94324 Yemen SABER Country Report EARLY CHILDHOOD DEVELOPMENT 2013 Policy Goals Status 1. Establishing an Enabling Environment Yemen has enacted several key laws to ensu re young children’s well-being. The National Strategy for Early Childhood Development is an important step to expand access and quality to preschool and other essential early childhood development services. Yemen could benefit from adopting additional policies. Finance systems are weak, and funding for the sector is inadequate. 2. Implementing Widely The current scope of nutrition programs does not address the acute need for nutrition interventions among young children and pregnant women. Existing health and education services do not reach large numbers of families. There is inequity in access to services between urban and rural areas, and poorer and wealthier citizens. 3. Monitoring and Assuring Quality Some data on early childhood development access and outcomes are available, but the types of data and number of children tracked could be expanded. There are few established quality standards for early childhood development services, although more standards are in development. There are few mechanisms for monitoring compliance with standards. THE WORLD BANK YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 This report presents an analysis of the Early Childhood SABER–Early Childhood Development Development (ECD) programs and policies that affect young children in Yemen. This report is part of a series of SABER-ECD collects, analyzes, and disseminates reports prepared by the World Bank using the SABER-ECD comprehensive information on ECD policies around framework and includes analysis of early learning, health, the world. In each participating country, extensive nutrition, and social and child protection policies and multi-sectoral information is collected on ECD policies interventions in Yemen, along with regional and and programs through a desk review of available international comparisons. government documents, data and literature, and interviews with a range of ECD stakeholders, including Yemen is a country of approximately 25 million people on government officials, service providers, civil society, the Arabian Peninsula. It has a young and growing development partners, and scholars. The SABER-ECD population, with roughly 5.8 million children below the framework presents a holistic and integrated age of 8. Its GNI per capita in 2011 was US$ 1,070. In assessment of how the overall policy environment in a 2012, it was ranked 160 out of 186 countries in the country affects young children’s development. This Human Development Index. The country is currently going assessment can be used to identify how countries through a period of political and social transition and address similar policy challenges related to ECD, with faces a number of challenges, including poverty, violence, the ultimate goal of designing effective policies for instability, and widespread malnutrition. young children and their families. The Government of Yemen (GoY) has developed a National Strategy for Early Childhood Development (2011- 2015) and is seeking funding to implement it. Among other goals, the strategy seeks to increase preschool enrollment from its current very low level. The ECD sector faces a number of challenges, including inequity in access to health, nutrition, and education services; lack of quality standards and monitoring echanisms; and inadequate funding. Weak institutional and governmental capacity — particularly in the country’s many rural areas — makes policy implementation difficult. Snapshot of ECD Indicators in Yemen with Yemen Egypt Ethiopia Iraq Sudan Regional Comparison Infant Mortality (deaths per 1,000 live births) 57 19 68 31 66 Under-5 Mortality (deaths per 1,000 live births) 77 22 106 39 103 Maternal Mortality Ratio (reported deaths per 100,000 370 55 670 84 1100 births) Gross Pre-primary Enrollment Rate (36-59 months, 27% 1% 29% 5% N/A 2010) (2009) Birth Registration 2000-2010 22% 99% 7% 95% 33% SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 2 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Box 1: A checklist to consider how well ECD is promoted at the country level What should be in place at the country level to promote coordinated and integrated ECD interventions for young children and their families? Healthcare x Standard health screenings for pregnant women x Skilled attendants at delivery x Childhood immunizations x Well-child visits Nutrition x Breastfeeding promotion x Salt iodization x Iron fortification Early Learning x Parenting programs (during pregnancy, after delivery, and throughout early childhood) x High-quality childcare, especially for working parents x Free pre-primary school (preferably at least two years with developmentally appropriate curriculum and classrooms, and quality assurance mechanisms) Social Protection x Services for orphans and vulnerable children x Policies to protect rights of children with special needs and promote their participation and access to ECD services x Financial transfer mechanisms or income supports to reach the most vulnerable families (could include cash transfers, social welfare, etc.) Child Protection x