A Policy Framework for Early Childhood Development

A POLICY FRAMEWORK FOR EARLY 

CHILDHOOD DEVELOPMENT AND ITS 

APPLICATION TO TURKEY 

March 2011 

Istanbul 

Cristobal Ridao-Cano Human Development Sector Coordinator, World Bank 

Meltem A. Aran Economist, World Bank

Overview 

1. The challenge: Childhood risks and inequalities in Turkey 

2. A framework for ECD programs and policies 

3. ECD programs and policies in Turkey 

4. Some preliminary reflections

Childhood risks and inequalities in Turkey

Hypothesized relations between poverty, stunting, child 

development, and school achievement 

Source : Walker S, Wachs T, Meeks Gardner J, et al. 2007. Child development: risk factors 

for adverse outcomes in developing countries LANCET 145-157.

Childhood risks and inequalities 

Early divergence in exposure to these risk factors by 

initial circumstances of children in Turkey today. 

We aim to: 

identify the extent to which “circumstances” are important in 

shaping children’s outcomes today, and therefore adult 

outcomes of the future; and how this has changed in recent 

times (2003-2008)

Circumstance definitions 

The 7 circumstance variables selected for the analysis are the following: 

1. Location of childhood: Urban or Rural (2 categories) 

2. Region of childhood: West, South, Central, North and East (5 categories) 

3. Mother’s Education: No formal education, primary, secondary, higher education (4 

categories) 

4. Father’s Education: No formal education, primary, secondary, higher education(4 

categories) 

5. Turkish mother tongue: Turkish, non-Turkish mother tongue spoken at home (2 

categories) 

6. Household wealth (asset) quintiles : 5 quintiles (5 categories) 

7. Gender of the child (2 categories) 

 

 

Disadvantaged: Rural location, primary or less than primary educational attainment of 

parents, non-Turkish mother tongue 

Advantaged: urban location, higher education of father and secondary education of mother, 

Turkish mother tongue.

Probability of not receiving care 

Health Care Utilization during Pregnancy and Birth 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

Significant inequalities persists in access to health care. However, healthrelated 

risks have decreased for antenatal care and birth, particularly 

among disadvantaged children. 

64% 

54% 

66% 

Least 

Advantaged 

26% 

25% 24% 

Average 

7% 

2% 3% 

Most 

Advantaged 

61% 

47% 

43% 

Least 

Advantaged 

27% 

14% 

12% 

Average 

2003 2008 

10% 

6% 5% 

Most 

Advantaged 

Mother has not 

received antenatal 

care during pregnancy 

Birth not at public or 

private health facility 

Birth not attended by 

skilled health staff 

Source data: 

TDHS 2003-2008

.1 .2 .3 .4 

0 

Kernel density 

.1 .2 .3 .4 

0 

Malnutrition Indicators (Stunting) 

•Prevalence of stunting (height-for-age measure below 2 standard deviations of the 

international median) was about 13.2 percent of children in the 0-4 year age group in Turkey in 

2003 and came down slightly to 11.2 percent in 2008. 

•The variation in stunting prevalence across circumstance groups is wide. Among the most 

“advantaged” group of children in the sample, the prevalence is 3.9 percent, while in the 

“disadvantaged” group this level is 28.7 percent as of 2008. 

Height-for-Age Measure (2003) 

(indicates stunting) 

Height-for-Age Measure (2008) 

(indicates stunting) 

-6 -4 -2 0 2 4 

Standard deviations from mean 

Source data: Turkey DHS 2003 

Least advantaged group 

Most advantaged group 

-5 0 5 

Standard deviations from mean 

Source data: Turkey DHS 2008 

Least advantaged group 

Most advantaged group

% of children in 

quintile (ages 0-4) 

Enrolment in center-based childcare and 

preschool services is highliy regressive 

Enrolment in center-based ECE services 

(for Ages 0-4), by income quintile 

20.0% 

15.0% 

10.0% 

5.0% 

0.0% 

0.8% 0.7% 0.8% 

Quint 1 

(poorest) 

