79929 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 Colombia SABER Country Report EARLY CHILDHOOD DEVELOPMENT 2013 Policy Goals Status 1. Establishing an Enabling Environment In the past, the ECD system in Colombia was separately managed by multiple institutions, with limited coordination among and between sectors. The new strategy involves all relevant ECD sectors and creates an enabling environment by establishing a strong legal framework to support young children and pregnant mothers, putting in place coordinating mechanisms across sectors, and assigning sustained financial resources for all young children and families in the country. 2. Implementing Widely Colombia has an advanced scope of ECD programs, with interventions existing in all sectors, mostly with a comprehensive scope. Coverage for health programs for children and pregnant women is well established, but coverage for essential nutrition services and ECCE still does not reach all children in Colombia. Inequities also exist in many areas of service delivery. 3. Monitoring and Assuring Quality Information on ECD outcomes and access partially exist at the national level. While standards for ECCE service delivery are well-defined, the government currently does not have mechanisms to monitor whether compliance with standards is met. THE WORLD BANK COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 This report presents an analysis of the Early Childhood population, particularly those who are poor and Development (ECD) programs and policies that affect vulnerable. The policies and programs associated with this young children1 in Colombia and recommendations new strategy are designed to guarantee that all children in to move forward. This report is part of a series of Colombia receive comprehensive early childhood care and reports prepared by the World Bank using the SABER- education (ECCE) in the early years. The challenge the ECD framework2 and includes analysis of early government now faces is to ensure an effective transition learning, health, nutrition and social and child to a multi-sectoral system with expanded coverage. This protection policies and interventions in Colombia, will require continued coordination and monitoring of along with regional and international comparisons. service delivery at both the national and local levels. Colombia and Early Childhood SABER – Early Childhood Development Development SABER – ECD collects, analyzes and disseminates comprehensive information on ECD policies around the world. The Republic of Colombia is an upper middle-income In each participating country, extensive multisectoral country with a population of 46.93 million information is collected on ECD policies and programs through inhabitants. Colombia is ranked 87th in the UNDP a desk review of available government documents, data and Human Development Index. The country has a gross literature, and interviews with a range of ECD stakeholders, national income of $6,110 per person, with 37 including government officials, service providers, civil society, percent of the population living below the poverty development partners and scholars. The SABER-ECD line. framework presents a holistic and integrated assessment of how the overall policy environment in a country affects young More than 5.1 million children between 0 and 5 years children’s development. This assessment can be used to old live in Colombia. More than 50 percent of these identify how countries address the same policy challenges children are poor. In 2010, the national government related to ECD, with the ultimate goal of designing effective developed a strategy called De Cero a Siempre (“From policies for young children and their families. Zero to Forever�) to create a comprehensive system of early childhood development (ECD) for this Snapshot of ECD Indicators in Colombia Colombia Argentina Brazil Chile Peru with Regional Comparison Infant Mortality (deaths per 1,000 live births) 17 12 17 8 15 Under-5 Mortality (deaths per 1,000 live births) 1 19 14 19 19 19 In Colombia, the scope of early childhood policy is Births attended by a skilled attendant 98% to children targeted 98%below 72 months 97% of age. 100% 84% 1 SABER-ECD is one domain within the World Bank Gross Preprimary Enrollment Rate (36-59 months, 2009) 51% Systems initiative, Better Education Approach to69% 74% No data Results79% (SABER), which is designed to provide comparable and comprehensive assessments of country policies. Children below 5 with moderate/severe stunting (2006-10) 13% 8% 7% No data 24% Birth registration 2000-2010 97% 91% 91% 99% 93% Source: UNICEF Country Statistics, 2010; UNESCO Institute for Statistics, 2009 1 In Colombia, the scope of early childhood policy is targeted to children below 72 months of age. 2 SABER-ECD is one domain within the World Bank initiative, Systems Approach to Better Education Results (SABER), which is designed to provide comparable and comprehensive assessments of country policies. 2 SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 Three Key Policy Goals for Early Childhood policy levers are identified, through which decision-makers Development can strengthen ECD3. SABER-ECD identifies three core policy goals that countries Strengthening ECD policies can be viewed as a should address to ensure optimal ECD outcomes: continuum; as described in Table 1, countries can range Establishing an Enabling Environment, Implementing Widely from a latent to advanced level of development within and Monitoring and Assuring Quality. Improving ECD the different policy levers and goals. requires as integrated approach to address all three goals. As described in Figure 1, for each policy goal, a series of Figure 1: Three core ECD policy goals Table 1: ECD policy goals and levels of development Level of Development ECD Policy Goal Establishing Non-existent legal framework; Minimal legal framework; some Regulations in some sectors; Developed legal framework; an Enabling ad-hoc financing; low inter- programs with sustained financing; functioning inter-sectoral robust inter-institutional Environment sectoral coordination. some inter-sectoral coordination. coordination; sustained financing. coordination; sustained financing. Universal coverage; Low coverage; pilot Coverage expanding but gaps Near-universal coverage in comprehensive strategies Implementing programs in some sectors; remain; programs established in some sectors; established across sectors; integrated Widely high inequality in access a few sectors; inequality in programs in most sectors; low services for all, some tailored and outcomes. access and outcomes. inequality in access. and targeted. Information on outcomes at Information on outcomes from Monitoring Minimal survey data Information on outcomes at national, regional and local national to individual levels; available; limited standards national level; standards for levels; standards for services standards exist for all sectors; and Assuring for provision of ECD services exist in some sectors; no exist for most sectors; system system in place to regularly Quality services; no enforcement. system to monitor compliance. in place to regularly monitor monitor and enforce compliance. compliance. 3 These policy goals were identified based on evidence from impact evaluations, instructional analyses and a benchmarking exercise of top-performing systems. For further information see “Investing Early: What Policies Matter� (World Bank, forthcoming). 3 SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 Policy and Practice: What should be in place in an key policies and interventions needed across sectors. effective ECD system? The policies and interventions are categorized by sector, Box 1 presents an abbreviated list of interventions and but coordination and planning across sectors is policies that the SABER-ECD approach looks for in required. The second and third columns of Box 1 display countries when assessing the level of ECD policy the current situation in Colombia. It is important to note development. This list is not exhaustive, but is meant to that the existence of some of these policies does not provide an initial checklist for countries to consider the necessarily translate into the desired outcomes. Box 1: A checklist to consider how well ECD is promoted at the country level What should be in place in an effective ECD Colombia: Colombia: system? In Policy: In Practice: Constitution of Colombia: Sentence T. 760 Standard health screenings for pregnant 89% of pregnant women receive antenatal care (at least 4 (Right to health); Law N° 100 (Creation of women times) Integral Social security system) Constitution of Colombia: Sentence T. 760 Skilled attendants at delivery (Right to health); Law N° 100 (Creation of 98% of births are attendant by skilled attendants Healthcare Integral Social security system) Childhood immunizations Expanded Program for Immunizations 88% of 1-year-old children are immunized against DPT 52% of children below five with diarrhea receive oral rehydration; Required well-child visits No policy 64% with suspected pneumonia taken to healthcare provider Specific data unknown for coverage on growth and monitoring and well-child visits Breastfeeding promotion 10-year Breastfeeding Plan 2010-2020 43% of infants are exclusively breastfed until 6 months of age Nutrition Decree N° 0547 (Health and Sanitary Salt iodization Specific data unknown Conditions Decree) Decree N° 1944 (Regulations for Flour Iron fortification Specific data unknown Fortification) Parenting programs (during pregnancy, after Zero to Forever strategy is expanding in 421,000 beneficiaries currently enrolled in FAMI (for pregnant delivery and throughout early childhood) PAIPI modalities women and mothers of children under 2 years) Early Learning Childcare for working parents (of high Zero to Forever strategy is expanding in Specific data unknown quality) expanding PAIPI modalities Free initial education (preferably at least two years with developmentally appropriate Law N° 1295 (Decree on Comprehensive 51% gross enrollment rate for preprimary (2009) curriculum and classrooms, and quality Social Security) assurance mechanisms) Families in Action Initiative reaches over 2.2 million families in Services for orphans and vulnerable children Law N° 1532 (Decree for Families in Action) over 1,000 municipalities Social Protection Policies to protect rights of children with special needs and promote their No policy Specific data unknown participation and access to ECD services Financial transfer mechanisms or income Families in Action Initiative reaches over 2.2 million families in supports to reach the most vulnerable families Law N° 1532 (Decree for Families in Action) over 1,000 municipalities (could include cash transfers, social welfare, etc) Decree N° 1260 (Statute of the Civil Mandated birth registration 97% birth registration rate Registry) Job protection and breastfeeding breaks for Yes: Law N° 1468 Specific data unknown new mothers Child Protection Specific provisions in judicial system for No policy Specific data unknown young children Guaranteed paid parental leave of least six Law N° 1468 (Labor Code: guarantees 14 Specific data unknown months weeks, not six months) Domestic violence laws and enforcement No policy Specific data unknown Tracking of child abuse (especially for young Defensores de Familia exist in Specific data unknown children) municipalities Training for law enforcement officers in regards No policy Specific data unknown to the particular needs of young children KEY: Red: requires urgent attention, no policy exists; Orange: in place, but with limitations in practice; Green: Colombia adequately addresses area. 4 SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 Policy Goal 1: Establishing an Enabling International Declaration and Plan of Action for Environment Nutrition, demonstrating its commitment to eliminate  Policy Levers: Legal Framework • hunger and all forms of malnutrition. Recognizing that Intersectoral Coordination • Finance iodine deficiency in pregnant women or young children can lead to cognitive impairments, the MoSP mandates An Enabling Environment is the foundation for the that all salt intended for human consumption be design and implementation of effective ECD policies.4 iodized. The Health and Sanitary Conditions Decree An enabling environment consists of the following: the (Decree N° 0547, 1996) sets requirements that salt existence of an adequate legal and regulatory contain 50-100 parts per million of iodine. In order to framework to support ECD; coordination within sectors reduce micronutrient deficiencies, the MoSP also and across institutions to deliver services effectively; regulates flour fortification. The Regulations of Flour and, sufficient fiscal resources with transparent and Fortification Decree (Decree N° 1944, 1966) mandates efficient allocation mechanisms. that the production of flour follows guidelines established by the National Institute of Medicine and Policy Lever 1.1: Food Surveillance. Flour that is produced within Legal Framework Colombia should be fortified with Vitamin B1, Vitamin B2, Folic Acid, and iron. The legal framework comprises all of the laws and Policies promote healthcare for young children and regulations which can affect the development of young women, but well-child visits are not mandated. Article children in a country. The laws and regulations which 44 of the Constitution states that health, social security, impact ECD are diverse due to the array of sectors which and balanced nutrition are fundamental rights for all influence ECD and because of the different constituencies children. Children are guaranteed the right to receive that ECD policy can and should target, including pregnant free care, regardless of ability to pay. While the women, young children, parents, and caregivers recognition of these rights is important, the GoC has not legally mandated well-child health visits (visitas de National laws promote appropriate dietary salud), which could ensure that all children receive consumption by pregnant women and young children. appropriate interventions to prevent and treat Implementation of regulatory frameworks to encourage childhood illness. In recent years, the GoC has, breastfeeding can be an effective strategy to reduce infant however, developed policies to improve access to early mortality rates and promote healthy child development. childhood healthcare for the most vulnerable The Ministry of Health and Social Protection-(MoSP, populations in Colombia (see Box 2). The MoSP also Ministerio de Salud y Protección Social) developed a Ten- runs an Expanded Program on Immunizations (EPI), year Plan for Breastfeeding 2010-2020 (Plan Decenal de offering a complete course of childhood immunizations. Lactancia Maternal), which outlines a plan for district In 2012, the MoSP expanded its strategy for vaccination authorities to promote breastfeeding and regulate the coverage for children in Colombia. marketing of infant formula and other products used as breast milk substitutes. The plan complies with the Under the Decree for Comprehensive Social Security provisions of the International Code of Marketing of Breast System (Law N° 100, 1993), women are guaranteed the Milk Substitutes, a global health policy framework adopted right to subsidized healthcare in the Social Security by the WHO. Health System (Sistema General de Seguridad Social en Regulations are also in place in Colombia to promote Salud). The MoSP guarantees prenatal care and salt iodization and flour fortification. At the UN World essential interventions for pregnant women. Resolution Summit for Children in 1990, Colombia committed to 412 (2000), which outlines activities and interventions eradicate micronutrient deficiencies in the population. for prevention and early detection in public health, In 1992, the Government of Colombia (GoC) signed the mandates standard health screenings for HIV and STDs 4 for pregnant women. Brinkerhoff, 2009; Britto, Yoshikawa & Boller, 2011; Vargas- Baron, 2005. 