1. ECE Study in Cambodia: evidence based advocacy for policy formulation and development of innovations with the focus on equity Natalia Mufel with Arianna Zanolini

2. 2 ECD Situation Cambodia Cambodia has experienced improvements in some indicators of infant and under-5 health, nutrition, and education in recent years. Despite these improvements, young children still face many risks. The under-5 mortality rate per 1,000 live births fell from 117 to 90 between 1990 and 2008. 30% of population below poverty line 5

3. Concerns: Child Under nutrition Sub-nationally 40% of children are stunted, and improvement appears to have stopped With the exception of Phnom Penh, little variation by province shows malnutrition is a national issue

4. 4 ECE Enrolment From 15 % of 3-5 years old in 2008 to 29 % in 2011 From 32 in 2008 till 52.6 % of 5 y.o. in 2011 Lack of inclusive preschools till 2011 Lack of Bilingual Preschools till 2011 10

5. 5 ECE Enrolment (5 y.o.) 11

6. ECE Programs –ECE programs in Cambodia are of three types 1. State Preschool (SPS): considered the “gold standard”, but expensive. Limited coverage 2. Community Preschools (CPS): organized at the commune level, community and volunteers based with technical support from the MOE 3. Home Based Programs (HBP): groups of mothers in the community gathering to discuss child development and health practices, led by a trained core mother.

7. ECE Study: Goals 1. Evaluate the impact of CPS and HBP on enrollment rates and learning achievements of children once they transition into primary school. 2. Compare the outcomes from the different types of ECE (and from being in no program at all). No real data available before this longitudinal study. 3. Inform development of the new initiatives; 4. Inform development of the ECCD Policy/National Action Plan. 7

8. ECE Study Sample 1. Total of 1312 children from 6 provinces. First interviewed at 5 years old in 2006 (Rao N., Pearson E. 2007 report), then followed yearly until 2010 2. In 2006, most of the children attended CPS: 45% of the total sample. 19% attended HBP, 10% SPS and 27% attended no preschool UNICEF

9. Results—year 06/07 and 07/08 Despite controlling for differences in parental education, provinces, and initial CDAT score, the results persist: 1. The improvement in CDAT scores after one year is not significantly different between SPS, HBP and CPS children. It is instead significantly lower for No Preschool children. 2. The probability of dropping out or repeating after first grade are significantly lower for SPS children compared to CPS, and significantly higher for No preschool children compared to CPS. No difference between HBP and CPS.

10. Coefficients of regressions06/07: Post Test:07/08: after first grade: Difference in CDAT score after one year controlling for parental education and for province fixed effects Probability of dropping out of school or repeating controlling for parental education, for province fixed effects AND for initial CDAT scores SPS0.3-11%** s.e.(1.99)(6%) HBP0.112-3% s.e.(1.54)(5%) No Program-3.26**+12*** s.e.(1.39)(4%) Baseline: CPS children The only children who improved significantly less than the CPS children were the children in No Program. No children improved significantly more. These children are also 12% more likely to drop out or repeat than CPS children Results—year 06/07 and 07/08

11. UNICEF Results– year 08/09 Children should be in the second grade (blue color) but –Kampong Speu and Svay Rieng provinces have almost 80% of the children in second grade, while Stung Treng has just over 40%. –Stung Treng also has the highest percentage of drop-out children (due to high percentage of ethnic minorities).

12. UNICEF Results 08/09, continued Children should be in second grade (green color) but –In “No Preschool”, 50% are either drop out or in first grade –In SPS, 13% are either drop out or in first grade –In CPS, 39% are either drop out or in first grade –In HBP, 31% are either drop out or in first grade

13. UNICEF Results—year 09/10 By the year 09/10 the children should be in Grade 3. Next table shows: Children who attended either SPS or HBP are significantly more likely to be in the expected grade than kids who attended CPS: respectively 17% and 20% more likely. Conversely, children who attended No Program are 9% less likely than children in CPS to be in the expected grade

14. 16 Coefficients of regressions 09/10 Probability of attending school compared to CPS children, controlling for parental education and for province fixed effects and for initial CDAT scores Probability of attending the expected grade, controlling for parental education and for province fixed effects and for initial CDAT scores SPS-6%17%*** s.e.(5%)(6%) HBP+3%20%*** s.e.(2%)(5%) No Program-7%**10%* s.e.(3%)(5%) Baseline: CPS children

15. UNICEF Summary of results Even after controlling for parental characteristics, children who did not attend any preschool program are lacking behind children who attended either CPS, HBP or SPS. Children in No Program are 10% more likely to be drop- outs than children in CPS

16. UNICEF Summary of Results, continued One interesting and surprising finding, which confirms the results found in the baseline (Nirmala Rao’s report), is the performance of the HBP program. The program does not seem to be doing any worst than CPS, and in some occasions seems even to perform slightly better. Significance of parenting involvement.

17. GPE/MoEYS ECE Impact Evaluation (cognitive development) The survey was conducted in some of the most disadvantaged areas in the country. The sample contains 4,072 children aged 36 to 59 months in 141 communities across seven provinces.

18. The TVIP (Test de Vocabulario en Imagenes Peabody) The TVIP was used as an indicator of cognitive development Involves presenting each child with four pictures and asks them to correctly identify the picture corresponding to the vocabulary word presented. For example, the child could be presented with pictures of a dog, a glass, a piece of cake, and a fork and be asked to point to the “glass”. The test continues until the child makes six mistakes in eight consecutive responses and is scored according to the number of vocabulary words the child correctly identified. It was translated into Khmer and extensively piloted before it was used in Cambodia.

19. The Results: Raw TVIP scores by age

20. 16 Results Young children in Cambodia are exposed to large cognitive delays that increase with age. Signs of delays are already apparent at age 36 months, when TVIP scores from the Khmer tests appear significantly below the mean score in the reference sample. In other words, five-year-old children in Cambodian sample show only limited increased language understanding compared with their three-year-old peers. In the absence of ECD interventions, poor children are likely to show serious signs of developmental delays by the time they enter primary school and to “play catch-up” for the rest of their lives

21. Implications for ECD programs The earlier the intervention the better. Socioeconomic status matters –Strategies on how to prioritize children from very low income households in ECED programs should considered

22. ECD is a priority for the Government of Cambodia. The National Development Plan target is expanding pre-school education and raising the level of general public awareness on the importance of ECD, including health and social protection services Target: widespread expansion of pre-primary school education; initially for the 60-72-month age group, with the goal of 75% coverage by 2015 ECCD Policy was approved by the Council of Ministers in February 2010. The policy called for cross-sector and multi-level government collaboration, aimed to build upon previous plans and strategies to improve educational development for children. ECD Pre-school – A PRIORITY

23. 25 Participation is key Essential to the success of developing and implementing a well-integrated ECCD policy, was the widespread and committed participation of key stakeholders. The new ECCD policy promotes a holistic approach to children that supports their survival, growth, development and learning, which includes interventions in health, nutrition and hygiene as well as cognitive, social, physical and emotional development. ECCD NAP was developed through the national consultation process, including nation-wide workshops. The draft was finalised, but was not approved as the establishment of ECCD National Committee is pending.

24. UNICEF ECD initiatives in Cambodia ECCD Contracted Worker - Holistic services at community level Inclusive preschool education for children with disabilities Bilingual Preschool education Targeted Parenting Programmes for ethnic minorities.

25. UNICEFEducation for Ethnic Minority Areas Parenting - Phnong

26. THANK YOU!