1993).

This combination results in complete abortion in more than 96% of cases; the rate of continuing pregnancies is less than 1% in gestations up to 63 days’ amenorrhoea (3-5). Misoprostol can also be given orally at a dose of 0.4 mg, but owing to the higher failure rate with this dose, it is recommended that oral misoprostol use at this dosage be restricted to very early pregnancy, i.e. <50 days (WHO, 2003; WHO, 2006).

It is likely that medical abortion will largely replace surgical abortion as the method of choice because of its unintrusive nature. Over-the-counter sales by pharmacists without medical prescription is common in some countries. While this trend represents an extension of choice, there are valid concerns about such unregulated use.

Surgical abortion

There are several methods of surgical abortion including Manual Vacuum Aspiration (MVA), Electric Vacuum Aspiration (EVA) and dilation and curettage (D&C). MVA is used to end a pregnancy up to 12 weeks. It is performed with the use of a handheld syringe as a source of suction for removing uterine contents. The procedure time is 5 to 15 minutes and a patient typically leaves a doctor’s office or a clinic within two hours. EVA is a procedure where the cervix is dilated and a cannula of appropriate size is inserted and the uterine contents are removed by EVA (sometimes curettage may also be performed at the end). D&C is a procedure in which the cervix is dilated and a forceps or curette is inserted to remove the uterine contents. All three methods can be performed under local anaesthesia (Blackrishan, 2010).

The choice of method would depend on the setting and equipment available. Both MVA and EVA are ideal for under-resourced settings. MVA may have a definite role in early abortions as it is inexpensive and the equipment needs very little maintenance. Since the operating time is markedly less with EVA compared to D&C, it may be a better choice for late terminations. This may be particularly relevant when local anaesthesia is used in busy clinics and in low-resource settings (Balakrishnan, 2010).

Surgical verses medical abortion

The main advantage of the medical method over surgical termination of pregnancy is the potential avoidance of an anaesthetic and complications such as cervical laceration and uterine perforation. Furthermore, the whole procedure can be undertaken either at home or in an outpatient setting. In under-resourced settings, these features can be an advantage as the direct healthcare cost is lower compared with the surgical option. The drawback with the use of mifepristone and misoprostol is the need to follow up with patients to ensure that the abortion process is complete (Chien and Thomson, 2006).

What works?

Evidence presented by WHO (2012) suggests that a reliance on abortion can be greatly reduced when:

  • women can plan pregnancies through effective contraception
  • counselling and services meet the unmet need for family planning, and appropriate method-mix of contraception (including the promotion of long acting and/or permanent contraception methods) is offered to all women, including those both married and unmarried. 

Additionally, available evidence underlines the importance of promoting access to the full range of abortion technologies, removing barriers to medical abortion, training providers, removing procedural barriers and ensuring adequate funding for both medical and surgical abortion (Center for Reproductive Rights, 2005).

In the meantime, ill-effects of unsafe abortion should be prevented by:

  • making safe abortion services available and accessible where abortion is not against the law
  • ensuring that permitted reasons for abortion are supported by the national legislative process and health systems
  • granting access to services for the management of complications arising from unsafe abortion
  • providing post-abortion counselling and offering contraceptive services, which will also help to avoid repeat abortion (WHO, 2012).

Key messages

  • Deaths attributable to unsafe abortion can be prevented by effective contraception, safe abortion services, and post-abortion services (Ahman and Shah, 2011).
  • Ending the silent pandemic of unsafe abortion is an urgent public health and human rights imperative.
  • Despite its frequency, unsafe abortion remains one of the most neglected global public health challenges, with an estimated 68,000 women dying every year.
  • Access to modern contraception can reduce but never eliminate the need for abortion.
  • Legalisation of abortion is a necessary but insufficient step toward eliminating unsafe abortion.
  • When abortion is made legal, safe, and easily accessible, women’s health rapidly improves. By contrast, women’s health deteriorates when access to safe abortion is made more difficult or illegal.
  • Treating complications of unsafe abortion overwhelms impoverished healthcare services and diverts limited resources from other critical healthcare programmes (Grimes et al., 2006).

Evidence Strength Assessment

Quality of evidence: Size of body of evidence: Consistency of results: Closely matched to topic: Overall assessment:
High Medium Fairly Consistent (medical advice very consistent but alternative views exist) High Medium/Strong

Overview

As already noted, in 2008, more than half of women (818 million) of reproductive age (15-49) in developing countries wanted to avoid a pregnancy so that they either limited their total number of births or spaced their childbearing (Singh et al., 2009). Of these women, 215 million (26%) have an unmet need for modern contraceptives and account for 82% of unintended pregnancies. In approximately a third of cases, cost was the reason for women not using contraceptives (WHO, 2005).

The cost of providing modern family planning services (for example, costs of contraceptives, labour costs of health workers and health system support costs) to the 603 million women who do use contraception was estimated at US$3.1 billion in 2008, paid for by a combination of the public (e.g. tax revenues) and private sectors (e.g. health insurance), and individual and international donations (Singh et al., 2009). It is estimated that it would cost a further US$3.6 billion to extend services to women with an unmet need for modern contraceptives (figure 10). The higher cost per head of meeting unmet need than for existing users reflects costs incurred in strengthening healthcare systems, especially in regions with the highest unmet need e.g. sub-Saharan Africa (Singh et al., 2009).

Figure 13. Cost of providing modern contraceptives to all who need them, 2008.
Figure 10. Cost of providing modern contraceptives to all who need them, 2008. Source: Singh et al., 2009.

What are the issues?

Providing both modern family planning and the recommended standard of maternal and newborn care is synergistic in terms of health and cost benefit. Helping all women who wanted to avoid unwanted pregnancies through using modern contraceptives would reduce the cost of providing the recommended standard of maternal and newborn care by US$5.1 billion. This means that for each additional dollar spent to provide modern contraceptives, US$1.40 would be saved in costs of medical care because of fewer unintended pregnancies (Singh et al., 2009).

As a result of pregnancy-related causes, the WHO estimated that 38 million disability-adjusted life years (DALYs) were lost among women globally in 2004 (WHO, 2009). About 40% of pregnancy-related DALYs lost worldwide are in sub-Saharan Africa, and another 36% are in South Central Asia. A DALY is a commonly used measure of the burden from mortality and morbidity and is roughly equivalent to one healthy year of life. Providing both modern family planning and the recommended standard of maternal and newborn care would reduce the number of DALYs lost because of pregnancy-related illness and premature death by 66% (Singh et al., 2009).

Savings would also accrue from fulfilling unmet need in terms of obstetric care, immunisation, and, after a lag, primary schooling. A study of 16 countries in sub-Saharan Africa shows that US$3,700 would be saved in meeting the Millennium Development Goals for every US$1,000 spent on family planning (Moreland and Talbird, 2006).

When the benefits of increased contraception in terms of DALYs are combined with the probable effects of reduced fertility on economic growth per head, the economic rationale for investing in family planning is further strengthened. A detailed review indicates benefit-cost ratios of the order of 90-150 (Kohler, 2012).

Focusing on HIV, the annual cost of providing family planning for all HIV-infected women who wish to prevent unintended births is over US$33 million globally. If all unmet need for family planning were met for women living with HIV, it is estimated that the cost for each unintended pregnancy prevented to women with HIV is US$63 globally (Halperin et al., 2009). Contraception is a cost-effective form of HIV prevention. Integrating family planning and the prevention of mother-to-child transmission of HIV (PMTCT) services would save an estimated US$660 for each HIV infection averted compared with US$1300 per infection averted with treatment alone (Stover et al., 2003). Thus, family planning is also cost-effective for preventing HIV transmission (Wilcher et al., 2003).