5 SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 Box 2: Political support and framework for vulnerable children in Colombia The Government promotes early childhood education, health, nutrition, and protection for vulnerable children. With 56 percent of the population of children below 5 years old living in poverty, the GoC has established a system to protect the rights of vulnerable children. To ensure that vulnerable children are provided their constitutional rights in health and education described above, the GoC has established specific regulations for ECCE for children in the lowest income categories. The Decree of Regulations for Comprehensive Care for Early Childhood for SISBEN 1, 2, and 3 (Law N° 1295, 2009) emphasizes that public priority should be placed on low-income children. The law states that the rights of children, which begin at gestation, and pregnant women are to be protected across sectors. Children from the lowest income levels are guaranteed adequate nutrition, preprimary education, and comprehensive healthcare. In addition to a framework for early childhood, the GoC recently strengthened its policies for impoverished children of all ages. The Department of Social Prosperity is responsible for regulating, implementing and monitoring the Families in Action Initiative (Familias en Acción) (Law N° 1532, 2012). Families in Action is a comprehensive social protection initiative that provides health and education interventions for all children below 18 years of age who live in poverty. The System for Selection of Beneficiaries of Social Programs, SISBEN, (Sistema de Selección de Beneficiarios para Programas Sociales) classifies families by socio-economic status based on their living conditions. Colombian families in the bottom two or three 5 wealth strata (out of six) often qualify for social subsidies, including the Families in Action Initiative and integral ECCE. The majority of this report focuses on early childhood interventions for SISBEN 1-3. It does not analyze private sector services, which are consumed primarily by families in strata 4-6 (for example, most middle- and upper-income children attend higher quality private preprimary institutions). Table 2: Regional comparison of maternity and paternity leave policies Colombia Argentina Brazil Chile Peru 14 weeks maternity, 10 days 13 weeks maternity, 2 17 weeks maternity, 1 18 weeks maternity, 1 13 weeks maternity at paternity at 100% of salary, days paternity at 100% of day paternity at 100% of day paternity at 100% of 100% of salary (no paid by state and employer salary, paid by state salary, paid by state salary, paid by state paternity), paid by state Source: ILO, 2012 Code protects workers from discrimination due to The Constitution of Colombia mandates the provision pregnancy or breastfeeding and prevents employers from of one year of initial education. The Constitution of dismissing pregnant women. Women are guaranteed two Colombia (Article 67) states that education is a right of 30-minute breaks in each working day for the first six every individual in the country and indicates that months. In extenuating circumstances, mothers can education should be free in all state institutions. present medical certificates to request more frequent Education is compulsory between five and fifteen years breaks from employers. of age, including at least one year of initial education. Under the new Labor Code, The GoC guarantees 14 weeks While the Constitution mandates some initial education of publically financed maternity leave. Maternity leave is for all children, the GoC has developed more concrete partially financed by the GoC and partially paid by the policies in recent years to ensure initial education for employer. New fathers are also protected under this law, the most vulnerable children in the country. Box 2 with 10 days of paid paternity leave. The GoC allots the reviews the framework for targeting vulnerable young greatest number of days for paternity leave and has children in Colombia. comparable maternity leave policies, compared to other Latin American countries. Table 2 provides a sample of Policies guarantee job protection for pregnant women leave policies from the region. Compared to Colombia, and opportunities for new parents to care for infants. high performing countries like Sweden and the United Women are guaranteed job protection in accordance with Kingdom, offer greater protection for parental leave and the International Labor Organization (ILO) Maternity focus on enhanced economic and social planning. Protection Convention. In 2011, the Labor Code (Law N° Sweden’s approach, which is detailed in Box 3, is an 1468) was amended to provide improved protection for advanced, flexible policy to ensure adequate care of the expecting mothers and parents. Article 239 of the Labor child. 5 SISBEN identifies the families and individuals based on their employment condition, income and housing characteristics, in order to provide subsidies (normally for education and health) and identify individuals as beneficiaries of social programs. SISBEN classification is distinct from the socioeconomic stratification in Colombia, which classifies properties in order to provide subsidies for utilities (public services). 6 SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 Box Box 3: 3: Relevant Relevant lessons lessons from from Sweden: Sweden: Protecting Protecting new new parents parents with with parental parental insurance insurance Example from Sweden: The Swedish Parental Insurance Benefit The Swedish Parental Insurance Benefit is the international exemplar for parental leave policy. Parental Insurance in Sweden is designed to benefit both men and women. In total, the leave includes 480 days of paid leave, 60 days of which are earmarked for the mother, 60 days for the father, and the remainder to be divided as the couple chooses. It commences up to seven weeks prior to the expected birth, and also is available for parents adopting a child. The compensation rate can vary; as a minimum, however, 80 percent of the employee’s salary is provided during leave. In addition, each parent is legally entitled to take unpaid leave until a child is 18 months old. Additional benefits include: temporary parental leave, which entitles a parent 120 days of parental leave annually to care for children under the age of 12 with illness or delay (child requires a doctor’s certificate); a pregnancy benefit, payable for a maximum of 50 days to expectant mothers who are unable to work because of the physically demanding nature of their jobs; and, pension rights for childcare years, which partially compensate the loss of future income during the period when the parent is at home with the child. Key considerations for Colombia:  Improved parental leave for fathers  Adequate, sustainable financial support to support families during early stage of child’s life  Additional benefits for families with children who have special needs National laws protect the rights of all children (Box 4). Box 4: Key Laws Governing ECD in Colombia In 1989, the GoC ratified the UN Convention on the Rights of the Child (UNCRC), protecting the rights of all • UNCRC (1989) children in Colombia. Under the UNCRC, every child is • Code of Childhood and Adolescence (Law N° 1098, guaranteed protection from being deprived his or her 2006) identity. Policies that mandate birth registration can be • Decree on Comprehensive ECD for SISBEN 1, 2, a critical first step to reach children with the services and 3 (Law N° 1295, 2009) they need and protect them against exploitation. The • Decree for Families in Action (Law N° 1532, 2012) GoC mandates that all births be registered in Article 5 of Other Laws & Policies Protecting Women & the Statute of the Civil Registry (Decree N° 1260, 1970). Children Civil registration should occur within the first month of • Convention on the Elimination of all Forms of life (Article 29, Law N° 1098, 2006). In addition to Discrimination Against Women (CEDAW) (1979) national policies, municipal and district ministries also • Ten -year plan for Breastfeeding 2010-2020 have local decrees to regulate birth registration. • Health and Sanitary Conditions Decree (Decree N° 0547, 1996) • Regulations for Flour Fortification (Decree N° The Code of Childhood and Adolescence (Law N° 1098, 1944, 1966) 2006) guarantees all children below 18 years old the • Statute of the Civil Registry (Decree N° 1260, right to healthy development. It states that protection 1970) of these rights is the joint obligation of family, society, • Decree for Families in Action (Law N° 1532, 2012) and the State of Colombia. Article 29 of the Code • Decree for Comprehensive Social Security System emphasizes the importance of the early childhood (Law N° 100, 1993) years, stating that rights recognized in international • Labor Code (Law N° 1468, 2011) treaties and in the Constitution of Colombia are guaranteed for children from 0 to 6 years of age. Under children below 5 years have physical, language, or learning disabilities in Colombia (National Planning Article 96 of the Code, specialized family advocates in Department, 2005). Strong ECD frameworks should municipalities and commissaries (Defensores de Familia) promote the participation of special needs children and are responsible for protecting the rights of children. guarantee inclusive access to ECD health, education, and child and social protection services. Under Article 41 of the Code of Childhood and Adolescence, the GoC Policies do not adequately protect the rights of is responsible for meeting the educational needs of children with disabilities. Approximately 2 percent of children with special needs. However, no policy exists to 7 SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 guarantee cross-sectoral services and support to target support from institutions across sectors, but it does not children with special needs. The Decree on include specific steps for implementation. Comprehensive ECD for SISBEN 1, 2, and 3 (Article 10, The education sector has also made strides in recent Law N° 1295) states that children ages 0 to 6 years with years to facilitate improved coordination under the new special needs who cannot attend traditional ECCE strategy. In its Ten-year Plan for Education (2006-2015), centers should receive specialized attention in the National Ministry of Education (MEN, Ministerio alternative locations. Limited information is available to Nacional de Educación) developed an education policy suggest how many children with special needs are for ECD. The plan outlines strategies to generate actually served in accordance with this policy. synergies with health, nutrition, and social protection sectors. In particular, the MEN outlines intentions to Policy Lever 1.2: work in closer collaboration with the Colombian Family Intersectoral Coordination Welfare Institute (ICBF), a government institution that also manages ECCE services. Development in early childhood is a multi-dimensional process.6 In order to meet children’s diverse needs Box 5: Key Political Frameworks for Multisectoral during the early years, government coordination is ECD Strategy essential, both horizontally across different sectors as • National Public Policy for Early Childhood (Conpes well as vertically from the local to national levels. In Social Document N° 109, 2007) many countries, non-state actors (either domestic or • Education Policy for Early Childhood/Ten-year international) participate in ECD service delivery; for Education Plan (2006-2015) this reason, mechanisms to coordinate with non-state • National Plan of Development 2010-2014 (Law N° actors are also essential. 1450) • Formation of Intersectoral Commission (Law N° Colombia has developed an explicitly stated 4875, 2011) multisectoral ECD strategy and implementation plan. • From Zero to Forever: Comprehensive ECCE In 2010, the GoC introduced the Comprehensive ECD Strategy (to be finalized 2012) Strategy, “From Zero to Forever� (de Cero a Siempre). The national strategy, endorsed by all relevant sectors, Finally, in the most recent National Development Plan is designed to ensure that every child in Colombia, (2010-2014), the GoC outlines clear actions for particularly the most vulnerable, is guaranteed their implementing the new FZTF strategy (Article 137, Law Constitutional right to free healthcare and education in N° 1450, 2011). The development and multi-sectoral the early childhood years. From Zero to Forever (FZTF) endorsement of these important political frameworks includes a set of national and district-level actions to have provided key inputs to the new detailed strategy. promote intersectoral work to promote comprehensive early childhood interventions. The Intersectoral Commission for ECD serves as an institutional anchor to coordinate ECD across sectors. The In addition to the Decree for Comprehensive ECD new FZTF strategy was developed with the support of the (discussed in Section 1.1), other noteworthy political Intersectoral Commission on Comprehensive ECD, “CIPI� precursors have served as foundations for the shaping (Comisión Intersectorial de Atención Integral en Primera of the new intersectoral strategy (Box 5). In 2007, the Infancia). The CIPI, legally established in 2011 (Law N° National Social and Economic Policy Council (CONPES) 4875, 2011), comprises delegates from the President’s 6 Office, MoSP, MEN, ICBF, Ministry of Culture (MoC), Naudeau et al., 2011; UNESCO-OREALC, 2004; Neuman, 2007. National Planning Department (DNP), and Social approved the National Public Policy on ECD (CONPES Prosperity Department (DPS). Figure 2 displays the Social Document N° 109), which highlights the institutional composition of the commission, as well as importance of ECD and outlines guidelines for an their institutional roles related to ECD. Each institution is effective multi sectoral ECD system. The policy solicits responsible for overseeing ECD services within its respective sector. As an institutional anchor, CIPI is 8 SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 responsible for setting ECD policies and standards and the National Senate and House of Representatives. A full- coordinating across various ECD service provision time officially appointed Technical Secretary from the agencies. The commission meets monthly and is Presidential Office of Special Programs provides