1. Multiple Indicator Cluster Surveys Survey Design Workshop
Questionnaire for Children Under Five:
Early Childhood Development
MICS4 Survey Design Workshop

2. Measuring Early Childhood Development: The Global Challenge
Nearly 9 million under-five children died in the past year
Over 220 million under-five children are not developing to their full potential
An estimated 20% loss in adult productivity
The issue of poor child development will remain as challenge unless substantial efforts are made to put the child development high on agenda
According to the latest estimates 8,8 million children died before reaching their fifth birthday in 2008.
Unfortunately, those deaths are the tip of iceberg.
According to the conservative estimates made by the Lancet, at least 220 million children under the age of 5 years are not developing their full potential. As a result, their countries suffer an estimated 20% loss in adult productivity.
The issue of poor child development, brought to the public attention again by the serial of Lancet papers, will remain a global challenge unless substantial efforts are made to put the child development high on agenda.
MICS4 Survey Design Workshop

3. I have the rights! To be vaccinated
The right to a name and nationality
To be vaccinated
To be properly fed
To play
To drink safe water
To be protected
from illnesses
To learn
There are many definition of early childhood development.
The one I like the most is based on the rights of the young children to a name and nationality, the right to play, to learn, the right to be protected against major and preventable diseases, to be well fed, etc.
Thank you for giving me a good start in life!
Cameroun

4. MICS4 Survey Design Workshop
STRATEGIC FRAMEWORK
CRC: Right to survival and development
WFFC Declaration: Children protection, growth and development, good health and proper nutrition essential foundation for human development
MTSP: Young child survival and development
Poverty alleviation & reduction of disparities
How does this module fit into the global agenda?
It is based on the right of each child, beginning with those most likely to falter, to be healthy, to be nourished, to play to live in a clean and safe environment, and to be able to thrive.
The module is directly linked with the goals and principles established at the World fit for Children and UNICEF Medium Term Strategic Plan.
In the WFFC Declaration (4): “Care for every child” – it is stated that child survival, protection, growth and development in good health and with proper nutrition is the essential foundation of human development. We will make concerted efforts to nurture children in a safe environment that enables them to be physically healthy, mentally alert, emotionally secure, socially competent and able to learn.
Medium Term Strategic Plan, the UNICEF strategic framework for action, under the Focus area 1 (Young Child Survival and development) key result area 2 is to improve family and community care practices, which have impacts on young child survival, growth and development.
Finally, the most effective interventions to improve human development and break the cycle of poverty occur in children’s earliest years.
MICS4 Survey Design Workshop 4

5. Why Measure Early Childhood Development?
Indicators
Birth
Schooling
Death -– to late?
We have:
Reliable info on child health/nutrition/mortality
A lot of data related to education
and…
Huge data gap on ECD
Why do we need to measure early childhood development?
When you look throughout the life cycle, we have a number of internationally accepted indicators related to birth, health and nutrition of children, and we would agree that accurate data in this area are extremely important. Inmost of the countries we have relatively good set of data related to mortality, which is also good, but at least for those who died it will be too late to plan the intervention based on this data.
We have data on schooling, informing us on the enrolment rate, completion of school, sometimes on school achievements – important indicators, but in terms of interventions those data will help us to address the issues identified (i.e. low enrolment rate, high drop out rates), but will not prevent those issues to arise.
According to all the evidence we have, the best time to intervene, and prevent many issues to arise (like malnutrition, drop-out rate, etc) is in the early years of life, sooner the better.
Yet, until now, we have huge knowledge gap when it comes to population level data on early childhood, and there was no single globally agreed methodology or indicators to measure what is happening in this sensitive part of life.

6. Improved Early Childhood Development Module
Children 0-4 years old
Additional focus on 3 and 4 year-olds
Questions to assess:
Supportive learning environment
(Inadequate) Care
Caregiver’s support for early learning
Access to early education
Early childhood development
For the purpose of this survey, early childhood is limited to under five children, with the additional emphasis on three and four years old children.
The parents/caregivers are primary duty bearers, accountable for educating and socializing children and to prepare them for life. Care giving has both, benefits and drawbacks. Positive care giving influence child’s ability to acquire cognitive, physical, emotional and social competencies. Poor or compromised care giving practices places optimal child development at risk. Care giving is multidimensional, supporting focus on specific cognition and practices. In MICS we focus on the domains which are developmentally significant and culturally universal. MICS questions specifically assess:
Supportive learning environment in the households
Amount of developmentally stimulating activities that the child is engaged in
Access to organized form of early childhood education
Early childhood development.

