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Measuring Early Childhood Development (ECD) in Manitoba:

Evaluating Child-Centred Public Policy at a Population Level

Presented by Dr. Rob Santos, Healthy Child Manitoba Office, Healthy Child Committee of Cabinet, Government of Manitoba

Measuring Early Child Development – April 26-28, 2006 – Vaudreuil, Québec, CanadaCentre of Excellence for Early Childhood Development

Presentation Overview• Part I: Measuring Early Childhood Development

(ECD): What Governments and Communities Need• Part II: Two Challenges for Government (and a

Possible Cure)• Part III: Child-Centred Public Policy: The Healthy

Child Manitoba Strategy• Part IV: Measuring ECD in Manitoba: A Good Start• Part V: Some Next Steps and Promising Possibilities

for Manitoba and Canada

Measuring Early Child Development – April 26-28, 2006 – Vaudreuil, Québec, Canada

Measuring ECD in Manitoba: Evaluating Child-CentredPublic Policy at a Population Level

Centre of Excellence for Early Childhood Development

PART I:

Measuring Early Childhood Development (ECD): What Governments and

Communities Need



What We Need • A comprehensive Early Childhood Development (ECD) system:– publicly funded– evidence-based– multilevel: universal, targeted,

clinical (best policy mix to reach all children that need support)

– reduces risk factors for ECD– promotes protective factors for ECD– measures and monitors cross-

sectoral ECD expenditures, activities, determinants, and outcomes across the life course



ACTIVITIES

DETERMINANTS

OUTCOME GRADIENTS &TRAJECTORIES

Healthy Children and Families in Communities

EXPENDITURES

Measuring Progress in ECD



PART II:

Two Challenges for Government(and a Possible Cure)



Two Challenges for Government

• Evaluation: Linking resources to results (especially causal designs)

• Evidence-based policy and budget:Linking results to resource allocation



. . . and a Possible CURE• Courage –> political will (despite the risks and costs)• Understanding –> outside pressure from the public

for evaluation (as a public good)• Resources –> for evaluation and knowledge exchange• Empowerment –> for government (an inside engine

for change) and for communities (to use evidence and evaluation for change)Important ingredients:A recognition that major government-wide policy pressures on health, education, child welfare, and justice systems (a) cannot be solved by any single department or sector alone, and (b) requires multilevel prevention and intervention in early childhood at a population level, with a special focus on parenting



PART III:

Child-Centred Public Policy: The Healthy Child Manitoba Strategy



Manitoba’s VisionThe best possible outcomes for Manitoba’s children



Leadership: Manitoba’s Premier and Healthy Child Committee of Cabinet• Established in March 2000 by Premier Gary Doer

• Only Cabinet committee in Canada dedicated to the well-being of children and youth

Current HCCC members:

• Theresa Oswald, Chair of the Healthy Child Committee of Cabinetand Minister of Healthy Living

• Oscar Lathlin, Minister of Aboriginal and Northern Affairs

• Eric Robinson, Minister of Culture, Heritage and Tourism

• Peter Bjornson, Minister of Education, Citizenship and Youth

• Christine Melnick, Minister of Family Services and Housing

• Tim Sale, Minister of Health

• Gord Mackintosh, Minister of Justice and Attorney General

• Nancy Allan, Minister of Labour and Immigration, Minister Responsible for the Status of Women

Gary Doer, Premier of Manitoba

“This century can be Manitoba’s century – with new hope for our young people . . . We know that children who grow up in safe, nurturing environments have better success throughout their lives . . . [this] is part of our ongoing commitment to building healthy, safer communities for Manitobans and their families.” (March 2000)



Bridging Government Departments: Intersectoral Structures in Manitoba

Executive Council

Healthy Child Committee of Cabinet

Chair andMinister of Healthy LivingHonourable Jim Rondeau

Healthy Child Deputy Ministers’ CommitteeChair and

Deputy Minister of Family Services and Housing

Milton Sussman

Healthy Child Manitoba Office

Secretary to the Committees andExecutive Director

Jan Sanderson

Minister of Aboriginal and Northern AffairsHonourable Oscar Lathlin

Minister of Culture, Heritage and TourismHonourable Eric Robinson

Minister of Education, Citizenship and YouthHonourable Peter Bjornson

Minister of Family Services and HousingHonourable Christine Melnick

Minister of HealthHonourable Dave Chomiak

Minister of Justice and Attorney GeneralHonourable Gord Mackintosh

Minister of Labour and Immigration andMinister Responsible for the Status of Women

Honourable Nancy Allan

Deputy Minister of Aboriginal and Northern Affairs

Harvey Bostrom

Deputy Minister of Culture, Heritage and Tourism

Sandra Hardy

Deputy Minister of Education, Citizenship and Youth

Gerald Farthing

Deputy Minister of Health and Deputy Minister of Healthy Living

Arlene Wilgosh

Deputy Minister of Justice and Deputy Attorney General

Ron Perozzo

Assistant Deputy MinisterManitoba Women’s Directorate

Manitoba Family Services and Housing Manitoba Aboriginal and Northern Affairs Manitoba Culture, Heritage and Tourism Manitoba Education, Citizenship and YouthManitoba Health and

