Study Overview
At its September, 2018, meeting in Argentina, the Development Working Group of the G20 launched its Initiative for Early Childhood Development.1 The initiative affirms the importance of early childhood as the foundation for future health and wellbeing, benefiting both individuals and societies. The Working Group expressed concern that, despite evidence of high returns, investment in early childhood development remains insufficient, and the initiative calls for closer examination of national investments in early childhood development, consideration of better assignments, and increases in the resources that benefit families in vulnerable situations. To support this call, we propose setting a minimum investment benchmark using a budget-based approach: a package of services is agreed, with the cost of delivering the package in different contexts expressed as a percentage of gross domestic product (GDP). A given package will comprise a larger share of GDP in lower-income contexts because of the larger proportion of children, increased needs of children, low levels of existing services, and constrained resources to address children’s needs. Furthermore, we propose an aspirational benchmark for investment, set at the same percentage of GDP as the country that currently invests the largest proportion of its GDP in early childhood development. We also propose a minimum expenditure per child to drive equity in services for all children, including a larger minimum for those with disabilities.
Study Results
The cost of a minimum package to enhance human capital has been estimated, which, for early childhood development, includes prenatal health care, immunisations, micronutrients, parental outreach, birth registration, and 1 year of quality preschool (excluding services for children with disabilities). For this minimum package, the required investment (including aid) would be 2.7% Of GDP for low-income countries, 1.2% for lower-middle-income countries, and 0.8% for upper-middle-income countries. This package requires a minimum average annual expenditure per child younger than 6 years of US$71 in low-income countries, $293 in lower-middle-income countries, and $390 in uppermiddle-income countries. Data from the Organisation for Economic Co-operation and Development suggest that Iceland makes the highest investment in early childhood development, investing 1.8% of GDP in formal day care and pre-primary services. To act as an aspirational target, this figure must be raised to include non-centre-based services for the youngest children. With the incomplete data available, a minimum domestic benchmark of 1% of GDP for early childhood development is indicated (with low-income countries requiring additional international assistance). However, this minimum domestic benchmark is likely to increase following a decision on the appropriate package of services needed. The aspirational goal proposed is 2%. Given price differences between countries, the cost per child for agreed services will differ substantially, and estimates need to be made per country income group.
Intervention: Package of services for early childhood development, with cost of delivering based on percentage of country's GDP