2.4 Scaling early child development programs
There is a critical missing link in the evidence-based policymaking process: understanding how to scale evidence-based programs (EBPs). The incredible promise of a 13% ROI [return on investment], not to mention the life-altering effects of participating in a high-quality early- childhood program, only hold true if the programs found to produce such results can be scaled up to serve a broader population.” (Center for Early Learning + Public Health, n.d., p. 2).
As we have learned throughout the modules, quality interventions, prenatally and in the early years, can have long term positive impacts. The Lancet Early Child Development Series of 2007, 2011 and 2016 all highlight research and programs that make a difference to the developmental health of children.
The evidence from neuroscience, from epigenetics and from several interventions such as the the Carolina Abecedarian Project, Aboriginal Head Start and others is clear – quality early childhood interventions have long term positive outcomes. Scaling such programs is vital to supporting the developmental health of all human beings. The complexities of how to scale successfully and economically, building on existing systems is a dominant discourse in the global early childhood sector.
Implementation and innovation
The debate is shifting from “why” invest in early childhood to “how” to invest in ways that are effective and far reaching. Scaling effective early child development (ECD) programs may begin by replicating an effective local program in multiple communities. If a program can demonstrate benefits for children and families and can operate within existing resources, it is often efficient to use the lessons learned and start up the same program in many other locations. However, each context is different; the challenge is not so much to replicate as to capture the key elements that make a program effective and know how to make them happen in various settings.
Scaling often involves tensions and trade-offs. The quality of programs may diminish as programs grow in scope and numbers but, without growth, it is not possible to reach the majority of children and families. Is it better to get something to everyone or something of high quality to a few? Or can both be accomplished? The study of how to do both well is called implementation science. The definition below comes from the health sector but is relevant to early child development programs.
Implementation science is the study of methods to promote the adoption and integration of evidence-based practices, interventions and policies into routine health care and public health settings. Implementation research plays an important role in identifying barriers to, and enablers of, effective global health programming and policy making, and leveraging that knowledge to develop evidence-based innovations in effective delivery approaches” (Fogarty International Center, 2025, para. 1).
Listen to Dr. Maureen Black explain implementation science in the next clip.
Next, Dr. Larry Aber, professor of Psychology and Public Policy at New York University, explains why implementation science is so important.
Aber remarks that “identifying an intervention that works is light years different from figuring out how to scale those interventions with sufficient quality to have population based impact”. What do you think are some reasons why this is the case?
Black ends her comments by saying that implementation science is all about “continuous quality improvement”. Why do you think this focus on quality is so important?
Read the next reading by Frances Aboud, Aisha Yousafzai and Milagros Nores (May 23, 2018) to learn more about the state of implementation research and practice. In particular, review ‘Box 1’, for a useful summary of what is known as well as recommendations for the future.
One example of implementation science is The Community Research & Engagement Lab (CoRE-LAB) in Vancouver, British Columbia. CoRE-LAB is a research lab within the Human Early Learning Partnership (HELP) at the University of British Columbia (UBC).
CoRE-Lab “is a co-laboratory of more than 60 academics, government, and community-based individuals and organizations that…work[s] with communities to co-create and mobilize community-based knowledge to influence transformational change in the systems that support children’s health and well-being” (CoRE-LAB, n.d., para. 3; Toye, 2023, para. 1).
You can learn more about the CoRE-LAB at the site below.
Listen as Dr. Brenda Poon, Principal Investigator at CoRE-LAB, describes why it was created. In this clip, Poon references the Early Development Instrument, or EDI. More information on EDI is found in DH 2.3.
One of CoRE-LAB’s guiding principles is “creating knowledge grounded in grassroots community engagement” (CoRE-LAB, n.d., Our Guiding Principles, para. 3). Listen as Dr. Brenda Poon describes how community engagement led to the systems maps that were created.
In the next clip, Poon describes what was learned from the systems maps created with communities.
Implementation science is an important new direction for ECD and key to improving the lives of children. In May 2018, The New York Academy of Sciences published a special issue on implementation science and early child development that includes the above article and others.
Scaling early childhood programs in Canada
An expansion in ECE would increase female labour market participation, improve child outcomes (particularly for disadvantaged children), and reduce inequality in Canada” (Alexander et al., 2017, p. ii).
A critical part of scaling is making programs either free or affordable. In Canada, the high cost of child care places an enormous financial burden on many families. Advocates argue for a universal system that would make licensed, quality care accessible to all families but most jurisdictions struggle to make this happen. The report Affordable for All, by Dr. Gordon Cleveland, published in 2018, looks at how licensed child care can be made affordable in Ontario. In the report below, go to the executive summary and read about chapters 5, 6 and 8 (starts on p. 5 of the document).
The Province of Quebec has long been ahead of the rest of Canada in providing affordable, accessible child care. The next reading demystifies some of the data about the system.
