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Jamaica

EARLY CHILDHOOD DEVELOPMENT SABER Country Report 2013

Policy Goals Status 1. Establishing an Enabling Environment

The early childhood development (ECD) system in Jamaica has a legal framework that includes policies, regulations, and a National Strategic Plan that protect children and their families and promote high quality service delivery. The Early Childhood Commission (ECC) serves as an institutional anchor and effectively coordinates across sectors. Financing for ECD, while adequate in some sectors, could be better coordinated with measures to ensure sustainable levels of investment in ECD.

2. Implementing WidelyA wide scope of ECD programs exists in Jamaica, with essential interventions available across all relevant sectors. Coverage for health programs is adequate, but access to certain nutrition interventions could be scaled to reach all young children and pregnant mothers. There is universal access to preprimary school for 3-6 year olds, but early learning opportunities are not as easily available for children in the 0-3 age group.

3. Monitoring and Assuring QualityJamaica has an advanced system to monitor levels of access and outcomes in ECD. Rigorous standards exist for ECD service delivery in the health and education sectors. Quality assurance measures have been enhanced in recent years, but compliance with standards could still be improved.

JAMAICAǀEARLYCHILDHOODDEVELOPMENT SABERCOUNTRYREPORT|2013

SYSTEMSAPPROACHFORBETTEREDUCATIONRESULTS 1

Table1:SnapshotofECDindicatorsinJamaicaandotherLatinAmericanandCaribbeancountries

Jamaica Barbados Brazil Chile ColombiaTrinidadand

Tobago

InfantMortality(deathsper1,000livebirths,2011) 16 18 14 8 15 25

Below5Mortality(deathsper1,000livebirths,2010) 18 20 16 9 18 28

Birthsattendedbyaskilledattendant 98% 100% 97% 100% 99% 98%

Moderate&SevereStunting(Below5,2006-2010) 4% Notavailable 7% Not

available 13% Notavailable

GrossPreprimaryEnrollmentRate(3-6years,2010) 112% 108% Notavailable 106% 49% 82%

(2007)

Birthregistration2000-2010 98% Notavailable 93% 100% 97% 96%

Source:UNICEFCountryStatistics,2010;UNESCOInstituteforStatistics,WHO,2011

1SABER-ECDisonedomainwithintheWorldBankinitiative,SystemsApproachtoBetterEducationResults(SABER),whichisdesignedtoprovidecomparableandcomprehensiveassessmentsofcountrypolicies.

This report presents an analysis of the Early ChildhoodDevelopment (ECD) programs and policies that affectyoung children in Jamaica and recommendationstomoveforward.Thisreportispartofaseriesofreportsprepared by the World Bank using the SABER-ECDframework 1 and includes analysis of early learning,health, nutritionand social and childprotectionpoliciesand interventions in Jamaica, along with regional andinternationalcomparisons.

JamaicaandEarlyChildhoodDevelopment

Jamaica isanuppermiddle-incomecountrywitha totalpopulation of 2.7 million. With a land area of 10,991squarekilometersJamaicaisthelargestEnglish-speakingisland in theCaribbean. TheGDP in Jamaica isUS$14.4billion. Jamaica is ranked 85th in the UNDP Humandevelopment index. The country has a gross nationalincomeofUS$4,800percapita,with17.6percentofthepopulationlivingbelowthenationalpovertyline.In2012,9 percent of the total population was younger than 6yearsold(411,055children).

The Government of Jamaica (GoJ) has recognized theimportanceofECDthroughitssupportofpublicpolicies

and programs for young children. In 2003, the EarlyChildhoodCommission(ECC)wasestablishedwithinthethenMinistryofEducationandYouthtocoordinatethevarioussectorsinvolvedinECDandoverseethequalityofearlychildhoodinstitutions(ECIs). In2008,theECCsupported the implementation of the GoJ’s firstNational StrategicPlan forECD (2008-2013).TheplanservedasaroadmapforimprovingthequalityofECDinthecountry.Since2008,theGoJhasmadeconsiderableprogressinimprovingtheECDsystem;thishasincludedstrengthening the ECC as an institutional anchor,creating a system for monitoring child developmentthroughChildHealth andDevelopment Passport, andenhancingandtrackingthequalityofECIs.

Asof2013,theGoJisintheprocessofdevelopinganewNationalStrategicPlan(2013-2017)aswellasanationalmulti-sector ECD policy. The present SABER-ECDanalysisisintendedtoidentifyachievements,aswellasgaps, inJamaicanECDpoliciesandprograms inhopesofinformingthedevelopmentofthenewplan.Table1presents a comparison of selected ECD indicators inJamaica and countries across the Latin American andCaribbeanregion.



SystemsApproachtoBetterEducationResults–EarlyChildhoodDevelopment(SABER-ECD)SABER – ECD collects, analyzes and disseminatescomprehensiveinformationonECDpoliciesaroundtheworld. In each participating country, extensivemultisectoral information is collected on ECD policiesand programs through a desk review of availablegovernment documents, data and literature, andinterviewswith a range of ECD stakeholders, includinggovernment officials, service providers, civil society,development partners and scholars. The SABER-ECDframeworkpresentsaholisticandintegratedassessmentof how the overall policy environment in a countryaffects young children’s development. This assessmentcanbeusedtoidentifyhowcountriesaddressthesamepolicychallengesrelatedtoECD,withtheultimategoalof designing effective policies for young children andtheirfamilies.Box1presentsanabbreviated listof interventionsandpolicies that the SABER-ECD approach looks for incountries when assessing the level of ECD policydevelopment.Thislistisnotexhaustive,butismeanttoprovideaninitialchecklistforcountriestoconsiderthekeypoliciesandinterventionsneededacrosssectors.

ThreeKeyPolicyGoalsforEarlyChildhoodDevelopment

SABER-ECD identifies three core policy goals thatcountries should address to ensure optimal ECDoutcomes: Establishing an Enabling Environment,Implementing Widely and Monitoring and AssuringQuality.ImprovingECDrequiresanintegratedapproachtoaddressallthreegoals.AsdescribedinFigure1,foreachpolicygoal,aseriesofpolicyleversareidentified,throughwhichdecision-makerscanstrengthenECD.Strengthening ECD policies can be viewed as acontinuum; as described in Table 2 on the followingpage,countriescanrangefromalatenttoadvancedlevelof development within the different policy levers andgoals.

Box1:AchecklisttoconsiderhowwellECDispromotedatthecountrylevelWhatshouldbeinplaceatthecountryleveltopromotecoordinatedandintegratedECDinterventionsforyoung

childrenandtheirfamilies?Healthcare

• Standardhealthscreeningsforpregnantwomen• Skilledattendantsatdelivery• Childhoodimmunizations• Well-childvisitsNutrition• Breastfeedingpromotion• Saltiodization• IronfortificationEarlyLearning• Parenting programs (during pregnancy, after delivery

andthroughoutearlychildhood)• Highqualitychildcareforworkingparents• Free preprimary school (preferably at least two years

with developmentally appropriate curriculum andclassrooms,andqualityassurancemechanisms)

SocialProtection• Servicesfororphansandvulnerablechildren• Policiestoprotectrightsofchildrenwithspecialneeds

andpromotetheirparticipation/accesstoECDservices• Financial transfer mechanisms or income supports to

reachthemostvulnerable families (could includecashtransfers,socialwelfare,etc.)

ChildProtection• Mandatedbirthregistration• Job protection and breastfeeding breaks for new

mothers• Specificprovisionsinjudicialsystemforyoungchildren• Guaranteedpaidparentalleaveofleastsixmonths• Domesticviolencelawsandenforcement• Trackingofchildabuse(especiallyforyoungchildren)• Trainingfor lawenforcementofficers inregardstothe

particularneedsofyoungchildren

Figure1:ThreecoreECDpolicygoals



Table2:ECDpolicygoalsandlevelsofdevelopment

ECDPolicyGoal

LevelofDevelopment

EstablishinganEnablingEnvironment

Non-existentlegalframework;ad-hocfinancing;lowinter-sectoralcoordination.

Minimallegalframework;someprogramswithsustainedfinancing;someinter-sectoralcoordination.

Regulationsinsomesectors;functioninginter-sectoralcoordination;sustainedfinancing.

Developedlegalframework;robustinter-institutionalcoordination;sustainedfinancing.

ImplementingWidely

Lowcoverage;pilotprogramsinsomesectors;highinequalityinaccessandoutcomes.

Coverageexpandingbutgapsremain;programsestablishedinafewsectors;inequalityinaccessandoutcomes.

Near-universalcoverageinsomesectors;establishedprogramsinmostsectors;lowinequalityinaccess.

Universalcoverage;comprehensivestrategiesacrosssectors;integratedservicesforall,sometailoredandtargeted.

MonitoringandAssuring

Quality

Minimalsurveydataavailable;limitedstandardsforprovisionofECDservices;noenforcement.

Informationonoutcomesatnationallevel;standardsforservicesexistinsomesectors;nosystemtomonitorcompliance.

Informationonoutcomesatnational,regionalandlocallevels;standardsforservicesexistformostsectors;systeminplacetoregularlymonitorcompliance.

Informationonoutcomesfromnationaltoindividuallevels;standardsexistforallsectors;systeminplacetoregularlymonitorandenforcecompliance.

Policy Goal 1: Establishing an EnablingEnvironmentØ Policy Levers: Legal Framework •IntersectoralCoordination•Finance

AnEnablingEnvironmentisthefoundationforthedesignand implementation of effective ECD policies. 2 Anenabling environment consists of the following: theexistenceofanadequatelegalandregulatoryframeworkto support ECD; coordinationwithin sectorsandacrossinstitutionstodeliverserviceseffectively;and,sufficientfiscalresourceswithtransparentandefficientallocationmechanisms.

Policy Lever 1.1:LegalFramework The legal framework comprises all of the laws andregulations which can affect the development of youngchildren in a country. The laws and regulations whichimpactECDarediverseduetothearrayofsectorswhichinfluenceECDandbecauseof thedifferentconstituenciesthatECDpolicycanandshouldtarget,includingpregnantwomen,youngchildren,parents,andcaregivers.

National lawsandregulationspromotehealthcare forpregnantwomenandyoungchildren.In2009,agazette

2Brinkerhoff,2009;Britto,Yoshikawa&Boller,2011;Vargas-Baron,2005

to theNationalHealthServicesActabolisheduser feesfor public health services. Both antenatal visits andskilled delivery are guaranteed in Jamaica. In addition,standardhealthscreeningsforHIVandSTDsforpregnantwomen are free and standard follow-up and referralproceduresareprovided.TheMinistryofHealth(MoH)hasoperationalguidelinesforpreventionofmother-to-child transmission and antenatal care as well as aNationalStrategicPlanforHIVandAidsinJamaica(2007-2012).

