58379 December 2010 Knowledge Brief A Snapshot of Early Childhood Development in Indonesia Hafid Inunuh Alatas Sally Brinkman Background · The Ministry of National Education (MoNE) is supporting a Findings presented in this brief were developed using baseline community-based Early Childhood Education and Development survey data. The baseline was the first of three rounds of data (ECED) project aiming to reach 738,000 children. collection envisioned as part of the evaluation. · To understand the impact of its project, MoNE is conducting an evaluation that tracks over 6,400 children ages 1 and 4 for Tracking children over time will help shape the project by a period of three years. providing information about the status of early childhood development of children it is targeting, and highlight areas that Early childhood is widely recognized as a critical time for may require further project attention and focus. Moreover, the development since it lays the foundation for skills and aptitude results can inform the development of local policies supported which people carry into adulthood (Shonkoff 2000). This by local data, which has to date been limited. While there have recognition stems from evidence demonstrating that rapid brain been studies describing the landscape of ECED in Indonesia, development occurs before a child is six, and how a maturing the baseline results are the first to show relationships between brain is affected by a child's environment, such as stimulation, parental education, nutrition, stimulating learning environments nurturing and nutrition dispensed at home and beyond (McCain and child developmental outcomes, as has been proven in other 2007). Services related to early childhood have proven to be countries (Nores 2009, Engle et al 2007). highly cost-effective, with the returns manifesting in school readiness, school completion, health, cognitive ability, and Also supported by a research grant from AusAID, the baseline general social and emotional skills (Heckman 2008). survey covers approximately 6,400 boys and girls aged one and fouri throughout nine districts that represent the projectii One of MoNE's initiatives in early childhood is to support an shown in Figure 1. Districts vary greatly in poverty, remoteness, ECED project aiming to reach 738,000 children in 50 districts over population density and service access, with Ketapang in five years. Financed by a credit from International Development Kalimantan being the most remote district, and Lombok Tengah Assistance (IDA) and a grant from the Government of the being the poorest. Kingdom of the Netherlands, the project provides block grants to communities whose residents decide how best to deliver early childhood services. In addition, the program funds training of community-based teachers to promote child development, and facilitates cooperation with district and national organizations that provide additional funding and quality control. In an effort to understand whether the project improves children's development and readiness for primary school, and what factors contribute to effectiveness of ECED services, MoNE i The purpose of selecting children 1 or 4 years of age at baseline is to determine if the ECED program has a differential impact on children of different ages and stages. The study follows is undertaking an impact evaluation. This evaluation uses a these children over the life of the evaluation, and they will be aged 4 and 7 by the endline survey. randomized design that allows for comparison between similar ii Sample districts are Sarolangun, Rembang, Kulon Progo, Sidrap, Majalengka, Ketapang, communities that receive the project at different points in time. North Bengkulu, Central Lombok and East Lampung. Child Health · The majority of Indonesian mothers consistenly breastfeed comprehensive nutrients breast milk provides. Additionally, it is their children for nearly two years though not exclusively for well known that contaminated fluids or food can present risks six months as is recommended. to developing babies, such as diarrhea, pneumonia and death · Compared to regional neighbors, Indonesia has high rates of (WHO 2010, UNICEF 2009). In the ECED sample, as shown in malnutrition. Figure 2, fewer mothers breastfeed exclusively for six months than in Indonesia as a whole, and compared to averages across The baseline survey looked at a wide range of child health countries in the region and around the world. On the positive outcomes including birth weight and length, current weight and side, over 60 percent of sample mothers continue breastfeeding height, breastfeeding practices, vaccination rates, frequency of until nearly two years of age, suggesting that breastfeeding diarrhea and other illnesses, and eating habits. is persistent, albeit mixed with other substances earlier than optimal. Here we highlight breastfeeding due to its relationship with child development.iii