Throughout the world governments and NGOs are recognizing the importance of investing in Early Childhood Education. Here’s an important story from Guest Blogger Professor Ann Garland describing a comprehensive evidence-based program in Ethiopia.
A dozen years ago three dedicated professionals (Irving Fish, MD, Tesfaye Zelleke, MD and Menelik Desta, MD, PhD), developed a comprehensive preschool intervention for children in Ethiopia. The team was motivated by concern about very discouraging school drop-out rates and low educational attainment linked to poor economic, health, and social outcomes. Traditionally, public school in Ethiopia had no preschool provisions before first grade (children entered grade 1 at age seven) and only wealthy families had access to private preschool or kindergarten programming. Thus, the majority of children were woefully unprepared for school. Among children who enrolled in first grade, 22% dropped out before reaching Second Grade and over 50% dropped out before completing Fifth Grade (Federal Ministry of Education of Ethiopia (2012/13).
For the past few years, I have been consulting with Dr. Desta and his team remotely, participating in research efforts and grant proposals, but I had never been to Ethiopia to witness the program in-person. Finally in January, I was thrilled to visit some of the schools to experience the transformative impact directly and to meet many teachers and students. Before sharing my personal reflections on the visit, I’ll provide some background about the development and growth of the impressive School Readiness Initiative (SRI) in Ethiopia.
DSRI is a free comprehensive intervention for children ages 3-6 to build school readiness by fostering pre-academic literacy skills, as well as health, socio-emotional development, family engagement, and parenting support. The program exemplifies the ideals of quality, evidence-based early childhood development interventions in that it incorporates multiple dimensions beyond just cognitive enrichment, such as nutrition support, health and mental health screenings and referral, parental engagement and constructive discipline training, and economic opportunities for mothers.
SRI began a pilot implementation in 2007 with 80 students in two schools in Addis Ababa. It was initially supported by philanthropic donors, foundation grants (e.g., ELMA Foundation and Grand Challenges Canada), and in-kind contributions by the leadership team. In 2010, the Bureau of Education of Addis Ababa joined SRI in an official partnership to support wider dissemination. The government Bureau now provides all the infrastructure support and pays the programs’ teachers. By 2016, SRI included 11,500 children across 52 preschools. Over 2000 teachers have been trained in early childhood education and socio-emotional development. Thousands of parents have participated in child development and parenting workshops and dozens of mothers have joined economic development cooperatives, including pottery making and poultry farming (developed by Ilene Fish, Esq.). The government’s Bureau of Education has adopted and is disseminating the core SRI supplementary teachers’ guidebooks to all its preschools.
The SRI program has been evaluated rigorously and training methods (e.g., training manuals, checklists, etc.) have been standardized and improved over time. Two studies reporting on SRI implementation have been published in international journals (Desta et al., 2017; Garland, et al., 2018) and a few more are in progress. The program’s primary aim of improving school readiness has been assessed using the established Early Development Inventory (EDI, (Janus, et al. 2011). This measure assesses five critical domains of early childhood development linked to school readiness and its psychometric characteristics have been demonstrated across multiple languages and international contexts (Janus, et al. 2011; Ip, et al. 2013). The EDI was administered at the end of the school year to 100 randomly selected children in the comprehensive SRI preschools and 150 randomly selected children sampled from “control” preschools with only a cognitive enrichment curriculum. The two groups did not differ on key socio-demographic variables, but the children in the comprehensive SRI schools exhibited significantly higher scores on overall development, social competence, emotional maturity, language and cognitive development and communication and general knowledge compared to the control sample (Deyessa et al., in progress).
Additional studies have demonstrated that the program (a) effectively trains the preschool teachers to more accurately identify children with clinically significant developmental and emotional problems (Desta, et al., 2017); and (b) utilizes an established international screening tool (WHO-5) to efficiently screen parents of preschool children for depression (Garland, et al., 2018).
I was initially drawn to serving SRI by the dedication and expertise of the leadership team and the impressive evaluation results of the intervention. Being able to experience the program in-person was truly inspiring and reinforced everything I had learned. One of the schools I visited (Behere Ethiopia) had approximately 400 students in central Addis Ababa. Despite rather stark physical surroundings, warmth and exuberance emanated from the classrooms, which were jam-packed with 40-50 children each. The children were animated and smiling, happy to share a song and to show-off their work to us. Some students in the older (age 5-6) groups demonstrated their reading prowess as their peers cheered them on and helped when they got stuck. Despite the crowded atmosphere, the classrooms were well organized. One of Dr. Desta’s concerns is that teachers may revert to traditional harsh corporal disciplinary practices to “keep children in line,” so he emphasizes more constructive classroom management and disciplinary strategies in teacher trainings. We certainly saw no evidence of children fearing the teachers
It was also notable to me that the teachers did not seem to be the least bit anxious about being observed by Dr. Desta. Without exception, the teachers we met exhibited a balance of warmth and authoritative professionalism. They proudly showed us examples of notebooks in which they communicate with parents (those who are literate) and translated the comments for us. They also showed us screening checklists where they rated each student’s pre-academic skill attainment, as well as behavioral and social-emotional skill development and general health. The rooms were filled with colorful child-friendly graphics similar to what one would find in a Western preschool (e.g., photos of animals and foods with the name written in Amharic and English). Each child had a folder full of recent work on the wall with their photo and their career aspiration (e.g., Firefighter, Doctor, Teacher, Mother, Cook, Police Officer, etc.).