In 2007, the MoH produced a comprehensive FamilyHealthManual,which includes detailedobjectives andstrategies for health service provision for infants andyoung children. The goal of the ECD section of themanual istoensureholisticchilddevelopmentthroughpromoting and protecting childwellness in the family,health center, and community settings. The manualoutlines specific strategies for structured serviceprovisionateachdevelopmentstage intheearlyyears(through 8 years). To guide child visits, the manualpresents norms for growth and various developmentalmilestones. It also summarizes age-specific clinicalproceduresaswellaskeymessagesforhealthprovidersto convey (immunization schedule, breastfeeding,hygiene,earlystimulation,etc.)ateachwellchildvisit.



In addition to age-specific guidelines for immunizationoutlinedintheFamilyHealthManual,thePublicHealthActstatesthatyoungchildrenarerequiredtoreceiveacomplete course of childhood immunizations(ImmunizationRegulationsof1986).

New draft policy will promote appropriate dietaryconsumptionbypregnantwomenandyoungchildren.JamaicacomplieswiththeprovisionoftheInternationalCode of Marketing of Breastmilk Substitutes, a globalhealthpolicyframeworkadoptedbytheWHOaswellastheInnocentiDeclarationforthePromotion,Protection,andSupportofBreastfeeding.However,accordingtotheMoH,only40percentofinfantsareexclusivelybreastfedin Jamaica at 3months3. TheMoHhas recognized theneed for increased emphasis on optimal infant andyoungchildfeedingpractices.ItrecentlydraftedanewNational InfantandYoungChildFeeding(NIYCF)Policy,which is being reviewed by Cabinet (April, 2013). Thedraft NIYCF Policy provides an operational frameworkand guidelines for programs and services that willpromote adequate nutritional practices for youngchildren.

While the Nutrition Department of theMoH does notreport a specific policy for salt iodization or flourfortification, it reports that all salt is iodized and ironfortifiedfoodisencouraged.Additionally,thenewNIYCFPolicypresentsguidelinesthatpromotecomplementaryfeeding with iron-rich foods for children 6-24months,includingfortifiedcereals.

Maternity leave and job protection is available, butJamaicanpolicycouldbetterpromoteopportunitiesforparents/caregivers to provide care to newborns andinfantsintheirfirstyearoflife.TheMaternityLeaveAct(1979) guarantees 12 weeks of maternity leave withguaranteed pay of 8 weeks. Leave is paid by theemployer. Fathers are not guaranteed any paid leave.Table3providesa sampleof leavepolicies fromotherLatin American and Caribbean countries. Compared toJamaica and other countries in the region, highperforming countries like Sweden and the UnitedKingdom,offergreaterprotectionforparentalleaveandfocus on enhanced economic and social planning.Sweden’s approach, detailed in Box 2, is an advanced,flexiblepolicytoensureadequatecareofthechild.

3Mothersshouldexclusivelybreastfeduntil6months.Updateddatadoesnotexistforthisperiod.

Jamaica follows some, but not all, guidelines inaccordance with the ILO Maternity ProtectionConvention. TheMaternity Leave Act protects againstdiscriminatorydismissalofpregnantwomen;employersarerequiredtogiveemployeesthesamejobwhentheyreturn from maternity leave. However, employers arenotrequiredtoprovidebreaksfornursingmothers.

Table3:Comparisonofmaternityandpaternity leavepoliciesinLatinAmericaandCaribbeanJamaica Colombia Brazil Trinidad Barbados12weeks

maternity,at100%for8weeks,paid

bytheemployer.Nopaternity

leave.

14weeksmaternity,10days

paternityat100%of

salary,paidbystateandemployer

17weeksmaternity,1daypaternity

at100%ofsalary,paid

bystate

13weeks,100%for1monthand50%for2

months,paidbyemployer.Nopaternity

leave.

12weekmaternityat100%of

salary,paidbystate.

Nopaternityleave.

Source:ILO,2012

Summary: The Swedish Parental Insurance Benefit is theinternational exemplar for parental leave policy. ParentalInsurance in Sweden is designed to benefit both men andwomen.Intotal,theleaveincludes480daysofpaidleave,60daysofwhichareearmarkedforthemother,60daysforthefather,andtheremaindertobedividedasthecouplechooses.Itcommencesuptosevenweekspriortotheexpectedbirth,and also is available for parents adopting a child. Thecompensationratecanvary;asaminimum,however,80%ofthe employee’s salary is provided during leave. In addition,eachparentislegallyentitledtotakeunpaidleaveuntilachildis18monthsold.Additionbenefitsinclude:temporaryparentalleave, which entitles a parent 120 days of parental leaveannuallytocareforchildrenundertheageof12withillnessordelay (child requires a doctor’s certificate); a pregnancybenefit, payable for a maximum of 50 days to expectantmothers who are unable to work because of the physicallydemanding nature of their jobs; and, pension rights forchildcareyears,whichpartiallycompensatethe lossoffutureincomeduringtheperiodwhentheparentisathomewiththechild.

KeyconsiderationsforJamaica:ü Mandatedparentalleaveforfathersü Adequate,sustainablefinancialsupporttofamiliesduring

earlystageofchild’slifeü Additionalbenefitsforfamilieswithchildrenwhohave

specialneeds

Box2:RelevantlessonsfromSweden:TheSwedishParentalInsuranceBenefit



Jamaican law guarantees the provision of freepreprimary education. In 2011, the GoJ added aconstitutional amendment called the Charter ofFundamentalRightsandFreedoms.Thecharterdeclaresthateverychildhasarighttopublicallyfundedtuitionatpreprimary(andprimary) level. Itshouldbenotedthatwhilefreeprovisionofpreprimaryschoolismandatedbylaw, the Government currently provides free publicpreprimaryeducationforonlyapproximately10percentofthepopulationofchildrenbetween3and6yearsold4.

Child protection policies and services, including birthregistration and protection from violence, areestablished in Jamaica. TheRegistration of Births andDeathsActstatesthatparentsorcaregiversofchildrenarerequiredtoreportachild’sbirthwithinfivedaystolocal district registrars. Since 2007, Civil BedsideRegistrars work in public and private hospitals tofacilitatethisregistrationprocess.

TheGoJpromotesthereductionoffamilyviolenceacrossrelevantsectors.TheChildDevelopmentAgency(CDA),theorganizationprimarilyresponsibleforJamaica’schildprotection system, has established several services topreventviolence.Thisincludeshomevisitingprograms,child abuse tracking and reports activities through theOffice of the Children’s Registry. In addition, the ECC(discussed in detail in the following section) promotestrainingprovisionforearlychildhoodcareandeducation(ECCE) teachers so that they are equipped to identifysituationsofchildabuseandneglect.Additionally,underthe Ministry of Justice (MoJ), several importantinterventionsare inplacetoprotectchildren, includingtraining for judges, lawyers, and law enforcementofficersonchildren’s rights.AnOfficeof theChildren’sAdvocate and specialized Children’s and Family Courtsalsoexist in thenational judicial systemtoprotect therightsofchildren.

SocialprotectionpoliciesandservicesareestablishedinJamaica to protect vulnerable young children. TheChildcare and Protection Act guarantees all children,includingorphansandvulnerablechildrenandchildrenwith special needs, a rangeof ECD services. TheAct isdesigned to protect the best interests of all children,includingeachchild’srighttosafety,continuityofcare,development of physical and emotional needs, qualityrelationships,andeducation.TheCDAandseveralnon-

4Publicpreprimaryschools,knownasInfantSchoolsandInfantDepartmentshavetraditionallybeenfor4and5yearoldsbutafewschoolshave3yearolds.

governmentalagenciesprovideservicestoorphansandvulnerable children, including those affected byHIV/AIDS.

The Early Childhood Act and Regulations (2005)promotes inclusive education for children withdisabilities.ItalsooutlinestherolesandresponsibilitiesofECIsandparents.TheGoJsupportsnon-governmentalcommunity-based programs that cater to disabledchildren who cannot access mainstream preprimaryeducation. The National Policy for Persons withDisabilitiesprovidesaframeworkfortheGoJtoprovideequalopportunitiesforpeople,includingyoungchildren,withdisabilities.

Box3:Keylaws,policies,andregulationsgoverningECDinJamaica

PolicyLever1.2:IntersectoralCoordinationDevelopment in early childhood is a multi-dimensionalprocess.5Inordertomeetchildren’sdiverseneedsduringthe early years, government coordination is essential,both horizontally across different sectors as well asvertically from the local to national levels. In manycountries, non-state actors (either domestic orinternational)participateinECDservicedelivery;forthisreason,mechanismstocoordinatewithnon-stateactorsarealsoessential.

5Naudeauetal.,2011;UNESCO-OREALC,2004;Neuman,2007

KeyECDLaws• ChildCareandProtectionAct(2004)• EarlyChildhoodActandRegulations(2005)• EarlyChildhoodCommissionAct(2003)• NationalParentingSupportCommissionAct(2012)

OtherPolicies/RegulationsProtectingWomen&Children• NationalStrategicPlanforEarlyChildhoodDevelopment2008-

2013• NationalInfantandYoungChildFeedingPolicy(DRAFT,2013)• NationalParentingSupportPolicy(2012)• CharterofFundamentalRightsandFreedoms(2011)• NationalHealthServicesAct(2008)• NationalStrategicPlanforHIVandAIDSinJamaica(2007-2012)• PublicHealthAct(1974)• FamilyHealthManual(2007)• MaternityLeaveAct(1979)• NationalPolicyforPersonswithDisabilities



TheECCservesas thenational institutionalanchor tocoordinate ECD across sectors. In 2003, the ECC wasestablished as an official agency to govern theadministration of ECD in Jamaica (Early ChildhoodCommission Act). Operating under the Ministry of

Education(MoE)andreportingdirectlytotheMinisterofEducation,theECCisresponsibleforadvisingtheMoEonECDpolicymatters.ItassistsinthepreparationaswellasmonitoringandevaluationofECDplansandprograms,acts as a coordinating agency to streamline ECDactivities, manages the national ECD budget, andsupervises and regulates ECIs. The ECC includes agovernance arm comprised of the officially appointedExecutiveDirector,aBoardofCommissioners,andsevensub-committees representing governmental and non-governmental organizations. It also has an operationalarm that provides support to the Board andsubcommittees. As displayed in Figure 2, the ECC isdesignedwithrepresentation fromall relevantsectors,including education, health, local government andcommunitydevelopment,labor,finance,protection,andplanning. Each ministry or government agencynominates a representative to serve on the Board ofCommissioners. The seven sub-committees whichprovide technical support to the ECC board arecomprised of 50 governmental and non-governmentalagencies.

The Government is in the process of drafting a newexplicitly-stated multi-sectoral ECD strategy. In 2008,withthesupportoftheWorldBank,theGoJdevelopedthe National Strategic Plan (NSP) for Early ChildhoodDevelopment2008-2013 to improve theECDsystem inJamaica. The NSP includes strategies for internalprocesses, including effective parenting, healthcare,screeningandearlyidentificationandreferralforat-riskchildren,qualityearlychildhoodfacilities,andcurriculum

delivery. It also includes strategies for workingenvironment processes, including a results-orientedframework for relevantsectoragenciesandtimelyandappropriateinformationavailability.