Exclusive breastfeeding up to six months As children move from breast milk to food, we look to measures is recommended by the WHO and UNICEF because of the of height and weight for age to determine whether they are receiving adequate nutrition to allow them to become Figure 1: ECED Study Locations healthy, mature and school-ready. Poor nutrition can affect brain development and later cognitive ability in older children and adults, leading to fewer years of schooling and reduced productivity. Indonesia is confronted with a high rate of stunting (37%)iv, which represents height-for-age or chronic malnutrition--the same rate is also seen in the nine-district Indonesia sample. As shown in Figure 3, in regional comparisons, Indonesia has higher stunting rates than would be expected for its GDP per capita. ECED Study Districts Figure 3: Stunting and GDP/Capita Figure 2: Breastfeeding Practices 60 Relationship between Stunting and GDP/Capita 55 East Timor 100 Indonesia (ECED) 50 Percent of Mothers Breastfeeding 90 Indonesia (national) India Cambodia Percent Stunting 80 45 East Asia and Pacific Vietnam 70 Pakistan Least Developed Countries 40 60 Indonesia World Indonesia (ECED) 35 50 Philipines 40 30 30 1. exclusively breastfed to six Mongolia East Asia and Pacific 25 20 months China 2. breastfed with food 6-9 months 20 10 0 1000 2000 3000 4000 5000 6000 3. still breastfed 20-23 months 0 GDP per Capita 1 2 3 2005 International $ Constant All data other than ECED from UNICEF State of the World's Children 2009 Source: World Development Indicators Database Child Development · In international comparison on a cognitive test, sample In looking at children's social and emotional development, and Indonesian children perform similarly to Jordan and better behavioral patterns, such as emotional expression, tendency than the Philippines. toward hyperactivity/inattention, peer relationships and · Using an international measure of school readiness, conduct problems, and positive social behavior,v we find that Indonesian children excel in communication and general Indonesian children do well when compared to children in other knowledge, and also in social competence, but show higher countries. These traits are noteworthy not only because they are rates of vulnerability in literacy-related skills and cognitive components of well-adjusted adults, but also lead to a child's development. success in school. Child development is measured by a variety of factors that In the area of cognitive development, one tested measure of a determine school readiness and ultimately growth and potential child's `executive function,' or the way a child uses different in later life, such as gross and fine motor skills, cognitive strategies, focus and memory to accomplish something, is a development, social competence, emotional maturity, and game played with cards of different shapes (motorbike and cat) communication and literacy skills. It is these skills upon school that are in different colors (red and blue), where some of the entry that determine how a child performs in school and beyond cards have borders and some do not.vi In international (Lloyd 2009, Wylie 2006, Le 2006). In the baseline survey, we comparison, as shown in Figure 4, Indonesian four-year olds capture these domains and more (some shown in Table 1) by perform similarly to those in Jordan and better than those in the observing children and consulting their caregivers. Philippines, with approximately 30 percent of children failing Table 1: Five Key Domains of Child Development Area of Child Development Characterized by children excel in communication and general knowledge, and also in social competence, but perform less well in literacy-related Language and Child is interested in reading and writing, can skills and cognitive development. This means that Indonesian cognitive count and recognize numbers and shapes. Child children are in comparison independent, can communicate development has the ability to understand similarities and differences, and recite back information from their needs, and act with patience and social appropriateness. memory. However, they appear to need further support with skills that Physical health and Child is healthy, independent, and has good fine are the precursors to reading, writing, and computing, such well-being and gross motor skills. as counting, number recognition and distinguishing between Social competence Child is able to control own behavior, has similarities and differences. appropriate respect for authority, has the ability to play and work with other children, and is self-confident. Figure 4: Card Sorting Task Results Emotional maturity Child is not too fearful or reactive, is patient, Indonesia and not aggressive or angry. Philippines Communication skills Child can tell a story, employs symbolic use of and general language, and has age-appropriate knowledge Jordan knowledge about life and the world around. Child can (%) 0 10 20 30 40 50 60 70 80 90 100 communicate with adults and children, and articulate needs and wants in socially Fail color, shape and border Pass color and shape only appropriate ways. Pass color, shape and border both the most basic color and shape games, over half of Figure 5: International Comparison of EDI Results four-year olds passing both of those games, and less than 20 percent passing the hardest game--the border game. This result 90 1. Canada 80 ** 2. Australia is encouraging for the cognitive potential of Indonesia's 3. Indonesia % children vulnerable 70 4. Mexico children, but it is an area that needs further attention, as 60 5. Jordan reinforced by other school readiness results below. 