Mandated birth registration x Job protection and breastfeeding breaks for new mothers x Specific provisions in judicial system for young children x Guaranteed paid parental leave of least six months x Domestic violence laws and enforcement x Tracking of child abuse (especially for young children) x Training for law enforcement officers in regards to the particular needs of young children Box 1 presents an abbreviated list of interventions and levers, upon which decision-makers can act in order to policies that the SABER-ECD approach looks for in strengthen ECD, are identified.1 Improving ECD requires countries when assessing the level of ECD policy an integrated approach to address all three goals. development. This list is not exhaustive, but is meant to Strengthening ECD policies can be viewed as a provide an initial checklist for countries to consider the key continuum. Different countries fall in different places policies and interventions needed across sectors. along the spectrum of ECD policy development and can range from “latent” to “advanced” within the different Three Key Policy Goals for Early Childhood policy levers, as described in Table 1. Development As presented in Figure 1, SABER-ECD presents three 1 core policy goals that countries should address to These policy goals were identified based on evidence from impact ensure optimal ECD outcomes: Establishing an Enabling evaluations, institutional analyses, and a benchmarking exercise of top- performing systems. For further information, see “What Matters Most for Environment, Implementing Widely, and Monitoring and Early Childhood Development: A Framework Paper” Assuring Quality. For each policy goal, a series of policy (http://siteresources.worldbank.org/EDUCATION/Resources/278200- 1290520949227/7575842-1365797649219/Framework_SABER-ECD.pdf). SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 3 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 Figure 1: Three core ECD policy goals Table 1: ECD Policy Goals and Levels of Development Level of Development ECD Policy Goal Latent Emerging Established Advanced   Non-existent legal Minimal legal framework; Regulations in some Developed legal Establishing framework; ad-hoc some programs with sectors; functioning inter- framework; robust inter- an Enabling financing; low inter- sustained financing; some sectoral coordination; institutional coordination; Environment sectoral coordination. inter-sectoral sustained financing. sustained financing. coordination. Coverage expanding but Near-universal coverage Universal coverage; Low coverage; pilot gaps remain; programs in some sectors; comprehensive strategies Implementing programs in some sectors; established in a few established programs in across sectors; integrated Widely high inequality in access sectors; inequality in most sectors; low services for all, some and outcomes. access and outcomes. inequality in access. tailored and targeted. Information on outcomes Information on outcomes Information on outcomes Minimal survey data at national, regional and from national to at national level; Monitoring available; limited local levels; standards for individual levels; standards for services and Assuring standards for provision of services exist for most standards exist for all exist in some sectors; no Quality ECD services; no sectors; system in place to sectors; system in place to system to monitor enforcement. regularly monitor regularly monitor and compliance. compliance. enforce compliance. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 4 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 Policy Goal 1: Establishing an Enabling National laws adequately promote appropriate dietary consumption by pregnant women and Environment children. A 2005 cabinet decree made iron ¾ Policy Levers: Legal Framework • fortification of staples mandatory. According to the Inter-sectoral Coordination • Finance Ministry of Public Health and Population (MoPHP), 80 percent of white flour in Yemen is fortified with iron An Enabling Environment is the foundation for the and folate, and 82 percent of cooking oils are fortified design and implementation of effective ECD policies.2 with vitamin A and vitamin D. An enabling environment consists of the following: the existence of an adequate legal and regulatory The anemia rates for young children and pregnant framework to support ECD; coordination within women are 68 percent and 58 percent, respectively. sectors and across institutions to deliver services According to the World Health Organization (WHO), effectively; and sufficient fiscal resources with these levels of prevalence constitute a severe public transparent and efficient allocation mechanisms. health problem. Anemia can have adverse health effects: mild anemia may impair work productivity, Policy Lever 1.1: and severe cases can increase risk of maternal and Legal Framework child mortality. The legal framework comprises all of the laws and While an iron fortification policy is an important regulations that can affect the development of young component of a strategy to reduce anemia, the children in a country. The laws and regulations government will need to do more to ensure that at- impacting