Asof June2013,theGoJ is intheprocessofdraftinganewNSP(2013-2017)aswellasanewECDpolicy,whichwillbeknownastheEarlyChildhoodDevelopmentPolicyof Jamaica. The national policy will be applied sub-nationally and cover education, health, nutrition, andchild and social protection. To complement this newpolicyandNSP,theGovernmentisencouragedtoincludeacostedimplementationplan.

Mechanismsexistforcollaborationwithlocalandnon-state stakeholders. In addition to national-levelcoordination, the ECC coordinates with the local-levelearly childhood actors. The ECC holds monthlycoordination meetings for ECD implementers at theservice delivery level. In addition, the ECC board hasrepresentatives from the Jamaica Early ChildhoodAssociation(JECA).JECA,anon-stateentity,iscomprisedofmanagementbodiesofallcommunity-basedECIs.TheECCarranges forbothtrainingand informationsharingmeetingswith local serviceproviders andpractitionersfromJECA.

AnewlyestablishedcommissioncreateslinksbetweenJamaican parents and the GoJ. In 2012, the MoEintroducedtheNationalParentingSupportPolicy(2012).TheGovernment recognized that parents should servean important role to promote and coordinateorganizational efforts and resources for positiveparentingpracticesandoptimalopportunitiesforyoungchildren. In conjunction with the policy, the NationalParentingSupportCommissionAct(2012)establishedanofficial coordinating body to ensure effective

Figure2:IntersectoralcompositionofEarlyChildhoodCommission



streamlining ofGoJ activities related to parenting. TheNational Parenting Support Commission (NPSC) isresponsible for monitoring and evaluating theimplementationoftheNationalParentingSupportPolicyandrecommendingbudgetaryallocationsforparentingprograms for the MoE. It is also responsible fordeveloping national standards for an accreditationsystemforparentingsupportservices.

In addition to the NPSC, another emerging parentinginitiativehasbeentheestablishmentofParents’Places,centersthatprovideparentinginformation,support,andtraining for both parents and practitioners. In 2011, 7Parents’ Places were successfully piloted. In the pastyear, Parents’ Places have been expanding and a newUSAIDparentingprojectissupportingtheestablishmentof 60 new Parents’ Places. Found in each parish, theECC’s Resource Centers that support practitioners in anumberofways,includingcurriculumsupport,willalsobecomeParents’Places.

ECDgoalshavebeenestablishedinallsectorsandthenewstrategicplan should serveasa commonplanofaction.ThecurrentNSPoutlinesintegratedECDservicesthatall Jamaicanchildrenshouldreceive. Additionally,eachsectorhasputforthitsownspecificECDgoals.Forexample, the Ministry of Labour and Social Security(MLSS)hasdesignedaconditionalcashtransferprogramcalled PATH (ProgramofAdvancement throughHealthand Education). PATH (which has benefits for familiesliving below the poverty line and other vulnerableindividuals)includesaspecificconditionalityforchildrenyounger than 6 years old to access preventativehealthcare. For the education sector, the MoE hasoutlinedspecificeducationgoals, includingqualityECIsand effective curriculumdelivery. In the health sector,the MoH disseminates Child Health & DevelopmentPassportstoallbabiesborninJamaicaorwhomovetothe country before they are six months old. Lawmandates theuseofallPassportsbyallhealthcentersand well-child clinics. The Passport is an innovativetracking tool to track immunizations, growth, anddevelopment,aswellasprovideanticipatoryguidancetoparents.Thepassportisfocusedonhealthinterventionsand outcomes, but also tracks several education andnutritional outcomes. While the Passport serves as avaluable mechanism for collecting information onholistic development for individual children, there iscurrently no integrated service delivery manual or

6Formoreinformationsee:SABER-ECDColombiaCountryReport

common plan of action for all practitioners deliveringservicestoyoungchildren.

TheChildHealth&DevelopmentPassportmayserveasa useful foundation for developing a cross-sectoralmanualwithguidelinesforintegratedserviceprovision.In considering the inclusion of a menu of integratedservices in the new strategic plan, the ECC may learnvaluablelessonsfromColombia,acountrywhichhasalsorecently developed a new multisectoral ECD strategy.Box4describeshowthenationalECDstrategyincludesanintegratedservicedeliveryschemeknownastheRutaIntegral,which presents a common plan of action forimplementationattheservicedeliverylevel6.

PolicyLever1.3:FinanceWhile legal frameworks and intersectoral coordinationare crucial toestablishinganenablingenvironment forECD,adequatefinancialinvestmentiskeytoensurethatresourcesareavailabletoimplementpoliciesandachieveservice provision goals. Investments in ECD can yieldhighpublicreturns,butareoftenundersuppliedwithoutgovernmentsupport.Investmentsduringtheearlyyearscan yield greater returns than equivalent investments

Summary: The Government of Colombia has recentlydevelopedtheDeCeroaSiempre,or“FromZerotoForever”strategy to promote comprehensive ECD system acrossrelevantsectors.AmajorcomponentofthenewstrategyistheRuta Integral de Atenciones, or the “Scheme forComprehensive Services,” which is an established list ofspecific ECD services that should be delivered to all youngchildren.ThisRutaIntegralprovidesanoperationalframeworkwhich spans from theprenatalperiod to6yearsofageandincludes interventions relatedtothehealth,nutrition,socio-emotional development, cultural understanding, andprotection of the child. Colombia’s new ECD strategyemphasizes implementation at the local level; eachmunicipality is expected to establish a municipal ECDcommittee. Thesemunicipal committees are responsible forcoordinating interventionsat the levelof servicedelivery toensurethat childrenreceiveall essential servicesoutlined intheRutaIntegral.

KeyconsiderationsforJamaica:ü BecausepolicydecisionsandinterventionsinECDspan

acrossmultipleministriesinJamaica,itisimportanttohaveacommonplanofaction,notonlyatthepolicylevel,butattheservicedeliveryandlocallevel.

Box4:RelevantlessonsfromColombia:RutaIntegral



made later in a child’s life cycle and can lead to long-lasting intergenerational benefits 7 . Not only doinvestmentsinECDgeneratehighandpersistentreturns,they canalso enhance the effectiveness of other socialinvestments and help governments address multipleprioritieswithsingleinvestments.

Insomesectors,explicitcriteriaareusedtodecideECDspending. In theeducation sector, funding isbasedonspecific criteria, including the number of childrenenrolledandhistoricalprecedent.TheECCrequiresthatECIsmeetcertaincriteria inordertoberegisteredandreceive materials, nutrition grants, or stipends forteachers.Inthehealthsector,thevaccinationbudgetisbasedonthenumberoftargetedchildrenanddoses.TheNutritionUnitwithintheMoH(andworkswiththeMoE’sSchool Feeding Unit) also has a budget for mealsprovidedinECIsaccordingtothenumberofchildren.Inthe social protection sector, the MLSS uses children’scharacteristicstodeterminePATHfunding.

TheECChasabudgetforspendingacrosssectors,butplanning and reporting of ECD budgets across otherministries could be better coordinated. The ECC hasbudget for spending across sectors, but this is notnecessarily coordinatedwith the other ministries.Table 4 displays the ECC’sreported expenditures ineducation, health, andnutrition.

The ECC holds an annual planning meeting with theMinistries of Education, Health, Labour and SocialSecurity, and Finance to share budgets. However,accordingtotheECCFinancesubcommittee,noexplicitcoordinating mechanisms exist to ensure that budgetplanning is truly a coordinated effort. It would bebeneficial to establish improved coordinatingmechanismsandaccuratelyreportECD-specificbudgets.For example, in the nutrition sector, the ECCmanagesJA$32millionofnutritiongrants forECIs.Additionally,theNutritionUnitoftheMoHhasabudgetforchildren’sgrowth and nutrition; and the MLSS has a budget forPATHNutritionalSupportandFeedinggrants(however,ECD-age specific expenditure data are not readilyavailableforeither).Similarly,inthehealthsector,whiletheECCreportsJA$17.5billionforanECD-specifichealth

7Valerio&Garcia,2012;WHO,2005;Hanushek&Kimko,2000;Hanushek&Luque,2003

budget, theMoH reports that itdoesnotdisaggregatespendingspecifictoECD-agedchildren.

Intheprotectionsector,theCDAdoesnotdisaggregateexpendituresforchildprotectionservicesspecificallyforECD-agedchildren.Within theMLSS,ECDexpendituresgo towards two programs, PATH and the EarlyStimulationProgram(anearlyinterventionprogramforyoung children with developmental disabilities, seePolicyLever2.2).TheMLSSallocated$JA18.2billionin2012-2013 for the Early Stimulation Project (excludingsalaries). However, the MLSS budget for PATH, whichtargetschildren0-18years,cannotbedisaggregatedbyspecificagegroup.

Thereisnonational lawestablishingaminimumlevelofpublicfundingforECDservices.Currently, financingforECDtakesplacewitharelativelyvoluntarynature.Noofficial mechanisms exist to ensure sustainableinvestments of ECD in Jamaica. Jamaica could turn toOECD countries, such as Australia, which ensuresustainable ECD financing with a more streamlinedsystem. Box 5 explains Australia’s system to ensuresustainablefinancingforECD.8

8Formoreinformation,seeAustralia’sNationalPartnershipAgreementonEarlyChildhoodEducation:http://www.deewr.gov.au/Earlychildhood/Policy_Agenda/ECUA/Pages/EarlyChildhoodEducationNationalPartnership.aspx.

Table4:ECCbudgetallocations(2012-2013)

Education JA$2.4billion

Health JA$17.5billon

NutritiongrantsJA$32million



In theeducation sector, the levelof ECD financemaynotbeadequate.AccordingtoUNESCO,Jamaicaspends1 percent of total government expenditures onpreprimary education 9 . Table 5 compares Jamaica’sdistributionofpreprimaryspendingwithothercountriesinLatinAmericaandtheCaribbeanthatspendagreaterproportion of government expenditures towardspreprimary.Table5:PublicexpendituresonpreprimaryinselectedLatinAmericanandCaribbeancountries

Jamaica Brazil Chile CostaRica Guyana

Distributionofpubliceducationexpenditureonpreprimary

9.0% 7.0% 12.0% 6.0% 11.0%

PreprimaryexpenditureaspercentageofGDP

0.6% 0.4% 0.5% 0.4% 0.4%

9AccordingtotheECCFinancesubcommittee,thetotalpublicexpenditureonECCEasapercentageofgovernmentexpenditureswas0.43percent.

Preprimaryexpenditureaspercentageoftotalgovernmentexpenditure

1.0% 1.3% 2.1% 1.4% 1.5%

Source:UNESCOInstituteofStatistics,2010

The burden of finance for ECCE is not equitablydistributedacrossvarioussegmentsofsociety.Whilelawguarantees free preprimary education for all,approximately10percentofchildrencurrentlyhavefreepreprimary education. In community ECCE centers(Basic Schools), which represent the large majority ofECIs,parentsareexpectedtopayschoolfees. InpublicECCE centers (Infant Schools and Departments), whichrepresentlessthan5percentofECIs,noschoolfeesarelevied,butparentsareexpectedtopayforuniformsandtransportation.