As noted, the physical condition of the schools and their surroundings was spartan, at best. The concrete walls showed cracks. There were a pair of swings and a slide for play equipment in the narrow dusty, pebbly, rutted outdoor space. However, the children gathered happily in small groups, laughing and running around in-between classes. As school dismissal time approached, mothers congregated in a relaxed manner and appeared to enjoy the time spent with each other. It was also notable that the mothers’ attire reflected a diverse and intermingled mix of observant Muslim women and many others in traditional and modern clothing.
At one of the schools, we found it curious that there was a large Ox tied up in the schoolyard and presumed it was some sort of informal school mascot. We were chagrined to learn that, in fact, the teachers had purchased it to butcher it later that night for food for the school for the week. So much for our quaint thoughts about bonding with farm animals.
At each of the schools, the children greeted us warmly and enthusiastically practiced their English skills. One boy particularly impressed me with his poise as he walked up to us in the school yard and said, “It is a pleasure to meet you… My name is Akiki.” When I praised his English he told me he was born in Uganda and had learned English in a refugee center. His smile and pride were infectious, as were all the children’s smiles. After all the time I’ve spent reading and writing about the SRI program, it was quite an emotional experience to be with the children and to feel their joy about being in school so directly. C
Global Investment in Early Childhood Education:
The positive impact of early childhood education has been established for decades, but is recently gaining greater international visibility from economic and political organizations such as the World Health Organization, UNICEF, the World Bank and even the representatives of the most recent G20 summit. The 2018 G20 Declaration states that the world leaders “stand ready to join all stakeholders in enhancing quality and sustainably financed early childhood programs that consider the multidimensional approach of early childhood development, as means of building human capital to break the cycle of intergenerational and structural poverty, and of reducing inequalities, specially where children are most vulnerable.” (G20 Leaders’ Declaration from G20 Information Centre, http://www.g20.utoronto.ca).
This high profile attention will hopefully translate to more significant investments in early childhood development efforts. A recent report from researchers at the University of Cambridge found that pre-primary education receives only 1% of all aid for children under age five (https://theirworld.org/resources/detail/just-beginning). Neuroscience research has demonstrated that the first five years of a child’s life are critical for brain development and future health, economic, and social outcomes. Quality early childhood development interventions are very cost-effective. A study utilizing data across 73 countries found that if pre-school enrollment could be increased from 25% to 50% of the population in low and middle- income countries, for every dollar invested there would be a benefit-to-cost ratio of between US$6.4 – 17.6 (Engle et al., 2011).
The data, complemented by my own first hard “lived experience,” reinforce the tremendous “bang for the buck” for investments in quality comprehensive preschool programming. Effective models are available and the SRI program is a wonderful exemplar of a successful partnership between a local NGO and a government entity to support long-term sustainability. While I am admittedly biased, I believe we all can learn from the noble work of Dr. Desta and his team.
SRI is supported by The Ethiopian School Readiness Initiative (ESRI) non-profit led by Dr. Irving Fish, with key supporters in New York, Washington D.C. and San Diego (see website for more information:
Meet Dr. Garland:
Desta M, Deyessa N, Fish I, Maxwell B, Zerihun T, Levine S, et al. (2017). Empowering Preschool Teachers to Identify Mental Health Problems: A Task-Sharing Intervention in Ethiopia. Mind, Brain, and Education. ;11(1):32-42.
Engle, Patrice, Lia Fernald, Harold Alderman, Jere Behrman, Chloe O’Gara, Aisha Yousafzai, Meena Cabral de Mello, Melissa Hidrobo, NurperUlkuer, IlgiErtem, and SelimIltus. (2011). Strategies for Reducing Inequalities and Improving Developmental Outcomes for Young Children in Low-Income and Middle-Income Countries. The Lancet 378 (9799):1339–53
Garland, A.F., Deyessa, N., Desta, M., Alem, A., Zerihun, T., Hall, K.G., Goren, N., & Fish, I. (2018). Use of the WHO’s Perceived Wellbeing Index (WHO-5) as an efficient and potentially valid screen for depression in a low income country. Families, Systems, and Health.
Ip P, Li SL, Rao N, Ng SSN, Lau WWS, Chow CB. (2013), Validation study of the Chinese Early Development Instrument. BMC Pediatrics;13:146.
Janus M, Brinkman SA, Duku EK. (2011). Validity and Psychometric Properties of the Early Development Instrument in Canada, Australia, United States, and Jamaica.Soc Indic Res;103:283–97.
Good overview article published by World Bank by Sophie Naudeau and Rifat Hasan, Early Childhood Development: A Review of the Global Evidence (2016): https://openknowledge.worldbank.org/bitstream/handle/10986/24575/K8737.pdf?sequence=2