5.8% 

16.5% 

Quint 2 Quint 3 Quint 4 Quint 5 

Per capita income quintiles 

Enrolment in preschool, 

childcare at center-based 

services or daycare 

Source data: Turkey EU SILC 2007

Hours per week 

Number of hours spent in center based childcare & 

preschool minimal for poorer quintiles 

30.0 

25.0 

20.0 

15.0 

10.0 

5.0 

- 

Mean number of hours of childcare per week 

(for children ages 0-4), 

by per capita income quintile 

4.0 

5.1 

3.8 

1.0 

1.8 11.9 

0.6 0.4 0.6 

4.5 

Quint 1 Quint 2 Quint 3 Quint 4 Quint 5 

(poorest) 

Per capita income quintiles 

Childcare by grandparent or 

familiy member other than 

parents 

Childcare by professional 

Childcare at center-based 

services or daycare 

Preschool 

Source data: Turkey EU SILC 2007

Exposure to Multiple Risk Factors 

4 biological and psychosocial risks: (i) Stunting , (ii) Iron deficiency anemia 

(iii) Low cognitive stimulation: Mother with no formal education (iv) Low 

90% cognitive stimulation: No access to preschool or kindergarten 

80% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

41% 

28% 

Exposure to at least 

1 risk factor 

20% 

12% 

5% 

0% 

3% 

0% 


2 risk factors 

Least Advantaged 

Average 

Most Advantaged 


3 risk factors

0.00 0.25 0.50 0.75 1.00 

Survival rate 

0.00 0.25 0.50 0.75 1.00 

The differences across opportunity groups before 

school are reinforced in the school system 

•Survival in basic and secondary education vary by opportunity group . 

•The breaking points in enrolments are at grade 5 and grade 8 for the 

disadvantaged group in both of these years. 

•However, up to grade 8, the survival rate of the disadvantaged group is 

consistently higher in 2008 when compared to 2003. 

Kaplan-Meier Survival Rates in School Enrolments (2003) 

(by advantage group) 


(by advantage group) 

0 1 2 3 4 5 6 7 8 9 10 11 12 

Note: Includes sample (age>=10 & age=10 & age

0.00 0.25 0.50 0.75 1.00 

Survival rate 

0.00 0.25 0.50 0.75 1.00 

Survival rates for girls and boys in most 

disadvantaged group 

•Improvement in survival rates for boys beyond grade 5, while for girls 

enrolments in the early years are higher, though after grade 5 the sharp 

decline in enrolments remain a problem. 


(by gender within disadvantaged group) 


(by gender within disadvantaged group) 

0 1 2 3 4 5 6 7 8 9 10 11 12 

Years of Educational Attainment 

Female in disadvantaged group 

Male in disadvantaged group 

Note: Includes sample (age>=10 & age=10 & age

A Framework for Benchmarking ECD Policies and 

Programs 

Step 1: Stock-take and classify ECD programs 

Step 2: Apply framework to evaluate the level of development ECD policies 

Step 3: Identify policy options to strengthen ECD policies and programs

Factors that affect ECD and life outcomes 

Context 

Macro (country) 

Micro (family) 

ECD Policies 

and programs 

Health, hygiene, 

and nutrition 

Education 

Poverty alleviation 

Early 

Childhood 

Development 

Cognitive development 

Socio-emotional 

development 

Physical well-being 

and growth 

Life Outcomes 

Education 

Health 

Fertility 

Income 

Risky behaviors 

Source: Vegas and Santibáñez 2010

Programs that affect ECD 

Healthcare and hygiene 

Maternal/prenatal health 

Water and sanitation 

Healthcare prevention 

Mental Health 

Child 

Prenatal 

0-2 

3-4 

5-6 

Education 

Preschool (3-6) 

Care (0-3) 

Nutrition 

Food and supplements 

Mother(prenatal) 

Mother/Father/ 

Caregiver 

Poverty alleviation 

Income transfers 

Maternity/paternity leave 

Female labor participation 

Home infrastructure

Impact of ECD interventions 

 

 

 

 

Interventions with nutritional components have positive effects on: 

growth and physical well-being 

cognitive development 

CCTs have positive impacts on: 

healthcare prevention and control 

cognitive and socioemotional development 

Preschool attendance has positive effects on: 

cognitive and socioemotional development 

the probability of continuing in school 

reduced participation in risky behaviors 

But the impact is greatest when interventions are multi-sectoral and 

integrated

Step 1: Stocktaking & classification 

of ECD programs 

9 Key Characteristics: 

i. Primary policy objective; 

ii. Brief description; 

iii. Focus area/intervention 

mechanism; 

iv. Coverage/access; 

v. Institutional arrangements; 

vi. Financing; 

vii. Service providers; 

viii. Quality assurance mechanisms; 

ix. Challenges for going to scale 

and improving service delivery. 