It is essential to examine the impact of integrating any component of STI or HIV prevention, care, and treatment into a family planning setting in developing countries. The weight of evidence demonstrates that integrated services can have a positive impact on client satisfaction, improve access to component services, and reduce clinic-based HIV-related stigma, and that they are cost-effective. Integrated services are thought to expand access to and coverage of critical services and to improve their efficiency and cost-effectiveness by reducing duplication of service delivery functions and delivering more services per client contact.

However, the cost of adding routine clinical screening for STIs among family planning clientele may not be justified by the number of infections detected and treated. There is an argument that sexually active, unmarried young people are at disproportionately high risk, both of unplanned pregnancy and of STI and HIV infection. So youth-friendly services in settings with a high prevalence of STIs or HIV should consider offering the full range of reproductive health services, with the clear understanding this is likely to increase operating costs.

The cost of saving one DALY through family planning and maternal and newborn care (US$62) (Singh et al., 2009) compares favourably with the cost-effectiveness of other common widely accepted health interventions, such as antiretroviral therapy (US$150 to US$547) (Bertozzi et al., 2006), BCG tuberculosis vaccination of children for tuberculosis (US$48 to US$203) (Dye and Floyd, 2006) and oral rehydration therapy (US$1,268) (Keusch et al., 2006). Family planning is therefore considered good value for money in global health because of its relative cost-effectiveness.

Research suggests that understanding the level of demand for family planning and better specification of both the gender barriers and pathways could help to make interventions more cost-effective and strategic (Sills et al., 2012). However, whilst efforts to change gender and other norms ultimately related to sexual and reproductive health outcomes can be costed, the credit they can take for increasing contraceptive use is difficult to measure. This makes it hard to assess their cost in relation to family planning, even though they may ultimately have effects not only on family planning and other aspects of sexual and reproductive health but on other areas of health and development. This also highlights the absence of a rights discourse to date in discussions about how much it costs to provide family planning to all who want it, although there have been some instances in other fields where the costs of ensuring human rights are factored in to overall costs. There are some examples of efforts to cost ‘rights’ and measure the impact of interventions to change gender norms and outcomes for family planning (UNFPA, 2012).

Key messages

  • It is cost-effective to provide family planning and the recommended standard of maternal and newborn care to all women of reproductive age in low income countries.
  • Integrating family planning services with other health programmes to reduce transmission of infections such as HIV could also be a cost effective service delivery method.
  • Fulfilling the unmet need of family planning is cost effective in preventing unwanted pregnancies, spacing childbirth and reducing the cost of providing the recommended standard of maternal and newborn care. Integrating with other services, such as HIV programmes, is also good value for money in preventing HIV infection. However, funding must be sustained to ensure ongoing progress.

Evidence Strength Assessment

Quality of evidence: Size of body of evidence: Consistency of results: Closely matched to topic: Overall assessment:
Medium/High Medium Fairly Consistent Medium/High Medium/Strong

 

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Nutrition /topic/nutrition/ Wed, 05 Jun 2013 11:50:25 +0000 http://www.heart-resources.org/?post_type=topic&p=22412 Read more]]>
Overview1. The nature of the problem2. Direct interventions – nutrition specific development3. Indirect interventions – nutrition sensitive development4. Implementation, international architecture and the enabling environment
This Topic Guide has been compiled to provide an overview of undernutrition in the context of development. It covers the nature, scale and complex range of causes of undernutrition and summarises the evidence for what works to address the problem. The Guide covers direct nutrition interventions (or nutrition specific development as it is often termed), indirect interventions (nutrition sensitive), and the global coordination structures, governance and funding which are essential for an enabling environment within which undernutrition can be successfully reduced. The focus of this Guide is on undernutrition, defined as the outcome of insufficient (quantity and quality) of food intake (hunger) and repeated infectious diseases. Undernutrition includes being underweight for one’s age, too short for one’s age (stunted), underweight for one’s height (wasted), and deficient in vitamins and minerals (micronutrient malnutrition). This review does not focus on the other component of malnutrition, which is overnutrition.

Where possible the evidence presented in this Topic Guide was taken from systematic reviews of high quality. Where no systematic reviews were available or appropriate, evidence was included from other sources, including primary and empirical studies, as well as theoretical and conceptual research, deemed to be of high quality. This judgement was reached based on various principles, including conceptual framing, openness, transparency, appropriateness and rigour, validity, reliability and cogency. The body of evidence that has been included is summarised for each section. This assessment is based on the quality, size, content and consistency of the studies included.

This document was originally written in April and May 2013 and updated in August 2013 to reflect the latest body of evidence.

Undernutrition is one of the world’s most serious but least addressed health problems. In developing countries nearly one-third of children are underweight or stunted (low height for their age). The human and economic costs are enormous, falling hardest on the very poor and on women and children. Undernutrition interacts with repeated bouts of infectious disease, causing an estimated 3.1 million preventable maternal and child deaths annually (Black et al, 2013), and its economic costs in terms of lost national productivity and economic growth are huge.

1a) The scale of undernutrition

Child undernutrition is commonly measured by:

  • Anthropometric measures, including a child’s height relative to the median for their age (a measure of stunting or chronic malnutrition); its weight relative to height (a measure of wasting or acute malnutrition); its weight relative to the median for its age (underweight, a composite measure of stunting and/or wasting), and being born with a low birth weight (under 2.5kg).
  • Deficiencies in vitamins and minerals (micronutrient malnutrition) such as vitamin A, iron and zinc.

Key messages

  • Stunting – Globally, an estimated 162 million children under-5 years of age, were stunted in 2012. Over 90 per cent of the world’s stunted children live in Africa and Asia.
  • Underweight – Globally, an estimated 99 million children under-5 years of age, were underweight in 2012. The prevalence of stunting and underweight among children under-5 years of age worldwide has decreased since 1990, however overall progress is insufficient and millions of children remain at risk.
  • Wasting – Globally, an estimated 51 million children under-5 years of age, were wasted in 2011, a 10 per cent decrease from an estimated 58 million in 1990. 67 per cent of the world’s wasted children live in Asia, most in south-central Asia. These children are at substantial increased risk of severe acute malnutrition (SAM) and death (UNICEF, WHO, World Bank, 2012).
  • 45 per cent of all child deaths (<5 years) globally is attributed to nutritional disorders (stunting, wasting, micronutrient deficiencies and foetal growth restriction).
Body of evidence

The evidence on the scale of the problem is based on statistics compiled by UNICEF and WHO which are systematic reviews. These are based on country level data and are widely regarded as being reliable sources. The evidence for the causes of malnutrition and progress towards MDG’s is based on a systematic analysis of the available literature and data and The 2013 Lancet Series on Maternal and Child Nutrition.

Nutrition and the Millennium Development Goals

Improving nutrition is essential for the achievement of the Millennium Development Goals (MDGs), many of which are dependent on good nutrition outcomes.

MDG 1: Eradicate extreme poverty and hunger

Reducing prevalence of underweight children under 5 years of age is an agreed target for MDG 1. Reducing undernutrition also increases economic growth.

MDG 2: Achieve universal primary education

Reducing undernutrition increases cognitive development and contributes to learning and school completion rates.

MDG 3: Promote gender equality

Promoting better nutrition practices contributes to empowering women and to reducing discrimination against girls in family feeding practices.

MDG 4: Reduce child mortality

Over 45 percent of deaths in children under 5 years of age are attributed to undernutrition as the underlying cause, directly, through acute malnutrition and more commonly through the many childhood diseases which become fatal in undernourished children.