Cuba – a country example
Consider…
Three year old Mirta and her grandmother are attending the Educa a tu Hijo (Educate your child) program in a park near their home in a barrio in the outskirts of Havana. Mirta finds her friends and soon is caught up in playing make-believe ‘doctor’…Read more
How do you think this experience will affect Mirta and her family?
Did you attend an early child development program when you were a child? If so, how do you think it may have affected you?
The Educa a tu Hijo program, attended by the child Mirta in the example above, is a remarkable example of a scaled up, high quality early childhood program. It not only encompasses the entire early childhood period (from conception to age 6), but also reaches close to 96% of the children and families in Cuba. Watch the following video to learn more about Educa a tu Hijo.
How do you think this program impacts children and their parents?
Why are the strong links between the program and families so important?
Educa a Tu Hijo includes multiple inputs from ministries – from health and education to sports and culture. How does its integrated nature contribute to its strengths?
Do you think this kind of program could exist in your context? Why or why not?
Can you think of some key factors that made it happen in Cuba?
The next reading describes the key elements of Cuba’s integrated early child development (ECD) system in the UNICEF report, Early Childhood Development in Cuba (2016a).
Cuba’s integrated ECD system developed within their particular political and cultural context and is a powerful example of the benefits of a coordinated, universal approach that has led to population-based impacts.
Workforce development
While not enough is yet known about how to scale-up effective interventions in early childhood (Global Child Development Group, 2011), one thing is clear: the quality of early childhood services, and ultimately the outcomes for children and families, depend on a well-supported and empowered early childhood workforce … Data from nearly 80 low- and middle-income countries indicated that, in nearly one-quarter of countries, fewer than half of all pre-primary teachers were trained to national standards” (Ionescu et al., 2016).
A great challenge in scaling is to sustain the quality of the original model that was shown to work well. Skilled, nurturing caregivers are critical to any high-quality early childhood program. The next reading discusses a workplace initiative focused on global and country-level analyses and developing workforce capacity.
When early childhood education services are scaled to serve a greater quantity of young children, why does quality often suffer?
Do you think policy makers have to make a choice between quantity and quality? Why or why not?
The article outlines four areas of policies and practices that support maintaining quality when scaling up an ECD program. To what extent are these present in your context?
Jurisdictions around the world have tried to address workforce development issues in different ways. Oftentimes, well intentioned campaigns or incentives are introduced without plans to measure their effectiveness. The province of British Columbia launched a recruitment and retention strategy in 2018, with a unique sector led evaluation. Dr. Reuben Ford, a research director at the Social Research Demonstration Corporation (SRDC), provides an overview of the strategy and highlights unique characteristics of the evaluation.
In the next two videos Dr. Ford provide details about key components of the evaluation.
Both recruitment and retention are important. Dr. Ford shares findings that have real implications for policy makers.
Visit the Early Childhood Educators of British Columbia (ECEBC) website to learn more about the most recent results. Scroll down the webpage to explore the Infographics that highlight key findings.
How can the results of the B.C. evaluation help inform others?
What recruitment and retention strategies are you familiar with in your jurisdiction?
Is there an evaluation component?
The B.C. Recruitment and Retention evaluation included a public opinion survey. Listen to some positive and encouraging findings.
The National Academy of Medicine has produced an excellent comprehensive multimedia guidebook Transforming the Early Childhood Workforce.
Dr. Laura Doan is an Associate Professor in the Faculty of Education and Social Work at Thompson Rivers University in Kamloops, British Columbia. Watch as she describes why she started research on experiences of early childhood educators related to retention.
Based on this research, Dr. Doan determined a peer mentoring program could help support the workforce. In the Peer Mentoring Program for Early Childhood Educators of British Columbia, groups of peer mentors get together in a Community of Practice or CoP. Pairs within each CoP connect weekly through a variety of mediums or in a face-to-face meeting. Watch as Dr. Doan describes the professional development that occurs in a CoP.
Think back to your first days working with children. Did you have experiences similar to those described by Dr. Laura Doan?
Do you think having a peer mentor and participating in a Community of Practice would have helped you to feel more confident and prepared for your work?
The groups and pairs in the CoP determine the content of these meetings based on their own goals. Listen as Kimi Henderson, Facilitator for the West Coast Peer Mentoring Program describes how topics are determined for that CoP.
In the next clip, watch Dr. Doan describe the findings of the research on the Peer Mentoring Program.
You can see more information on the Community of Practice model used in the Peer Mentoring Program, including research methods and results, at the Peer Mentoring Program website, below.
The Peer Mentoring for Early Childhood Educators of British Columbia website shows results of this research. At the beginning of this research, there were less than 20 Communities of Practice. How many exist now?
One infographic lists four findings that helped build the community of practice. What are these?
What other findings in this research are related to your work?
Now watch as Brianna Winters, a participant in a Community of Practice, describes connections and how these connections support the field.
Review the information about workforce development in this quiz.
As you can see from this research, recruitment and retention are both important to the early childhood system. A stable, high quality early childhood workforce is needed to maintain a stable, high quality, early childhood system for children, families, communities and society as a whole.