7. Supportive Learning Environment: Questions
EC1.
EC2.
Questions EC1 and EC 2 should be administered to all under five children in the household. We are using the same questions as in MICS3.
The first question: “How many children’s books or picture books do you have for (name)?” asks specifically about children’s books or picture books for the child. This excludes schoolbooks (appropriate for or belonging to older children), as well as other books for adults that are present in the household. Record the number of books in the space provided. There is no need to make an actual count of books yourself. Rely on the respondent’s answer, and avoid asking to see and count the books yourself, since this is likely to require extra time. If the respondent is unsure about the number of children’s books or picture books and is not able to provide an answer the first time you ask the question, ask her/him if there are more than 10 such books. If yes, circle ‘10’. If she/he says that there are less than 10 such books, probe further to get an exact number. If there are no such books in the household, record ‘00’.
The second question is used to learn about different types of playthings used by the child. We want to know if the child has objects to play with, and what these are, even if they do not include store-bought toys. We are interested in learning about other objects that are used as playthings, such as ordinary household objects and natural materials. Extra care should be taken to ask this question and record the responses. Experience has shown that respondents find it very easy to give the same answer (“Yes”) to a list of different playthings. Do not pause after reading the first sentence and continue by saying “Does (name) PLAY with” and start asking whether the child plays with playthings from each of the categories listed. For example, ask: “Does (name) PLAY with homemade toys (such as dolls, cars, or other toys made at home)?” and so on. If the respondent answers ‘Yes’ to any of these prompted categories, then probe to learn specifically what the child plays with to ascertain the response (for example, “What does he/she specifically play with?” or “Can you please give an example?” If you ascertain that the child uses playthings that would fall into each of the prompted categories, circle ‘1’ . If the child doesn’t play with items mentioned in a specific category, or the respondent doesn’t know circle ‘2’ or ‘8’, for that specific category. Read each category aloud and circle the code corresponding to the response before proceeding to the next category.
MICS4 Survey Design Workshop

8. Supportive Learning Environment: Indicators
# 6.3 Learning materials: children’s books
Numerator: Number of children under age 5 who have three or more children’s books
Denominator: Total number of children under age 5
# 6.4 Learning materials: playthings
Numerator: Number of children under age 5 with two or more playthings
We use this question to calculate the following indicators: availability of children’s books and playthings, as part of supportive children’s environment.
Having access to a variety of formal (books, toys from a shop or manufactures toys) and informal materials (homemade toys and household objects) for learning at home is important. They could all be used to learn about letters, words, shapes, colours and so on. Availability of those items shows a consistent relation to children’s competence and achievement.
MICS4 Survey Design Workshop

9. (Inadequate) care: questions
The question EC 3 is for all under five children in the household.
The question sets up a hypothetical situation, one in which the mother/primary caretaker would be gone for more than just a moment – situations in which the child could be left alone for an hour or more. The question specifies that we want to know about situations in which the respondent actually leaves the premises, not simply going out of sight of the child, such as to another part or another room of the house.
Enter the response in the spaces provided. If the child was not left in the care of another child during this period, enter ‘00’ for ‘None’. Note that ‘another child’ is defined as a child less than 10 years old.
MICS4 Survey Design Workshop

10. (Inadequate) care: Indicator
Numerator: Number of children under age 5 left alone or in the care of another child younger than 10 years of age for more than one hour at least once in the past week
Denominator: Total number of children under age 5
Based on the question we are calculating the percentage of Under Five children left alone or in the care of another child younger than 10 years of age for more than an hour, at least once in the past week.
Rationale: Caregivers’ care and support includes making sure that child is protected from physical danger. Leaving child alone or in the care of another child would expose the child to an increased risk of injury, abuse and neglect.
MICS4 Survey Design Workshop

11. Attendance to early childhood education: questions
EC5.
EC6.
If the child is 3 or 4 years old, check the appropriate box and continue with EC5. If not (if the child is 0, 1 or 2 years old), check the appropriate box and go to next module.
The question asked is: “ Does the child attend any organized learning or early childhood education programme, such as a private or government facility, including kindergarten or community child care?
You are asking this question for all children in the household who are months old.
In the preparatory part of the survey you need to ensure that local terms for these types of education programmes are included in the questionnaire. If you are unsure of whether a programme qualifies as an ‘early childhood education programme’, contact the MICS4 regional coordinator.
Circle the appropriate code. Skip to EC7 if the answer to this question is ‘No’ or ‘DK’.
You are also asking “Within the last seven days, about how many hours did the child attend”? This question is asked if the child is attending an organized learning or early childhood education programme. Record the estimated number of hours the child attended any organized learning or early childhood education programme in the last 7 days (excluding the day of interview). Use a leading zero if necessary.
MICS4 Survey Design Workshop