responsible for submitting biannual reports on the operational support to improve coordination between the progress of ECD policy implementation and coordination various institutions of the commission. Figure 2: Institutional composition and responsibilities in CIPI In addition to multisectoral coordination at the national level, the new strategy encourages coordination across sectors at the local level. To complement the efforts of CIPI, local governments are responsible for taking further action in accordance with the national ECD policy. In the Decree on Comprehensive ECD, the GoC states that department, municipal, and district governments should develop ECCE intersectoral plans based on the needs of the local population (Article 6, Law N° 1295). To locally implement the national government’s plans for improved ECD, many municipalities have established technical committees. Like the national CIPI, these municipal committees comprise of representatives from across sectors. Figure 3 displays an example of a municipal technical ECD committee. The activities and regularity of meetings for these committees varies, depending on municipal regulations and priorities. Figure 3: Institutional composition of Municipal Technical ECD Committees 9 SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 The new strategy is intended to improve coordination The Government is in the process of developing a at the point of service delivery. Before the menu of integrated ECD services. A major component introduction of the new ECD strategy, Colombia of the FZTF strategy is an established list of specific ECD lacked cohesive coordination among and between services that should be delivered to all young children. sectors. In education, standards and methods for This Scheme for Comprehensive Services (Ruta Integral ECCE service delivery varied widely. While the FZTF de Atenciones) spans from the prenatal period to 6 strategy is still in its final stages of development, it is years of age and includes interventions related to the intended to create a more organized and coordinated health, nutrition, socio-emotional development, cultural system of policy implementation and service delivery. understanding, and protection of the child. The GoC is Previously, two government institutions separately in the process of developing strategies for classifying managed ECCE services. Both the MEN and ICBF have which service providers offer each essential been providing ECCE services for more than 30 years intervention in order to identify gaps in delivery. in Colombia. The MEN provided services through the Comprehensive ECCE Program, “PAIPI� (Programa Atención Integral a la Primera Infancia). ICBF Policy Lever 1.3: provided services through child and family Finance programming, including the Community Welfare Homes Program, “HCB� (Hogares Comunitarios de While legal frameworks and intersectoral coordination Bienestar), among others. are crucial to establishing an enabling environment for ECD, adequate financial investment is key to ensure are Under the FZTF strategy, ICBF and MEN have joined available to implement policies and achieve service forces to coordinate service delivery throughout the provision goals. Investments in ECD can yield high public country. In consideration of the institutional capacity returns, but are often undersupplied without of the two entities, CIPI called for a major shift in government support. Investments during the early responsibilities of MEN and ICBF. The MEN will no years can yield greater returns than equivalent longer be in charge of service provision and all ECCE investments made later in a child’s life cycle and can services delivered through PAIPI will be gradually lead to long-lasting intergenerational benefits.7 Not transitioned to ICBF. The new strategy bestows the only do investments in ECD generate high and MEN with full responsibility for regulation and quality persistent returns, they can also enhance the control of all ECCE services (including both those effectiveness of other social investments and help from the previous PAIPI and HCB). ICBF will have a governments address multiple priorities with single new role of managing and implementing all public investments. ECCE services in the country. With the support of the MEN in monitoring and regulating, ICBF can focus its Transparent budget processes exist for ECD spending efforts on improved service delivery for all ECCE across all sectors. ECD budget planning is a coordinated centers throughout the country. Further details of the effort between multiple government institutions in re-delegation of institutional responsibility for ECCE Colombia. The MoSP, MEN, MoC, DSP, and ICBF each services will be discussed in proceeding sections. have clearly delineated budgets for early childhood. The MoSP, MEN, and ICBF use specific criteria to allocate In addition to improved coordination among the ECD budgets. Financial needs and allocations for ECD education sector, the new FZTF Strategy incorporates are discussed at the monthly meetings of CIPI. CIPI is he health, nutrition, and protection sectors to ensure responsible for coordinating both the implementation access to comprehensive services. The National and coordination of finance for ECCE services. For Development Plan states that the Intersectoral example, for ECCE provider training activities, ICBF Commission must create mechanisms for the MoSP to funds most of the activities and the MoC may finance integrate services within the larger initiative, including some of the relevant cultural training materials. In antenatal and childhood health, nutrition services, and addition to sectoral budgets dedicated to ECD, CIPI also child protection. has its own operating budget. 7 Valerio & Garcia, 2012; WHO, 2005; Hanushek & Kimko, 2000; Hanushek & Luque, 2003 SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 10 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 The Government is shifting overall budget allocations The level of public sector financial commitment to ECD for ECD to achieve more efficient and coordinated is adequate. Approximately 15 percent of total efforts with the largest sum of spending by ICBF. government expenditures go towards education in Before the establishment of the FZTF strategy, both the Colombia (representing approximately 5 percent of MEN and ICBF separately financed ECCE services. In GDP). Of the entire education budget, 6 percent is 2011, as part of the new strategy, the government allocated to initial education (UNESCO, 2010). Figure 4 started to create a more efficient system to finance and presents the percentage of education expenditures on implement ECD services in Colombia. In the National initial education in selected Latin American countries. Development Plan, the GoC shifted funding so that ICBF As of 2010, Colombia had the lowest proportion of its can prioritize finance for ECCE services (Article 136, Law education spending allocated towards initial education. N° 1450, 2011). The MEN is required to coordinate its new budget with the ICBF. While there is no set pay scale for ECCE providers, Table 3 displays national ECD budgets across sectors . In 8 monthly pay for teachers ranges from USD 817 to 1,048 2011, the MEN initial education budget was $126 (COL 1,582,612 to 2,030,485), representing a relatively million USD ($226.800 million COP). In the following competitive pay in Colombia. The MEN transfers year, nearly three-fourths of the national early funding directly to service providers for teacher pay. childhood budget was shifted from MEN to ICBF. In Figure 4: Percentage of education expenditures on 2012, the ICBF early childhood budget has grown to initial education $809 million USD ($1.4 billion COP). With an increased budget, ICBF will now be responsible for all ECCE service Chile 13% implementation and infrastructure. The MEN, with a smaller budget, will now be responsible only for Peru 12% regulating and designing pedagogical guidelines. In Argentina 8% 2013, ICBF is expected to have an even larger Brazil 7% proportion of ECCE spending, which will allow the institution to expand under the FZTF strategy. Colombia 6% 0% 2% 4% 6% 8% 10% 12% 14% Table 3: ECD budget across sectors in Colombia for Source: UNESCO, 2010 2011 and 2012 9 2011 2012 The MoSP has an adequate budget for ECD health National Ministry of spending, particularly for low-income families. Table 4 US$126,538,885 US$32,237,898 Education (MEN) compares several health expenditure indicators10 in Colombian Family Colombia with other countries in the region. US$459,312,098 US$809,908,167 Welfare Institute (ICBF) Compared to other Latin American countries, the GoC Ministry of Health and US$95,373,214 Not available spends a greater proportion of its GDP on health. One Social Protection (MoSP) area for improvement in the health sector is Ministry of Culture US$1,044,383 US$1,547,987 compensation of community health workers, who (MoC) currently are not paid by the GoC. Community health Source: MEN, MoSP, ICBF workers serve as valuable resources in promoting healthy child development. 8 10 In the social protection sector, the DSP allocates a large portion Out of pocket expenditure is any direct outlay by households, of funding towards ECD health and protection services through including gratuities and in-kind payments, to health practitioners the Families in Action program. However, the specific ECD and suppliers of pharmaceuticals, therapeutic appliances, and budget is not available for this report. other goods and services whose primary intent is to contribute to 9 Based on USD exchange rates: January 2012: 0.0005159959, the restoration or enhancement of the health status of individuals January 2011: 0.0005221932 or population groups. These expenditures are not ECD- specific. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 11 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 Public ECD expenditures ease the burden of finance Policy Options to Strengthen the Enabling for low-income families. As demonstrated in Table 4, out of pocket health expenditures in Colombia are Environment for ECD in Colombia lower than other Latin American countries. The Legal framework: MoSP’s subsidized healthcare system benefits 24 million people in the low-income population. The  Create mechanisms to promote the provision of system is financed through general taxes. Many of the free healthcare to young children, such as services of the subsidized system are essential establishing requirements for regular well-child visits. services for young children and mothers, including Laws promote free and comprehensive healthcare for prenatal controls, labor and delivery, prevention children, but without required well-child visits and services, and control programs in maternal and mechanisms to enforce the provision of free childcare. healthcare. However, the general policies do not create mechanisms to promote adequate access to In the education sector services provided by ICBF and healthcare for young children. A policy that requires MEN, the GoC covers the majority of the cost of these that children attend well-child visits on a regular basis services targeted to low-income families. For ICBF could better ensure that all children in Colombia, even community-based services (traditional HCBs, see Box those not covered by Families in Action, receive 3, Section 2.1), payment is not obligatory, but parents appropriate health interventions in early childhood. are asked to contribute to teacher salaries. ICBF Universal provision of health services in early requests the optional contribution to community childhood can ensure the prevention and treatment of ECCE service providers (Community Mothers) 58 leading causes of death for children below 5 years, percent of daily minimum wage (equating to including diarrhea and pneumonia. approximately USD 182 per month). For family-based  At department and municipal levels, expand child ECCE services (Family Environment Program, see Box protection interventions, such as specialized training 3, Section 2.1), parents are asked to contribute to in domestic abuse and exploitation for judges, providers’ salaries based on a sliding scale. lawyers, and law enforcement officers. Legal frameworks should ensure protection and fair Table 4: Regional comparison of health expenditure representation for the early childhood population. indicators Policies must be designed to protect young children, Colombia Argentina Brazil Chile Peru Out-of-pocket health given that they can be particularly vulnerable to expenditure as exploitation. In Colombia, the endorsement of family 20% 30% 31% 33% 40% percentage of total advocates (Defensores de Familia) at district and expenditure on health Out-of-pocket municipal levels of government is commendable. The expenditure as 71% 66% 58% 64% 86% GoC could also consider creating other mechanisms in percentage of all private the judicial system to protect young children. This health expenditure could include specialized training for judges and General government expenditure on health as 20% 15% 7% 16% 14% lawyers to ensure child-friendly courts; or child- a percentage of GDP accessible hotlines and training law enforcement Total expenditure on officers to better identify cases of abuse or USD health per capita in 2009 USD 569 USD USD 1,17 USD exploitation. (adjusted for purchasing 1,387 943 400 2 power parity)  Develop an inclusive education policy to guarantee Percentage of routine Not inclusion and equitable access to ECCE for children with 100 EPI vaccines financed by 100% 100% avail 100% government % able special needs. The GoC might consider adjusting policies Source: WHO Global Health Expenditure Database, 2010; UNICEF to promote the participation of children with disabilities Country Statistics, 2010 and special needs. The existing policy (Law N° 1295) is designed to ensure children with disabilities have access to specialized and appropriate ECCE, which may not exist in regular ECCE centers. The policy may, however, SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 12 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 unintentionally exclude these children from the ECCE important to establish a common plan of action for system. Given that children living with disabilities can service delivery. The already established list of essential already be prone to discrimination or exclusion, an services (Ruta Integral) is a good step towards this improved policy would better guarantee inclusion. Many common plan. The next step will be to create countries have inclusive education policies for children mechanisms to coordinate with ECCE service providers with special needs, which protect their rights to in order to guarantee that every child has access to all participate in education with non-disabled children. of the essential services. Evidence suggests that inclusive education policies can be a cost-effective strategy to improve language and social Municipal Technical ECD Committees already exist in skills of children with disabilities, promote diversity many municipalities in Colombia. Serving the role of among all learners, and discourage social exclusion or local implementation the national government’s negative attitudes towards children with special needs. 