ECD are diverse due to the array of sectors risk populations are receiving adequate iron. A draft that influence ECD and because of the different National Nutrition Strategy for Yemen issued by the constituencies that ECD policy can and should target, MoPHP proposes reducing iron deficiency anemia including pregnant women, young children, and through: increasing awareness of iron rich foods; parents and caregivers. technical training for wheat flour producers on iron fortification; establishing monitoring systems for Some national laws promote healthcare for young wheat fortification; expanding iron/folic acid children and pregnant women, but aspects of policy supplements for pregnant and lactating women; and could be strengthened. Article 54 of the Yemeni reducing the risk of parasitic infection. constitution states that healthcare is a right of all citizens, and the government guarantees this right A 1996 law mandates salt iodization. According to through health institutions. Law 45 on Children’s UNICEF data from 2007-2011, 30 percent of Yemeni Rights (2002) guarantees primary healthcare for households consume iodized salt. The draft National pregnant mothers and young children; the care is Nutrition Strategy proposes to address iodine supposed to be free for those who cannot afford it. deficiency through public awareness, training salt Immunizations are free for all children. Young children factories on iodization, and monitoring salt production are not required to have well-child visits. for compliance. The law does not require pregnant women to be The GoY has some policies to encourage screened for HIV/AIDS and STDs. Currently, 14 health breastfeeding, but could do more to promote the facilities around the country offer voluntary HIV/AIDS practice. Yemen’s laws comply with the International counseling and testing, and four prenatal care centers Code of Marketing of Breast Milk Substitutes. This is provide free Prevention of Mother to Child an important component of efforts to promote Transmission treatment services. In 2011, 1 percent of breastfeeding. According to the Yemeni Labor Code, pregnant women received HIV testing. employed women can leave work early to breastfeed their babies. However, employers are not required to 2 Brinkerhoff, 2009; Britto, Yoshikawa & Boller, 2011; Vargas-Baron, 2005. provide breastfeeding facilities. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 5 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 Despite some beneficial policies, according to UNICEF, from working in industries and occupations that are between 2007 and 2011 the rate of exclusive hazardous, arduous, or harmful to health or social breastfeeding for babies below 6 months is 12 standing; or to work at night. percent. The low rate may be explained by lack of public understanding of the importance of the There is no right to return to a job after pregnancy and practice. maternity leave, and no explicit prohibition on discrimination based on pregnancy or parental status. The GoY should undertake a public awareness The Labor Code states that women and men are equal campaign to promote breastfeeding, and particularly “in relation to all conditions of employment and exclusive breastfeeding the first six months of life. employment rights, duties and relationships, without Such an effort is crucial in light of the malnutrition that any discrimination.” afflicts so many young Yemeni children, and the potential of breastfeeding to help alleviate this crisis. Table 2 presents information on parental leave policies in select countries in the Middle East and Families need to be educated on the many health North East Africa. Egypt offers longer maternity leave benefits of breastfeeding. Babies who are breastfed than Yemen, and Ethiopia offers both prenatal and have lower incidence of mortality and morbidity than postnatal leave. It is difficult to evaluate the extent to those who are not. Misconceptions about the poor which these policies are followed. Due to the large quality of breast milk in the first few days following informal economies in many countries in the region, birth need to be addressed. Not only does formula these policies may not actually apply in practice to the lack the wealth of nutrients found in breast milk, when many parents working in the informal sector. Even formula is made with poor-quality water common in government or formal-economy private employers many parts of the country, it can cause diarrhea and may not pay full wages during leave. Table 3 further erode a child’s health. Anecdotally, it seems summarizes parental leave policies in several countries that some mothers give their babies sweetened tea, with similar income levels to Yemen. Those policies which has negligible nutritional value. Breastfeeding are similar to Yemen’s in length of leave and wage also costs nothing. See Box 2 for ideas on how the GoY benefits. could promote breastfeeding in ways that would be Table 2: Regional Comparison of Parental Leave Policies most appropriate and applicable for the country. Yemen Egypt Ethiopia Jordan National laws promote opportunities for parents to 60 days paid 90 days paid 30 days prenatal 50 days paid maternity leave at