ELIZABETH NINAN DULVY AND SERVAAS VAN DER BERG: SA must invest more in children — and better!

SA’s children still perform far below expectations in international tests of reading, mathematics and science. Even in the early grades many have fallen far behind. In addition, health outcomes for children are poor for an upper-middle-income country. There is an urgent need to improve health and educational outcomes for young children before they enter school, as early deficits are often compounded in schools.

The early childhood development (ECD) sector has been underfunded and neglected in SA, despite its importance in ensuring children’s future success. The recent shift of ECD functions from the department of social development to the department of basic education offers an opportunity to address these issues and improve ECD services in SA.  

It is globally recognised that good quality investments in ECD can yield high returns, higher than interventions for any other age group. Investing in children’s health and nutrition during their first 1,000 days can improve health outcomes over their lifetime. Quality ECD programmes that promote adequate stimulation better prepare children, particularly those from disadvantaged backgrounds, for entry into primary school and are linked to higher learning achievement.  

There is now almost universal access to grade R (one year of preschool before entering primary education), but enrolment in ECD programmes is far lower, particularly for poor children. Access increases with age, but only 45% of those who do attend ECD reach the desired learning standards by age five. Child malnutrition is high, with a 27% prevalence of stunting among under-fives in 2016. 

The World Bank and Stellenbosch University’s (SU’s) Resep research group, in partnership with the department of basic education, recently completed a Public Expenditure and Institutional Review (Peir) of ECD in SA, which finds that ECD outcomes are inconsistently measured, spending on ECD is low for a middle-income country and current spending on ECD services can be better targeted and more efficient.  

Measurement of ECD outcomes in SA must be strengthened 

The lack of data on ECD outcomes in SA is cause for concern. While globally, Multiple Indicator Cluster Surveys (MICS) have collected data on children under five, SA has not implemented such surveys until the recent Thrive by Five Index Survey in April 2022. Worryingly, this survey found that only 43% of five-year-olds attending ECD programmes met expected learning standards and were not stunted. The measurement of ECD outcomes must be further strengthened, including for younger children and those not attending ECD programmes. This is essential to understand the problem and target interventions towards the poorest and most vulnerable children. 

Spending on ECD interventions must increase 

Despite the evidence of the importance of ECD interventions, government spent only R36.1bn in 2021/22 on ECD programmes for children aged naught-five, about 1.7% of public expenditure and 0.6% of GDP in 2021/22. This is extremely low compared to the spending on children in schools and to spending in comparable countries. 

Of this amount, almost three quarters was spent on cash transfer programmes such as the child support grant, care dependency grant and foster care grant. Very little was spent by provincial departments of social development on childcare and child protection services. Most of the rest of the spending was on early learning interventions by provincial education and social development departments.

Given the high prevalence of stunting, malnutrition and food hunger reported in SA, we were surprised to observe how little direct nutritional support for younger children below grade R exists (though admittedly it is difficult to identify all funds spent on nutrition services for preschool children by the departments of health, social development and basic education). 

Spending on ECD is insufficient to meet the needs of children, particularly those from poor families. For example, the ECD subsidy, which aims to support ECD provision for children from poor families (R17 per child per day for up to 264 days per year), only reaches about 40% of poor children. In addition, this subsidy is inadequate to cover ECD programme operating costs, estimated at about R31 per child per day.    

Better targeting and implementation of existing ECD interventions  

Most ECD programmes are run by private providers. If they are registered and serve poor children, they qualify to receive government subsidies. But there are substantial barriers discouraging private providers from offering such services. To register, a provider must comply with a plethora of municipal bylaws, building and zoning requirements and meet infrastructure standards to obtain environmental health and safety certification. That is why the Peir report recommends reviewing municipal bylaws to make them less onerous for ECD providers and supporting providers to comply with infrastructure requirements. 

Staff in ECD programmes often have limited qualifications — over 60% do not meet the NQF level 4 requirement (equivalent to matric). The government does offer upskilling programmes, but these take staff out of the ECD programme for an extended period, and many do not return. Our report recommends a practical approach used in countries such as Ghana and Kenya to conduct a needs assessment of staff and to develop shorter, entry-level national qualifications that can be subsidised and widely introduced through accredited training providers. 

Most spending on ECD is channeled through social grants, especially the child support grant. However, the child support grant reaches relatively few children under the age of one — the age group most at risk. The cumbersome grant application process requires substantial documentation and in-person submission, which cause delays. The Peir recommends that women should be allowed to apply for the grant during the second trimester of pregnancy and that conditional approval be given based on the provision of a birth certificate after the child is born.

This would get more resources to the caregivers when they are most needed. Additionally, linking the grant programme with information about stimulation and improved nutrition support services could yield better child development outcomes if it is co-ordinated with community-based health and social workers. 

There is thus much that needs to be done to improve ECD outcomes for young children. This includes streamlining regulations for ECD programmes to register and receive subsidies, providing adequate support for private providers, improving the skills of ECD staff, and increasing funding and co-ordination between government departments to ensure access to high-quality ECD services for all children.

This would in time also improve educational and health outcomes for all children. 

• Ninan Dulvy is Southern Africa programme leader for human development at the World Bank. Van der Berg, a professor of economics at Stellenbosch University, held the National Research Foundation’s SA research chair in the economics of social policy.