4 General Types of Programs: 

1. Sectoral 

2. Cross-sectoral 

3. Multi-sectoral 

4. Comprehensive

Complexity of Institutional Arrangements 

Coordinated 

interventions across 

multiple sectors 

Comprehensive 

Multi- 

Sectoral 

Cross- 

Sectoral 

Sectoral 

Single Sector 

Intervention Areas/Mechanisms 

Specific Sector w/ inputs 

from other sector 

Multiple sectors, specific 

programs for targeted or 

universal populations 

Comprehensive regular 

monitoring, some universal 

services, with tailored 

interventions

Step 2: Application of conceptual framework to 

evaluate the level of development ECD policies 

4 dimensions: 

4 levels of development: 

Enabling environment 

Degree of implementation 

Monitoring & quality assurance 

Policy focus 

• Legal framework 

• Coordination 

• Financing 

• Coverage 

• Programs 

• ECD information 

• Quality 

standards & 

compliance 

• Sectoral to 

comprehensive 

Latent 

Emerging 

Established 

Mature

Step 3: Identification of policy options to 

strengthen ECD policies & programs 

Policy lessons can be drawn from countries that have 

achieved “established” and “mature” levels of 

development in the core dimensions of ECD 

Countries include Australia, England, New Zealand, and 

Sweden 

These lessons need to be adapted to local contexts in each 

country, to identify policy options

Key lessons from the selected OECD 

countries - General 

 

 

 

 

 

The establishment of the rights of children in law provides the foundation for an ECD 

system. 

Effective ECD systems do not work through government alone: stakeholders in ECD include 

all levels of government, research institutions, educators, not-for-profit organizations, private 

enterprises, and children and families. 

The best approach to developing an ECD system involves taking incremental steps, with 

emphasis on long-term policy design, establishing financial stability, and effective quality 

assurance mechanisms. 

Universal preschool services and a comprehensive social protection system are substantial 

components of ECD systems in the selected systems. 

Experiences from all four countries underlie the importance of establishing an institutional 

anchor to administer early childhood development policies and to foster and lead 

collaborative efforts amongst the different government agencies and stakeholders in the 

sector.

Key lessons from the selected OECD 

countries - Specific 

Substantial advancements in ECD have been made in England over the past 15 

years, demonstrating that significant strides can be made in a shorter period of 

time. 

 

 

Sweden is a standard for high-level ECD, with an extensive early childhood 

education system and a multi-tiered financial family policy that includes financial 

benefits, generous and equitable parental leave, and a needs-tested component to 

support families and children particular needs. 

Sweden illustrates some of the potential benefits of a decentralized approach to 

governance. Provision of early childhood services is the responsibility of local 

authorities, which are able to deliver services that are specific to local needs.

ECD programs and policies in Turkey

Overview of ECD programs in Turkey 

Child 

Development 

Stage 

Early Childhood Development Goal Tools/Prograsm Examples of Actors in Turkey 

Prenatal – Birth Healthy antenatal development Parental support and education Pregnancy Monitoring - MOH 

Infancy 

(0-18 months) 

Toddler and posttoddler 

(18-36 

months) 

Healthy growth and nutrition 

Sensory learning (auditory and visual) 

Attachment to caregiver, Control of physical 

actions 

Breastfeeding and nutrition programs Growth monitoring - MOH 

Parent training programs 

Parent training (MONE) 

Nutrition Nutrition Growth monitoring (MOH) 

Coordination, language, ability to think, social 

skills advance 

Parent training 

Day Care Centers 

Community Driven Programs and 

Private Nurseries 

Parent training (MONE) 

Private day-care and nurseries 

(Private Sector) 

Private Community driven models 

(KEDV neighborhood nurseries) 

Preparation for school 

Programs linked to education and 

cognitive development 

Public preschools and kindergartens - 

for 5-6 year group (MONE) 

Preschool (Ages 

3-4-5) 

Early primary 

(Ages 6-7) 

Socialization Parent training programs Private preschools (Private Sector) 

Circle of peers and caregivers widens 

Health and nutrition remain important 

School preparedness programs 

Home-based MOCEP (for 6 year 

group only) (MONE & ACEV) 

SHÇEK Community Centers 

Transition to school Primary school Basic Education (MONE)

Toddler and posttoddler 

(18-36 

months) 

Prenatal 

Infancy (0-18 

months) 

Preschool 

(Months 36-72) 

While many different ECD model programs exist in 

Turkey, coverage of children remains low.. 