11 strategy, these committees have the potential to ensure that children have access to all services outlined in the Intersectoral Coordination: Ruta Integral. The GoC could better ensure its strategy  Finalize a costed implemented plan for FZTF is locally implemented by (a) ensuring that all strategy. Finalizing a policy for the FZTF strategy will be municipalities have functioning technical committees; a crucial step in creating an enabling environment for and (b) building the capacity of these committees to effective ECD in Colombia. The overall vision and ensure local delivery of Ruta Integral interventions. detailed design of the strategy are praiseworthy, and A next step the GoC could consider would be to conduct the GoC will need to ensure that the intentions of the a needs assessment of the capacity of the strategy are met. The National Plan of Development municipalities. Once the level of capacity is better 2010-2014 and the Public Policy for Early Childhood understood, a training plan for municipal technical from the National for Social and Economic Policy committees could be developed. This training plan Council (CONPES 109) outline explicit criteria for the should entail that all municipal committees are familiar design of the new FZTF national ECD strategy. It will be basic child development principles as well as the important that all sectors play an active role in moving evidence to support ECD as a municipal priority. forward to implementing the new policy. The FZTF Committees must be informed on the FZTF strategy and strategy requires substantive institutional changes, the Ruta Integral. Additionally, they must have the particularly in the education sector among ICBF and capacity to coordinate across municipal agencies, local MEN. To ensure smooth and effective transition, the stakeholders, and service providers. Peer learning from Intersectoral Commission will need to continue to have municipalities with effective ECD technical committees access to adequate financial, political capital, and could be a good option for promoting best practices. human resources. The Government of Cuba’s ECD strategy, Educa a Tu If achieved, the integration of service delivery models of Hijo, which is described in Box 8 (Page 21) is an the MEN and ICBF is likely to be more efficient and cost- exemplary case of ECD capacity building across all levels effective. ICBF, which already has wider coverage and of government 12 . Educa a Tu Hijo was successfully coordination at the point of service delivery, now has expanded largely in part due to capacity building at all the opportunity to ensure that children receive levels of government. Initial training, which lasted essential services from other sectors. This will require approximately one year, involved inter-level capacity constant coordination between ICBF and the MEN, as building whereby the national level trained the well as with other sectors. provincial level, the provincial level trained the  Develop strategies to deliver all services outlined in municipal level, and the municipal level trained the local Ruta Integral, including capacity building of Municipal level. All levels, according to their needs and previous Technical ECD Committees. Given that essential ECD experience in ECD, were trained in basic child services are provided across multiple sectors, it is 11 12 For additional information, UNESCO’s Policy Guidelines on Inclusion in For additional information, see Tinajero, A., 2010. Scaling-up Early Child Education (2009) presents the importance of inclusive education as well Development in Cuba. Brookings Institution & Bernard van Leer Foundation. outlines steps for developing an effective policy. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 13 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 development principles as well as improving child and departmental levels, to commit to sustained development plans. financial support of the new FZTF strategy. Box 6 provides an example from Australia, where all state and Finance: territorial governments have agreed to maintain  Strengthen coordination mechanisms between financial support to the preprimary education sector. ICBF and MEN. Overall, the system for financing ECD is The CIPI should consider working with departmental strong. Continued coordination and adequate levels of and municipal governments to streamline Colombia’s financial support will be necessary to effectively and financial system. This will require improved efficiently implement the new FZTF strategy. accountability measures and clear and available  Ensure coordinated, sustainable, and adequate expenditure data across sectors. As will be further commitment to ECCE spending. As illustrated in Figure discussed under Policy Goal 3, a unified information 4, Colombia allocates the smallest proportion of its system that tracks both expenditures and ECD overall education budget to initial education. It will be indicators will be of utmost value for the Colombian important for public institutions, both at the national Government in tracking and sustaining investments in early childhood. Box 6: Relevant lessons from Australia: sustainable financial investment13 Example from Australia: The National Partnership Agreement on Early Childhood Education Education is the responsibility of the State and Territory governments in Australia. In the 2007/2008 academic year, nearly 70 percent of preschool eligible children attended, and six out of the eight jurisdictions had enrolment rates above 85 percent. However, enrollment was low for specific sub-groups within the population, especially Aboriginal children. To address this issue and increase enrollment across the country, in 2008, through the Council of Australian Governments, all state and territory governments in Australia jointly agreed to the National Partnership Agreement on Early Childhood Education. The National Partnership aims to provide all children with access to a quality early childhood education program by 2013, delivered by a four-year university-trained early childhood teacher, for 15 hours a week, 40 weeks a year, in the year before formal schooling. Prior to the National Partnership, th Australia’s investment in ECD was only 0.1 percent of GDP, which ranked 30 out of the 32 OECD countries, and well below the 0.45 percent of GDP average. To achieve quality, universal coverage, all parties agreed to increased, sustained financial investment, which was partially aided though additional funding of $970 million (AUD) by the Commonwealth of Australia over a five-year period. The Australian strategy calls for streamlined mechanism for management and finance at the national, state, and local levels. It requires effective accountability mechanisms, with clearly defined roles and responsibilities at each respective level. The Best Start Program in the State of Victoria is an example of a comprehensive ECD program with sustainable financing mechanisms. The program uses a decentralized approach and is co-financed by municipal and local governments, with contributions from regional stakeholders. The program’s multi-pronged funding approach is effective largely due to strategic mapping, constant monitoring, and extensive evaluation methods at the local level. Key lessons for Colombia:  In order to expand coverage and effectively implement FZTS, commitment from both the national and departmental levels to maintain financial support to ECD will be essential.  Similar to the Australian context, Colombia’s decentralized system requires the development of a methodology to enforce efficient top-down expenditure allocation. In creating a sustainable system, definition of roles and accountability measures for financing and allocating funding for ECD services between the national, departmental, and municipal governments is essential.  With improved availability of expenditure data and a unified information system to monitor FZTS progress across ECD indicators, (further discussed under Policy Goal 3), Colombia is more likely to sustain adequate finance levels and monitor its investments in ECD. 13 For more information, see Australia’s National Partnership Agreement on Early Childhood Education: http://www.deewr.gov.au/ Earlychildhood/Policy_Agenda/ECUA/Pages/EarlyChildhoodEducationNationalPartnership.aspx. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 14 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 the most disadvantaged young children and their Policy Goal 2: Implementing Widely families.  Policy Levers: Scope of Programs • Coverage • Equity Policy Lever 2.1: Scope of Programs Implementing widely refers to the scope of ECD programs available, the extent of coverage (as a share Effective ECD systems have programs established in of the eligible population) and the degree of equity all essential sectors and ensure that every child and within ECD service provision. By definition, a focus on expecting mothers have guaranteed access to the ECD involves (at a minimum) interventions in health, essential services and interventions they need to live nutrition, education, and social and child protection, healthfully. The scope of programs assesses the extent to and should target pregnant women, young children and which ECD programs across key sectors reach all their parents and caregivers. A robust ECD policy should beneficiaries. Figure 5 presents a summary of the key include programs in all essential sectors; provide interventions needed to support young children and their comparable coverage and equitable access across families via different sectors at different stages in a child’s life. regions and socioeconomic status – especially reaching Figure 5: Essential interventions during different periods of young children's development SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 15 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 Programs cover a wide range of beneficiary groups and vaccination coverage have increased and malnutrition are established across all relevant sectors to meet the rates have been reduced. holistic needs of children. ECD Interventions exist in The education sector is undergoing transformation to the education, health, nutrition, and child protection more efficiently provide a wide scope of essential ECCE sectors and target a range of beneficiaries in Colombia. services. As previously discussed, both ICBF and MEN As presented in Figure 6 interventions in Colombia exist have been separately implementing ECCE programs in for all target beneficiaries. The differentiated Colombia. Both the HCB (Community Homes) program interventions in the country not only reach infants and of ICBF and the PAIPI (Comprehensive ECCE) program of young children, but also pregnant women and MEN primarily target children below 6 years old from caregivers. For example, ICBF manages programming the lowest two wealth quintiles (SISBEN I and II) or for parents in the home-based and community-based children displaced by violence. Both the MEN and ICBF training programs to teach families and caregivers how hire private third parties to provide services. to provide quality care to young children. The HCB program, adopted by ICBF in the 1980’s, Figure 6: Scope of selected ECD interventions in currently has the widest ECCE coverage in the country Colombia by major sector and target population reaching more than 1.3 million children in 2011. ICBF’s HCB program has delivered a variety of single-sector modalities, including separate child care, health, and family education programs, as well as a comprehensive ECCE modality (Hogares ICBF Integrales). The MEN has implemented the PAIPI program at a smaller scale, reaching approximately 81,000 children in 2011. PAIPI services are education-focused, but also provide comprehensive care in health and nutrition. PAIPI services are delivered through center-, community-, and home-based modalities. Under the FZTF strategy, the GoC is undergoing a shift in service provision. Rather than the varying service delivery models (between ICBF and MEN, there are more than 10 different modalities), all ECCE modalities will transition to three standard models: center-based, family/community-based or home-based. Box 7 reviews Figure 7 presents a selection of single-sector, multi- the FZTF’s new service delivery model. sector and comprehensive ECD interventions in Colombia. One noteworthy program in Colombia is the For each sector, a series of specific interventions are comprehensive Families in Action program. essential to support young children. Table 5 illustrates Internationally, comprehensive ECD programming that ECD interventions exist across sectors, ranging relatively rare; Colombia should be recognized for this from education, health, nutrition, parenting, special comprehensive social protection, health, and education needs, and anti-poverty programming. While it is initiative. The program provides conditional cash commendable that nearly all of the essential transfers to encourage them to access adequate health interventions exist in the multiple sectors of Colombia and education interventions for their young children. It the scale of service delivery is also an important also provides parenting education programming, consideration. Table 5 also displays the scale of including activities to address family violence. Since coverage of selected ECD programs in Colombia initiation of the program, school attendance and demonstrating that levels if access can vary. This will be discussed further in Section 2.2. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 16 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 Figure 7: Selected ECD programs in Colombia Box 7: Snapshot of the transitioning ECCE system in Colombia under new strategy The FZTF Strategy creates a new model that replaces two previous systems of service provision. Eventually all public ECCE (previously MEN and ICBF managed) will transition to the following three standard modalities: Center-Based Early Childhood Development Centers- CDIs (Centros de Desarrollo Infantil): The Colombian Family Welfare Institute (ICBF) will manage CDIs for children below 6 years old. Community organizations are responsible for the operations of CDIs. The CDI program is intended to be a complementary effort to the actions of the family and community. CDIs are designed to provide intersectoral services, with teams of ECCE teachers, psychologists, social workers, nutritionists, and nurses. Family -Based Family Environment Programs (Ambito Familiar): The previous MEN Family-based PAIPIs and ICBF family programs will transition to become part of the Integral Family Environment Program. Service provision is prioritized for children and families living in rural areas or with difficult access to institutional care settings. The program includes home educational meetings and group educational meetings in the community. Community-based Community Homes/HCB (Hogares Comunitarios de Bienestar): This child care program, based in the homes of local mothers, currently provides the highest level of coverage for children under 6 years old. It provides food supplements, nutritional controls, and protection components. The program is run by community mothers - operating in their place of residence - who receive training and support from ICBF and care for up to fifteen children from the local community. Under the new strategy, where possible, some Community Homes will be transferred into Center-based CDIs, but the majority will remain in the homes of local mothers. According to the new strategy, all community mothers who manage the Community Homes program will receive additional training in order to provide better care for children. However, compared to CDIs and Family Environment Programs, these Community Homes programs, referred to as traditional HCBs in the remainder of the document, do not have a specific education component. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 17 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 Table 5: ECD Programs and Coverage in Colombia Scale Number of Regions Approximate % of ECD Intervention Pilot Covered Eligible Population Programs (out of 33) Covered EDUCATION (STIMULATION AND EARLY LEARNING) 14 State-subsidized comprehensive ECCE ALL 18% ICBF and MEN comprehensive care (Family and Center-based) 15 State-subsidized child care ALL 34% Traditional HCBs (no education component) HEALTH Antenatal and newborn care ALL Data not available MoSP Integrated Management of Childhood Illnesses ALL Data not available MoSP Growth Monitoring and Promotion Programs ALL Data not available MoSP and PAIPI Immunizations ALL 88% Expanded Immunization Program NUTRITION Food supplements for children 0-71 months Percentage not ALL 16 Nutritional Recovery Centers and Ambulatory Nutritional Recovery available Breastfeeding promotion programs Data not available ICBF Family-based Modality (previously FAMI) Feeding programs in initial education schools 17 ALL 100% Feeding in ICBF programs PARENTING Parenting integrated into health/community programs 18 Yes 1 6% ICBF Family-based Modality (previously FAMI) Home visiting programs to provide parenting messages Data not available MoSP SPECIAL NEEDS Programs for OVCs 31 Data not available ICBF Foster Homes (Hogar Sustito Internado) Interventions for children with special needs (physical) 27 Data not available Foster Homes (ICBF ) Interventions targeted at children affected by HIV/AIDS 18 Data not available ICBF, Support Program Interventions targeted at children that have been sexually abused 10 Data not available ICBF; Support Program ANTI-POVERTY/COMPREHENSIVE Cash transfers conditional on ECD services or enrollment/intervention in 33 variety of sectors- track individual children: Familias en Accion Source: SABER-ECD Program and Policy Instruments (Collected from MEN, ICBF, MoSP, DPS) 14 Includes Center-based, Home-based, and Community-based (See Box 7). 15 As mentioned in Box 7, the majority of HCB models will remain basic child care programs in homes. 16 In 2012, 38269 children ages 0-23 months received services from nutritional recovery centers; percentage of eligible population is unknown. 17 Note, 100 percent of ECCE centers enrolled in school feeding receive food, but this does not imply that all eligible children are not benefiting from school feeding programs. 18 241,805 families participated in the Family-based modality, out of 4,291,149 members of eligible population SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 18 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 in basic child care from the traditional HCB model (non- comprehensive); and 33 percent are not enrolled in any Policy Lever 2.2: ECCE programs. Figure 10 reveals that level of coverage Coverage for ECCE (including MEN and ICBF services) increase by A robust ECD policy should establish programs in all age group. For children ages 3 to 5 years old, the essential sectors, ensure high degrees of coverage and enrollment rates in ECCE are the highest, at reach the entire population equitably–especially the approximately 30 percent. most disadvantaged young children–so that every child and expecting mother have guaranteed access to Figure 9: Coverage of ECCE services essential ECD services. 566,429 748,694 not children Initial education coverage in Colombia is inadequate, enrolled in enrolled in but gradually expanding. Despite the array of ECCE ECCE Compre- services in Colombia, enrollment rates are still relatively 25% hensive 33% ECCE low. Figure 8 displays gross preprimary (Initial Education) enrollment rates in a selection of Latin 929,141 America countries. These data reflect the number of children children enrolled in preprimary (regardless of age) as a 42% enrolled in HCB percent of the total ECCE age population. Despite an daycare increase of ten percentage points in enrollment between 2007 and 2009, Colombia still falls behind in Out of 2,244,264 children 0-4 years old providing initial education access, compared to neighboring countries. In 2009, only 49 percent of Figure 10: Enrollment in ECCE by age children were enrolled in initial education. 2,000,000 Number of Children The GoC has recognized the need to reach more 1,500,000 Total children with ECCE services. As previously discussed, number of children recent government efforts have been focused on 1,000,000 unenrolled targeting children from SISBEN 1-3. Figure 9 displays the 500,000 31% proportion of children covered by comprehensive and 20% 29% 0.2% 9% HCB ECCE services out of all eligible low-income 0 Total children below 5 years old. The GoC reports that 25 number of children percent of the eligible population of children below 5 enrolled years of age receives comprehensive ECCE, including center-based and family-based; 42 percent are enrolled Age Group Figure 8: Gross preprimary enrollment rates (age 3-5) in Latin America 120 Ecuador 100 (no data 2009) Enrollment Ratio (%) Preprimary Gross 80 Peru 60 Argentina 40 20 Chile 0 (no data 2001) 2001 2002 2003 2004 2005 2006 2007 2008 2009 Colombia Year (no data 2003) Source: UNESCO Institute for Statistics SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 19 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 Colombia provides good coverage to essential child Table 7: Level of access to essential health services for protection interventions. As demonstrated on Table 6, young children and pregnant women in Latin America Colombia provides nearly universal coverage for birth Colombia Argentina Brazil Chile Peru registration19, with the second highest registration rate 1-year-old children immunized against DPT of countries in Latin America. In addition to (corresponding 88% 94% 94% 92% 93% guaranteeing the right to identity, the GoC also has an vaccines: DPT3ß) established child welfare system; a total of 15,556 new Children below 5 with diarrhea receive oral No No and existing cases of children below 6 years old are rehydration/ continued 52% No data data data 66% currently registered. feeding (2010) Children below 5 with suspected pneumonia No Table 6: Level of access to birth registration in Latin taken to healthcare 64% No data 50% data 68% America provider (2010) Colombia Argentina Brazil Chile Peru Births attended by 98% 98% 97% 100% 84% skilled attendants Birth 97% 91% 91% 99% 93% Pregnant women registration receiving antenatal No Source: UNICEF Country Statistics, 2010 89% 89% 91% 93% care (at least four data times) Colombian children and mothers have adequate access Source: UNICEF Country Statistics, 2010 to most health interventions, but coverage for selected interventions is still far from universal. Promoting Access to essential nutrition interventions in Colombia healthy development of young children requires that is inadequate. Table 8 displays the level of access of ECD health services operate at scale. Table 7 compares essential nutrition interventions in Colombia and other coverage levels for essential ECD health services in Latin American countries. Colombian children are not Colombia and other Latin American countries. The receiving adequate access to the nutritional services they Colombian national health system provides adequate need to grow and thrive. Of all infants below 6 months old, coverage to many essential health services for young 43 percent of them are exclusively breastfed. This might children. However, there remains room for suggest that the widely accepted practice can be further improvement, particularly in expanding immunization encouraged so that all children can benefit from coverage. As demonstrated in Table 7, DPT3ß breastfeeding. There remains room for improvement for immunization rates in Colombia are lower than other overall nutrition of young children, as 13 percent of countries in Latin America. Table 7 also reveals that children below 5 years are moderately or severely stunted. children in Colombia have relatively low access to Additionally, similar to other Latin American Countries, treatment for diarrhea and pneumonia. According to Colombia has a high prevalence of anemia in pregnant the MoSP, acute respiratory and diarrheal infections are women. among the leading causes of mortality for children below 4 years old. Compared to health services Table 8: Level of access to essential nutrition coverage for children, access to essential health interventions for young children and pregnant women interventions for pregnant mothers is moderately in Latin America better. As presented in Table 7, nearly 90 percent of Colombia Argentina Brazil Chile Peru Children below 5 with mothers have access to regular prenatal visits and moderate/severe 13% 8% 7% No 24% nearly all births are attended by skilled attendants in data stunting (2006-10) Colombia. Infants exclusively No breastfed until 6 months 43% No data 40% 68% data of age (2010) Infants with low birth 6% 7% 8% 6% 8% weight Prevalence of anemia in 19 Birth registration data based on UNICEF statistics, but these data 31% 25% 29% 28% 43% pregnant women (2010) have not been confirmed by in country sources. Source: UNICEF Country Statistics, WHO Global Database on Anemia SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 20 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 Policy Lever 2.3: Access to essential ECD services is higher in urban Equity areas than rural areas. Data from UNICEF also reveal Based on the robust evidence of the positive effects that access to ECD services vary by geographical ECD interventions can have for children from location in Colombia, as illustrated in Figure 12 Children disadvantaged backgrounds, every government should and families living in urban areas have better access to pay special attention to equitable provision of ECD birth registration and selected health interventions than services. One of the fundamental goals of any ECD those living in rural areas. When compared to policy should be to provide equitable opportunities to international data on equity of ECD services, however, all young children and their families. these differences are relatively small. The greatest disparity between rural and urban families is in access ECD services are not equitably provided to rich and to an improved sanitation facility. Slightly more than poor families in Colombia. With new ECD policies half of rural families in Colombia have access to a basic targeting low-income children and families, the GoC has toilet, while more than four-fifths of urban families do. made strides in working towards equitable provision of ECD services. However disparities in access to services Figure12: Access to ECD services by rural/urban for young children and pregnant mothers still exist. location in Colombia Figure 11 compares the levels of access to selected 99% 97% health and nutrition interventions for the poorest and 100% 95% 94% richest quintiles. In the richest quintile, 100 percent of 90% 81% mothers deliver their babies with a skilled attendant 80% present, yet only 93 percent of mothers from the 70% poorest quintile do. Disparities also persist for children’s 60% 55% 55% access to adequate nutrition and healthcare: 64 percent 45% 50% of rich children are treated for diarrhea while only 46 40% percent of poor children are. Additionally, the underweight prevalence in children below 5 years old is 30% 4 percent higher for poor children. 20% 10% Figure 11: Access to ECD services and ECD outcomes 0% for poor and rich in Colombia Birth Skilled Under-fives Access to registration (%) attendant at with diarrhoea Improved 100% 93% 100% birth (%) receiving oral Santation 90% rehydration Facility treatment (%) 80% 70% 64% Source: UNICEF, 2010 Rural Urban 60% 50% 46% 40% 30% Girls and boys have equitable access to ECCE services. 20% While disparities persist sub-nationally, socio- 6% 2% 10% economically, and between rural and urban regions, 0% Colombia provides equitable access to ECCE services by Skilled attendant at Under-fives with Underweight birth (%) diarrhoea receiving prevalence in children gender. In 2011, 540,268 girls and 501,227 boys were oral rehydration under five (%) 2006- attending ECCE centers. treatment and 2010 continued feeding (%) Poorest Quintile Richest Quintile Source: UNICEF, 2010 SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 21 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 Policy Options to Implement ECD Widely in Coverage & Equity Colombia  Facilitate enhanced capacity of local authorities to Scope of Programs identify and address gaps in coverage. While disparities in access to some essential services between the rich  Ensure all essential interventions are available and poor and urban and rural areas do exist, they are throughout the country through improved coordination relatively low when considering international at the point of service delivery. Colombia has an excellent comparisons. As discussed above, coordinating scope of ECD programs to cover all domains of child interventions at the point of service delivery can be an development. Despite a wide range of existing ECD effective strategy to ensure that a comprehensive scope interventions, the majority of them are not operating at of services is delivered. While national frameworks can scale. In integrating the former ICBF and MEN ECCE service promote increased coverage, efforts at the municipal delivery models, the GoC could consider developing level are essential. Scaling up ECCE services cannot be mechanisms to ensure that all essential interventions are achieved with national government’s efforts alone. available throughout the country. The consolidation of Department and municipal authorities will also need to modalities is likely to help provide a more comprehensive take an active role in expanding coverage to larger package of services to beneficiaries. However, at the local populations. In Cuba, the Educate Your Child (Educa a tu level, ICBF and the MEN should coordinate with the MoH, Hijo) program has successfully been expanded across MoC, and DPS to guarantee that children receive all the country through national, provincial, municipal, and components of the Ruta Integral. These institutions are local management. While the Cuban context is in many participating members of the CIPI at the central level, and ways unique, the success of this program still reveals it is recommended that the technical ECD committees in transferable and valuable