50 6. Chile 7. Mozambique 40 8. Philippines 30 * Good result on social, This study also utilizes one of the most well-known measures of 20 communication and general knowledge school readiness--the Early Development Index (EDI)vii. The EDI 10 ** Low language and cognitive * measures five developmental domains (see Table 1 above). The 0 1 2 3 * 4 5 6 7 8 skills EDI is a relative indicator and can be used to compare groups Physical Social Emotional Language Communication and of children across geographic areas. As shown in Figure 5, Cognition General Knowledge compared to children in other countries, we find that Indonesian Household · Reading and storytelling are uncommon at home, especially telling stories, drawing or scribbling, playing music, singing or for younger children, while children engage in music, song and dancing. Here we examine the frequency with which those dance more frequently. practices take place. On average, over half of the households we · Over half of sample households have no books in the home. surveyed have no books at home. Given this result, it may not be surprising that our results also show that children are rarely read As mentioned above, the survey work focuses not only on to. These results are consistent with the deficiencies we see in the children, but on other factors in a child's sphere of influence language and cognitive domain results in the EDI. As shown in that affect development, such as caregiving practices, parents' Figure 6, nearly 80 percent of one-year olds and nearly 60 percent education and employment, household poverty, and access to of four-year olds never spend time reading or looking at books, basic services and infrastructure by the household (for example, while less than 10 percent of children in those age groups are clean water, electricity, health care, schooling). exposed to books almost daily. On the positive side, we see that around 40 percent of children in both age groups are playing By caregiving practices we mean actions that household members music, singing or dancing nearly daily--which covers many areas take to stimulate child development, such as reading books, of child development--and less than 20 percent of children never do these activities. Figure 6: Child Activities throughout the Week Never iII For example, breast milk contains antibodies that can protect babies from illness and germs, such as diarrhea, respiratory infections, stomach viruses, diabetes, and leukemia; and 1-2 days a week breastfeeding supports sensory and cognitive development. WHO 2010, UNICEF 2009. iv Riskesdas 2007. http://www.litbang.depkes.go.id/riskesdas/download.htm 3-5 days a week v To measure this, we utilize the Strengths and Difficulties Questionnaire (SDQ) and the Early Development Instrument (EDI). With both of these instruments being used internationally, the 6-7 days a week results can be compared across countries. 100 90 80 70 60 50 40 30 20 10 0 0 10 20 30 40 50 60 70 80 90 100 vi There are three progressively more challenging stages to the game: sorting by color, sorting by shape, and sorting by color when the card has a border, sorting by shape when it does not. Reading Books/Magazines Playing Music, Singing, Dancing The game is generally played by children up to age 7. vii In most countries, the EDI is administered by teachers, but in this study the EDI was Age 1 Age 4 administered by interviewers with the primary caregiver being the respondent. The EDI is validated for children from age 3 to 6. Number of times child engaged in activity in the past week with someone in the household Community · Nearly all one-year olds and over half of four-year olds have Children may have not had exposure to ECED services because never had exposure to early childhood services. the service does not yet exist. There is significant variation in the provision of services across districts. For example, in the most Beyond the household, a child's development is influenced by remote district, Ketapang (Kalimantan), there are almost no how a community approaches caring for and nurturing children, early childhood education services per 1000 people, while in often evidenced by the quantity and quality