Child Development Phase Intervention Coverage of Age Group 

Pregnancy Monitoring, MOH (2008) 

Immunizations - all complete, MoH (2008) 

~ 80% 

~ 90% 

Growth and Psycho-Social Monitoring - Family Doctors, MoH (2008) 

Parent training (0-6 year old), MONE (2009) 

Private day-care centers, nurseries and community driven models (2008) 

Parent training (0-6 year old), MONE (2009) 

< 10 % 

< 3 % 

< 1 % 

< 3% 

100 % 

coverage line 

Growth and Psycho-Social Monitoring, MoH (2008) 

SHÇEK Community Centers (2008) 

< 2% 

< 10 % 

Home-based MOCEP - for 6 year group only, MONE (2009) 

Private preschools (2008) 

< 3% 

~ 1% 

Public preschools & kindergartens - for 48-72 month group, MONE (2008) 

~ 39 % 

0% 20% 40% 60% 80% 100%

TL in 2008 

Low coverage is linked to low levels of public spending on 

ECD programs targeting children ages 0-6. 

Per Capita Social Expenditures by Age Group in Turkey (2008) 

(Central Government, Excluding Social Security Contributions) 

2.5 

2.0 

Education 

Social Protection 

Health 

1.5 

1.0 

0.5 

- 

0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 

Age Group (0-90) 

Source: World Bank (2009) “Turkey Expanding Opportunities for the Next Generation”

Complexity of institutional arrangements 

Summary of ECD Programs in Turkey 

Coordinated 

interventions across 

multiple sectors 

Comprehensive 

Private 

Community 

Initiatives (KEDV) 

Family Training 

Programs 

Multi- 

Sectoral 

Public 

Preschools 

The Family 

Doctors Scheme 

Cross- 

Sectoral 

SHCEK 

Community 

Centers 

Sectoral 

Single sector 

Specific sector w/inputs 

from other sector 

Focus Areas- Mechanisms 

Multiple sectors, specific 

programs for targeted or 

universal populations 

Comprehensive regular 

monitoring. Some universal 

services, with tailored 

interventions

ECD Policy Dimensions and Levels of Development 

in Turkey – Preliminary Findings 

ECD 

Policy Dimensions 

ENABLING ENVIRONMENT 

DEGREE OF IMPLEMENTATION 

MONITORING AND QUALITY 

ASSURANCE 

Variables 

Legal framework 

Coordination 

Financing 

Coverage 

Programs 

ECD information 

Quality standards and compliance 

Level of Development 

Established 

Emerging 

Emerging 

Emerging 

Established 

Established 

Emerging 

POLICY FOCUS 

ECD interventions (health, nutrition, 

education & child protection) 

Established

Strengthening ECD in Turkey: Some Preliminary 

Reflections 

 

 

 

 

Consider developing a comprehensive ECD strategy that integrates and coordinates 

interventions in different areas, providing a clear organizational framework for ECD. 

 

define roles and responsibilities of public agencies involved in ECD (including the coordinating 

body) and also NGOs and the private sector, which plays an important role. 

Increase funding for ECD to expand coverage, particularly of disadvantaged children. 

Set clear standards for ECD that are linked directly to child development and learning 

(rather than only infrastructure inputs), and strengthen the quality assurance system to 

monitor and ensure compliance with these standards. 

Facilitate private sector and community-based expansion for ECD by closely regulating 

and possibly co-financing these initiatives.

TEŞEKKÜR EDERİZ 

March 2011 

cridaocano@worldbank.org, 

meltem.aran@economics.ox.ac.uk,

Appendix

Determinants of access to health care 

Over time, circumtstance variablles have become less strong as correlates or 

determinants of access to health care 

Probability of Birth not being attended by skilled staff 

Gender of child: Female 

Asset quintile 4 




# of children: 5 or more 

# of children: 3-4 

Mother Tongue: Non-Turkish 

Father’s Educ: Secondary 

Father’s Educ: Primary 

2003 

2008 

Father’s Educ: No education 

Mother’s Educ: Secondary 

Mother’s Educ: Primary 

Mother’s Educ: No education 

Location: Rural 

0 0.05 0.1 0.15 0.2 0.25 

Partial correlation coefficient in Probit regression

Determinants of Stunting 

As of 2008, asset quintiles (wealth) and mother tongue remain theonly significant determinants of 

stunting. Father’s educational attainment, gender of chlid and rural loction are no longer associated 

with higher likelihood of stunting. 

