title: Strengthening systems for integrated early childhood development services: a cross-national analysis of governance.
abstract: While there has been substantial growth in early childhood development (ECD) services in low- and middle-income countries (LMICs), there is considerable inequity in their distribution and quality. Evidence-based governance strategies are necessary, but currently they are insufficient for widespread, quality implementation. In particular, there is a limited understanding of the use of systems approaches for the analysis of ECD services as they go to scale. The aim of this paper is to present findings from four countries, using a cross-national case study approach to explore governance mechanisms required to strengthen national systems of ECD services. While different sets of governance strategies and challenges were identified in each country, overarching themes also emerged with implications for systems strengthening. Study results focus on local, mid-level and central governance, with recommendations for effective coordination and the integration of ECD services in LMICs.
authors.affiliation: United Nations Children's Fund, New York, New York, The Edward Zigler Center in Child Development and Social Policy, and The Child Study Center, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Pia Rebello
authors.initials: PR
authors.lastname: Britto
authors.affiliation: Harvard Graduate School of Education, Cambridge, Massachusetts.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Yoshikawa
authors.affiliation: The Edward Zigler Center in Child Development and Social Policy, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Jan
authors.initials: J
authors.lastname: van Ravens
authors.affiliation: The Edward Zigler Center in Child Development and Social Policy, Yale School of Medicine, New Haven, Connecticut.|The Child Study Center, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Liliana Angelica
authors.initials: LA
authors.lastname: Ponguta
authors.affiliation: The Edward Zigler Center in Child Development and Social Policy, Yale School of Medicine, New Haven, Connecticut.|The Child Study Center, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Maria
authors.initials: M
authors.lastname: Reyes
authors.affiliation: Harvard Graduate School of Education, Cambridge, Massachusetts.
authors.forename: Soojin
authors.initials: S
authors.lastname: Oh
authors.affiliation: The Child Study Center, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Roland
authors.initials: R
authors.lastname: Dimaya
authors.affiliation: Harvard Graduate School of Education, Cambridge, Massachusetts.
authors.forename: Ana María
authors.initials: AM
authors.lastname: Nieto
authors.affiliation: University of Southern California, Los Angeles, California.
authors.forename: Richard
authors.initials: R
authors.lastname: Seder
mesh_terms: D002648:Child; D002657:Child Development; D002675:Child, Preschool; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D018479:Early Intervention, Educational / Q000458:organization & administration*; D061345:Early Medical Intervention / Q000458:organization & administration; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009313:National Health Programs
keywords: coordination; early childhood; governance; low- and middle-income countries (LMICs); systems strengthening