12. Attendance to early childhood education: Indicators
Numerator: Number of children age months who are attending an early childhood education programme
Denominator: Total number of children age months
Based on the EC 5 question, you are calculating percentage of children aged months who are attending any form of organized preschool activity.
Early childhood care and learning is the foundation of quality basic education. Expanding and improving comprehensive early childhood education, especially for the most disadvantaged children, is one of the major strategies to enable all children to realize their right to learn. A variety of early learning programmes exist worldwide: community based centres, day care centres, kindergarten, pre-schools, which can be organized by the state, private, or by different community based organizations (including religious groups). The bottom line is that the child is participating in organized early learning programme. Baby-sitting or child-minding, even if done in a special place such as a day-care centre, does not qualify as such a programme unless it includes organized learning activities. You must ensure that the mother or primary caretaker understands the meaning of “Organized learning or Early Childhood Education Programme”.
MICS4 Survey Design Workshop

13. Support for early learning: questions
With EC7 question we are asking mother was she or any household member over 15 years of age engaged in any of the following activities in the past three days, with the child:
[A] Read books or looked at picture books ?
[B] Told stories?
[C] Sang songs?
[D] Took the child outside the home, compound, yard or enclosure?
[E] Played with the child?
[F] Named, counted, or drew things to or with the child?
Read each items shown below. If ‘No’, circle ‘Y’ and move to the next item on the list. If ‘Yes’, ask: “Who engaged in this activity with (name)”
For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle ‘X’. If the respondent is the primary caretaker of the child and has engaged in any of these activities, code ‘X’ should be circled.
Note that in a household where there are no adults other than the child’s mother and father, ‘X’ should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
MICS4 Survey Design Workshop

14. Support for early learning: Indicators
# 6.1 Support for learning
Numerator: Number of children age months with whom an adult has engaged in four or more activities to promote learning and school readiness in the past 3 days
Denominator: Total number of children under age months
# 6.2 Father’s support for learning
Numerator: Number of children age months whose father has engaged in one or more activities to promote learning and school readiness in the past 3 days
Denominator: Total number of children age months
Based on the questions provided, we are calculating two indicators:
Percentage of under five children with whom an adult was engaged in four or more activities, as well as percentage of under five children whose father has been engaged in one or more activities to promote early learning.
The difference between children who survive and thrive, and those who don’t can be attributed largely on the quality of care provided at home. The purpose is to measure caregivers’ activities that have educational value for the child. By reading to their children, by telling stories, singing songs and by engaging in naming, counting, drawing and playing with them, caregivers equip their children with basic cognitive skills and set the stage for their child’s entry into the worlds of literature, school, and the wider culture. Such interaction is also important for child’s social and emotional development.
MICS4 Survey Design Workshop

15. The Early Child Development Index
Preparatory work – compilation of relevant items
Validity testing in Philippines and Jordan
Part of MICS4 Pilot in Mombasa, Kenya
Finally, a new and exciting news - we have the set of last ten questions which we use to calculate the Early Childhood development Index.
Here is the summary how it has been developed.
Firstly, the list of relevant questions was compiled, largely based on the number of international instruments used. Rigorous testing of those instruments was undertaken in the Philippines and Jordan among 3,4 and 5 years old children, for a total of almost 2000 children. Using statistical methodology, association with direct measures and trying to ensure the broadest possible relevance of items, we arrived at a 48-item index, which has been then reduced to 18. After successful piloting in Mombasa, the questionnaire was further reduced to 10.
Finally we have a tool which we needed in order to establish adequate and reliable knowledge of early childhood development.
MICS4 Survey Design Workshop 15

16. A tool to assess: Literacy/numeracy Social/emotional Learning
A new tool is developed in order to assess the child development domains: language/cognitive, social/emotional, physical and approaches to learning.
Development is a process of change where child master more and more levels of moving, thinking, feeling, and interacting with people and objects in their environment. The following questions will be used to calculate the Child Development Index (CDI). The primary purpose of the CDI is to inform public policy regarding the collective wellbeing of children within a given nation, population subgroups, gender, and economic class. It is based on the caregivers report on five developmental domains of the child: language and emergent literacy, cognitive development, approaches to learning, social-emotional development and motor development. The question specifies some benchmarks that children would be expected to have if they are developing like majority of children in that age group.
Learning

17. Literacy & Numeracy Domain
Recognising letters
Recognising numbers from 1 to 10
Reading simple, popular words
Language/cognitive development is assessed through the set of three questions, assessing the ability of the child to recognize letters, recognize numbers from 1 to 10, and read simple words.
Before you start with the questions, explain to the mother that we are going to ask some questions related to health and development of the child. Explain that children do not all develop and learn at the same rate - for example, some walk earlier than others. Explain that these questions are related to several aspects of your child’s development.