Probability of Stunting 

Gender of child: Female 

0.02 





# of children: 5 or more 

# of children: 3-4 

Mother Tongue: Non-Turkish 

Father’s Educ: Secondary 

Father’s Educ: Primary 

Father’s Educ: No education 

0.03 

0.03 

0.05 

0.06 

0.07 

0.08 

0.09 

0.11 

0.12 

0.15 

0.18 

2003 

2008 

Mother’s Educ: Secondary 

Mother’s Educ: Primary 

Mother’s Educ: No education 

Location: Rural 

0.02 

- 0.02 0.04 0.06 0.08 0.10 0.12 0.14 0.16 0.18 0.20 

Partial correlation coefficient in Probit regression

Determinants of low birth weight 

Mother’s educational attainment is the only strong determinant of low birth 

weight in infants 

Determinants of Low Birth Weight 

Probability of Low Birth Weight (

Child Health Programs (MOH) 

Category 

Objectives 

Description and 

areas of 

intervention 

Coverage 

Cross-Sectoral 

Improve Child Health, reduce under 5 and Infant Mortality 

Optimum Care for Newborns Program; Growth Monitoring of Babies and Children Program; Intensive 

Care for Newborns Program; Screening of Newborns Program; Nutrition Program for Mothers and 

Children (iron and vitamin D supplementation, complementary feeding; fighting Iodine Deficiency 

Disorders ; promoting breastfeeding; Prevention of Childhood Infections Program; Monitoring of Infant 

Deaths Program 

Nationwide, across the health care system, Children U5, pregnant women 

Institutional 

arrangements 

Financing 

Service providers 

Quality assurance 

Challenges 

MOH/Mother and Child Health and Family Planning General Directorate; 

Government: Curative and cost of medication for Green Card holders; Pregnancy and childbirth related 

expenses of all women covered through maternal insurance; Social Risk Mitigation Program, financial 

support during pregnancy, childbirth and childhood period; Iron and Vit D supplements are provided 

during pregnancy and childhood period as free of charge 

Health care providers in maternity hospitals and primary care; 

Monitoring and evaluation indicators for each program were prepared. Protocols, indicators defined, 

monitoring of electronic databases; Monitoring of data in electronic media for computer programs were 

made. Data crosschecked via major surveys(DHS); patient satisfaction survey conducted; program 

reviews conducted. 

Vary by program; mainstreaming the programs into the pre-service training; increase the awareness of 

the population with respect to child care

The Family Doctor Scheme 

Category 

Objectives 

Description 

Areas of 

intervention 

Coverage 

Institutional 

arrangements 

Financing 

Service 

providers 

Quality 

assurance 

Sectoral 

To provide healthcare and monitor young children’s growth and cognitive and psycho-social development. 

Pregnant women assigned to family doctors who monitor children’s health and development. 

Growth Monitoring 

Immunization 

Tracking cognitive and psycho-social indicators 

As of 2009, implemented in 54 provinces in Turkey, reaching 8.3% of all children age 0-6 in 2009. Coverage is 

planned to expand to all 81 provinces in Turkey by the end of 2010. 

The Ministry of Health oversees the program through three directorates: Mother and Child Health, Primary 

Health and Mental Health Units. 

Family Doctors receive a per capita incentive payment based on the number of families in their jurisdiction. 

Family doctors, at the local level, provide services. 

The MOH has adopted a computerized monitoring tool capable of tracking all children in Turkey, starting at the 

pregnancy of the mother. The database should be able to serve as a child-centered development policy tool to 

track children and respond to those with lagging indicators across sectors. Family doctors are given some 

specialized training in ECD and the Integrated Management of Childhood Illness (IMCI) to participate in the 

program. 

Challenges The program is slated for expansion to nationwide coverage by the end of 2010.

Family Training Programs 

Category 

Objectives 

Description 

Areas of 

intervention 

Coverage 


To empower parents as caretakers and educators of their children, improving school readiness of children. 