Inthehealthsector,thelevelofECDfinanceallowsforfree healthcare for young children and mothers. TheMoH does not report ECD-specific expenditures.However, all health services in the public sector,including antenatal check-ups, labor and delivery,immunizations,growth-monitoringandpromotion,andwell child visits, are officially free. Table 6 comparesselected health expenditure indicators in JamaicawithothercountriesinLatinAmericanandtheCaribbean.

Table6:Regionalcomparisonofselecthealthexpenditureindicators,2010 Jamaica Barbados Brazil Chile Colombia

TotalhealthexpenditureasapercentageofGDP 5% 7% 9% 7% 7%

Outofpocketexpenditure10aspercentageofprivatehealthexpenditure

71% 81% 58% 69% 68%

Generalgovernmentexpenditureonhealthpercapita(adjustedforpurchasingpowerparity)

USD220

USD998

USD474

USD562

USD304

RoutineEPIvaccinesfinancedbygovernment 100% 100% 100

%Not

available 100%

Source:WHOGlobalHealthExpenditureDatabase,2013;UNICEF,2013

TheGoJdoescompensatecommunityhealthaidsandpublic ECCE providers; however for the majority ofservice providers who work in Basic Schools,remunerationisnotadequate.Communityhealthaids,who visit homes and promote healthy caregiving andhelp identify high-risk situations, are paid an annualsalaryofJA$445,856toJA$504,445peryearbytheGoJ.Inpublic InfantSchoolsandDepartments, teachersare

Summary: In 2008, through the Council of AustralianGovernments,allstateandterritorygovernments inAustraliajointlyagreedtotheNationalPartnershipAgreementonEarlyChildhood Education. Prior to the National Partnership,Australia’s investment in ECD was only 0.1 percent of GDP,which ranked 30th out of the 32 OECD countries. To achievequality,universalcoverage,alllevelsofgovernmentagreedtoincreased, sustained financial investment,whichwaspartiallyaidedthoughadditional fundingof$970million (AUD)by theCommonwealthofAustraliaoverafive-yearperiod.The Australian strategy calls for streamlined mechanism formanagement and finance at all levels. It requires effectiveaccountability mechanisms, with clearly defined roles andresponsibilitiesateachrespectivelevel.TheBestStartProgramintheStateofVictoriaisanexampleofacomprehensiveECDprogramwithsustainablefinancingmechanisms.Theprogramuses a decentralized approach and is co-financed by localgovernmentsand regionalstakeholders.Theprogram’smulti-prongedfundingapproach iseffective largelydueto strategicmapping, constant monitoring, and extensive evaluationmethodsatthelocallevel.

KeyconsiderationsforJamaica:ü Accountabilitymeasuresforfinancingandallocatingfundingacross sectors and between sectors and the national andprovincialgovernmentsü Improved availability of expenditure data and a unifiedinformationsystemtomonitortheNSPacrossECDindicatorsinordertotrackandsustainadequatefinancing.

Box5:RelevantlessonsfromAustralia:sustainablefinancialinvestmentsinECD



paid using the same compensation scale as those inprimaryandotherlevelsofthepublicschoolsystemona scale agreed upon for the Jamaica Teachers’Association.

TheGoJpays4,000earlychildhoodpractitionersasalarysubsidy determined by qualifications and experience,whichrangesfromJA$177,600toJA$307,743peryear.TeachersinBasicSchoolsaresupposedtobepaidonthesame salary scale based on their training qualification.However, many of them are not compensated by theGovernment. Approximately 2,400 practitioners withvocational training received salary subsidies in 2013.11However, more than 4,600 teachers have vocationaldegrees (3,635 from Basic Schools). This means thatmany teachers that comply with minimum teachingqualifications (See Policy Lever 3.2) are still notadequately compensated. In addition to governmentsalary subsidies, teachers from Basic Schools rely oncompensationfromschoolfees.Unfortunately, inBasicSchools, parents do not always pay the fees, andthereforeteachers’salariesareofteninadequate.

PolicyOptionstoStrengthentheEnablingEnvironmentforECDinJamaica

Legalframework:Ø Consider providing better protection for newparentstopromoteopportunitiestocarefornewbornsand infants in their first year of life. The GoJ couldimprove its parental leave policies to expand theguaranteedpaidleaveformothersand/oraddpaternityprotection. Sixty countries around the world mandatebetween14and25weeksofpaidleave.Thebenefitsofpaidparentalleavepoliciesextendbeyondtheindividualbenefitsforyoungchildrenandtheirfamilies.Researchshowsthatwomenaremorelikelytoreturntothesameemployerwhentheyhaveaccesstobetterfamilyleavepolicies, which reduces the lost investment foremployerswhomightloseemployeesfollowingthebirthofachild. Inaddition, improvedchildhealthoutcomesand reduced healthcare costs for children benefit thegovernment.12 Jamaica could consider turning to high-

10Out of pocket expenditure is any direct outlay by households,includinggratuitiesandin-kindpayments,tohealthpractitionersandsuppliers of pharmaceuticals, therapeutic appliances, and othergoods and services whose primary intent is to contribute to therestoration or enhancement of the health status of individuals orpopulationgroups.

performingcountrieslikeSwedentoimproveitsparentalleavepolicies(SeeBox2).

IntersectoralCoordination:

Ø Ensure that the new strategic plan includes acommonplanofactionforintegratedservicedelivery.The Child Health & Development Passport alreadyoutlinesacomprehensive listofessential interventionsfor young children, which is commendable. The newstrategicplancouldexpandon this toensure thatECDinterventions are not only tracked, but also that allchildren have access to them. The upcoming nationalstrategyforECDshouldcontinuetoprovideandexpandupon explicit mechanisms to promote sustainedcoordination across health, education, and protection.An integrated service delivery manual within thestrategicplanwouldbeanimportantstepfortheGoJtonot only guaranteeholistic ECD services onpaper, butalso establish mechanisms to ensure that children,particularlythemostdisadvantaged,actuallyhaveaccessto these interventions. Box 4 provides an example ofColombia’s integrated service delivery manual, RutaIntegral.

Finance:Ø EnsurethelevelofECDfinanceisadequatetomeettheneedsofthepopulation.Jamaicaspends0.6percentof its GDP on preschool (UNESCO, 2010) and couldconsider a higher level of ECD financing to ensure theneedsofyoungchildrenaremet.TheOECDrecommendsapublicinvestmentof1percentofGDPastheminimumrequired toensureprovisionofqualityearly childhoodcare and education services. 13 Jamaica could turn tocountries like Australia, where sustainable financialinvestmentmechanismsexist(Box5).

Ø Improvebudgetcoordinationandaccuratereportingof ECD-specific spending across ministries. OECDgovernmentsspendanaverageof2.36percentofGDPonabroadrangeofservicesforyoungchildrenandtheirfamilies(includingpreprimaryexpenditures).14IftheGoJcanreportandcoordinateallministerialexpendituresforECD-specific interventions, it can better capture theentirepictureofECDfinancing.RecentresearchonECDfinancingsuggeststhatsustainabilityandadministrative

11Source:WorldBankJamaicaECDProjectResultsMonitoring12Heymann&McNeill,201213OECD,201114OECD,2006



simplicity are two of the key characteristics in ECDfinance strategies15. A unified information system thattracks both expenditures and ECD indicatorswill be ofutmost value for the Government in tracking andsustaining ECD investments across sectors. WithimprovedavailabilityofexpendituredataandaunifiedinformationsystemtomonitortheimplementationofallECD activities in the country, the GoJ will be able tobetter track its investments and identify areas whereincreasedfinancelevelsarenecessary.

Ø CreatemechanismssothatallECCEprovidershavethe opportunity to receive salary subsidies from theGovernment. While Jamaica has reached nearlyuniversal coverage for preprimary, inadequatecompensationforECCEserviceprovidersislikelytohaveimplications to the quality of services received. Theexistingqualification-based teacherpayscale isagoodmeasuretoincentivizeECCEproviderstobeadequatelyequippedwiththeskillsandknowledgetodeliverqualitycareandeducation.However,thispaymentmechanismisstillnotreachingmanyteacherswhomeetminimumqualifications.TheGoJshouldconsidera)requiringthatECIs report the level of training of its teachers andadequately compensate those that meet minimumrequirements;andb)ensurethatthoseteachersthatdonot have adequate training have the opportunity toattain affordable tertiary education trainingopportunities(SeePolicyOptionsinPolicyGoal3).

PolicyGoal2:ImplementingWidelyØ PolicyLevers:ScopeofPrograms•Coverage•Equity

Implementing Widely refers to the scope of ECDprogramsavailable,theextentofcoverage(asashareoftheeligiblepopulation)andthedegreeofequitywithinECD service provision. By definition, a focus on ECD

15Garcia&Valerio,2012

involves (at a minimum) interventions in health,nutrition,education,andsocialandchildprotection,andshouldtargetpregnantwomen,youngchildrenandtheirparents and caregivers. A robust ECD policy shouldinclude programs in all essential sectors; providecomparable coverage and equitable access acrossregionsand socioeconomic status–especially reachingthe most disadvantaged young children and theirfamilies.

PolicyLever2.1:ScopeofProgramsEffective ECD systemshaveprogramsestablished in allessential sectors and ensure that every child andexpecting mothers have guaranteed access to theessential services and interventions they need to livehealthfully.Thescopeofprogramsassessestheextenttowhich ECD programs across key sectors reach allbeneficiaries. Figure 3 presents a summary of the keyinterventionsneededtosupportyoungchildrenandtheirfamilies via different sectors at different stages in achild’slife.



Programscoverawiderangeofbeneficiarygroupsandareestablishedacrossallrelevantsectorstomeettheholisticneedsofchildren.AsdemonstratedinFigure4(onthefollowingpage),Jamaicahasanexcellentscopeof programs available to address the health needs ofpregnantwomen,mothers,andyoungchildren.Awidescope of health interventions are available, includingparenting programs, antenatal visits, skilled delivery,immunizations, and regular tracking of growth anddevelopment are available. In the education sector,programs for parents and children 0-6 years old areavailable. In child and social protection, anti-poverty,birth registration, and domestic abuse preventionprograms are available for both parents and youngchildren.Finally,inthenutritionarea,breastfeedingandschool feeding programs exist, but no structured foodsupplementation program for pregnant women ormicronutrientsupportprogramforyoungchildrenexist.It is commendable that the majority of the essentialinterventions are listed within the Child Health &DevelopmentPassportor theMaternalRecordBook,atrackingtoolforhealthyrisk-freepregnancies.Thesetwodocuments serve as a tool to ensure that pregnantwomen,children,andcaregiversaccessthewidescopeofessentialECDinterventionsinJamaica.

On the following page, Table 7 displays the range ofprograms across sectors available and provides theavailable coverage data for each intervention. PolicyLever2.2willreviewtheextenttowhichthepopulationhasaccesstotheseinterventions.

