Abstract
This study uses 36 standardized population and health surveys – Multiple Indicator Cluster Surveys, Demographic and Health Surveys and Pan-Arab Project for Family Health – from sixteen countries for years 2002–2015 to assess the evolution of early childhood opportunities in countries across the Arab region. Fifteen indicators for children’s basic opportunities – including qualified care for mothers during pregnancy and child delivery, children’s access to minimum nutrition, health, parental care and developmental activities – are assessed. The typical level of opportunities, inequality in opportunities across various socio-economic groups, and household characteristics responsible for the inequality are reviewed.The study concludes that access to ECD opportunities is largely inadequate and subject to vast inequality across the Arab region as well as within countries – particularly children’s height, access to iodized salt, enrolment in nurseries and preschool programs, cognitive stimulation at home, and violent disciplining. Across most countries, children’s height falls behind in the first two years of children’s life, suggesting that this is a crucial period in which a targeted institutional intervention could be most fruitful. While ECD opportunities are improving and becoming more equal over time across many countries, progress is uneven. For the rates of skilled care during child delivery, child immunization, and enrolment in preschool programs, access is deteriorating, perhaps reflecting low priority given to them in public policy. Among Arab countries, a number of indicators were deteriorating in Djibouti, Mauritania and Syria. Surprisingly, countries experiencing uprisings fare better than other Arab countries in terms of the level and trends in ECD opportunities. Regarding inequality in ECD opportunities, inequality in child mortality, rate of underweight, enrolment in preschool programs, engagement in developmental activities at home, violent disciplining of children, and child labor is deteriorating. Algeria, Djibouti and Syria have seen deterioration of inequality across many dimensions of ECD. Among household characteristics contributing to inequality, wealth accounts for 20–30 percent of inequality, parents’ education for another 25–35 percent, differences across administrative regions for 20–35 percent, and rural vs. urban residence for 5–15 percent. Interestingly, wealth affects inequality for ECD activities facilitated by markets or local governments such as nursery and preschool attendance, but not as much for non-market activities such as child disciplining and child labor. The relative influence of wealth and residence falls over time, while that of administrative regions and mother’s education rises. These findings have important policy implications. A number of the identified effects can be remedied with narrow interventions or assistance by state governments or non-governmental organizations. The study therefore provides some guidance regarding the most beneficial and cost-effective targets for limited public resources.
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