Manitoba Healthy LivingManitoba Justice Manitoba Labour and Immigration

Deputy Minister of Labour and Immigration

Jeff Parr

Minister of HealthHonourable Tim Sale

Chair and Minister of Healthy LivingHonourable Theresa Oswald

• Both horizontal and vertical structures are essential

• HCMO : 5-part mandate (community development, research, policy, practice, evaluation), dedicated staff and budget, direct access to Ministers and Deputy Ministers, and direct collaboration with all partner ministries and cross-sectoral community partners



Bridging Government and Community:Intersectoral Structures in Manitoba

• Healthy ChildCommittee of Cabinet

• Healthy Child Deputy Ministers’ Committee

• Healthy Child Manitoba Office

• Healthy Child Interdepartmental Committees

• Citizens and communities

• Parents and families

• Children and youth

• Community agencies

• ECD Advisory Committee

• Parent-Child Centred Coalitionsand Council of Coalitions

KNOWLEDGE

ACTION



REGIONAL & COMMUNITYPARENT-CHILD CENTRED

COALITIONS

FASDPREVENTION

STRATEGYHEALTHY BABYPARENT-CHILD

CENTRED APPROACH

FAMILIES FIRST(HOME VISITING)

MANITOBACHILD CARE

CHILDREN’SSPECIAL

SERVICESNATIONAL CHILD BENEFIT

RESTORATION

MANITOBA HEALTH -EARLY CHILDHOOD

HEALTH PROMOTION

MANITOBA EDUCATION, CITIZENSHIP & YOUTH -

ECD INITIATIVE

Early Childhood DevelopmentPriority Investments in Manitoba’s

Continuum

TRIPLE P – POSITIVE PARENTING PROGRAM



PART IV:

Measuring ECD in Manitoba:A Good Start



Some Key Data Components (to Date)• Universal, post-partum screening

– population-based (n = 13,000 births annually)– includes module on alcohol use during pregnancy for evaluating FASD prevention (national first)– partners: Manitoba Regional Health Authorities

• ECD program evaluation– sample-based (e.g., evaluation of Families First home visiting program, n = 250 families)– partners: Manitoba Regional Health Authorities, Manitoba Centre for Health Policy (MCHP) at

University of Manitoba• Early Development Instrument (EDI)

– population-based (n = 12,500 Kindergarten students in public schools)– began province-wide, voluntary phase-in across all Manitoba school divisions– uptake: 63% of school divisions in 2003, 74% in 2004, 82% in 2005, and 100% in 2006– partners: Manitoba school divisions, Manitoba parent-child coalitions, Offord Centre for Child Studies

• EDI Parent Survey– random population sample survey of 1000 parents in 2004 (and 2006) linked to EDI results– partners: Human Resources and Social Development Canada, Social Research and Demonstration

Corporation, and POLLARA• Administrative data linkage

– ECD programs, and other health, education, and social services– partners: MCHP, Human Early Learning Partnership (HELP) in British Columbia




Using ECD Measures in Manitoba• In 2004, Treasury Board directed HCCC partner departments and HCMO

to develop an annual, cross-departmental, evidence-based budget process to allocate (and reallocate) funds toward ECD

– about 4% of provincial budget = ECD investments– but 8% of Manitoba population = ECD age group– limited evaluation capacity across government (only 0.3% of total ECD budget)– investments in prevention increased from 30% of ECD in 2000 to 42% in 2005

• Data from 2004 EDI and 2004 EDI Parent Survey, with National Longitudinal Survey of Children and Youth (NLSCY) data, used to facilitate

– HCCC commitment in 2004 to improve parenting at a population level, and – Treasury Board commitment to fund implementation of the Triple P – Positive Parenting

Program System province-wide for children prenatal to age 5 years, beginning in 2005 (national first)

• Parent-Child Coalitions using EDI results to identify community priorities, strengthen local partnerships, and influence government priorities



PART V:

Some Next Steps and Promising Possibilities for Manitoba and Canada



. . . for Manitoba• Enabling legislation for child-centred public policy

– including cross-sectoral evaluation, budgeting, public reporting on progress

• Large-scale, longitudinal birth cohort study of child development – linked to EDI and other administrative data– opportunities for “best policy mix” evaluation, including RCT and RDD

• Population-level evaluation of the Triple P – Positive Parenting Program System using the EDI and other population-based data

• Intergovernmental collaboration on ECD evaluation (e.g., MOU with Government of Canada, MOU with Government of South Australia)

• Interdisciplinary training program in prevention science and policy, focusing on ECD (with University of Manitoba)



. . . and for Canada

• First national survey on Aboriginal ECD

• New national birth cohort studies

• A national network for ECD evaluation to– promote community-based ECD measurement;

– link ECD measures to later health, learning, social, and community measures across the life course;

– assist communities in evaluating ECD initiatives; and

– disseminate results and exchange knowledge on ECD




Our Opportunity“The charge to society is to blend the skepticism of a scientist, the passion of an advocate, the pragmatism of a policy maker, the creativity of a practitioner, and the devotion of a parent - and to use existing knowledge to ensure both a decent quality of life for all of our children and a promising future for the nation.”

Source: National Research Council and Institute of Medicine (2000, p. 415)



Thank You For more information, please visit the Healthy Child Manitoba website:

www.gov.mb.ca/healthychild



Dr. Rob SantosHCMO

[email protected]


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