MDG 5: Improve maternal health

Maternal undernutrition contributes to maternal mortality and other complications during pregnancy and childbirth. Maternal health can be improved through programmes of behaviour change and micronutrient supplementation.

MDG 6: Combat HIV/AIDS, malaria and other diseases

Undernutrition makes individuals more susceptible to disease, which in turn increases nutritional needs and weakens the capacity of the body to assimilate food. Nutritional care is therefore a key dimension of successful clinical treatment of HIV/AIDS patients.

MDG 8: Global partnership for development

Addressing hunger and malnutrition around the world is a key element of, and argument for, the global partnership for development. This applies particularly for the least developed countries, where levels of undernutrition are highest.

While there has been good progress toward MDG 1c (to halve the proportion of people who suffer from hunger) in a number of regions (East Asia and the Pacific, Latin America and the Caribbean and Central and Eastern Europe) progress in South Asia, all regions of Africa, and the Middle East, has been insufficient and is not on track to meet the target by 2015 (UNICEF, 2012).

The Causes of Undernutrition

The causes of undernutrition are complex and span across sectors. Figure 1 illustrates the immediate, underlying and basic causes of undernutrition. Understanding this framework is important, as interventions at every level can have an impact on maternal and child nutrition outcomes.

Figure1 - Causal framework of malnutrition (UNICEF 1990, reproduced in Black et al. 2008)

Figure 1. Causal framework of malnutrition (UNICEF 1990, reproduced in Black et al. 2008)

1b) The consequences of undernutrition

Maternal and child undernutrition is highly prevalent in low and middle-income countries, resulting in substantial increases in mortality and overall disease burden. Undernutrition weakens the immune system, stunts physical growth and cognitive development and can have a lifelong and intergenerational effect on educational attainment and economic potential for individuals, families and whole nations. It has been estimated that co-exposure to a range of related factors which have undernutrition as their underlying cause (including a weakened immune system and susceptibility to infectious diseases such as malaria, diarrhoea and pneumonia) combined with the effects of growth restriction, micronutrient deficiencies, and suboptimum breastfeeding accounts for 45 per cent of all child deaths (Black et al. 2013). The consequences of stunting and cognitive development tend to be irreversible after the age of two, with the period from conception until a child’s second birthday becoming known as the 1,000 day ‘window of opportunity’ to prevent irreversible damage. Children who are undernourished in the first two years of life and who put on weight rapidly later in childhood and in adolescence are at high risk of chronic diseases related to nutrition for example, obesity.

Maternal undernutrition and the stress this causes upon the foetus in utero (in the womb) can increase the risk of intrauterine growth retardation (causing babies to be born Small-for-Gestational Age – SGA), and can have long lasting effects on the health of an individual throughout the life course, and longer term implications for chronic diseases including cardiovascular diseases and type II diabetes (Victoria et al. 2008). Micronutrient or protein deficiencies can also have serious effects during pregnancy. For example there is also evidence suggesting that iron deficiencies may have a negative effect on maternal health and maternal mortality.

Adolescent pregnancy (for which rates are exceptionally high in some developing countries) has been shown to have a significant impact on nutritional status of both the mother and the child. Adolescents are usually understood to be young people between the ages of ten and 19 years. Adolescent girls have a much higher risk of dying from maternal causes compared to women in their 20s and 30s. These risks increase greatly as maternal age decreases. Moreover, babies born to adolescents also face a significantly higher risk of death compared to babies born to older women. Poor adolescent nutrition combined with stunted growth, resulting in stunted mothers increases the likelihood of a child being born low birth weight (LBW) and being a stunted child. This intergenerational effect is illustrated below in figure 2.

Figure 2. Negative intergenerational effects of undernutrition on growth

Figure2 - Negative intergenerational effects of undernutrition on growth

 

 

 

 

Key messages:

  • Poor foetal growth or stunting in the first two years of life leads to irreversible damage, including shorter adult height, lower attained schooling and reduced adult income.
  • Children who are undernourished during the first two years of life are at high risk of chronic diseases.
  • Maternal undernutrition has immediate and long term negative consequences for the offspring.
  • Adolescent pregnancy greatly increases the risk of mortality to mother and child.
Body of Evidence

The evidence on the consequences of undernutrition presented here is based on The 2013 Lancet Series on Maternal and Child Nutrition which is a series of peer reviewed papers that review the body of evidence. The evidence is strong for the consequences of undernutrition outlined.

1c) The benefits of scaling up undernutrition reduction

Firstly and most importantly, undernutrition is preventable. Reducing undernutrition not only saves millions of lives, but investing in scaling up represents significant value for money in comparison with other development interventions. The Copenhagen Consensus,  in which economists weigh the value for money of a number of potential development interventions – ranked three nutrition interventions in the top five development solutions in 2008, with vitamin A and zinc micronutrient supplements for children ranked first. In the 2012 update they ranked bundled micronutrient interventions to fight hunger and improve education as the top investment.

Recent analysis suggests the current total of deaths in children younger than 5 years can be reduced by 15 per cent if populations can access ten evidence-based nutrition interventions at 90 per cent coverage. These ten interventions are:

Folic acid, multiple micronutrient, calcium and balanced energy-protein supplementation for pregnant and women of reproductive age.

Promotion of exclusive breastfeeding, complimentary feeding, vitamin A supplementation, preventative zinc supplementation and management of moderate and severe acute malnutrition for infants and children.

The estimated total additional annual cost involved for scaling up access to these ten direct nutrition interventions in the 34 countries with the highest burden of undernutrition is $9·6 billion per year.

The benefits of scaling up interventions to reduce undernutrition are usefully summarised in the new framework developed for The Lancet series 2013 (see Figure 3).

 Figure 3: Framework for actions to achieve optimum foetal and child nutrition and development
Figure 3

This framework shows the means to optimum foetal and child growth and development, rather than the determinants of undernutrition as shown in the conceptual model developed by UNICEF (Fig. 1). This new framework shows the dietary, behavioural, and health determinants of optimum nutrition, growth, and development and how they are affected by underlying food security, caregiving resources, and environmental conditions, which are in turn shaped by economic and social conditions, national and global contexts, resources, and governance. The 2013 Series examines how these determinants can be changed to enhance growth and development through scaling up activities in three domains: nutrition specific, nutrition sensitive and through building an enabling environment. The framework shows the potential effects of nutrition-specific interventions which address the immediate causes of undernutrition and nutrition-sensitive interventions that address the underlying determinants of malnutrition, incorporating specific nutrition goals and actions. It also shows the ways that an enabling environment can be built to support interventions and programmes to enhance growth and development and their health consequences.

Key messages:

  • Effective interventions are available to reduce stunting, micronutrient deficiencies, and child deaths.
  • Nearly 15 per cent of deaths in children under 5 could be reduced (1 million lives) if the ten interventions identified from the latest evidence are scaled up.
  • These interventions, if scaled up to 90per cent coverage in the 34 highest burden countries, could reduce stunting by 20 per cent (33.5 million children) and reduce prevalence of severe wasting by 61.4per cent.
  • Interventions with the greatest potential to reduce mortality in children under 5 years are: management of SAM, preventative zinc supplementation and promotion of breastfeeding.
  • Improvement of complementary feeding through strategies such as counselling about nutrition for food-secure populations and nutrition counselling, food supplements, conditional cash transfers, or a combination of these, in food-insecure populations could substantially reduce stunting and related burden of disease.
  • Interventions for maternal nutrition (supplements of iron folate, multiple micronutrients, calcium, and balanced energy and protein) can improve outcomes for maternal health and births, but few have been assessed at sufficient scale. Delivery mechanisms remain a logistical challenge to scale up.
  • Although available interventions can make a clear difference in the short term, elimination of stunting will also require long-term investments to improve education, economic status, and empowerment of women.
Body of Evidence

The benefits of scaling up nutrition are widely agreed upon and the body of evidence is strong. The evidence presented in this section is based on a review of the evidence published in The Lancet in 2008 and updated in 2013, a framework which bases its recommendations on two evidence reviews and a paper published by the Copenhagen Consensus 2012 which is a review of the evidence base to inform the prioritisation of investing in scaling up activities by an expert panel of economists.