Programs vary but are mostly home-based, providing parents with strategies to help children develop in 

the home environment. 

MOCEP (Home-based preschooll program) - Age 6 

Father Training Programs – Fathers of children ages 3-11 

My family Program (Ages 0-18) modules being developed 

Only an estimated 3% of the 36-72 month old group in Turkey are covered 

Institutional 

arrangements 

Financing 


Parenting programs are administered by MONE through the Non-formal Directorate in Adult Education 

Centers. Financed through the European Commission; delivery is in conjunction with ACEV, UNICEF and 

other partners. 

A cost-benefit analysis of Preschool education in Turkey found home-based programs highly cost-effective, 

with a benefit-cost ratio of 8:1 for MOCEP. 

Teachers and staff at Adult Education Centers. 

Counselling Teachers in Basic Education schools (Father Training Programs) . 

Quality 

assurance 

Regular supervision visits by master trainers to the field. 

Several quantitatvie impact evaluations of MOCEP have proved these programs to be effective. 

Challenges 

The program is financed under a series of other adult education programs. 

Earmarked financing specifically for Parenting Programs necessary to clarify annual budgets.

Public Preschools 

Objectives 

Description 

Category 

Areas of intervention 

Coverage 

Institutional 

arrangements 

Financing 



Challenges 

Improve school readiness of children. 

Sectoral 

Provide preschool training through public school system. 

Increasing cognitive stimulation, school readiness, developing preliteracy and prenumeracy skills. 

Rapid expansion in recent years; in 2008-2009 the enrollment rate for the 4-5 year old (48-72 month) 

group was 38.5 %. Coverage remains low in international comparisons. 

MONE Preschool DG is centrally responsible for the prorgam curriculum and expansion. Public 

preschool classes are built inside existing basic education schools or in separate buildings. 

Teacher salaries are centrally financed through MONE. Infrastrcuture investments are made through 

project financing or local government financing. High private user fees prevent the access of the 

poor (50-200 TL nutrition user fees charged, not standard across the country). 

MONE appointed preschool teachers (4 year university graduates). 

Lack of standards on education programs and practices. Standards mainly focus on building 

requirements and infrastructural needs. 

Little or no inspection by inspectors with ECE background. 

Expansion of the system depends on infrastructure financing and compensation of hired teacher 

costs through the expansion. 

There is no common curriculum and teaching materials for preschool (quality depends highly on 

teacher). 

Restrictions to hire only 4 –year university graduates increases salary bill and possibly makes 

expansion more difficult.

SHÇEK Community Centers 

Category 

Objectives 

Description 

Areas of 

intervention 

Coverage 

Multi-Sectoral 

To provide families and young children in disadvantaged communities with a variety of services. 

Multi-purpose centers delivering services to disadvantaged communities, including: vocational training, 

childcare, family training and counseling. 

Protective and preventive services for children in need, offered through community centers. 

81 centers nationally, with an estimated reach to 40,000 children – this is very limited coverage, as 

compared to need and demand. 

Institutional 

arrangements 

Social Services and Child Protection Agency manages the Community Centers and Family Counseling 

Programs nationwide. 

Financing 



Challenges 

Lack of funding limits program expansion. 

Center-based delivery of services. 

Unknown 

Coverage is currently very limited, as compared to need.

Private/Community Initiatives (KEDV model) 

Category 

Objectives 

Description 

Areas of 

intervention 

Coverage 

Institutional 

arrangements 

Financing 



Provide affordable day-care, of good quality, in poor neighborhoods. 

KEDV organizes women into economic cooperatives to operate small businesses and creates Women and 

Child Centers for affordable daycare for working mothers. 

A community-driven model of privately provided center-based daycare. 

Extremely low. Public regulation and subsidies necessary for expansion of such community based 

models. 

ECD experts at KEDV train local mothers to serve as “neighborhood mothers” and facilitate the hiring of 

pre-school teachers. KEDV assists with the establishment of the centers and then women members are 

responsible for the continued financing and management of the centers. 

The costs of the day-care center are paid by members using a sliding scale based on ability to pay. 

Trained “neighborhood mothers” and preschool teachers. 


Challenges 

No public monitoring. 

Public regulation of such centers would enable expansion and ensure quality. 

The centers become self-sustaining after the initial set-up of facilities and programs by KEDV staff. 

Increased funding is required for program expansion.

A Policy Framework for Early Childhood Development

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