maternity leave at and 60 days maternity leave at provide care to newborns and infants in their first 100% wage; 100% wage; up to postnatal 100% wage; up to 1 year of life, but could be further strengthened. The additional leave 2 years unpaid maternity leave at year unpaid Yemeni Labor Code grants women 60 days maternity available for twins maternity leave; 100% wage; no maternity leave; no leave with full pay. The employer is responsible for or medical condi- no paid or unpaid paid or unpaid paid or unpaid tion; no paid or paternity leave paternity leave paternity leave payment of wages. An additional 20 days are available un-paid paternity for twins or a difficult labor as established by a leave medical report. There is no paid paternity leave. These provisions apply to both public and private sector Table 3: Comparison of Parental Leave Policies in Countries with Similar Income Levels to Yemen workers. Yemen Cote d’Ivoire Ghana Pakistan From the sixth month of pregnancy on, women can 60 days paid 70 days paid 60 days paid 60 days paid work five hours per day. After maternity leave is over maternity leave maternity leave maternity leave maternity leave at 100% wage; at 100% wage; 15 at 100% wage; at 100% wage; and before the baby is 6 months old, a mother can additional leave additional days 10 or more illegal to work work five hours a day to allow for breastfeeding. available for for medical additional days within 6 weeks twins or medical condition; no for twins or after delivery; no Employers are not required to provide facilities for condition; no paid or unpaid medical paid or unpaid breastfeeding, and the shorter working day is paid or unpaid paternity leave condition; no paternity leave paternity leave paid or unpaid intended to allow women to return home to paternity leave breastfeed. The Labor Code also prohibits women SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 6 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 According to World Bank data, the adult female labor Box 2: Brazil’s campaign to promote breastfeeding, force participation rate in Yemen in 2011 was 25 and lessons for Yemen percent. The labor force participation rate for women with young children is not clear, but it is likely lower. Brazil’s campaign to promote breastfeeding is an Ensuring non-discrimination at the workplace and example of successful effort to change public perceptions and healthcare practices, resulting in a implementation of maternity leave policy could help significant increase in breastfeeding. The campaign was improve female labor participation. Many families initiated in 1980 by the National Food and Nutrition struggle financially to provide the necessities of life. Institute. UNICEF and the Pan-American Health Income earned by a mother can improve her family’s Organization helped to develop public awareness access to nutritious food, healthcare, education, and materials that addressed the lack of informational housing. This is crucial to both a family’s well-being materials on breastfeeding in Portuguese. Instructional and the country’s economic growth. brochures were widely distributed to mothers. A media campaign featured radio, television, and print media Yemeni law provides free preschool education. spots, and endorsements by well-known personalities. Yemen’s General Education Law 45 (1992) recognizes The WHO and UNICEF held training courses on preschool as part of the country’s education system. breastfeeding for healthcare workers and managers, All levels of education are supposed to be provided for and the Baby Friendly Hospital Initiative was widely free, starting at age 3. In practice, preschool implemented to initiate early feeding. A coalition of numerous actors helped make the campaign a success. attendance is very rare. In the 2010-2011 school year, The Catholic Church, mothers groups, associations of there were 549 preschools, most of them private. medical professionals, community leaders, politicians, They enrolled a total of 30,137 students, meaning that and the media were all engaged in the effort. The net enrollment was less than 1 percent of children exclusive breastfeeding rate rose from 3.6 percent in ages 3 to 5. Preschools are very rare outside of urban 1986 to 40 percent in 2006. areas. The National Strategy for Early Childhood 2011- Key recommendations for Yemen, drawing on Brazil’s 2015 aims to greatly expand preschool enrollment. experience: 9 Develop and disseminate Arabic language materials National laws and regulations promote child on the benefits of breastfeeding for a variety of protection and care for disadvantaged children, but audiences. These could include training materials for could be strengthened. Under the National Strategy healthcare workers, awareness pamphlets for for Supporting Birth Registration, the registration of community leaders and NGOs, and instructional children at birth is mandatory in Yemen. Registration brochures for mothers, including mothers who are is free of charge. Birth registration outreach programs illiterate. target internally displaced people in the country. 