Figure3:Essentialinterventionsduringdifferentperiodsofyoungchildren'sdevelopment



Figure4:ScopeofECDinterventionsinJamaicabytargetpopulationandsector

Table7:ECDprogramsandcoverageinJamaica

ECDIntervention

Scale

Pilotprograms

NumberofRegionsCovered(outof14)

Coverage(ifavailable)

EducationNon-stateECIs - 14 125,865StateECIs(Infantschools,infantdepartments) - 14 12,815HealthAntenatalandnewborncare - 14 40,000-60,000

(100%)Integratedmanagementofchildhoodillnessesandcarefordevelopment - 14 200,000Childhoodwellnessandgrowthmonitoring:ChildHealth&DevelopmentPassport - 14 11,273(100%)Nationalimmunizationprogram - 14 80,000(100%)NutritionMicronutrientsupportforpregnantwomen(MoH) - 14 40,000-60,000

(100%)Foodsupplementsforpregnantwomen(doneatlocallevel-FoodforthePoor) Yes - -Micronutrientsupportforyoungchildren:IDB-supportedSprinklesdistribution Yes - -Foodsupplementsforyoungchildren(doneatlocallevel-FoodforthePoor) Yes - -BreastfeedingpromotionprogramsBabyFriendlyHospitalInitiative - 14 61,000Anti-obesityprogramsencouraginghealthyeating/exercise - - -FeedingprogramsinpreprimaryschoolsSchoolFeeding/PATHNutritionalSupport - 14 NotavailableParentingParentingintegratedintohealth/communityprograms:Parents’Places Yes 4(expanding) NotavailableHomevisitingprogramstoprovideparentingmessages - 14 NotavailableSpecialNeedsProgramsforOVCsChildDevelopmentAgency - 14 NotavailableInterventionsforchildrenwithspecialneedsEarlyStimulationProgram - 5 1,412ProgramsforHIV/AIDSPreventionEliminationofMTCTofHIV/Syphilis - 14 600Anti-povertyCashtransfersconditionalonECDservices(PATH) - 14 400,000Source:ECCECIDatabase,2012;SABER-ECDProgramandPolicyInstruments



PolicyLever2.2:CoverageA robust ECD policy should establish programs in allessential sectors, ensure high degrees of coverage andreach the entire population equitably–especially themostdisadvantagedyoungchildren–so thateverychildand expecting mother have guaranteed access toessentialECDservices.

Pregnant women have adequate access to prenatalhealthcare, but it is unclear whether they haveadequate access to essential nutrition interventions.Table 8 displays selected indicators for heathinterventionsforpregnantwomeninJamaicaandotherLatinAmericanandCaribbeancountries.UNICEFcountrystatistics reveal that pregnantwomen in Jamaica havenearly universal access to prenatal care and skilleddeliveries. An estimated 32,000 people are living withHIV(1.7percentoftheadultpopulation)andtheGoJiscontinuing to intervene with pregnant women andnewborns to prevent mother-to-child transmission(MTCT).In2011,theGoJprovidedanti-retrovirals(ARVs)to87percentofpregnantwomenwhowereHIVpositive(an increase ofmore than ten-percentage points since2005). Additionally, 97 percent of newborns receiveARVs.16 Since 2000, the transmission rate for HIV hasreducedfrom25percenttolessthan5percent.

Whiledatashowexcellentaccesstohealthinterventionsforpregnantwomen,the levelofcoverageofessentialnutritioninterventionsforpregnantwomenisnotaswellmonitored. The latest data available for prevalence ofanemia in pregnant women was in 2006, when 41percent of pregnantwomenhad anemia, a level ratedsevere by theWHO. As demonstrated in Table 8, thislevel of prevalence also exceeds the levels of othercountriesintheregion.TheMoHreportsthat60percentofanemicpregnantwomenareadequatelytreatedandhasagreedwithregionalhealthauthoritiestoachieveatargetof100percentcoverageby2013.TheMoHalsoreports that 82 percent of anemic pregnant womenreceiveironandfolicacidandhasagreedonatargetof95percentcoverageby201317.TheMoHisencouragedtocontinueworkingwithregionalhealthauthoritiestomeetthesetargets.

16UNAIDSCountryProgressReportforJamaica,2012.17MoH,2012.ServiceLevelAgreementIndicators

Table8:Regionalcomparisonoflevelaccesstoessentialhealthandnutritioninterventionsforpregnantwomen Jamaica Barbados Brazil Colombia Chile Trinidad

Skilledattendantatbirth 98% 100% 97% 98% 100% 98%

Pregnantwomenreceivingantenatalcare(atleastfourvisits)

87% 100% 91% 89% Notavailable 96%

PercentageofHIV+pregnantwomenreceivingARVsforPMTCT

84% 96% 50% 49% 72% 82%

Prevalenceofanemiainpregnantwomen(2006)

41% 23% 29% 31% 28% 30%

Source: UNICEF Country Statistics, 2010; UNAIDS, 2012;WHO GlobalDatabaseonAnemia

Young children in Jamaicamay not receive adequatecarewhentheyaresick.Table9displaysUNICEFcountrystatistics18of selected indicators foraccess toessentialhealthinterventionsforyoungchildren.TheChildHealth&DevelopmentPassport serves as aneffective tool toencourage routine health check-ups. Coverage forgrowthmonitoringandimmunizationisnearlyuniversal.However,whenachild is sick, theymaynotalwaysbeaccessing adequate medical attention. As displayed inTable9,accordingtoUNICEF,inJamaicawhenchildrenyounger than five years old have an acute respiratoryinfection, only approximately half of them are treatedwithantibiotics.TheMoHreportsthatallchildrenwithdiarrheaaretreatedwithoralrehydrationsalts.

Table9:RegionalcomparisonoflevelaccesstoessentialhealthinterventionsforECD-agedchildren Jamaica Barbados Brazil Colombia Chile Trinidad

1-year-oldchildrenimmunizedagainstDPT(correspondingvaccines:DPT3ß)

99% 91% 96% 85% 94% 90%

Childrenbelow5withsuspectedpneumoniareceiveantibiotics

52% Notavailable

Notavailable

Notavailable

Notavailable 34%

Source:UNICEFCountryStatistics,2007-2012

Thelevelofaccesstoessentialnutritioninterventionsfor young children is inadequate.Table 10presents aregionalcomparisonofselectednutritionindicatorsforyoungchildren.WhilestuntingprevalenceinJamaicaisquite low, young children may not be receiving theadequate nutrients for proper development. Only 40

18UNICEF,StateoftheWorld’sChildren,2013



percent of infants are exclusively breastfed at 3months19.TheWHOreportedthatin2006(lastyearwithavailable data), 48 percent of preschool aged childrenwere anemic. The coverage level for Vitamin Asupplementation is not available. In its service levelagreementwithregionalhealthauthorities,theMoHdidnot report the currentpercentageofpregnantwomenreceivingbreastfeedingeducationorthepercentageofcaregiversreceivingeducationonappropriateinfantandyoungchildfeedingpractices.However,theMoHhasseta target of 80 percent coverage for both of thesenutritionpromotioninterventions.TheMoHandUNICEFpartneredtoimplementanexclusivebreastfeedingpilotprojectintwoparishes(ClarendonandSt.Catherine)andsuccessfully increased the rates of exclusivebreastfeeding. TheMoH is encouraged to expand thisprogramatthenationallevel.

Table10:RegionalcomparisonoflevelaccesstoessentialnutritioninterventionsforECD-agedchildren Jamaica Barbados Brazil Colombia Chile Trinidad

Childrenbelow5withmoderateorseverestunting

4% Notavailable 7% 13% Not

availableNot

available

Infantsexclusivelybreastfeduntil6monthsofage

Seefootnote19

Notavailable 41% 43% Not

available 13%

Infantswithlowbirthweight 12% 12% 8% 6% 6% 19%

Prevalenceofanemiainpreschoolagedchildren(2006)

48% 17% 54% 28% 24% 30%

Source:UNICEFCountryStatistics,2007-2011;WHOGlobalDatabaseonAnemia,2006;MoH,2013

There isnearlyuniversalbirth registration in Jamaica.98%ofbirthsareregisteredinJamaica.Table11displaysthe birth registration rate across the region, which isnearlyuniversal.

Table11:Regionalcomparisonofbirthregistrationrate Jamaica Barbados Brazil Colombia Chile Trinidad

Birthregistration2000-2010 98% Not

available 93% 97% 100% 96%

Source:UNICEFCountryStatistics,2007-2011

Thegrosspreprimaryenrollmentrateforchildrenage3-6yearsoldisover100percent.Figure5displaysthemost recently reported gross preprimary enrollment

19AccordingtotheMoH,40percentofchildrenareexclusivelybreastfedat3monthsand96percentofmothersreportearlyinitiationofbreastfeeding.Updateddatanotavailableonexclusivebreastfeeding<6months.

ratios for selected Latin American and Caribbeancountries(UNESCO).In2010,thegrossenrollmentratioin Jamaica was 112 percent. This rate is high byinternationalstandards.Itwillbeworthconsideringthenext step of ensuring universal coverage of qualitypreprimaryeducation.

Figure5:Grossenrollmentrate(age3-6)inselectedLatinAmericanandCaribbeancountries

Whilechildren3yearsandolderhaveadequateaccessto ECCE, only 12 percent of children younger than 3haveaccesstoearlychildhoodcare.Figure6comparesthe level of coverage for children younger than3withthat for children age 3-5 20 . The majority of Jamaica’syoungestchildrenarenotaccessingECCEinterventions.Table13displaysenrolmentbyagegroupforstateandnon-state ECIs. Children younger than 3 years old areconcentrated in non-state ECIs. For private ECIs (otherthan community schools), 25 percent of the childrenenrolled are younger than 3 (8 percent in communityschoolsandlessthan2percentinpublicschools).

Figure6:Levelsofcoverageforchildren0-2versus3-5inJamaica(2012)

Table12:ECIEnrolmentbyagegroupandfacility

20TheStatisticalInstituteofJamaicareportedthatin2012,therewere119,695childrenyoungerthan3and127,070ages3-5yearsold.TheECCreportedthatin2012,13,782childrenyoungerthan3attendedECCE,and116,645children3-5yearsoldattendedECCE.



Childrenlessthan3

years

Children3-5yearsold

Childrenolderthan5years

Totalenrolment

StateECIsInfantschools&departments

190 12,083 620 12,893

CommunityECIsBasicSchools/Pre-schools

7,286 85,526 2,021 94,833

AllotherprivateECIs21

6,185 17,656 608 24,449

Source:ECCECIDatabase,2012

Children younger than 3 years generally have fewerstimulatingresourcesathome.Inadditiontohavinglessopportunity to access center-based care, childrenyounger than three years old have fewer stimulatingresources at home. Figure 7 illustrates data from theJamaica Survey of Living Conditions (2010) (JSLC)regarding the percentage of children in different agecohorts with stimulating resources at home. Morechildrenaged3to5yearsoldhavestimulatingresourcesat home (with the exception of musical instruments)thanchildrenaged0to2years.Additionally,significantlymore3-to5-year-oldsengagedinstimulatingactivitieswith their caregivers than0- to2-year-olds (SeeFigure8).