of services accessible Sarolangun (Sumatra) there are around three early childhood by the child and household. Access can mean whether the education centers per village per 1000 people. service exists, how far the service is from the household, the cost of the service, and whether the service provides the kind Table 2: Percent of Children Exposed to Type of ECED Service of child development programs that the household values. One One-year Four-year of the first steps in utilizing a service is just knowing where it is olds (%) olds (%) (if one exists). We find that information remains a challenge for Daycare (TPA) <1 <1 caregivers--only 66 percent know the nearest location of an ECE (KB/TPK) 2 11 early childhood service (such as daycare, playgroup), whereas Kindergarten (TK/RA) N/A 13 nearly all caregivers know the location of the integrated health Other early childhood education service* 6 26 post (posyandu) or the public health clinic. This is not surprising, Children who have never had exposure** 92 56 as shown in Table 2, given nearly all one-year olds and over half Total 100 100 of four-year olds have never had exposure to early childhood * Includes any early childhood service that is private, unrelated to the project, or does not fit in another category. services. ** Does not include posyandu since nearly all children are exposed to posyandu. Note: Letters in parenthesis are Indonesian abbreviations. Key Findings and Recommendations: What can policymakers in Indonesia do to support improved child development outcomes? This study finds that Indonesia is not living up to its full potential In focusing on Indonesia's potential, Table 3 presents of preparing students for success and proper adjustment in opportunities for the ECED project as it progresses in school and beyond. Of course, Indonesia is not alone--it is implementation. These pre-project findings show that MoNE estimated that poverty is suppressing the cognitive potential of can strengthen services by focusing on areas of vulnerability, around 200 million children throughout the world such as language and cognitive development. It is also notable (Grantham-McGregor 2007), but ECED projects like the one that early childhood development services seem to be very supported by MoNE have a chance to reverse or mitigate the limited and/or little utilized, so this presents an opportunity for effects of such suppression. the project to reach thousands of children who haven't been exposed before. Table 3: ECED Baseline Key Findings and Recommendations Findings Recommendations Chronic nutrition problems need to be addressed if Project could better coordinate with posyandu by asking posyandu staff to educate teachers and parents at children are to flourish centers, and center staff could refer parents to posyandu. Children's social and communication skills are strong Current level of project attention in this area is sufficient. Children's language and cognitive vulnerability Direct resources to books, storytelling and cognitive stimulation at centers, and teaching parents to do this presents opportunity for project to better prepare at home. Consider offering books for home borrowing as part of ECED center, and/or work with children for primary school community libraries to promote reading to children and lending books. Consider educating posyandu staff about vulnerability and ways to address it since exposure is near universal at posyandu. Parents could be exposed to more ways of stimulating Project's greatest potential for affecting child development is engaging parents. Support parental child development caregiving education to promote attachment and early stimulation by role modeling and engagement in playgroups. Nearly all of one-year olds and over half of four-year Programs can have the greatest impact at younger ages. Significant scope to increase participation, olds have never been exposed to an early childhood especially for younger children (ages 0-3). Add more focused services, linking with posyandu, a model for service early childhood service delivery. ABOUT DESP Funded by the Government of the Kingdom of the Netherlands, the government achieve its education strategic plan. The findings, the Dutch Education Support Program (DESP) Trust Fund provides interpretations, and conclusions expressed in this paper do not support to the Government of Indonesia through the World Bank for necessarily reflect the views of, the Government of the Kingdom of the purpose of developing policies, studies, and programs that help the Netherlands or the Government of Indonesia. Prepared by the Education Unit, World Bank Indonesia For more information, please contact: Human Development Sector Jl. Sudirman Kav. 52-53, Jakarta 12190 Mae Chu Chang: mchang@worldbank.org World Bank Office Jakarta Phone (021) 5299 3000 Sheila Town: stown@worldbank.org Indonesia Stock Exchange Building Tower 2, 12th floor Fax (021) 529 3111