Scaling-Up Early Child Development in Cuba - Cuba's Educate Your Child Program: Strategies and Lessons from the Expansion Process

From the Brookings Global Economy and Development working paper series with funding from The Bernard van Leer Foundation, This paper gives a historical review of child development services in Cuba, particularly, its universal preschool education, the Educate Your Child Program.

As stated in the Introduction, "Cuba’s advancement with respect to child development services is a result of the ideology, culture, and values that have oriented and driven the country’s social policies in recent decades....The Educa a Tu Hijo program, the main subject of this case study, is a noninstitutionalized, multisector, community-based program run by the Ministry of Education that places the family at the center of program activities. Seventy percent of Cuban children under the age of six years participate in the program, along with pregnant women. Following the success of Educate Your Child, the program methodology was replicated in Ecuador, Chile, Brazil, Mexico, Venezuela, Colombia, and Guatemala....This case study attempts to answer a number of questions regarding the implementation and expansion of the Educate Your Child Program in Cuba between 1992 and 1998. ...", including questions about its implementation, assessment, and replication.

The programme is multisectoral in its implementation, involving: the state; the active participation of the population; the participation of the family; the contribution of universities, teaching institutes, and research centres; and social policies, particularly in the areas of education and health care, in promoting child development. This arises from the Cuban system in which political activities, social mobilisation, and education and health programmes are all interlinked, decentralised, and interconnected at the national, provincial, municipal, and local levels. The original programme evolved from the Círculos Infantiles (Infant Circles), which involved families in education and nutrition services and health and dental care to children through visits of doctors and nurses.

The 3 principles from which the early childhood education system evolved are: the need to provide services from an early age, the need to provide high-quality teacher training, and the need to ensure participation of the family, the community, and other key individuals in a child’s development. The system that supports these principles includes: poly clinics (local clinics with family care, including maternal and newborn genetic risk assessment for early intervention); hogares maternos (maternity homes) for pregnant women, particularly those at risk; Centros de Diagnóstico y Orientación (Diagnosis and Guidance Centres) for the early detection of developmental disabilities and provision of recommendations; Salones de Pre-escolar - preschool sessions for 5-6 year olds; and training of family and community members in the  Educate Your Child Program and ongoing monitoring for programme improvement.

As stated here: "In order to understand the Educate Your Child Program model as a whole, one must first understand the social vision behind the program. Children and families are not alone: they are backed by a community. Social cohesion means that child development is a shared responsibility. That is the driving force behind the program....The program’s objective is to achieve the maximum level of development possible for each child in the areas of emotional communication, intelligence, language, motor development, habit formation, health, and nutrition."

"The 0-2 age group receives individualized care from facilitators who visit homes once or twice a week. The in-home sessions consist of demonstrations of stimulation activities by the facilitators, which serve as examples for the parents.....Children in the 2-6 age group participate alongside their parents or caretakers in group sessions held once or twice a week in a community space (parks, cultural centers, sports centers)." Coordinating groups at the local level implement the programmes and meet once a month to discuss issues related to programme operations. "The local coordinating groups call on people’s organizations, communities, and families to analyze the progress of local plans." Education promoters provide paedagogical guidance to the groups and also provide training for doctors and other professionals who do not have a traditional link with education.

"The monitoring process uses a previously designed population-based methodology that has been applied every few years since 1994 to determine the quality of the program and its processes. The evaluations examine children’s cognitive, motor, language, and social-emotional development; families’ ability to act as stimulating agents for their children; community participation; and local coordinating groups’ preparation to lead activities. The workers and organizations that provide services participate in the evaluations along with parents."

The document shows results of United Nations Educational, Scientific and Cultural Organization (UNESCO) "Regional Comparative and Explanatory" studies of children in Latin America and the Caribbean over a period of years showing a consistency in the rate of preschool attendance and the health of Cuban children from birth, correlated with high primary school attendance and high academic performance at the 3rd, 4th, and 6th grade level. Lessons from the Cuban experience include:

• It is important to integrate health and education programmes in a universal early human development programme, including the training of health and education professionals in child development (health, learning, and behaviour), the formation of integrated health and education working teams, and the provision by community polyclinics and family doctors of health care and development services during pregnancy and the entire early child development period.
• Broad social mobilisation and multisector participation has a positive impact on a programme on child development and families' ability to promote child development. 
• A stable political system with long-term strategic child development plans and ongoing financing of social policies and programmes in the areas of health and education can prioritise social equity and child development, offering free, participatory, universal, decentralised, preventive health care and education programmes through a high number of health and education professionals per inhabitant.
• The active participation of universities, teaching institutes, and research centres supports the design and implementation of social policies and child development programmes.
• The eradication of illiteracy, a high level of social mobilisation, and the contribution of the media to health and education programmes also support the success of a universal early child development programme.

The document turns to the question of scaling up the programme through its use in other countries. The examples of Brazil’s Primeira Infância Melhor - Better Early Childhood - programme and Ecuador’s Creciendo con Nuestros Hijos - Growing with Our Children - (CNH) programme show implementation of various aspects of the Cuban programme. As stated here, "Both Brazil and Ecuador were able to implement the basic elements of the Educate Your Child program successfully." Brazil involved the participation of the secretariats of health, education, culture, and justice and social development, giving the program a multisector and comprehensive character with regard to child development services. Further, in Ecuador, the significant characteristics are local participation and the formation of management committees.