Figure7:Stimulatingresourcesathomefor0-2and3-5agegroup,2010

21Includespreschool,kindergarten,preparatoryschool,nursery,daycare,specialeducation22Engleetal,2011;Naudeauetal.,2011

PolicyLever2.3:EquityBasedontherobustevidenceofthepositiveeffectsECDinterventionscanhaveforchildrenfromdisadvantagedbackgrounds, every government should pay specialattentiontoequitableprovisionofECDservices22.Oneofthe fundamental goals of any ECD policy should be toprovideequitableopportunitiestoallyoungchildrenandtheirfamilies.

There isequitableaccess toECCE for3-5yearoldsbygenderandsocio-economicstatus.Girlsandboyshaveequitable access to preprimary school,withmarginallymoremalesthanfemalesenrolled.AccordingtotheECC,in2012,59,093boysand57,552girlsinthe3-5agegroupwereattendingECIs.Therearenomajordifferences inenrollment rates by wealth quintile: both the poorestandrichestquintilehave100percentenrolment,withallfivequintilesmorethan98percent(JSLC,2010).

ECCE services accommodate children’s special needsand promote access for all children. An estimated 4percentofchildreninJamaicalivewithadisability23.AsdiscussedinPolicyLever1.1,EarlyChildhoodAct(2005)promotes inclusive education for children withdisabilities. The ECC reports that 60 children wereenrolled in special education in 2012.Additionally, theMLSS’sEarly StimulationProgramprovides services foryoungchildrenwithdevelopmentaldisabilitiesandtheirfamilies. Child Development Officers are trained inchildhood disabilities, intervention and rehabilitation,and early childhood development.Officers visit homesandpublicandprivateECIs.Asof2013,therewere1,412directbeneficiariesoftheprogram.TheECChasrecentlydevelopedandapprovedachilddevelopmentscreeningtool and countrywide identification process for at-riskhouseholds in Jamaica. In addition, children are nowscreenedfordevelopmentaldelaysintheChildHealth&Development Passport and subsequently referred forintervention within the MLSS Early InterventionProgram.TheGoJalsoplanstodevelopanationalpolicyonscreening,diagnosisandearlyinterventionforat-riskchildrenandhouseholds.24

Inaddition,UNICEFissupportingthedevelopmentofacurriculum with practitioner certification for childrenwithspecialneeds.Thecurriculumexposespractitioners

232009UNICEFestimateinComprehensiveAssessmentofExistingServiceDeliveryOptionswithintheECSector24PartofNSP2013-2017.



to childhood disabilities and appropriate referralprocesses. The new Child Development TherapyAssociate’s degree encourages the training ofprofessionals to go into homes to work with specialneedschildren.UNICEFisalsoworkingwiththeMoEtodevelop a curriculum for children with moderate tosevere disabilities for specialized pre-primary andprimaryinstitutions.

In ruralandurbanareas, there isequitableaccess toservicesandlearningopportunitiesforyoungchildren.Access to improved sanitation facilities is relativelyequitable:inurbanareas,therateofaccessis82%andin rural areas, it is 84%. Skilled deliveries are alsoequitablyavailablebygeographicarea: inurbanareas,therateofskilledattendantsatbirthis99percentandinruralareas,therateis98percent.

According to the JSLC (2010), children in KingstonMetropolitanArea (KMA),otherurbanareas,andruralareasallhaveequitableopportunitiesforthemajorityofstimulating activities for children, including stories,songs,games,counting,anddrawing.

Poor children do not have the same opportunities toearly learningaschildrenfromtherichestquintile.AsillustratedinFigure8,childrenfromthepoorestquintileareproportionatelylessengagedinactivitieswithadultsthan children from the richest quintiles (JSLC, 2010).Figure 8 also displays, as discussed under Policy Lever2.2,childrenyoungerthanthreeyearsoldarelesslikelytobeengagedinactivitieswithadultsthanchildrenaged3to5yearsold.

Figure8:Adultsengagedinstimulatingactivities,byageandwealthquintile

25In2011,outof1,000childrenborninJamaica,18diedbeforetheirfifthbirthday(UNICEF).

PolicyOptionstoImplementECDWidelyinJamaicaCoverageØ Improve coverage to essential nutritioninterventions for pregnant women. The MoH isencouraged to meet its targets to reduce anemiaprevalenceinpregnantwomen.Iron-folatesupplementsduring pregnancy can prevent anemia for the motherandneuraltubedefectsforthefetus.Reducinganemiaprevalenceinpregnantwomencanpreventintellectualandphysicalimpairmentinchildren.

Ø Expand coverage to essential health and nutritioninterventionsforyoungchildren.TheWHOreportsthatin2006,nearlyhalfofpreschoolagedchildrenhadirondeficiency anemia, which can significantly impede ayoungchild’sdevelopment.Lessthanhalfofmothersareexclusively breastfeeding their babies. Exclusivebreastfeedinguntil6monthscanreduceinfantmortalityand promote healthy development. The MoH shouldcontinue toencourage localhealthauthorities tomeetthetargetofimprovednutritioneducationinterventions.It will also be important to seek out updated data onanemiainpregnantwomenandpreschoolagedchildrentodeterminewhetherwomenandyoungchildrenhaveadequateaccesstofoodsenrichedwithiron.

TheGoJshouldconsiderhowtoexpandaccess tocarefordiarrheaandpneumonia,twoofthe leadingcausesofdeathinchildrenyoungerthanfive.25TheChildHealth&Development Passport should serve as a useful toolandcouldbepossiblyexpandedtoencouragecaregiverstotakechildrentoseekhealthcarewhentheirchildrenshowsignsofillness.

Ø Considerprovidingadditionalopportunitiesforearlychildhood care for children younger than 3 years.Roughly9outof10childrenlessthan3arenotattendingECCE programs. Evidence suggests that the strongestcognitive benefits for center-based ECD programs areexperiencedbyyoungerchildren(rangingfrom9monthsto<3years).26Eveniftheyoungestcohortofchildrenarenotgoingtocenter-basedECCE,theGoJshouldconsider

26Loebetal,2007;Armecinetal,2006;NICHD,2003



strategies,includingexpandinghomevisitprograms27orplaygroups,toensurethatchildrenyoungerthanthreeyears old have adequate opportunities for earlystimulation.TheJSLCrevealedthatcomparedto3-to5-year-olds,childreninthebirthto2yearcohorttendtohave fewer stimulating resources at home and theircaregiversengagewiththemless.Thefirst1,000daysisan essential period for child development and qualityinteraction and stimulation is essential to ensurecognitiveandsocial-emotionaldevelopment.28

Internationally recognized research from Jamaica hasrevealedthathomevisitsandbetterparentingprogramsareboth feasibleandhave thepotential to impact thedevelopmentoftheyoungestagecohort.Jamaicashouldbecommended forboth the surrounding researchandexpansion of these interventions. However, it will beimportanttoplaceincreasedemphasisoncontinuingtoscaleup theseprograms forparentsand their childrenfrom0to2yearsofage.

EquityØ Ensureequitableearlylearningopportunitiesforthepoorestchildrenstartingfrombirth.Whilepoor3-to5-year-old children have equitable access to preprimaryeducation,poorchildrenyoungerthan3donothavethesame learning opportunities (see Figure 8). Lack ofappropriate early experiences places children at adisadvantage before they even start school. Targetinghomevisitsorparentingsupport interventionstowardsthepoorest familiescouldbeuseful toensurethatthemostvulnerablechildrenhaveequitableopportunities.

Policy Goal 3: Monitoring and AssuringQualityØ PolicyLevers:DataAvailability•QualityStandards•CompliancewithStandards

MonitoringandAssuringQualityreferstotheexistenceofinformationsystemstomonitoraccesstoECDservicesandoutcomesacrosschildren,standardsforECDservicesand systems to monitor and enforce compliance withthose standards. Ensuring the quality of ECDinterventions is vital because evidence has shown thatunless programs are of high quality, the impact onchildrencanbenegligible,orevendetrimental.

27SeveralhomevisitprogramalreadyexistinJamaica,suchastheRuralFamilySupportOrganization’sRoversprogram.28Black,etal,2008.

PolicyLever3.1:DataAvailabilityAccurate,comprehensiveandtimelydatacollectioncanpromotemoreeffectivepolicy-making. Well-developedinformation systems can improve decision-making. Inparticular,datacaninformpolicychoicesregardingthevolume and allocation of public financing, staffrecruitmentandtraining,programquality,adherencetostandardsandeffortstotargetchildrenmostinneed.

Jamaica has advanced availability of relevantadministrative and survey data. Table 13 displaysJamaica’s availability of common ECD indicators. Therelevant ministries in Jamaica collect excellentadministrative data on important indicators related toaccess to ECD services. UNICEF MICS data alsocontributestotherichdataavailableregardingJamaica’syoungchildrenandmothers.

Table13:AvailabilityofdatatomonitorECDinJamaicaAdministrativeData:

Indicator TrackedECCEenrollmentbyregion üChildrenenrolledinECCEbysub-nationalregion(#) üChildrenenrolledinECCEbysocioeconomicstatus(%) üSpecialneedschildrenenrolledinECCE(#) üChildrenattendingwell-childvisits(#)29 üChildrenbenefittingfrompublicnutritioninterventions(#) üWomenreceivingprenatalnutritioninterventions(#) üAverageperstudent-to-teacherratioinpublicECCE üIsECCEspendingdifferentiatedwithineducationbudget? üIsECDspendingdifferentiatedwithinhealthbudget?30 XSurveyDataIndicator Tracked

Populationconsumingiodizedsalt(%) üVitaminASupplementationrateforchildren6-59mo.(%) XAnemiaprevalenceamongstpregnantwomen(%) ü

(2006)Anemiaprevalenceamongstpreschool-agedchildren(%) ü(2006)Childrenbelowtheageof5registeredatbirth(%) ü

ChildrenimmunizedagainstDPT3atage12months(%) üPregnantwomenwhoattendfourantenatalvisits(%) ü

The Jamaica Survey of Living Conditions provides anexcellent picture of the status of young children inJamaica. The JSLC, a joint publication of the PlanningInstituteofJamaica(PIOJ)andtheStatisticalInstituteofJamaica(STATIN)monitorsocialindicators,includinganentire section on ECD. Indicators include: parenting,

29TheMoHplanstocollectthisfor2012-2013(Servicelevelagreementindicator).30TheMoHdidnotprovideintheSABER-ECDPolicyInstrument.



activities engaged in with children by an adult,stimulating resources at home, disciplinary practices,and safe environment. Specific child developmentoutcome indicators are also collected to capture thedevelopmental competencies and readiness skills,including both socio-emotional and cognitivedevelopment, for Jamaican children age 4 and 5 yearsold.The2010JSLCexaminedanECDagecohortsampleof860children.In2014,thesurveywillcollectdataoneverychildattheageof4yearsold.