Nutrition specific interventions refer to those programmes and approaches which have a direct impact on nutritional outcomes, addressing the immediate causes of undernutrition i.e. inadequate food intake, poor feeding and care practices and high burden of infectious disease. There have been countless studies in different contexts looking at the effectiveness of nutrition interventions. The 2008 Lancet Series provided the first review of the evidence base to summarise ‘what works’ and this has been updated in 2013, reflecting the progress that has been made in implementing at scale providing a growing body of evidence of effectiveness for both nutrition specific interventions and their delivery platforms.

The 2008 Lancet paper categorised the effective interventions into the following two sections:

1)      Interventions with an evidence base sufficiently strong to warrant the recommendation to implement in 36 of the world’s highest burden countries

2)      Interventions those where the evidence was strong in specific contexts.

These interventions are focused on maternal and child health and are outlined in Figure 4.

 Fig 4. The Lancet 2008, Key Interventions

Figure3  -The Lancet 2008 – key interventions

Building from these interventions, the SUN framework for action (2010) identified a more selective package of 13 highly cost-effective interventions.

Most recently, The Lancet 2013 series includes an updated review of the evidence, including the evidence for effectiveness of nutrition interventions and delivery strategies. Ten interventions were identified, which if delivered at scale could reduce deaths in children younger than 5 years by 15 per cent. The ten interventions identified include providing folic acid, calcium, and balanced energy protein and micronutrient supplements to pregnant women; promoting breastfeeding and delivering appropriate complementary feeding to infants; providing vitamin A and zinc supplements to children up to the age of five; and using proven treatment strategies to manage moderate and severe malnutrition in children. The authors also evaluated delivery strategies and concluded that community based delivery strategies had much potential to improve nutrition and reduce deaths among the poorest sections of the population.

While these interventions were chosen for their proven ability to reduce illness and deaths in women and children in a cost-effective way, the authors also examined a much wider range of nutritional interventions, many of which have the potential to make a substantial difference in the fight against malnutrition

Table 1 below looks at the similarities and differences between the 13 interventions from SUN and the latest Lancet 2013 ten costed interventions.

Table 1: Comparison of the 13 recommended interventions from SUN 2010, with the 10 interventions from 2013

Intervention Year of inclusion
Vitamin A supplementation/fortification Both
Promotion of breastfeeding Both (2013 stress exclusive BF)
Management of SAM Both
Management of MAM Both
Complimentary feeding Both
Iodine through salt* Both
Zinc management for diarrhoea 2008
Iron/ Folic acid supplementation 2008
De worming 2008
Iron fortification of staples 2008
Hand washing/Hygiene 2008
Multiple micronutrient powders 2008
Maternal  multiple micronutrient supplementation 2013
balanced energy-protein supplementation 2013
Folic acid supplementation 2013
Calcium supplementation 2013
Preventative zinc supplementation 2013

*Salt iodisation is included in The Lancet 2013 costing of interventions, but not in the full impact modelling

There are six interventions which feature in both (Vitamin A supplementation, promotion of breastfeeding, management of SAM and MAM, complementary feeding and in part salt iodisation).

There are six which were in the Sun list but are not in The Lancet 2013 (Zinc management for diarrhoea, iron and folic acid for pregnant women, deworming, iron fortification of staple foods, hand washing/hygiene and multiple micronutrient powders for children). Each missing intervention has a different reason for omission: hand washing / hygiene and therapeutic zinc for diarrhoea management are still fully endorsed by The Lancet authors and water and sanitation programmes in particular are widely considered as important in the fight against malnutrition but for categorisation reasons (they are about disease control) they were not listed in The Lancet 2013 list. Iron and Folic supplementation is now subsumed by maternal multiple micronutrient supplementation. Iron fortification of staples is listed as beyond scope of review. There are increasingly mixed views on the evidence of benefits for multiple micronutrient powders for children and deworming.

Five of The Lancet 2013 are new inclusions which did not feature in SUN (maternal multiple micronutrient supplementation, maternal balanced protein energy supplementation, folic acid supplementation, calcium supplementation and preventative zinc supplementation). These reflect new evidence and new understandings about the importance of maternal nutrition.

The following sections provide a brief review of the evidence for the interventions for each target group.

2a) Maternal and birth outcomes

The nutritional status of a woman before and during pregnancy is important for a healthy pregnancy outcome and during this time women often become more deficient in nutrients, with the need to provide nutrition for the baby too. Maternal malnutrition is a key contributor to poor foetal growth, LBW babies and short- and long-term infant morbidity and mortality.

The 2013 Lancet Series provides a comprehensive update of the evidence for the intervention identified in the previous series.

Key messages:

  • Interventions to address adolescent nutrition are critical to affect the period before first pregnancy
  • Maternal supplementation with key micronutrients (iron folate, calcium and multiple micronutrients) are effective at improving maternal and birth outcomes
  • Increasing iodine intake through iodized salt is an effective intervention and delivery mechanism.
  • A package of 4 interventions to provide optimal nutrition during pregnancy (maternal multiple micronutrients, use of iodised salt, calcium, and balanced energy protein supplementation) is estimated to save 102,000 lives at a cost of $571 per life year saved.
Body of evidence

The evidence for interventions to improve maternal and birth outcomes is strong for those interventions outlined above. This is based on The Lancet 2013 review and evidence from a systematic review and an evidence review.

2b) Newborn babies

Infants who are not breastfed are at a far higher risk of infectious diseases like pneumonia and diarrhoea, and mortality than those who are breastfed. A mother’s breast milk provides more than just essential nutrients for the newborn baby, but contains a unique mix of proteins, fats, sugars, enzymes and antibodies to develop the baby’s immunity and help its digestive system to grow and function properly. The mother’s first milk, called colostrum, is produced only in the first days after birth and contains a powerful and concentrated mix of these immune, growth and tissue repair factors. It is not only ensuring that more babies are breastfed that is important, but reducing the time delay from when breastfeeding is initiated. It is estimated that early initiation of breastfeeding (within the first hour of birth) could prevent 22 per cent of newborn deaths (Edmond et al. 2006).

Breastfeeding support was highlighted in The Lancet (2008 and 2013) series as an effective intervention to increase breastfeeding rates, which in turn have a significant positive effect on child mortality and morbidity. Counselling and education for mothers on breastfeeding has been shown to be effective, while the forum through which this counselling is provided has been shown to be important (Sudfeld et al. 2012).

Key messages

  • Breastfeeding is rated as the single most effective intervention to improve neonatal mortality rates.
  • Exclusive breastfeeding is when the infant only receives breast milk without any additional food or drink, not even water. Oral rehydration salts (ORS), drops and syrups (vitamins, minerals and medicines) are regarded as an exception to this. Babies who are not exclusively breastfed are at four times higher risk of death.
  • Early initiation (within one hour of birth) of breastfeeding could reduce neonatal mortality by 44 per cent.
  • Breastfeeding promotion and counselling through (both individual and group) improves rates of exclusive breastfeeding, but promotion programmes should also emphasize early initiation.
Body of evidence

There is a strong evidence base for the following interventions to improve nutritional status of newborn babies. This is based on a meta-analysis and a peer reviewed study.