18. MICS4 Survey Design Workshop
ECDI Questions EC8-10
Start with the question: “Can a child identify or name at least ten letters of the alphabet?” Circle the code corresponding to the response. A ‘Yes’ answer means that the child can name ten or more letters of the alphabet while a ‘No’ answer means that the child can name less than ten or none at all.
The next question is “Can a child read at least four simple, popular words?” Circle the code corresponding to the response. A ‘Yes’ response means that the child can read at least four simple, popular words while a ‘No’ response means that the child can only read one or two, or none at all. Try to create a list of locally used simple and popular words (from poems, lullabies, or songs) during the training and field work. This may help them to give examples if necessary, while asking this question.
Continue with the question: “Does (name) know the name and recognize the symbol of all numbers from 1 to 10?” Circle the code corresponding to the response. If parent seems hesitant, prompt with “does the child know ‘1’? Does the child know 2?” etc. A ‘Yes’ answer means that the child can recognize the symbol of all numbers from 1 to 10 while a ‘No’ answer means that the child can recognize less than ten or none at all.
The child is developmentally on target if at least two out of three are true:
can identify/name at least 10 letters of alphabet
Can read at least four simple popular words
knows the name and recognizes the symbol of all numbers from 1 to 10.
MICS4 Survey Design Workshop

19. Physical Domain Motor skills; being able to manipulate objects
Freedom of frequent illness
The following are the questions related to child physical health and wellbeing. What we are looking at are whether the child is pron to frequent illnesses, and child’s fine motor skills.

20. MICS4 Survey Design Workshop
ECDI Questions EC11-12
We are asking “Can your child pick up a small object with two fingers, like a stick or rock from the ground?”. You should circle the code corresponding to the response. If necessary, use the pen you are holding to demonstrate the grip. Consider the small objects mentioned before when asking about the items children play with (sticks, rocks, animal shells or leaves). A ‘Yes’ answer means that the child is able to pick up small objects without difficulty while a ‘No’ answer means that the child seems to have difficulty with small items.
Then you ask: “Is the child sometimes too sick to play? Circle the code corresponding to the response. A ‘Yes’ answer means that the child often gets sick and cannot play or do many physical activities. It also may mean that the child complains of pains or aches (tummy, head) and does not want to do physical activities, while a ‘No’ answer is in cases when the child is consistently ready to be active and play and only appears tired when it is appropriate for him/her to be so (e.g., in the evening; at the usual nap time).
The child is physically on target if one or both of the following is true: can pick up a small object with two fingers and/or is not too sick to play frequently
MICS4 Survey Design Workshop

21. Learning Domain Ability to follow simple directions
Being able to occupy himself/herself independently
The following two questions are related to child approaches to learning. We are looking at child’s ability to follow simple directions, and he/she’s ability to occupy himself/herself independently.

22. MICS4 Survey Design Workshop
ECDI Questions EC13-14
We start with the question: “Does the child follow simple directions on how to do something correctly?” Circle the code corresponding to the response. A ‘Yes’ answer means that the child can do things easily and correctly when asked to do so while a ‘No’ answer means that the child usually does not accomplish the simple tasks she/he is given successfully. Do not concern yourself with the reasons why not.
We continue with the question: “When given something to do, is (name) able to do it independently?” Circle the code corresponding to the response. A ‘Yes’ answer means that the child is able to occupy herself/himself independently for an appropriate length of time, without constant asking for assistance or giving up quickly (e.g., colouring, building structures, etc.) while a ‘No’ answer means that the child cannot occupy herself/himself independently, asks for help or assistance, or gives up the work/play easily if not provided with help.
The child is developmentally on target if one or both of the following is true: follows simple directions on how to do something correctly, and/or when given something to do, is able to do it independently.
MICS4 Survey Design Workshop

23. 2-3) Maturity Social & Emotional Domain
Ability to get along with other children
Not being physically aggressive with other children
Ability to focus and concentrate without getting easily distracted
Finally, we finish the assessment of child development with a last set of questions related to social and emotional competences domain. We are assessing child's ability to get along with other children, their ability not to be aggressive with other children, and their ability to focus and concentrate without getting easily distracted.