PolicyLever3.2:QualityStandardsEnsuringqualityECDserviceprovisionisessential.Afocusonaccess–withoutacommensuratefocusonensuringquality–jeopardizestheverybenefitsthatpolicymakershopechildrenwillgain throughECD interventions. Thequality of ECD programs is directly related to bettercognitiveandsocialdevelopmentinchildren31.The ECC has established a legal framework that setsforthclearstandardsforallpublicandprivateECIs.Box6outlinesthethreedocumentsthatcomprisetheECC’sframework for ECCE service delivery standards. TheEarly Childhood Act and Early Childhood Regulationsspecify legally-bindingminimum levels for ECD servicedelivery.Accordingtothesedocuments,ECIsthatdonotfollowthestandardsarenotallowedtoberegisteredorallowed to operate. The Standards for Operation,Management, and Administration of ECIs include clearindicationofstandardsthatarerecommendedminimumlevel of quality and those that are legally binding. Thestandards include guidelines for staffing,developmental/education programs, interactions andrelationships with children, physical environment,equipment, furnishing and supplies, health, nutrition,safety, child rights and protection, interactions withparents and communitymembers, administration, andfinance.

31Taylor&Bennett,2008;Bryceetal,2003;Naudeauetal,2011V;Victoriaetal,2003

Box6:LegalframeworkforECIstandards32

Clear learning standards are established for ECCE inJamaica. The national Early Childhood Curriculum,endorsedbytheMoEin2008,providesspecificguidancefor ECCE providers for caregiving and teaching in ECIs.The curriculum is evidence-based and aligns with theLearningOutcomesforECDintheCaribbean.33Relevantstakeholders from the primary education sector wereinvolvedindesignofthecurriculum,ensuringcoherenceandcontinuumofthecurriculumintoprimaryeducation.Thecurriculumincludesascopeandsequenceforbothchildrenaged0-3yearsandchildren4-5yearsoldandcomprises of skills development in the cognitive,affective, creative, and psychomotor domains. AnassociatedcurriculumguideforECCEteachersallowsforplanning, preparation, and implementation of dailyactivities in ECIs.While endorsed by the Government,theuseofthenationalcurriculumisnotmandated;theStandards dictate that ECIs may use any curriculumapprovedbytheECC.

ECCE professionals are required to meet pre-servicetrainingstandards.TheEarlyChildhoodActmandatesbylawthatECIoperatorsmustbetrainedbyaninstitutionthat is approved by the ECC. The Regulations andStandards expand upon this, stating that in ECIs thatprovide care for children above 3 years, at least oneteacher(LeadTeacher)mustbe“qualified.”“Qualified”teachers are required to have, atminimum, a tertiarydiplomaissuedbyarecognizedteachertrainingcollege.

32WhiletheActandRegulationsaretechnicallylegally-binding,theGoJhasnotyetactedupontheconsequencesinordertoallowtimeforadjustmenttothenewstandards.33ChildFocusIIProject,(2005).CaribbeanChildDevelopmentCentre,UniversityoftheWestIndies,Mona,Kingston,Jamaica.

Ø TheEarlyChildhoodAct(2005):RequiresoperatorsofECIstoapplyforregistrationwiththeECCandtofacilitatetheprocessofinspection.SignificantlegalconsequencesexistforfailuretocomplywiththeAct.

Ø The Early Childhood Regulations (2005): Providesprovisions to the Early Childhood Act, includingprocedures and requirements which may evolve overtime.Legalconsequences(lessseverethantheAct)existforfailuretocomplywiththeRegulations.

Ø Standards for the Operation, Management, andAdministrationofECIs(2007):Includes(i)legally-bindingstandards(stemmingfromtheActorRegulations)and(ii)standards to serve to improvepracticevoluntarily,with“acceptable”categoryforquickreference.



Minimumstandardsexistforotherteachers(whoworkwithLeadTeachers)inECIs:atleast50percentshouldbetrained and certifiedwith a Level III vocational degree(Associate Teachers) and at least 50 percent must betrainedandcertifiedwithaLevelIIvocationaldegree.

TheJamaicaTeachingCouncil,operatingundertheMoE,is responsible for professional teaching standards andcertification. The Joint Board of Teacher Education(JBTE),whichoperateswithintheSchoolofEducationoftheUniversityoftheWestIndieshasaBachelor’sdegreein Education program of the Teachers Colleges ofJamaica.TheUniversityoftheWestIndiesdeliversthisprogramandalsosupervisesthequalityofdeliveryoftheJBTEDegree by several other teacher training collegeswhich deliver the program on a franchise basis.Educationdegrees requirestudents tocompleteapre-servicepracticumwhichconsistsofavarietyofaspects,including school visits and a 3-month student teachingprogram.

Professional development opportunities for ECCEprovidersareavailable.TheStandardsrecommendthatECCE providers attend in-service training to improveservicedelivery.TheECCprovidestrainingonceamonthfor public and private ECIs, focusing on childdevelopment, curriculum, and other areas of ECCEservice delivery. The ECC tracks whether providerscomplete training, but it is notmandated by law. TheJBTEprogramof theUniversityof theWest Indiesalsoprovidesongoingprofessionaldevelopmentforcurrentteachers.

Established service delivery and infrastructurestandards for ECIs exist. The Standards outlineacceptableguidelines for teacher-to-child ratios forallpublicandprivatecenters:1:5forchildren0-12months;1:8forchildren1-3years34;1:10forchildren3-6years.TheActstatesthatdaycarecentersmustoperateatleastsixhoursperdayfourdaysaweek,butbasicschoolsdonot have a required number of opening hours. TheRegulationsandStandardsprovidespecificguidelinestoensurethatECIshaveadequateinfrastructureandplayareas for young children. ECIs are required to havefunctionalhygienicfacilities,potablewatersource,roof,

34ItshouldbenotedthattheEarlyChildhoodRegulationscallforslightlydifferentteacher-to-childratiosthantheStandardsdocument(1:8ratiofor1-2yearolds;1:7for2-3yearolds)Itisadvisedtorevisethesedocumentstomatchsoasnottomandateconflictingstandards.

floor,structuralsoundness,windows,buildingmaterials,andconnectiontoelectricity.

Establishedregistrationproceduresforbothstateandnon-state ECIs exist. TheAct states that all ECIsmustregisterwiththeECCtooperateandaretobeinspectedto determine compliance with minimum acceptablestandards. The ECC inspects each registered ECI todetermine whether it complies with the Act andRegulations.35TheRegulationsstatethatECIsshouldbeinspectedtwiceperyear.However,inreality,thisisnotmanageable due to resource constraints and highenrollmentrates.TheECCplanstorevisethelegislationtocallforinspectionsannuallyoreverytwoyears.Asof2013,therewere29inspectorsand4senior inspectorstrainedattheECC.

The ECC acknowledges that some institutions mayexceed minimum requirements and promotes thehighest standards of practice. It not onlymonitors theminimum requirements (outlined in the Act andRegulations)butalsomonitorsthestandardsthatarenotlegally binding (the Standards document classifiesperformanceas“needsimprovement,”“acceptable,”or“good”).

Rigorous standards for ECD service delivery in thehealth sector ensure quality healthcare. Anaccreditation system for well child clinics has beendevelopedandapprovedconjointlybytheMoHandECC.Thesystemwillcoverspecificguidelinesthatwellchildand child health clinics should meet, includinginfrastructureandequipment,datamanagement, leveloftrainingofhealthstaff,healthpromotion,andsafety.In addition, several standards are specifically targetedtowardsECD-agedbeneficiariestoensureprocessesforaccessandeffectivedeliveryofservicesforchildren0-3yearsold.

All community health aids receive training in ECD andhowtodelivermessagesaboutdevelopmentmilestones.Additionally, in the Child Health & DevelopmentPassport,thescheduleofchildhealthcheck-upsincludesimportant messages for health workers to deliverregardingchilddevelopment,milestones,and safety inthe home. TheMoH is finalizing a flip chart to deliver

35LegislationallowstheECCtoconductunannouncedinspections,butinpractice,inspectionstendtobeannounced.



certainmessages aboutbreastfeeding, safety, hygiene,and immunizations that will be used by primaryhealthcareprovidersinhealthcentersandcommunities.

PolicyLever3.3:CompliancewithStandardsEstablishing standards is essential to providing qualityECDservicesandtopromotingthehealthydevelopmentofchildren.Oncestandardshavebeenestablished,itiscritical that mechanisms are put in place to ensurecompliancewithstandards.

QualityassurancemeasuresareprogressinginJamaica,but improvements are still needed. As of 2013, 48percentofECIshave submitteda completeapplicationfor registration to the ECC. The ECC reports that 92percent of ECIs have received at least one completeinspection (57 percent in the last year). 52 percent ofECIshavebeenissuedapermittooperate.

The ECC quality assurance system is transparent andrevealsthatnotallECIscomplywithqualitystandards.InspectionreportsforECIsareaccessibletothepublic36and provide detailed information on ECI’s compliancewith the 12 standards (outlined in the Standardsdocument, see Policy Lever 3.2). There is still not 100percentcompliancewithall standards.Forexample,ofthe2,261ECIsinJamaica(stateandnon-state),theECCreports that 78 percent comply with floor standards:1727 receive an “acceptable” rating (flooring is solidthroughout, with no cracks or holes) and 37 receive a“good” rating (acceptable plus flooring surface allowschildrentomoveeasilyfromplacetoplace).Additionally,64 percent of ECIs complywithwall/ceiling standards:1,449receivean“acceptable”rating(wallsandceilingsareclean,paintedwithlightcolors,goodcondition)and5 receive a “good” rating (acceptable plus regularscheduledpainting).

ECCE professionals from public ECIs report highercompliance with pre-service training standardscompared to those from non-state ECIs. Table 14displaysthereportedteacherqualificationsforstateandnon-stateECIs.BasedonguidelinesforaLeadTeacher,only 27 percent of all teachers comply. Conversely, 73

36Asof2013,1,750inspectionreportswerepostedontheECC’swebsite:http://www.ecc.gov.jm/ecc/ECIReports/index.php?dir=37TertiaryincludesBachelor'sdegree,educationdiploma,andMaster'sdegree38Preschool,kindergarten,preparatoryschool,nursery,daycare,specialeducation

percentofteachersdonotmeettheminimumtrainingstandard, holding either a primary secondary, orvocationaldegreeornotreported.

Table 14 also reveals that compliance is higher in theminority of state ECIs (Infant Schools and InfantDepartments), 77 percent of all teachers holding atertiary degree (28 percentwith bachelor’s degree, 46percent with education diploma, and 3 percent withmaster’s degree).On theother hand, in Basic Schools,only24percentofteachersholdatertiarydegreeand64percentholdavocationaldegree.

