Social Impact Investing

SOCIAL IMPACT INVESTMENT: BUILDING THE EVIDENCE BASE
5.4.1.2 Services supporting families with young children: what works?
5.61 Services to support families represent a different type of ‘investment’ expenditure and clear links
with later life outcomes (in some cases creating returns decades after an intervention). Relative to the
‘treatment’ of frailty in old-age, family supports are an investment designed to ‘prevent’ children from
being unprepared for school, the economy and society. Moreover, there is evidence of unmet demand for
childcare in different countries of the OECD, as well as evidence of increasing public commitment to
family services in every country in relative terms (the exception is Japan, where overall family spending
has tripled, and although absolute level of family service spending has increased, this is relatively lower
than cash spending).
5.62 Service interventions for families and children in France, the United Kingdom and the United
States that have been subject to RCTs, show that: 23
Nurse-family partnerships and home health visits providing pre- and post-natal care for low
income mothers and their infants in their own homes in New York, Memphis, and Washington
produced positive gains in intended child well-being (including educational outcomes) and
parenting outcomes including parenting practices (Greenberg and Shroder, 2004).
Integrated childcare interventions in the United States (North Carolina’s Abecedarian programme
and Michigan’s Perry Preschool), although relatively small (109 and 123 participants, respectively)
produced large, long-term gains in education and health. These results have persisted over several
decades, and in the case of the Perry Preschool service, early childcare also produced benefits in
adult income and employment (Schweinhart and Weikart, 1993; Schweinhart, 2003).
Evaluations of general family supports had mixed outcomes, with positive outcomes from the
French intervention in Créteil that actively engaged parents and school to remedy truancy and
disciplinary issues, and the Carrera programme in the United States which offered integrated
support services to teenagers to improve educational engagement. Among the other family support
interventions aimed at providing services for parent and child well-being, there were few benefits.
Practices here included: case management and integrated service delivery (U.S. Comprehensive
Child Development Programme), home visits by “supportive listeners” or community groups
(British Social Support and Family Health Programme), and case management to teen mothers (the
Young Families Can, Phoenix, United States) (OECD, 2014f).
5.63 Mobile home health units, and delivery of services in the home were successful in producing the
desired social outcomes due to benefit of home service that reduce service take-up barriers (affordability,
motivation etc.) and the chance it provides to professionals to gauge the full extent of the family living
conditions and needs (McKeown, 2000). Childcare practices were successful where multiple integrated
services (e.g. education, nutrition, health) are provided in childcare settings for the most at-risk children
and less successful where fewer at-risk families took up the service (see OECD, 2104f). Finally, for more
general family service interventions, successful interventions included engaging with parents in the school
(for truancy and discipline), and less successful interventions included comprehensive support (parent and
child well-being), case working (teen pregnancy) and supportive listening (maternal and child health – see
OECD, forthcoming 2014).
5.64 Some key messages for SII here include: the highest social returns are found in the most
vulnerable groups, although these groups will often require more intensive services; returns on social
interventions in childhood may take many decades to come to fruition; and, providing services in people’s
homes, and to family units, creates unique opportunities for tailoring care to specific needs.
23 . The following evidence is summarised from OECD 2014g, Chapter 3, section 3.4.
© OECD 2015 77