24. MICS4 Survey Design Workshop
ECDI Questions EC15-17
We are asking “Does (name) get along with other children?” Circle the code corresponding to the response. A ‘Yes’ answer means that the child does well playing and interacting with other children while a ‘No’ answer means that the child is uncomfortable around other children, prefers to be alone, or gets into conflicts.
Then we ask “Does (name) kick, bite, or hit other children or adults?” Circle the code corresponding to the response. A ‘Yes’ answer means that the parent has noticed that the child can physically hurt (kick, bite, hit) other children while a ‘No’ answer means that the child does not do it. Do not concern yourself with what may be the reason of such behaviour (e.g., if parent tries to explain the reasons, or excuse the child).
We are finishing with the question “Does (name) get distracted easily? “ Circle the code corresponding to the response. A ‘Yes’ answer means that the child has difficulty sticking with/continuing any activity for the necessary length of time, gets easily distracted by anything happening around her/him, or finds other activities before completing the one started while a ‘No’ answer means that the child doesn’t get easily distracted.
The child is developmentally on target if at least two of the following are true: gets along well with other children; does not kick, bite, or hit other children; does not get distracted easily.
MICS4 Survey Design Workshop

25. MICS4 Survey Design Workshop
ECDI Indicator
# 6.6 Early Childhood Development Index
Numerator: Number of children age months who are developmentally on track in literacy-numeracy, physical, socio-emotional, and learning domains
Denominator: Total number of children age months
ECDI = percentage of children who are developmentally on track in at least three of the four component domains
Responses to questions EC8-EC17 will be used to determine whether children are developmentally on target. ECDI is percentage of children who are developmentally on target in at least three of the four component domains.
The primary purpose of ECDI is to inform public policy regarding the collective wellbeing of children within a given nations, population subgroups, gender, economic class.
MICS4 Survey Design Workshop

26. Methodological issues
All questions contributing to the indicator need to stay
Careful translation needed
Details in the Manual
Technical assistance available (free of charge)
We had lot of methodological issues and theoretical discussion during the preparatory phase of ECDI. We hope that most of them are resolved in three pilot testing's.
The main message here is that all questions contributing to one indicator needs to stay – that’s way I presented the questionnaire in a form of question's set, each set contributing to one indicators.
Also, it is very important to pay attention to the translation – if necessary, please consult the technical expert.
The last part of the questionnaire is new. As with all new things in MICS 4, please pay due attention to this module during the testing phase. Pay attention to probing, explain in detail in the Manual – monitor the performance of interviewers and see whether they are administrating survey correctly.
Finally, due to the sensitivity of new module, UNICEF is willing to provide you with the technical assistance during the critical phase of the survey. Note that the assistance is free of charge.

27. Programmatic & Policy Implications
Understanding of child development
Put the child development high on political agenda
Indicators will improve countries abilities to (1) set the targets; (2) allocate resources; (3) monitor progress and ensure accountability
Investment with long lasting effects: improved family care practices, stimulating environment, improved child wellbeing
What are the policy and programmatic implications? Firstly, we will be able to understand the ECD much better. Now when we have outcome indicator, ECDI, and we have a possibility to cross analyze the child development with other info collected (i.e. child nutritional status, environment in which they live) we will have a full picture on the most important factors affecting child development. New knowledge will help us putting child development high on political agenda.
The indicator provides the basis for setting the prevention and intervention targets aiming at improving the wellbeing of young children, to allocate adequate resources, monitor progress and will ensure duty bearers accountability in achieving the stated results. Hopefully, this efforts will result in improved family care practices, increased access to quality ECD services and commodities obtained at community level stimulating environment, and finally improved child wellbeing.

28. MICS4 Survey Design Workshop
Vision of ECD
All children should be physically healthy, mentally alert, socially competent, emotionally sound and ready to learn (World Fit For Children)
Now we can measure it!
We hope that the whole exerciser, from survey to use of MICS4 findings to improve the young child development will significantly contribute to the old vision of ECD, that all children should be physically healthy, mentally alert, socially competent, emotionally sound and ready to learn. Now, for the first time in the history, we are able to measure the vision. And there is a saying, what we measure, we treasure!
Thank you very much for the attention.
Now, I am ready for questions!
MICS4 Survey Design Workshop 28

29. MICS4 Survey Design Workshop
Prepared by:
Magdalena Janus
Offord Centre for Child Studies, McMaster University, Hamilton, Canada
Oliver Petrovic
Early Childhood Development Unit, PDO
UNICEF New York
MICS4 Survey Design Workshop