Table14:ECCEteachers'highestlevelofeducationobtainedinstateandnon-stateECIs

Not

reported Primary SecondaryVocational Tertiary37 TotalTeachers

StateECIsInfantschools&departments 2.8% 9.8% 1.7% 9.2% 76.5% 541

Non-stateECIsCommunityECIsBasicSchools/Pre-schools

1.3% 7.1% 3.7% 64.3% 23.6% 5,653

AllotherprivateECIs38 6.5% 18.7% 4.6% 46.3% 24.0% 2,028

TOTAL 2.7% 10.1% 3.8% 56.2% 27.2% 8,222

73%Nocompliance/unknownforLeadTeacher39

27%meetstandardforLeadTeacher

Source:ECCECIdatabase,2013

StateECIsdonot complywith child-to-teacher ratios.Table 15 displays average child-to-teacher ratios, asreported by the ECC.40 The average state ECI has oneteacher for every 18 children, which does not meetcompliancefortheStandardsguidelineofa1:10ratioforchildren3-6yearsold(themajorityofchildrenenrolledin state ECIs are in this age group- see Table 12).Communityschoolsalsoexceedthemaximumchild-to-teacher ratio guideline. The average ratio for all otherprivate ECIs meets with the standard for children 3-6years old, but not for younger children (one-fourth ofchildren enrolled in all other private ECIs are youngerthan3-seeTable12).

39BasedonguidelinesforAssistant/AssociateTeachers(dictatingaminimumofvocationaldegree),83percentofteacherscomply.However,therearecurrentlyveryfew,ifany,ECIswithtwoteachersinoneroom.40Theseareonlyaverageratiosanddonotreflecttherealityofovercrowding,anissueinmanyECIs.



Table15:Averageteacher-to-childratiosinECIs Averageteacher-to-childratioStateECIsInfantschools&departments 1:18

CommunityECIsBasicSchools/Pre-schools 1:16

AllotherprivateECIs(seefootnote39) 1:9

Source:ECCECIdatabase,2013

PolicyOptionstoMonitorandAssureECDQualityinJamaicaQualityStandards&CompliancewithStandards

Ø Improve compliance with teacher qualificationguidelines for current ECCE practitioners byincentivizing tertiary education. Currently 73 percent(5,988) of teachers do not have a tertiary degree. Theoptionsavailabletoteachersfortertiaryleveldegreesinearly childhood is a commendable achievement inJamaicaandshouldbemademoreaccessibletocurrentECCE teachers who do not yet meet teachingqualifications. Since affordability is often a barrier totertiary degrees, the GoJ may consider strategies toincentivize untrained practitioners to pursue tertiaryeducation. This could include better student loanarrangements, encouraging more organizations toprovidescholarships,orworkstudyprograms..

Ø Encouragenewstudentstoenter theECCEteacherworkforce.Itwouldbevaluabletomakethepre-serviceopportunities and tertiary level programs available tonew students interested in becoming ECCE teachers.Withuniversalenrollmentinpreprimary,thereisaneedto serve the large preschool population with qualifiedECCEteachers.IncreasingthenumberofECCEteacherscould contribute to reducing overcrowding in ECIs.Additionally,ECCEteacherswillalsobeneededtocaterto children in the 0-3 age group, who are currentlyunderserved.

Ø ContinuetoinspectECIsonaregularbasisandworkto improve outcomes based on results of standards.WhileprogresshasbeenmadeinrecentyearswithECIinspections,approximatelyhalfofECIsstilldonothaveapermittooperate.Itisadvisabletoincreasethecapacityof the ECC to regularlymonitor standards compliance.Furthermore, the ECC should target ECIs that need toimproveoutcomes.Thiscouldincludeincreasecapacityof development officers and/or targeted in-service

training for ECIs that do not comply with qualitystandards.

ComparingOfficialPolicieswithOutcomesTheexistenceof lawsandpoliciesalonedonotalwaysguaranteeacorrelationwithdesiredECDoutcomes. Inmany countries, policies on paper and the reality ofaccess and service delivery on the ground are notaligned.Table16comparesECDpoliciesinJamaicawithECDoutcomes.SomepoliciesreflecttherealityforsomeECD interventions, such as availability of preprimaryschool, immunizations, and birth registration. On theotherhand,thelowrateofexclusivebreastfeedingandaccesstofreepreprimaryeducationdonotseemtoalignwiththerespectivepolicies.

Table16:ComparingECDpolicieswithoutcomesinJamaicaECDPolicies Outcomes

NationalInfantandYoungChildFeedingPolicycomplieswiththeInternationalCodeofMarketing

ofBreastMilkSubstitutes

Exclusivebreastfeeding

rate(3months):40%

Policyguaranteestheprovisionofpreprimaryschool

Grosspreprimaryschoolenrollment:

112%

GoJmandatestheprovisionoffreepreprimaryschool

3-6yearoldswithfreepreprimaryaccess:

10%

Youngchildrenarerequiredtoreceiveacompletecourseof

childhoodimmunizations

ChildrenwithDPT(12-23months):

99%

PolicymandatestheregistrationofchildrenatbirthinJamaica

Completenessofbirthregistration:

98%

PreliminaryBenchmarkingandInternationalComparisonofECDinJamaicaOn the following page, Table 17 presents theclassificationofECDpolicyinJamaicawithineachoftheninepolicyleversandthreepolicygoals.TheSABER-ECDclassificationsystemdoesnot rankcountriesaccordingto any overall scoring; rather, it is intended to shareinformationonhowdifferentECDsystemsaddress thesamepolicychallenges.Table18presentsthestatusofECDpolicydevelopmentinJamaicaalongsideaselectionofOECDcountries.Swedenishometooneoftheworld’smost comprehensive and developed ECD policies andachievesabenchmarkingof“Advanced”inallninepolicylevers.



Table17:BenchmarkingEarlyChildhoodDevelopmentPolicyinJamaica

ECDPolicyGoal LevelofDevelopment PolicyLever LevelofDevelopment

EstablishinganEnablingEnvironment

Established

LegalFramework

Inter-sectoralCoordination

Finance

ImplementingWidely Established

ScopeofPrograms

Coverage

Equity

MonitoringandAssuringQuality

Established

DataAvailability

QualityStandards

CompliancewithStandards

Legend:Latent

Emerging

Established

Advanced

Table18:InternationalClassificationandComparisonofECDSystems

ECDPolicyGoal PolicyLever LevelofDevelopment

Jamaica Australia Chile Colombia Sweden Turkey

EstablishinganEnabling

Environment

LegalFramework

Coordination

Finance

ImplementingWidely

ScopeofPrograms

Coverage

Equity


DataAvailability

QualityStandards

CompliancewithStandards

Legend:Latent

Emerging

Established

Advanced

ConclusionTheSABER-ECDinitiativeisdesignedtoenableECDpolicymakers and development partners to identifyopportunities for furtherdevelopmentofeffectiveECDsystems. This CountryReport presents a framework to

compare Jamaica’sECD systemwithother countries intheregionandinternationally.Eachoftheninepolicy



leversareexaminedindetailandsomepolicyoptionsareidentifiedtostrengthenECDareoffered.

Table19summarizesthekeypolicyoptionsidentifiedtoinform policy dialogue and improve the provision ofessentialECDservicesinJamaica.

Table19:SummaryofpolicyoptionstoimproveECDinJamaicaPolicy

Dimension PolicyOptionsandRecommendations

EstablishinganEnabling

Environment

Ø Considerprovidingbetterprotectionfornewparentstopromoteopportunitiestocarefornewbornsandinfantsintheirfirstyearoflife.

Ø Ensurethatthenewstrategicplanincludesacommonplanofactionforintegratedservicedelivery.

Ø EnsurethelevelofECDfinanceisadequatetomeettheneedsofthepopulation.

Ø ImprovebudgetcoordinationandaccuratereportingofECD-specificspendingacrossministries.

Ø CreatemechanismssothatallECCEprovidershavetheopportunitytoreceivesalarysubsidiesfromtheGovernment.

ImplementingWidely

Ø Improvecoveragetoessentialnutritioninterventionsforpregnantwomen.Ø Expandcoveragetoessentialhealthandnutritioninterventionsforyoung

children.Ø Considerprovidingadditionalopportunitiesforearlychildhoodcareforchildren

youngerthan3years.Ø Ensureequitableearlylearningopportunitiesforthepoorestchildrenstarting

frombirth.


Ø ImprovecompliancewithteacherqualificationguidelinesforcurrentECCEpractitionersbyincentivizingtertiaryeducation.

Ø EncouragenewstudentstoentertheECCEteacherworkforce.Ø ContinuetoinspectECIsonaregularbasisandworktoimproveoutcomes

basedonresultsofstandards.

AcknowledgementsThis Country Report was prepared by the SABER-ECDteam at theWorld Bank headquarters inWashington,DC.ThereportpresentscountrydatacollectedusingtheSABER-ECD policy and program data collectioninstrumentsanddatafromexternalsources.Thereportwas prepared in consultation with the World BankHuman Development Latin American and Caribbeanteam and the Government of Jamaica. For technicalquestionsorcommentsaboutthisreport,pleasecontacttheSABER-ECDteam([email protected]).

AcronymsARV Anti-retroviral

CDA ChildDevelopmentAgency

ECC EarlyChildhoodCommission

ECCE Earlychildhoodcareandeducation

ECD EarlyChildhoodDevelopment

ECI EarlyChildhoodInstitution

GoJ GovernmentofJamaica

ILO InternationalLaborOrganization

JBTE JointBoardofTeacherEducation



JECA JamaicaEarlyChildhoodAssociation

JSLC JamaicaSurveyofLivingConditions

KMA KingstonMetropolitanArea

MLSS MinistryofLabourandSocialSecurity

MoE MinistryofEducation

MoF MinistryofFinance

MoH MinistryofHealth

MoJ MinistryofJustice

MTCT Mothertochildtransmission

NPSC NationalParentingSupportCommission

NSP NationalStrategicPlan

NIYCF National Infant and Young Child Feeding(policy)

OVC OrphansandVulnerableChildren

PATH Program of Advancement through HealthandEducation

WHO WorldHealthOrganization

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The Systems Approach for Better Education Results (SABER) initiative produces comparative data and knowledge on education policies and institutions, with the aim of helping countries systematically strengthen their education systems. SABER evaluates the quality of education policies against evidence-based global standards, using new diagnostic tools and detailed policy data. The SABER country reports give all parties with a stake in educational results—from administrators, teachers, and parents to policymakers and business people—an accessible, objective snapshot showing how well the policies of their country's education system are oriented toward ensuring that all children and youth learn. This report focuses specifically on policies in the area of Early Childhood Development.

ThisworkisaproductofthestaffofTheWorldBankwithexternalcontributions.Thefindings,interpretations,andconclusionsexpressedinthisworkdonotnecessarilyreflecttheviewsofTheWorldBank,itsBoardofExecutiveDirectors,orthegovernmentstheyrepresent.TheWorldBankdoesnotguaranteetheaccuracyofthedataincludedinthiswork.Theboundaries,colors,denominations,andotherinformationshownonanymapinthisworkdonotimplyanyjudgmentonthepartofTheWorldBankconcerningthelegalstatusofanyterritoryortheendorsementoracceptanceofsuchboundaries.

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www.worldbank.org/education/saber

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