lessons. Countries like local governments play an active role in ensuring essential Ecuador and Brazil have replicated components of the interventions in the Ruta Integral are available for children Educate Your Child methodology. Box 8 provides a in the respective regions. Coordination between the snapshot of how all institutions contributed to scaling health, nutrition, protection, and education sectors in local up Cuba’s ECCE program. governments will be crucial. This coordination could include sharing coverage data and collaborating to identify gaps in service delivery. Box 8: Relevant lessons from Cuba: Scaling up ECCE Example from Cuba: Educate Your Child program20 The Educate Your Child (Educa a Tu Hijo) program, piloted in the 1980’s, is a multisector, community-based early childhood program for families and young children. The program targets children ages 2-6 years old and their parents. Teams of ECCE and health professionals and local coordinating groups are responsible for implementing the program. The Educate Your Child program was expanded nationally during the 1990’s. Cuba now provides universal coverage to preschool programs (including Educate Your Child and two other national programs). The Educate Your Child program was expanded through national, provincial, municipal, and local bodies, where program management and coordinating groups were created at each level. Groups from all levels received training on child development essential services necessary for each stage of development. Preliminary training lasted approximately one year. The national level trained the provincial level, the provincial level trained the municipal level, and the municipal level trained the local level. The newly built capacity allowed coordinating groups to facilitate effective implementation at their respective levels. At the local level, coordinating groups were responsible for designing an awareness and promotion campaign, carrying out a census of all young children to establish a basic development profile, selecting and contracting service providers, and monitoring the program. Key Lessons for Colombia:  Departmental and municipal technical ECD committees already exist in many regions in Colombia and will play an integral role in implementing the FZTS strategy. These technical committees should receive adequate training in the Ruta Integral. Local authorities should also be trained in the Ruta Integral to promote adequate delivery of all essential services at the local level.  As discussed in Policy Lever 1.3 (Inter-sectoral coordination), Colombia could learn from the Cuban strategy for inter-level capacity in which each level of government is trained by one level above in ECD management. 20 Tinajero, A., 2010. Scaling-up Early Child Development in Cuba. Brookings Institution & Bernard van Leer Foundation. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 22 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013  For children already attending traditional HCB income and vulnerable children. The GoC may also need modalities, expand the scope of services (outlined in to consider expanding this strategy in access to health the Ruta Integral de Atenciones) by providing quality and nutrition services. Access to nutrition interventions, training to Community Mothers. Currently, only 25 such as programs to promote breastfeeding and percent of eligible children receive comprehensive parenting education about healthy eating, could be services. In focusing on improving access to ECCE, MEN more available for families. Providing access to and ICBF should not only target the one third of nutritional services, particularly improved access or eligible low-income children with absolutely no access, knowledge about the consumption of foods with iron but also work to expand the scope of services available could lower anemia prevalence. Reducing anemia to the 42% of low-income children who attend the prevalence in pregnant women could also prevent traditional HCB programs. The child care, health and intellectual impairment and mental retardation of nutritional services the children receive in the children. traditional HCB programs are certainly beneficial. However, the GoC should consider mechanisms to To expand access to essential nutrition interventions, provide all services outlined in the Ruta Integral de particularly in poor and rural populations, the GoC could Atención, particularly the educational and psychosocial consider leveraging existing networks in these areas. stimulation components. Given that the Colombian health system already provides relative good coverage for many health The new strategy is already providing training to interventions, including access to birth attendants and Community Mothers. To widen the scope of services antenatal care, the CIPI could work with the MoH to covered in the HCB modalities, this additional training attach essential nutrition interventions, such as should include building Community Mothers’ nutritional education to the MoH’s existing health knowledge and capacity to promote child learning and interventions. Integrating nutritional education development through quality educational and programs into existing health services could be an psychosocial stimulation activities. excellent opportunity to increase coverage in hard-to-  Improve access to nutrition interventions by reach areas. Box 9 discusses a nutrition program leveraging existing resources and networks in the implemented by the Government of Senegal, where this health sector. New early childhood policies targeting has proven to be very successful. SISBEN 1-3 have focused on access to education for low- Box 9: Relevant lessons from Senegal: Improving access to nutrition interventions in hard-to-reach populations Example from Senegal: Coordinating service delivery across sectors In 2002, the Nutrition Enhancement Program (NEP) was launched by the Government of Senegal to provide multisectoral support for nutrition and enhance nutritional conditions for children below five and pregnant and lactating women. It includes a community- based growth monitoring and promotion and community IMCI (Integrated Management of Childhood Illness) with maternal counseling, home visits, and cooking demonstrations. The project integrated nutrition interventions (i.e. growth monitoring and promotion) with existing health sector interventions (i.e. IMCI). The Ministry of Health and local development agencies already provided a relatively good scope of coverage of health interventions in local communities. Thus, the nutrition sector leveraged existing resources for delivering the NEP interventions. Due to the synergetic effect of bringing together the nutrition and health sectors, the NEP became a mechanism for delivering other essential health and nutrition services provided by existing programs (including insecticide-treated bed nets and vitamin A supplements). By 2012, the Government of Senegal expanded the community nutrition program to reach more than 60 percent of the target population. Key Lessons for Colombia:  Given that the MoH in Colombia already provides relatively good access to health services, including birth attendants and prenatal care, these health sector programs could be expanded to include nutritional components.  Promoting feeding practices combined with the delivery of essential health services can be an effective strategy to promote the holistic development of children. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 23 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013  Support community-based nutrition/health education through training, materials, and compensation for community promoters. Community- Policy Lever 3.1: based nutrition promotion has been identified has one Data Availability of the most cost-effective investments for a country’s development.21 Outreach initiatives and information Accurate, comprehensive and timely data collection can campaigns in local communities can promote positive promote more effective policy-making. Well-developed parenting behaviors that will ensure healthy and well- information systems can improve decision-making. In nourished children. Through community-based particular, data can inform policy choices regarding the education, parents will be more likely to access ECD volume and allocation of public financing, staff services as well as promote healthy practices at home. recruitment and training, program quality, adherence to standards and efforts to target children most in need. Providing education materials as well as training and support to local community workers could be a In the education sector, data on access to ECCE feasible and effective approach for the Government to services have been separately collected and managed ensure that poor and rural populations are accessing by ICBF and MEN. Currently, the MEN and ICBF have two essential health and nutrition interventions. As completely separate systems to collect data on children’s mentioned in the previous recommendation, ICBF access to essential health and education ECD services. The Community Mothers, could serve as an outlet for MEN’s Information System for Early Childhood- educating mothers on how to access ECD “SIPI�(Sistema de Información Primera Infancia) tracks a interventions. Similarly, health and nutrition education variety of basic indicators for each child enrolled in PAIPI, through community health workers could also be a including age, gender, socio-economic status, indigenous cost-effective way for the MoH to expand coverage to status, and parental education. The comprehensive hard-to-reach communities. Given their familiarity system also tracks health and protection outcomes, with the local context, community members can serve including whether each child: has vaccinations and as a valuable resource to reach out to mothers and childhood wellness and growth monitoring; is physically, young children. In addition to education materials and linguistically, or mentally handicapped; is gifted; has been training, as previously recommended in Policy Goal 1, affected by conflict; or is enrolled in Families in Action or compensating community health workers could be an other social protection interventions. The internet-based effective strategy to complement the existing health management system tracks a child’s history from when he system ECD services or she enters PAIPI until primary school entry when basic education begins. ICBF has a different system to track children enrolled in HCB and other ICBF programs. The Policy Goal 3: Monitoring and Assuring registry of beneficiaries-“RUB� (Registro Único de Quality Beneficiarios) collects basic data on program participants.  Data Availability: Quality Standards: Additionally, a system called “Metrix� tracks Compliance with Standards anthropometric information to monitor early childhood nutritional status. Data are collected on a quarterly basis Monitoring and Assuring Quality refers to the existence of and submitted to the Directorate General of ICBF. information systems to monitor access to ECD services and outcomes across children, standards for ECD services and In both systems, information is reported on ECCE systems to monitor and enforce compliance with those enrollment. The MEN’s SIPI system is more comprehensive, standards. Ensuring the quality of ECD interventions is vital tracking some information on child outcomes and teachers. because evidence has shown that unless programs are of In the integration of ICBF and MEN into a new ECCE model, high quality, the impact on children can be negligible, or the GoC will have important decisions to make on a new even detrimental. information system. Given that ICBF contracts third parties 21 Copenhagen Consensus, 2008. For more information: to operate the majority of ECCE centers, it does not have http://www.copenhagenconsensus.com/Home.aspx extensive data available for these centers. Once all centers transition under ICBF management, the challenge will be to SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 24 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 ensure that information from all ECCE providers is tracked Table 9 displays a series of key indicators that a country and available. could track to monitor young children’s development. These indicators are divided into both administrative The MoSP collects data on access, training of and survey data (collected both by DANE and UNICEF). service providers, and basic child outcomes in It is important to note that sometimes indicators health. The MoSP keeps individual records for each tracked administratively are only partially available. For child’s usage of health services. In preparation of this example, the MEN SIPI system tracks the number of report, data were not available on the number of special needs children enrolled in ECCE, while ICBF does children and pregnant women receiving specific health not22. On the other hand, ICBF tracks the number of interventions. The MoSP does, however, produce an children benefitting from nutrition interventions annual public report documenting the overall health provided by HCB. Ideally under the new strategy a new situation in the country. The report outlines child health system that could consolidate these indicators can be indicators, including principal sicknesses and leading created. causes of mortality for children below 4 years of age. In addition to data collected by MoSP, the National Administrative Department of Statistics (DANE- Departamento Administrativo Nacional de Estadistica) conducts a Quality of Life Survey (Encuesta de Calidad de Vida), which analyzes household socioeconomic conditions, including access to health and social security services. Table 9: Availability of data to monitor ECD in Colombia Administrative Data: Indicator Tracked ECCE enrollment rates by region X Special needs children enrolled in ECCE (number of)  Children attending well-child visits (number of)  Children benefitting from public nutrition interventions (number of)  Women receiving prenatal nutrition interventions (number of) X Children enrolled in ECCE by sub-national region (number of)  Average per student-to-teacher ratio in public ECCE  Is ECCE spending in education sector differentiated within education budget?  Is ECD spending in health sector differentiated within health budget?  