2c) Infants and children

Breastfeeding remains the single most effective intervention to improve infant and young child nutrition. The WHO recommends six months of exclusive breastfeeding and up to two years of continued, partial breastfeeding. As discussed above, interventions to promote breastfeeding and increase rates of exclusive breastfeeding through individual or group counselling and education have been shown to be effective (Sudfeld et al. 2012).

When breast milk is no longer enough to meet the nutritional needs of the infant, complementary foods should be added to the diet of the child. In cases where the nutrient needs of the child are not being met through complimentary foods, fortification or supplementation with micronutrients, specifically zinc, vitamin A and iodine has been proven to be effective. The evidence base has tended to be strongest for supplementation with micronutrients, but fortification of staple foods, whether by the manufacturers (such as salt iodization) or at home fortification (often through micronutrient rich powders) is increasingly being shown to be an effective intervention for improving the micronutrient status (Bhutta et al. 2008).

The 2013 Lancet series (Bhutta et al. 2013) included a review of 16 trials and programmes that assessed the effect of nutrition education and provision of additional complementary foods. Studies of nutrition education in food secure populations showed a significant increase in height and weight and in food insecure populations significant effects on height for age, weight for age and stunting prevalence. The provision of complementary foods in food insecure populations was associated with significant gains in height for age and weight for age but did not show a significant effect on stunting prevalence.

One of the consequences of sub optimum infant and child feeding is acute malnutrition, estimated to affect 52 million children under five globally in 2011. Severe Acute Malnutrition (SAM) which refers to those children with a very low weight for height – below -3 z scores of the median WHO growth standards, poses the most immediate threat to child mortality. Treatment of SAM was identified in the 2008 Lancet Series as a key intervention to be implemented in all high burden countries. Approaches for treatment of acute malnutrition have evolved in recent years with a shift from facility based to community based care, an approach which includes the early detection of malnourished children and the use of specifically formulated therapeutic foods (WHO, WFP, UNSCN, UNICEF, 2007).

Key messages

  • Breastfeeding remains the most effective intervention for infant and young child nutrition.
  • Promotion and counselling to improve rates and duration of exclusive breastfeeding is recommended.
  • Appropriate complimentary feeding, including a sufficient intake of micronutrients is essential.
  • Supplementation programmes for vitamin A and zinc are effective for improving micronutrient status of children and reducing incidence of some diseases and deaths.
  • Fortification of foods with micronutrients has also been shown to be effective at improving micronutrient status of children.
  • Treatment of SAM through the community based model using specially formulated therapeutic foods has been shown to be effective.
Body of evidence

The evidence for interventions to improve the nutritional status of infants and children is strong for those interventions outlined above. This is based on the Lancet review of the evidence base, a systematic review and a joint report from the WHO, WFP, UNSCN and UNICEF who review and present the evidence. We also present the evidence from three large randomised controlled trials which provide the most up to date emerging evidence, however it should be noted that the trials are all studies from single country settings and the findings should be interpreted with caution.

The 1990 UNICEF framework (see figure 1) is particularly helpful in identifying the ways in which the basic and underlying determinants of undernutrition move beyond considerations of food and basic care practices, to wider considerations of household income and resources, the role of gender and other factors in the intra-household allocation of these resources, or wider environmental factors affecting health and sanitation. Furthermore, nutrition specific interventions that address the immediate causes of undernutrition have been estimated to be effective at addressing only 20% problem. Therefore interventions that tackle some of these underlying causes are thus an essential part of the response to tackle 80% of the problem. These nutrition sensitive approaches address the underlying factors that contribute to malnutrition, including hunger, poverty, gender inequality, and poor access to safe water and health services by integrating nutrition actions into other sectors. These include measures ranging from cash transfers (and other forms of social protection) to augment household resources; agricultural development to improve rural incomes and increase basic household food security; women’s empowerment; wider health systems strengthening; and improved water and sanitation supply.

3a) Agriculture

Agricultural interventions have long been thought to have an effect on nutrition. Hoddinott (2011) described six pathways commonly associated with agricultural production impacting on nutrition and health:

i.          Changes to incomes: When changes in agricultural production lead to increases in household income, the income can be used to purchase goods that affect health status.

ii.          Changes in crops, farm practices, and markets: Changes in agricultural production can result in the introduction of new foods into diets.

iii.          Changes to crop varieties and production methods: Changes in the types of crops that are grown or changes in production processes may make agricultural work either more or less physically intensive.

iv.          Changes to the use of time: Where changes increase the returns to time spent in agriculture, households may increase the amount of labour they devote to agricultural production (often particularly applicable in terms of womens time allocated to care).

v.          Changes to savings: Where changes in agricultural production result in higher incomes, individuals and households may choose to save some of these higher incomes in the form of assets that improve health.

vi.          Changes in intra-household resource allocation: Changes in agricultural production may result in changes in the allocation of resources within the household. If this change results in women earning greater income, then this may affect how households spend money, how food is allocated, and the types of assets that are accumulated. Holding all other factors constant, this may improve health and nutrition.

Despite the clear pathways, from the current evidence available, the effectiveness of agricultural interventions on nutrition is not clear. Data indicates the relationship is complex, producing either mixed results or demonstrating no impact (Masset et al. 2012). Part of the reason for lack of conclusive evidence can be explained by programmes not originally being designed to address nutrition outcomes or evidence collected for nutrition outcomes, and an over reliance on Randomised Controlled Trials (RCTs) as the gold standard of proof (Ruel and Alderman 2013).  RCTs do not lend themselves to the assessment of health and nutrition effects resulting from agricultural programmes, are generally impossible to apply to the food system, except in small projects. The impact of agriculture on health and nutrition is difficult to assess with RCTs, partly because treatments cannot be randomised and because of the intrinsic length of the effect pathway (Pinstrup-Andersen 2013). Despite limited evidence surrounding the impact of agricultural interventions on nutrition, there is agreement between stakeholders on main principles that should be included in any programmes designed to improve them both. With regards to planning, it is recommended that explicit nutrition objectives are included in agricultural projects, programmes, and policies. Opportunities must be maximised by multisectoral coordination. Women play an important role, in terms of maximising impact of household income on nutrition, in their role as the main producers of domestic food in many countries and also with regards to targeting the most vulnerable groups. Effective and transparent monitoring and evaluation of interventions should take place to measure its impact on beneficiaries and enable learning of experience and sharing of knowledge (Herforth, 2012).

Key messages

  • Evidence suggests that agricultural interventions may have a positive effect on the production of the agricultural goods, but not on households’ total income.
  • To improve nutrition through agriculture, access to rural markets must be improved. Also the legal rights of farmers must be recognised and protected.
  • Improvements in agricultural programmes need to be matched by complementary actions in health, sanitation, other direct interventions for nutrition, and female empowerment
  • Agricultural interventions were successful in promoting the consumption of foods rich in protein and micronutrients, but the effect on the overall diet of poor people remains unclear.
  • No evidence was found of an effect on the absorption of iron, but some evidence exists of a positive effect on absorption of vitamin A.
  • Biofortified vitamin A-rich orange sweet potatoes have been shown to be both effective for increasing maternal and child vitamin A intake and status. Very little evidence was found of a positive effect on the prevalence of stunting, wasting, and underweight among children aged under-5.
  • Despite the lack of evidence demonstrating the impact of agricultural interventions on nutrition, most stakeholders are in agreement on main principles regarding good practice for programmes linking the two. Strong monitoring and evaluation of new programmes is needed to inform future programmes. Results from research are needed to fill the current gap in evidence available.
  • Although evidence is lacking, food security is believed to improve as a result of agricultural programmes.
Body of evidence

The body of evidence for the impact of agriculture on nutrition is moderate. While the pathways linking nutrition and agriculture seem well established, the empirical data illustrating the impact of each is limited.

