Progress in child well-being: Building on what works

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This report argues for increased investment in ‘childsensitive’ development and specifies the drivers of change and the key steps to achieving progress in child well-being over the last twenty years. The argument for investing in children is based on the moral obligation of countries to address child deprivation as well as the potential economic benefits for countries which include higher productivity, lower population growth and child and infant mortality.

Investment in children and their well-being is put forward as a crucial factor in breaking the cycle of intergenerational poverty. It is stated that investment in adolescents increases the likelihood of countries to achieve demographic dividends whereby the youth of a country's population reach adulthood with the skills to be productive members of society and the economy, assisting growth social and political cohesion.

About

This report analyses improvements made to children’s lives over the past two decades in five sectors: health, nutrition, water and sanitation, education and child protection. It states that there was a short time available for the project and as a result in depth analysis of other areas important to child well-being, such as governance, were not able to be carried out. Accordingly the report seeks to provide a 'broad brushstroke' of research findings of the five sectors.

Section 1 offers an introduction to the report and is followed by section 2 which gives an overview of global trends in income poverty. Section 3 goes into detail on the progress achieved in each of the five areas associated with child well-being: health (focus on child survival and prevention of mother-to-child transmission of HIV); nutrition; water and sanitation; education (including early childhood development); and child protection. Within each sector an overview of progress in the developing world is offered and factors contributing to successes are highlighted. One or more case studies are offered for each sector.

Case studies

The report includes case studies of countries that have made significant progress in improving certain areas of children’s well-being in recent decades: Bangladesh - reductions in child mortality due to consistent investment in child health. Brazil - lowered prevalence of stunting and underweight children through a combination of interventions in conjunction with a large-scale cash transfer scheme Botswana - decline in HIV prevalence amongst children due to the introduction of a programme targeting the reduction of mother-to-child transmission of HIV, free testing of HIV for pregnant women and free antiretrovirals for those women found to be living with HIV Ethiopia - rise in primary school enrolment following greater government investment in facilities, a rise in the quality of education and gender parity, the abolishment of school fees, and the introduction of programmes designed to target disadvantaged children. Vietnam - decline in absolute poverty in recent decades, partly due to an explicitly child focused development strategy that included increased spending on children's health, nutrition, education and access to clean water and sanitation.

Measuring progress

The methodology employed for the report included a desk review and analysis of primary and secondary data carried out between August and October 2011. The objective was to identify trends in child well-being over the past two decades, document successes and identify the factors that contributed to this, with a particular emphasis on resourcing and the role of aid. Collation of existing evidence of trends in child well-being, case studies of significant improvements in child well-being and analysis of the factors underpinning successes was undertaken using secondary sources.

These above results were complemented with analysis of primary data on trends in aid flows to particular sectors and countries and, analysis of the relationship between aid and certain elements of child well-being. The principal research question for this section was 'have countries that received the most aid also made the most progress improving the lives of children?'. To answer it, the relationship between the average annual quantity of aid received by each country during the last ten years (where data was available) and the average annual improvement in childhood outcomes over the same period, specifically infant mortality, childhood malnutrition and the number of children living with HIV, were calculated.

Analysis was restricted to sub-Saharan Africa as other regions were found to lack enough data or had too few countries to permit cross country analysis. A broad measure of aid was employed to ensure that all forms of aid relevant to the areas of childhood outcomes were captured.

Drivers of progress

The report states that specific factors drive progress. These are:
- Government commitment
- Social investment and economic growth
- Development assistance
- Multidimensional, well-planned and implemented programmes
- Reducing inequities, including gender inequality
- New technology and innovation