Survey Data Indicator Tracked Population consuming iodized salt (%) X Vitamin A Supplementation rate for children 6 -59 months (%) X Anemia prevalence amongst pregnant women (%)  Children below the age of 5 registered at birth (%)  Children immunized against DPT3 at age 12 months (%)  Pregnant women who attend four antenatal visits (%)  Children enrolled in ECCE by socioeconomic status (%) X 22 Data is not available from either institution on the number of special needs children receive specialized attention in alternative locations outside of traditional centers (As mandated in the Decree on Comprehensive ECCE for SISBEN 1, 2, and 3 (Article 10, Law N° 1295) SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 25 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 Family Environment Programs. With these guidelines, Policy Lever 3.2: the MEN will have the opportunity to promote quality Quality Standards learning at the local level, as each department or municipality is responsible for building its own Ensuring quality ECD service provision is essential. A focus pedagogical approach. on access – without a commensurate focus on ensuring quality – jeopardizes the very benefits that policymakers The MEN and ICBF require that ECCE providers are hope children will gain through ECD interventions. The qualified to meet the needs of young children. In the quality of ECD programs is directly related to better new framework for service delivery expectations, the cognitive and social development in children. MEN establishes clear guidelines for teacher experience, qualifications, and child-to-teacher ratios. Under the new strategy, the MEN is responsible for Explicit standards exist for CDIs, Family Environment providing regulation and guidance for all ECCE centers. Programs, and Home-based modalities. For example, in As previously discussed, the service delivery model for CDIs, all ECCE teachers are required to have a tertiary ECCE is undergoing a major transition. ICBF will become level of education and direct experience in ECCE. The entirely responsible for all ECCE service provision. The MEN requires one teacher for every 10 children below 2 MEN, which previously contracted third party providers years old, and requires one teacher for every 20 for PAIPI, will no longer manage or fund service children older than 3 years old. To provide support to provision or infrastructure of ECCE centers.23 Instead, it teachers, the MEN states that there should be one will take on a new role of regulating all centers. It also is teacher assistant (auxiliares pedagógicos) for every 10 responsible for establishing technical guidelines to children under 2 years old and one teacher assistant for ensure quality pedagogy and service provision. The every 30 to 40 children 2 to 5 years old. Separate MEN has recently developed a framework of standards exist for teacher assistants in CDIs, Family established guidelines and standards agreed upon by Environment, and Home-based modalities. Teaching the MoSP, ICBF, and DNP. The framework details quality assistants in CDIs must have a complete upper- components expected for both CDIs and Family secondary high school education. In Family and home- Environment Programs. These components include based programs, the standard is higher, requiring that expectations related to pedagogy, health and nutrition, teaching assistants have a university degree and direct family and community involvement, and ECCE service experience working with young children. providers from multiple sectors. The MEN requires that modalities provide in-service Strategy promotes comprehensive child development, training to all ECCE providers based on an established but clear standards for what children should learn and training plan. This plan has been approved by CIPI, but know are not yet established. Currently, neither a has not yet been implemented. It includes training in national initial education curriculum nor established first aid, breastfeeding, nutrition, sanitation, and learning standards exist in Colombia. However, the MEN domestic abuse prevention. is in the process of reviewing and adjusting a document with regulations and guidelines for defining pedagogical Standards also exist for ECCE providers to cover other criteria for ECCE, which is expected to be finalized in components of ECCE services delivered through CDIs December 2012. The document reviews the and Family Environment Programs. The MEN’s communication, body, social, and cognitive dimensions framework for both modalities includes requirements of child development. It also considers pedagogical for experienced professional service providers from strategies for young children to promote development. other sectors, including coordinators, teachers, nurses Once finalized, this document could serve as an or health workers, psychologists, and nutritionists. The excellent foundation for a curriculum in both CDIs and MEN defines provider-to-child ratios for each professional. For example, for CDIs, there should be 1 23 ICBF has previously had its own set of standards and regulations psychologist/social worker for every 200 children. for ECCE services, but this section focuses on the current MEN standards, given that the MEN will now be responsible for setting standards. APPROACH FOR BETTER EDUCATION RESULTS SYSTEMS 26 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 Operations guide establishes standards for centers are visited and evaluated on an array of service infrastructure and service delivery. In 2010, the MEN, delivery indicators, which are based on stricter and more with support of ICBF, developed an Operations Guide to specific standards than those outlined in the Operations promote the quality service delivery and operations at Guide. Once municipalities and departments become part the local level. The MEN delivers training based on the of the fund, they need to continue to meet higher criteria. operational guide to ECCE providers as well as local Currently, 785 municipalities and 3 departments are part authorities responsible for regulating ECCE services of this special fund as a result of applying for and meeting (mayors, municipal secretaries of education, etc.). The these regulations. guide provides specific criteria on the official requirements for infrastructure, teaching and learning In moving forward, the ICETEX fund will no longer materials, and general operations for service delivery. It function and ICBF will be responsible for allocating also provides detailed responsibilities and activities for funds to municipalities. service providers, secretaries of education, regional ICBF directors, and local representatives from the Policy Lever 3.3: health sector. Overall, the guide is an extremely Compliance with Standards valuable tool to communicate national quality standards at the local level. Establishing standards is essential to providing quality Within the FZTF strategy, standards for infrastructure ECD services and to promoting the healthy for CDIs and home-based modalities have also been development of children. Once standards have been established. These guidelines, which include minimum established, it is critical that mechanisms are put in standards for windows, walls, floors, stairs, electricity, place to ensure compliance with standards. and doors, are designed to guarantee the safety and security for children. Compliance with ECCE service provision standards is not well monitored. Despite clear standards for service Basic accreditation procedures exist for all ECCE provision outlined in the Operations Guide and new MEN service providers, but accreditation is not carefully framework for CDIs and Family Environment Programs, monitored by the MEN. All providers of public ECCE the level of compliance with these standards is mostly services must meet quality standards to be able to unknown. For example, the GoC does not collect data on operate. The MEN contracts a private auditing firm to the number of caregivers and educators with training. The evaluate whether service providers meet basic standards. MEN does contract an auditing firm to evaluate basic However, the MEN does not manage all of the information service provision. However, these evaluations do not collected by this auditing firm, nor does it verify whether comprehensively monitor all quality standards, such as all ECCE centers meet all quality service delivery standards teacher education level. Thus, while the MEN have are met. established a minimum level of education and experience for ECCE providers, it does not have mechanisms in place A portion of municipalities and departments that meet to evaluate whether providers meet standards. stricter accreditation criteria receive special ECCE funding. In addition to the basic standards (verified by While data are available for some ICBF and MEN the auditing firm), municipalities and departments can opt modalities, information does not exist for all ECCE to be evaluated for compliance with stricter criteria. Under service providers, nor does it necessarily reflect the a special fund to promote ECCE (Fondo de Fomento a la up-to-date situation at the point of service delivery. Atención Integral de la Primera Infancia), the MEN and a Compliance with standards for child-to-teacher ratios government institute that promotes education through and operating hours is unknown. Compliance is only education credits, ICETEX, provide an opportunity for partially monitored for infrastructure standards. municipalities and departments interested in being Before transition to new strategy, in 2011, when the rewarded for meeting high quality standards. If MEN was responsible for monitoring only the existing municipalities or departments choose to be considered for PAIPIs, it reported that all 927 of the centers met the special funding, the MEN and ICETEX monitor their infrastructure standards. ICBF, which manages 73,404 respective ECCE centers and award extra funding to local centers, has had a greater challenge in monitoring governments who meet certain requirements. ECCE SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 27 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 compliance. It reports that all of the 1,111 ICBF connect this information are crucial. Ensuring coordination centers meet infrastructure standards; but this does and consistency of data from all sectors is crucial if the convey whether other ICBF modalities meet these GoC is to measure the impact of its investments and standards. Once many of these modalities are guarantee that at the local level all children are provided transferred under MEN supervision, ICBF and MEN will the services outlined in Ruta Integral. Box 8 provides an need to coordinate to not only monitor compliance example from Chile, where a comprehensive information with standards in more detail, but also at a system has already proven effective. dramatically larger scale.  Collect and maintain data on child development Policy Options to Monitor and Assure ECD outcomes. In addition to tracking access to services, an Quality in Colombia expanded tracking system could monitor child development outcomes. SIPI already collects basic data Data Availability: on anthropometric outcomes, and whether a child is handicapped or gifted. It would be beneficial to track  In order to measure impact and guarantee all other domains of child development. Measuring children are provided services outlined in Ruta cognitive, linguistic, physical, and socio-emotional Integral, an online tracking system should be created development can help policymakers evaluate the to monitor and track service provision. Perhaps one of impact of existing interventions and decide which the greatest challenges to the integration of MEN and interventions are most effective. ICBF under the new strategy is effective incorporation of the monitoring and data collection system. The SIPI, Quality Standards & Compliance with RUB and Metrix are not robust enough to support the Standards: FZTS strategy. The SIPI system of the MEN is more advanced, but also has been functioning at a Adapt Operations Guide and service provider training significantly lower scale than that of ICBF. Additionally, to reflect new FZTF strategy. The newly developed it only collects information in the education sector. RUB guidelines for CDIs and Family Environment Programs monitors a larger number of beneficiaries, but only are detailed and encompass many components of collects basic Information. If the MEN is to monitor the service delivery. The challenge that ICBF and the MEN entire ECCE service delivery system, as intended in the will now face is in finding mechanisms to make sure FZTF Strategy, it will need to strengthen its current M&E these standards are met. Specific strategies are needed system. to ensure that local entities effectively and efficiently deliver ECCE services. The MEN developed the The GoC has recognized the need to establish an improved Operations Guide before the GoC’s introduction of FZTF Monitoring and Evaluation system that would help and the restructuring of the modalities. The guide guarantee that eligible beneficiaries receive the provides excellent details on service delivery standards, appropriate services. In the National Development Plan but it does not completely align to the new structures of (2010-2014), the GoC outlines the need to devise a service provision. Adapting this guide as well as strategy that links local and national level management complementary training workshops for all ECCE service across sectors of the new policy. It highlights the need to providers is necessary to better reflect the goals of the create diagnostic components and measuring instruments new strategy. An updated operations manual is in the to monitor social spending in childhood. Given that there process of being designed. The GoT is encouraged to appears to already be political will and an existing web- finalize this manual as soon as possible, as it can serve based system operating at a smaller scale, an expanded as a valuable tool for local implementation of the new internet tracking system could be feasible. strategy. Additionally, a finalized document with pedagogical guidelines will support departments and  Improve coordination of sectors involved in data municipalities in regulating learning standards. collection for ECD services. Given that essential data inputs for comprehensive information on how the ECD system come from a variety of sources, mechanisms to SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 28 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 Box 10: Relevant lessons from international experience in ECD tracking system Example from Chile: Online Registration, Monitoring, and Referral System The “Chile Grows with You� initiative-CCC-(Chile Crece Contigo) is a comprehensive child protection system to prove intersectoral support to children from 0 to 4 years. One innovative component of CCC is an online monitoring system that follows each child through the CCC system. The system tracks child’s eligibility for and receipt of services, as well as his or her developmental outcomes. It allows service providers and policymakers to monitor the delivery of benefits as well as evaluate program impact. Key Lessons for Colombia:  Given the SIPI system is already web-based, expansion to a more comprehensive tracking system should be feasible.  If created in Colombia, a comprehensive online system could reduce bureaucratic complications, which would be valuable under the FZTF strategy, where a variety of governmental institutions are involved.  This system could also support better monitoring of compliance with standards, as it tracks which children receive specific benefits and services.  This tracking system is particularly beneficial for improved intersectoral coordination at the point of delivery, as it provides an accessible platform for health, education, and child protection service providers to be on the same page about child’s needs and receipt of services.  