3b) Social protection

Social protection in this context refers to policy instruments used to address poverty and vulnerability, including social assistance, social insurance and efforts at social inclusion, as well as subsidies. Social protection programmes may aim to improve food security by providing ‘entitlement’ to food by means of labour (public works programmes), trade (food price subsidies, grain reserve management), or transfers (school feeding, supplementary feeding, and cash transfers – both conditional and unconditional). Results from individual studies indicate some effects on younger children exposed for longer durations, but weaknesses in nutrition goals and actions, and poor service quality probably explain the scarcity of overall nutritional benefits. Before the benefits of these programmes in terms of improved maternal and child nutrition is realised, nutrition goals and the quality of services must be strengthened. Many of the programmes that are not originally designed to improve nutrition, have great potential to do so (Ruel & Alderman, 2013).

Cash transfers can be direct and predictable non-contributory cash payments that help poor and vulnerable households to ‘even out’ food consumption and income over the year. There is consistent evidence that households receiving cash transfers spend more on food, resulting in significant gains in children’s weight and height in several countries (Arnold et al. 2011). However the latest evidence shows an absence of overall effect of both unconditional cash transfers and conditional cash transfers on child nutritional status globally (Ruel & Alderman, 2013). The gender of the recipient has also been shown to be an important factor, with programme designs often favouring women, with the aim of increasing their control over the intra-household allocation of resources, which has been shown to impact on child health and nutrition status. However, the programme design must be handled with care, with some studies reporting an increase in household violence when women are targeted as cash recipients (Richards et al. 2011).

Cash transfer programs are being used to meet a variety of needs in humanitarian and transitional settings. The relationship between cash transfer interventions in crisis contexts and malnutrition has received little attention, even though cash transfers can improve access to quantity and quality of food (Bailey & Hedlund, 2012)

School feeding programmes are a form of conditional transfer and can reduce hunger and stimulate learning. Over the past two decades, many governments and organisations have renewed efforts to develop more effective school-based health and nutrition programmes in low-income countries. There is a growing body of evidence linking children’s health and education; and the impact of school health and nutrition. Evidence indicates that school feeding programmes have small effects on school-age children’s anthropometry, particularly in low-income settings (Ruel & Alderman, 2013). Food for education programmes can provide iron and other key micronutrients, but these programmes are not designed to address the most critical nutritional constraints in low-income settings, simply because they are not targeted at the most vulnerable period in child development, which is between conception and 2 years of age (Alderman & Bundy, 2011).

School feeding programmes are designed to improve attendance, achievement, growth, and other health outcomes. Results from higher quality studies indicate that school feeding in low-income countries resulted in a weight gain of 0.39 kg over an average of 19 months. In lower quality studies weight gain was on average 0.71 kg over 11.3 months. For height, school feeding resulted in the greatest height gain for younger children. School feeding was found to increase average attendance between 4 to 6 days per year. Maths gains were consistently higher for children who were fed and in short-term studies, small improvements in some cognitive tasks were found. It can be concluded that school meals may have some small benefits for disadvantaged children, but further research is needed (Kristjansson et al. 2007).

Some evidence suggests that school feeding programmes may be an effective method of both improving nutritional status and reducing poverty. School feeding can use value chains to link agriculture and nutrition, with potential livelihood and income benefits for farmers and nutrition benefits for young children and their families. School feeding may also assist with iron intake, which is particularly important for teenage girls (Ruel & Alderman, 2013).

Key messages

  • Social safety nets have the potential to improve the nutritional status of mothers and children.  For this to happen nutrition goals and the quality of services need to be strengthened.
  • School feeding programmes are popular but costly, and the evidence of their effectiveness is weak and there is no agreement on best practice for implementation.
  • CCT programmes provide a potentially powerful delivery mechanism for improving child nutrition, but require clearer nutrition objectives and actions, as well as monitoring and evaluation if they are to meet their potential.
  • CCTs are found to have positive impact on nutrition in certain settings but it is unclear how dependent their success is on the context in which they are implemented and how effective they would be if they were replicated in a different setting.
  • Evidence shows an absence of overall effect of both unconditional cash transfers and conditional cash transfers on child nutritional status.
  • Children who are fed at school attend school more frequently than those who are not fed.
  • School meals may have small physical and psychosocial benefits for disadvantaged pupils.
Body of evidence

There is a large body of high quality evidence on the various aspects of social protection, but limited evidence on the general concept. The evidence is based on reviews of the literature and suggests the various aspects of social protection have a positive impact on nutritional outcomes, but the impact of each aspect is not clear.

3c) Water, sanitation and hygiene (WASH)

A growing body of evidence has demonstrated the critical importance of water, sanitation and hygiene (WASH) for children for many reasons, including improved nutrition. Along with several other factors, poor hygiene and sanitation cause high levels of maternal and child undernutrition in developing countries (Ahmed et al. 2012). The total number of deaths caused directly and indirectly by malnutrition induced by unsafe water, inadequate sanitation and insufficient hygiene is estimated at 860,000 deaths per year in children under-5 years of age (Prüss-Üstün et al. 2008).

Diarrhoea is a major cause of death and disease, especially among young children in low-income countries. Many of the microbial agents associated with diarrhoea are transmitted via the faecal-oral route and are associated with exposure to human faeces. A review by Clasen et al. (2010) found that interventions to improve excreta disposal are effective in preventing diarrhoeal disease, but that the quality of the evidence is generally poor and does not allow for quantification of any such effect. The authors acknowledge that the review does not address the potential contribution of improved excreta disposal to preventing important health threats associated with inadequate sanitation, including malnutrition. A review by Dangour et al. (2013) found that WASH interventions may result in a small benefit on the growth of children who are under five years old. However, the authors urge caution in using this conclusion, as it is based on data from relatively short-term studies of low methodological quality.

Key messages

  • 860,000 deaths per year in children under-5 years of age are caused directly and indirectly by malnutrition induced by unsafe water, inadequate sanitation and insufficient hygiene.
  • Interventions to improve excreta disposal are effective in preventing diarrhoeal disease, and are likely to have a positive impact on nutritional status, but the potential effectiveness of excreta disposal on diarrhoea is not currently known.
  • One tenth of the global disease burden is preventable by achievable improvements in the way we manage water, meaning improvements are crucial to improve nutritional status.
  • WASH interventions may result in a small benefit on the growth of children who are under five years old
Body of evidence

The body of evidence includes three systematic reviews and one unclassified paper. While it is suggested there is a likely link between improved hygiene and nutritional status, the evidence linking the two is weak.

This section gives an outline on the coordination structures that exist to address undernutrition. In addition, it considers how both governance and funding impacts on the challenge of addressing undernutrition.

4a) Coordination structures

The global architecture of organisations and institutions focusing on tackling nutrition, and more specifically undernutrition, has changed over the years. So have the targets and frameworks that define their work. In May 2012, Ministers of Health attending the World Health Assembly (WHA) agreed a range of maternal, infant and young child-focused undernutrition targets to be achieved by 2025, including a target to reduce stunting by 40 per cent (WHO, 2012).

In 1977 the UN set up an Administrative Committee on Coordination (ACC) subcommittee on nutrition. With reform of the UN ACC this became the United Nations System Standing Committee on Nutrition (UNSCN). It acts as a forum, allowing the UN to harmonise nutrition policy. The UNSCN has a mandate to promote cooperation among UN agencies and stakeholders involved in nutrition. Its goal is to end malnutrition in the current generation. It works through improving advocacy, awareness and mobilising commitment for improved nutrition (UNSCN, 2013).

In response to a global food crisis, world leaders convened in Rome in 2009, at the UN Food and Agriculture Organization (FAO) Headquarters for the World Summit on Food Security. They unanimously adopted a declaration pledging renewed commitment to eradicate hunger from the face of the earth sustainably and at the earliest date. It was agreed to work to reverse the decline in domestic and international funding for agriculture and promote new investment in the sector, to improve governance of global food issues in partnership with relevant stakeholders from the public and private sector, and to proactively face the challenges of climate change to food security (FAO, 2013).

Scaling Up Nutrition (SUN) is a collective movement focused on improving nutrition. It involves actors from governments, civil society, the United Nations, donors, businesses and researchers to address malnutrition. It calls on country leaders and governments to develop and commit to policies which prioritise dealing with poor nutrition. Collaborating with partners is encouraged to implement programs with shared nutrition goals. SUN advocates for the mobilisation of resources to effectively scale up nutrition, with a core focus on empowering women. The movement was founded on the principle that all people have a right to food and good nutrition. SUN was started in September 2010, and the governments of 41 countries have committed to it as of September 2013 (SUN, 2013).

The SUN framework supports the specific nutrition interventions of support for exclusive breastfeeding up to 6 months of age and continued breastfeeding, together with appropriate and nutritious food, up to 2 years of age; the fortification of foods; micronutrient supplementation; and the treatment of severe acute malnutrition (SAM). It also supports the nutrition-sensitive approaches including agriculture, clean water and sanitation, education and employment, health care, support for resilience and women’s empowerment (SUN, 2013).

In 2012, leaders of the world’s wealthiest eight countries (the G8) and African leaders committed to the New Alliance for Food Security and Nutrition, a shared commitment to achieving global food security. The goals of the New Alliance are to increase responsible domestic and foreign private investments in African agriculture, take innovations that can enhance agricultural productivity to scale, and reduce the risk borne by vulnerable economies and communities. The significance of the critical role played by smallholder farmers, especially women, in transforming agriculture and building thriving economies is recognised. (Feed the future, 2012). The New Alliance has published a progress report that focuses on progress in implementing mutual commitments and issues and challenges emerging from the early stages of the initiative (The New Alliance for Food Security and Nutrition, 2013). The report identified the following key challenges and opportunities that will need to be addressed by the New Alliance in the future:

  • Country-level leadership
  • Facilitating a new type of dialogue
  • Institutional ‘pace’ and capacity
  • Joined-up government
  • Access to finance
  • Leveraging and focusing public investment
  • Women’s economic empowerment
  • Learning how to work with smallholders at scale
  • Engaging local and global civil society organisations (CSOs)

There are also several broad approaches and partnerships focused on improving nutrition, including the Renewed Efforts Against Child Hunger and undernutrition (REACH) initiative and 1,000 Days. REACH was established in 2008 as an approach that UN agencies adopt to better provide joint and coherent support to governments of countries with a high burden of child and maternal undernutrition. It aims to help them to accelerate the scaling up of food and nutrition actions. As of April 2013 it operates in 12 countries. The UN agencies involved in the consortium are the FAO, the UN Children’s Fund (UNICEF), the World Food Programme (WFP), and the World Health Organization (WHO). The International Fund for Agricultural Development (IFAD) joined REACH later on with an advisory role (REACH, 2013).

At the United Nations Millennium Development Goals Summit in September 2010, the former U.S. Secretary of State Hillary Clinton and former Irish Foreign Minister Micheál Martin launched the 1,000 Days Partnership. The purpose of creating the partnership was to draw attention to the critical window of opportunity that exists during the first 1,000 days between a woman being pregnant and the child’s second birthday. During this period, the impact of maternal and child undernutrition is potentially irreversible. The partnership promotes targeted action and investment in interventions during this period to scale up nutrition. Targeted action during this period can have a life-changing impact on a child’s future and help break the cycle of poverty. The right nutrition during the 1,000 day window can have a profound impact on a child’s ability to grow and learn. It can also shape a society’s long-term health, stability and prosperity. The 1,000 Days partnership brings together a wide range of partners including NGOs, donors, and the private sector. The partnership transcends a variety of sectors including health, agriculture and food security, water, sanitation and hygiene, economic development and gender equality. As an advocacy hub, the 1,000 Days initiative promotes action and investment in early nutrition through informing key stakeholders about the impact and cost-effectiveness of investing, engaging new stakeholders, and catalysing collaboration and partnership across sectors (Thousand Days, 2013).

4b) Governance

It is doubtful that the world will be able to feed its growing population in a nutritious way without a substantial scale up of political commitment (Haddad, 2013). In recent years, the context or the wider ‘enabling environment’ for undernutrition reduction at national level has drawn increasing interest. This is believed in part to be down to the recognition that systemic capacity constraints at the governance level need to be addressed if the burden of undernutrition is to be permanently and sustainably reduced.

At the Nutrition for Growth Event held in June 2013 and organised by the UK’s Department for International Development, a compact was endorsed by 90 stakeholders made up of partners, businesses, scientific and civil society groups. All the signatories committed to:

  • Improving the nutrition of 500 million pregnant women and young children.
  • Reduce the number of under-fives who are stunted by a further 20 million.
  • Save the lives of at least 1.7 million children by preventing stunting, increasing breastfeeding and better treatment of severe and acute malnutrition.
  • Financial commitments by donors, philanthropy and CSOs included new commitments of up to £2.7 billion to tackle under-nutrition up to 2020.
  • An estimated £12.5 billion for improved nutrition outcomes from nutrition sensitive investments in agriculture, social protection and water, sanitation and hygiene.
  • A pledge from 27 businesses to improve the nutrition, and consequently the productivity and health, of over 927,000 members of their workforces in more than 80 countries.
  • New partnerships between business and science to research new solutions and scale effective technologies.
  • Commitments from 14 governments to scale up their national nutrition plans, and many announced targets for reductions in stunting. (DFID, 2013)

The Hunger and Nutrition Commitment Index (HANCI) is one result of the recent drive towards researching the enabling environment. It was launched in 2013. It ranks governments on their political commitment to tackling hunger and undernutrition and measures what is being achieved and which policies are failing in an effort to provide greater transparency and public accountability. It praises governments where due, and highlight areas for improvement. The HANCI findings support civil society to reinforce and stimulate additional commitment towards accelerating the reduction of hunger and undernutrition. It also assesses whether improving commitment levels lead to a reduction in hunger and undernutrition. An important finding was that economic growth has not necessarily led to a commitment from governments to tackle hunger and undernutrition and conversely low wealth or slow economic growth in a country does not necessarily imply low levels of political commitment. Significantly, within areas of high and growing hunger and undernutrition prevalence, some countries are clearly showing much greater political commitment to address these problems than others. There is also variation between relative commitment to hunger reduction and the relative commitment to nutrition (te Lintelo et al. 2013).

The research base on how to improve the enabling environment for nutrition is limited. However, the inclusion of a paper by Gillespie et al. (2013) that was focused solely on this topic in the 2013 Lancet Series on Maternal and Child Nutrition indicates its importance and relevance to the undernutrition agenda, reflecting the increase in political discourse on this topic. Commitments from many national governments, international organisations, and donors have increased, with momentum driving and being driven by The Scaling Up Nutrition movement. Harmonisation has increased among stakeholders, with regard to their understanding of the main causes of malnutrition and to the various options for addressing it. An enabling environment is vital for nutrition before the positive impact of policies and processes can be experienced by those that need improved nutrition the most. High quality and well-resourced nutrition interventions are vital. These can be bolstered by ensuring that programmes involving agriculture, social protection, and water and sanitation systems are aligned with nutrition goals. Sustained and effective political support to improve nutrition status must be based on knowledge and evidence, and reinforced through policies and governance. To be a success the resources must be available to gather and analyse the evidence, and to make, monitor and evaluate the policies.