An improved online system could improve targeting and triggers for at-risk children. guidelines already exist in the Operations Guide, it should  Consolidate system to monitor compliance with be to monitor this list of standards to track whether standards. A consolidated system to monitor centers meet specific requirements. The Operations Guide compliance with standards is needed. Previously, the is already useful in communicating national quality MEN was responsible for monitoring compliance of standards. The GoC should consider using the Operations standards for less than 1,000 ECCE centers. ICBF Guide as a tool for a more formalized accreditation operates an additional 73,400 ECCE centers that will be process. In addition to identifying a monitoring agency, transitioned under MEN regulations. The MEN will need formalizing the accreditation process will require MEN to to coordinate with ICBF to ascertain the reality at the establish a process for granting certificates/licenses of point of service delivery. In addition to improving data accreditation, decide the length of time for which the availability, an expanded online tracking system could license is valid, and ensure efficient and valid record potentially support the MEN and ICBF in tracking keeping24. compliance with standards (see Box 10).  Incentivize high quality standards in an increased  Formalize the accreditation process by monitoring number of ECCE centers. Previously, the Fund to specific information to evaluate whether ECCE centers Promote ECCE of the MEN and ICETEX rewarded meet standards. While accreditation procedures are in municipal compliance with high quality standards. place for all service providers, ministries do not directly While this process will no longer continue, it would be verify if centers are meeting standards. Previously, an beneficial for ICBF and MEN to develop a system for external auditing firm monitored compliance with rewarding municipalities that have ECCE service standards, but the fact that all centers currently meet providers which exceed minimum quality standards. standards might suggest that the auditing process is not as Given that ICBF will be responsible for allocating tight as it should be. The MEN and ICBF must identify an resources to municipalities, a new system will need to agency that will be responsible for monitoring and the be created to promote local government accreditation process. Ideally, this agency will track strengthening and coordination with ICBF. It is whether each service provider meets the criteria on official requirements for infrastructure, teaching and 24 For more information on effective accreditation learning materials, and general operations for service processes, please see CARICOM Regional Guidelines: delivery (such as class size). It is recommended to establish For Developing Policy, Regulation, and Standards in a more formal licensing process in which service providers Early Childhood Development Services (2008). are officially approved by MEN to operate. Given that SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 29 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 suggested to develop a new model to incentivize local above, the GoC has developed policies that specifically governments to take responsibility for quality target vulnerable children. As such, it is noteworthy to assurance measures. compare outcomes in initial education enrollment for the overall population versus the population in SISBEN Comparing Official Policies with Outcomes 1, 2, and 3. As displayed in Table 10, Article 67 of the Constitution mandates one year of compulsory initial The existence of laws and policies alone do not always education, and the overall initial education enrollment guarantee a correlation with desired ECD outcomes. In rate is 48 percent. On the other hand, the Decree for many countries, policies on paper and the reality of Comprehensive ECCE for SISBEN 1, 2, and 3 mandates access and service delivery on the ground are not initial education for low-income children, and the initial aligned. Above, Table 10 compares ECD policies in education enrollment rate for this eligible population is Colombia with ECD outcomes. Some policies result in 64 percent. desired outcomes better than others. As discussed Table 10: Comparing ECD policies with outcomes in Colombia Policy Outcomes Ten-year Plan for Breastfeeding promotes breastfeeding for children Rate of exclusive breastfeeding until 6 months: below 2 years old 43% Scheme for Expanded Program on Immunization requires vaccines Children with DPT (12-23 months): for children 88% Statute of the Civil Registry mandates birth registration of all Birth registration rate: children 97% Colombian constitution states one year of initial education is Gross initial education enrollment (4-5 years): mandatory for all children 48% Decree on Comprehensive ECCE guarantees initial education for Eligible vulnerable population receiving ECCE 21 children in SISBEN 1-3 services (0-6 years): 64% Preliminary Benchmarking and International Comparison of ECD in Colombia Table 12 presents the status of ECD policy development On the following page, Table 11 presents the in Colombia alongside a selection of OECD countries. classification of ECD policy in Colombia within each of Sweden is home to one of the world’s most the nine policy levers and three policy goals. The SABER- comprehensive and developed ECD policies and ECD classification system does not rank countries achieves a benchmarking of “Advanced� in all nine according to any overall scoring; rather, it is intended to policy levers. share information on how different ECD systems address the same policy challenges. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 30 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 Table 11: Benchmarking Early Childhood Development Policy in Colombia Level of Level of ECD Policy Goal Policy Lever Development Development Legal Framework Establishing an Enabling Inter-sectoral Coordination Environment Finance Scope of Programs Implementing Widely Coverage Equity Data Availability Monitoring and Assuring Quality Standards Quality Compliance with Standards Latent Emerging Established Advanced Legend: . Table 12: International Classification and Comparison of ECD Systems Level of Development ECD Policy Goal Policy Lever Colombia Australia Chile Sweden Turkey Legal Framework Establishing an Enabling Coordination Environment Finance Scope of Programs Implementing Coverage Widely Equity Data Availability Monitoring and Quality Standards Assuring Quality Compliance with Standards Latent Emerging Established Advanced Legend: Conclusion The SABER-ECD initiative is designed to enable ECD the region and internationally. Each of the nine policy policy makers and development partners to identify levers are examined in detail and some policy options opportunities for further development of effective ECD are identified to strengthen ECD are offered. systems. This Country Report presents a framework to Table 13 summarizes the key policy options identified to compare Colombia’s ECD system with other countries in inform policy dialogue and improve the provision of SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 31 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 essential ECD services in Colombia. If the FZTF strategy ensure that all young children have a strong start in life is effectively implemented and outcomes are regularly and are afforded the opportunity to reach their full monitored and tracked, the GoC has the opportunity to potential. Table 13: Summary of policy options to improve ECD in Colombia Policy Policy Options and Recommendations Dimension • Create mechanisms to promote the provision of free healthcare to young children, such as establishing requirements for regular well-child visits • At department and municipal levels, expand child protection interventions, such as specialized training in domestic abuse and exploitation for judges, lawyers, and law enforcement officers Establishing an • Develop an inclusive education policy to guarantee equitable access to ECCE for children Enabling with special needs Environment • Finalize a costed implementation plan for From Zero to Forever strategy • Develop strategies to deliver all services outlined in Ruta Integral, including capacity building of Municipal Technical ECD Committees • Strengthen coordination mechanisms between ICBF and MEN on funding for ECCE • Ensure coordinated, sustainable, and adequate commitment to ECCE spending • Ensure all essential interventions are available throughout the country through improved coordination at the point of service delivery • Facilitate enhanced capacity of local authorities in order to identify and address gaps in coverage • For children already attending traditional HCB modalities, expand the scope of service Implementing (outlined in the Ruta Integral) by providing quality training to Community Mothers Widely • Improve access to nutrition interventions, such as breastfeeding promotion and parental education on healthy eating, by leveraging existing resources and networks in the health sector • Support community-based nutrition/health education through training, materials, and compensation for community promoters • Create online tracking system to monitor and track service provision • Improve coordination of sectors involved in data collection for ECD services • Collect and maintain data on child development outcomes • Adapt Operations Guide and service provider training to reflect new From Zero to Forever Monitoring and strategy Assuring Quality • Finalize a document with pedagogical guidelines to promote and regulate learning standards • Consolidate system to monitor compliance with standards • Formalize the accreditation process by monitoring specific information to evaluate whether ECCE centers meet standards • Incentivize high quality standards in an increased number of ECCE centers SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 32 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 Acknowledgements Abbreviations and Acronyms This Country Report was prepared by the SABER-ECD team CDI Child Development Centers (Centros de at World Bank headquarters in Washington, DC. The Desarrollo Infantil) report presents country data collected using the SABER- ECD policy and program data collection instruments and CIPI Intersectoral Commission on Comprehensive data from external sources. The report was prepared in Early Childhood (Comisión Intersectorial de consultation with the World Bank Human Development Atención Integral en Primera Infancia) LAC team and the Government of Colombia. For technical CONPES National Social and Public Policy Council questions or comments about this report, please contact (Consejo Nacional de Política Económica Social) the SABER-ECD team (helpdeskecd@worldbank.org). DANE National Administrative Department of References Statistics (Departamento Administrativo Nacional de Estadística) Britto, P., Yoshikawa, H., Boller, K. 2011. “Quality of Early Childhood Development Programs: Rationale for Investment, Conceptual DNP National Planning Department (Departamento Framework and Implications for Equity.� Social Policy Report, Nacional de Planeación) 25 (2): 1-31. DPS Social Prosperity Department (Departamento de Engle, P. L., L. C. H. Fernald, H. Alderman, J. Behrman, C. O’Gara, A. Prosperidad Social) Yousafzai, M. Cabral de Mello, M. Hidrobo, N. Ulkuer, and the Global Child Development Steer Group. “Strategies for ECCE Early Childhood Care and Education reducing inequalities and improving developmental outcomes for young children in low-income andmiddle-income countries.� ECD Early Childhood Development The Lancet, Early Online Publication, 23 September 2011. Doi:10.1016/S0140-6736(11) 60889-1. EPI Expanded Program on Immunizations Hanushek, E. (2003). "The Failure of Input-Based Schooling Policies." GoC Government of Colombia The Economic Journal 113; 64-98. HCB Community Welfare Homes (Hogares Hanushek, E. A. and D. D. Kimko. (2000). “Schooling, Labor-Force Comunitarios de Bienestar) Quality, and the Growth of Nations." The American Economic Review, Vol. 90, No. 5, 1184-1208. ICBF Colombian Family Welfare Institute (Instituto Colombiano de Bienestar Familiar) Naudeau, S, N. Kataoka, A. Valerio, M. J. Neuman, L. K. Elder. 2011. Investing in Young Children: An Early Childhood Development ILO International Labor Organization Guide for Policy Dialogue and Project Preparation. World Bank, Washington, DC. MEN National Ministry of Education (Ministerio Nacional de Educación) Neuman, M. J. 2007. “Good Governance of Early Childhood Care and Education: Lessons from the 2007 Education for All Global MoC Ministry of Culture (Ministerio de Cultura) Monitoring Report.� UNESCO Policy Briefs on Early Childhood. United Nations Educational, Scientific and Cultural MoSP Ministry of Health and Social Protection Organization, New York. (Ministerio de Salud y Protección Social) UNESCO-OREALC. 2004. “Intersectoral Co-ordination in Early PAIPI Comprehensive ECCE Program (Programa Childhood Policies and Programmes: A Synthesis of Experiences Atención Integral a la Primera Infancia) in Latin America.� Regional Bureau of Education for Latin America and the Caribbean, United National Educational, RUB Registry of Beneficiaries (Registro Único de Scientific and Cultural Organization, Santiago, Chile. Beneficiarios) Vargas-Barón, E. 2005. “Planning Policies for Early Childhood SIPI Information System for Early Childhood Development: Guidelines for Action.� Paris: UNESCO/ADEA/UNICEF (United Nations Educational, Scientific (Sistema de Información Primera Infancia) and Cultural Organization/Association for the Development of SISBEN System for Selection of Beneficiaries of Social Education in Africa/United Nations Children’s Fund). Programs (Sistema de Selección de Beneficiarios Victoria, B. H., L. Adair, C. Fall, P. C. Hallal, R. Martorell, L. Richter, para Programas Sociales) and H. S. Sachdev 2008. “Maternal and Child Undernutrition: Consequences for Adult Health and Human Capital. “ The UNRC United Nations Convention on the Rights of the Lancet 371 (9609): 340-57. Child SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 33 COLOMBIA │ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT │ 2013 www.worldbank.org/education/saber The Systems Approach for Better Education Results (SABER) initiative produces comparative data and knowledge on education policies and institutions, with the aim of helping countries systematically strengthen their education systems. SABER evaluates the quality of education policies against evidence-based global standards, using new diagnostic tools and detailed policy data. The SABER country reports give all parties with a stake in educational results—from administrators, teachers, and parents to policymakers and business people—an accessible, objective snapshot showing how well the policies of their country's education system are oriented toward ensuring that all children and youth learn. This report focuses specifically on policies in the area of Early Childhood Development. This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. THE WORLD BANK SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 34