A review of four recent principal research streams finds that all note the importance of visibility, commitment and accountability but do not provide much guidance how they should be attained, suggesting further research is needed (Haddad, 2013).

Previous work on the enabling environment found that capability, accountability and responsiveness are three key aspects of effective nutrition governance. Capability in this context refers to coordination between government ministries to improve diet, sanitation, health and education. Undernutrition is often invisible until it becomes highly acute. As such, citizens may need to generate public awareness and demand officials take accountability and deliver appropriate action. The window of opportunity for preventing irreversible damage from undernutrition is only 1,000 days, so a rapid government response is needed to address the needs of the most vulnerable in society (Haddad et al. 2012).

Political and system commitment can be generated through sustained efforts from policy entrepreneurs and nutrition champions. Research suggests that mid-level actors from ministries and external partners struggle to capitalise on windows of opportunity. Opportunities may be missed due to capacity constraints and differing opinions on what action to take. Ownership and responsibility may also be a limiting factor. If systematic capacity constraints remain unaddressed, the consequences on the ability to achieve the desired goals are lightly to be negative (Pelletier et al. 2012).

Key messages

  • Strong leadership is key to reducing undernutrition through the promotion cooperation between sectors, organisations and stakeholders.
  • Different levels of governance must be supported by appropriate structures for effective action to be successful.
  • National and global commitment for improving nutrition is needed for change. Capacity to achieve change must be systematically strengthened.
  • Sustainable funding sources will be vital to the success of interventions.
  • Interventions that can be scaled-up should be prioritised.
  • Investment in research, monitoring and advocacy will lead to results. Research in this context may include operational research of delivery, implementation, and scale-up of interventions, and contextual analyses about how to shape and sustain enabling environments.
  • Strategic capacities must be strengthened as this will lead to commitment building, policy based balling and ultimately capacity building for nutrition focused operations.
  • Economic growth does not automatically result in commitment from governments to tackle hunger and undernutrition and conversely low wealth or slow economic growth in a country does not necessarily imply low levels of political commitment.
  • There is variance between the political commitment of different countries to address hunger and malnutrition. There is also variation between commitment to hunger reduction and the commitment to reducing undernutrition.
  • Political commitment can be developed in a short time, but commitment must not be squandered—conversion to results needs a different set of strategies and skills
  • Framing of undernutrition reduction as an apolitical issue is short sighted and self-defeating. Political calculations are at the basis of effective coordination between sectors, national and subnational levels, private sector engagement, resource mobilisation, and state accountability to its citizens.
  • The private sector has substantial potential to contribute to improvements in nutrition, but efforts to realise this have to date been hindered by a scarcity of credible evidence and trust. Both these issues need substantial attention if the positive potential is to be realised.
Body of evidence

The body of evidence for this section comes from a range of documents and study types with varying methodologies. The consensus is that strong governance is needed to reduce undernutrition, with predictable and stable funding sources being available to facilitate this. One study provides evidence that suggests economic growth does not automatically result in commitment from governments to tackle hunger and undernutrition. Further research is needed on the relationship between governance and nutrition.

4c) Funding

Evidence suggests nutrition interventions have the potential to have a significant impact on health and education, preserving human capital. Yet the investment by national governments, non-government organisations and international donors is not currently enough to end undernutrition. Despite the proportion of Official Development Assistance (ODA) focused on basic nutrition increasing from 0.2% in 2004 to 0.4% in 2011, there is still a shortfall when the demand is considered. Basic nutrition ODA funding is still small when compared with emergency and development food aid. Appropriate levels of basic nutrition financing is needed as a key component in the battle to eradicate poverty. (Di Ciommo, 2013).

Between 2005 and 2009, 10 of the world’s leading bilateral and multilateral donors contributed an average of US$73 million per year to direct nutrition interventions which address the immediate determinants of undernutrition. This represents just a fraction of the estimated need and is dwarfed by investment in indirect nutrition interventions (US$365 million), which address the underlying causes of undernutrition. Investments in aid to tackle the escalating challenge of undernutrition remain inadequate (Mutuma et al. 2012).

With a growing global population, the problem is likely to get worse without increased investment. In the current climate, there is increased competition for funding but also increased expectation to invest in the most cost effective interventions. Evidence suggests that a 15 % reduction in deaths in children younger than 5 years can achieved if populations can access ten specific direct nutrition interventions at 90% coverage. The total additional annual cost to scale up access to these ten direct nutrition interventions in the 34 focus countries that have 90% of the world’s children with stunted growth is estimated to be $9.6 billion per year (Bhutta et al. 2013).

In some cases, nutrition aid is not being invested in countries with the highest rates of undernutrition and some donors frequently do not honour their commitments. In addition, there is a major lack of transparency in nutrition aid, highlighting the need for donors to be more accountable to their electorates (Mutuma et al. 2012). Improvement of the monitoring and evaluation of the nutrition financing activities of donors is required, to allow ‘best practices’ to be identified, understood and replicated. Accountability also needs to be improved. It is also suggested that efforts of those working in various sectors including donors, academia and civil society, are combined when dealing with the financing of scaling up nutrition to avoid a fragmented approach. If the current dearth of funds is ever to be overcome, long-term, sustainable and predictable funding will be needed for the full nutrition package which is aligned with complementary initiatives in health, food security and agriculture (Spratt, 2012).

As part of the SUN initiative, signatory countries are in the process of calculating the cost of scaling up nutrition in their respective countries. As many as 20 countries have currently collated costs from budgets and nutrition-related plans. Data on cost estimates of scaling up nutrition are needed to mobilise support and resources at a regional, national and international level. As more data is gathered, a better understanding will be gained of the resources needed to address undernutrition, which will be vital for policy and planning (SUN, 2013).

Key messages

  • Undernutrition imposes a significant global human and economic cost.
  • Nutrition focused ODA has increased in the last decade, but is still small when compared with emergency and development food aid. Nutrition focused ODA currently does not meet demand.
  • Investments in aid to tackle the escalating challenge of undernutrition remain inadequate and significant extra funding is needed to implement direct nutrition interventions that have demonstrated effectiveness.
  • Micronutrient supplementation and fortification are found to be cost effective implementations and to work well even when capacities are constrained, making them a sensible option for further investment.
  • An estimated $9.6 billion per annum is needed to scale up 10 direct interventions to 90% coverage in 34 focus countries with the most significant stunting burden.
  • There is a major lack of transparency in nutrition aid, highlighting the need for donors to be more accountable to their electorates.
  • OECD needs to improve monitoring and evaluation of the nutrition financing activities of donors to allow ‘best practices’ to be identified, understood and replicated. Accountability also needs to be improved.
  • Donors, academia and civil society need to work together to avoid a fragmented approach to solving undernutrition.
  • Innovative financing to provide long-term, sustainable and predictable funding for the full nutrition package which is aligned with complementary initiatives in health, food security and agriculture is suggested.
Body of evidence

There is a mixture of study types on the relationship between funding and nutrition. While there is some evidence available on various aspects, such as undernutrition imposing a significant global human and economic cost and the lack of transparency on data, it is clear more research is needed into the relationship between nutrition and funding.

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