9 Encourage breastfeeding from an Islamic perspective, Despite these policies, the birth registration rate and engage religious organizations and leaders to spread awareness. between 2005 and 2011 was 22 percent according to 9 Train healthcare workers to educate mothers on the UNICEF. benefits of breastfeeding, and to support them to Some primary teachers are trained to identify child initiate and maintain the practice. abuse and neglect. The Ministry of Social Affairs and 9 Engage the support of NGOs, women’s associations, Labor (MoSAL) established the Social Monitoring and health workers, community leaders, etc. Child Protection with Community Protection program (Source: Implementation of Breastfeeding Practices in Brazil: in 2007 to track child abuse and return runaway http://www1.paho.org/English/DD/PUB/NutritionActiveLife-ENG.pdf ) children to their families. Program centers are established in Taiz and Hodaida but have not yet been The judicial system has training for judges, lawyers, expanded to other governorates. As child protection and law enforcement officers on interacting with and programs expand, they should follow an approach that protecting children. Training is provided through puts children’s safety and well-being first, which may cooperation between government ministries and not include returning runaway children to their organizations such as UNICEF, Save the Children, or families. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 7 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 the International Labor Organization. The system’s the Social Welfare Fund. Orphans are exempt from capacity to handle child protection cases could be paying healthcare and school fees. improved by establishing special children’s courts. The Children’s Parliament and other NGOs advocate on In 1997, the MoE adopted a policy to ensure the behalf of children. inclusion of all children with special needs. It is not clear that there is an explicit policy to promote the Currently, Yemen lacks a national system of care for participation and access of children with disabilities to disadvantaged and vulnerable children. In addition to ECD services. However, the Yemeni Constitution the many children living in poverty, large numbers of recognizes healthcare as the right of all citizens, children are internally displaced, live in conflict zones, guaranteed by the state through healthcare facilities. are victims of trafficking, or are refugees from Somalia. Many of these children do not receive Additional details about the status of children with adequate (or any) support services from the special needs and disabilities are included in this government. The government also lacks adequate report in section Policy Lever 2.3: Equity. policies to protect children from child abuse. Weak government institutions and rule of law in many areas Key Laws and Regulations Governing ECD in Yemen of the country make implementation of child x UN Convention on the Rights of the Child protection measures more difficult. x The Yemeni Constitution provides a right to education and health; it also obliges the state to According to research conducted for the UNICEF “protect motherhood and childhood,” and to Multiple Indicator Cluster Survey, between 2005 and “guarantee adequate provision of social safeguards 2011, 95 percent of adult caregivers of children to citizens.” between the ages of 2 and 14 reported using violent x Children’s Rights Law (2002) brings Yemeni laws discipline (defined as physical punishment and/or roughly in line with international agreements on psychological aggression) within the previous month. children’s rights. This includes free primary This high figure suggests that there may be healthcare for pregnant women and children for those who cannot afford to pay, right of disabled widespread social acceptance of the use of violence to students to special services, right to social services discipline children. for children in distressed circumstances, guarantees free education, and other measures. The UNICEF/Ministry of Social Affairs and Labor x General Education Law (1992) recognizes preschool (MoSAL) Child Protection Cluster has plans to address as a part of the education system. gaps in the child protection system, but it is not clear that funding is secured to implement them fully. These plans include offering psychosocial support services to Policy Lever 1.2: children, developing monitoring and reporting Inter-sectoral mechanisms on child rights violations, providing free Coordination legal aid for children who are detained, expanded Development in early childhood is a multi-dimensional training for law enforcement officers on child rights, process.3 In order to meet children’s diverse needs the development of children’s courts, awareness during the early years, government coordination is sessions and community-based violation prevention essential, both horizontally across different sectors as on child abuse, and support for trafficked children. well as vertically from the local to national levels. In Policies do not exist to provide orphans and many countries, non-state actors (either domestic or vulnerable children with ECD services. However, the international) participate in ECD service delivery; for MoSAL’s Care and Rehabilitation program, along with this reason, mechanisms to coordinate with non-state NGOs and the Ministry of Education (MoE), runs 30 actors are also essential. orphanages. Orphans are often cared for by family members. They receive monthly cash assistance from 3 Nadeau et al., 2011; UNESCO-OREALC, 2004; Neuman, 2007. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 8 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 Yemen has a multi-sectoral ECD strategy, and is responsible for ECD provision. The HCMC also currently seeking funding to implement it. In 2010, proposes laws, regulations, and systems to ensure the the government created the National Strategy for rights of motherhood and childhood, and reviews any Early Childhood Development (2011-2015). It was legislation related to these issues. The HCMC board is drafted according to a holistic approach to children’s comprised of government ministers, civil society development, and with recognition of the value of representatives, and ECD experts. children in Islam. The Strategy covers the essential sectors of education, health, nutrition, and social and The Early Childhood Development Center (ECDC) also child protection. It includes an implementation plan, has a role to play in setting ECD policy and programs. but is not costed. A technical committee comprised of The Center was established within the MoE government institutions, civil society organizations, Curriculum Department in 2009 with support from donors, and the private sector participated in drafting UNESCO and Agfund to develop and disseminate best the document. practices around holistic, play-based early childhood education. It currently operates a preschool that is The Strategy has seven pillars. These include policies meant to serve as a model, is training 80 teachers and legislation, sources of information on early from different governorates, and is developing childhood, strengthening institutions working on early classroom materials. childhood, providing high-quality holistic early childhood services, raising awareness on the The Social Development Fund is a government- importance of early childhood, providing funding for administered foundation that implements many ECD- early childhood activities and programs, and related activities. It conducts projects such as monitoring and evaluation of strategy preschool construction, classroom renovation, and implementation. teacher training courses. The Strategy’s implementing actors are numerous and Figure 2: Inter-sectoral coordination for ECD policies diverse, and include the MoH, MoE, MoSAL, Ministry and programs of Media, Ministry of Civil Services, Ministry of Human Rights, Ministry of Interior, Ministry of Communications, Ministry of Waqfs (Islamic Endowments), the High Council for Motherhood and Childhood (HCMC), the Social Development Fund, civil society organizations, local councils, and the private sector. The government’s National Strategy for Childhood and Youth also has early childhood components. These include management of childhood illnesses, routine vaccination, developing a comprehensive national plan for nutrition, and developing a national program for Mechanisms for ECD service delivery coordination ECD. are in place. The HCMC convenes ministries and civil society organizations working on ECD to discuss The High Council for Motherhood and Childhood HCMC’s plans, and share information about policies (HCMC) is the institutional anchor for ECD policy and and programs they are conducting. Meetings are not programs. The HCMC was established in 1991 as the held according to a set schedule. To improve the lead policy and coordination agency for governmental body’s effectiveness, it may be useful to establish a and civic early childhood activities. Its responsibilities regular meeting schedule. include setting policies related to ECD, setting standards for ECD providers, monitoring ECD access and quality, and coordinating across various agencies SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 9 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 The National Strategy for Early Childhood and sub-national allocations. This will promote Development establishes a menu of ECD services that transparency and efficient use of resources, increasing young children should receive. the likelihood of funding going to where it is most needed. In education, criteria could include student While the HCMC meetings and Strategy establish a characteristics at each institution, such as framework for coordination, it is not clear that socioeconomic, internally displaced, or special needs interventions are coordinated at the level of service status. This would help ensure that adequate delivery. Many planned interventions are not in fact resources are available for schools that may serve implemented for reasons related to lack of funding large numbers of children requiring extra support. In and capacity. health and nutrition, budget allocations to each health center could take into account the number of young State and non-state stakeholders collaborate on ECD children covered at each center. issues. Civil society organizations (CSOs) were involved in shaping the National Strategy for Early Childhood Ministries do not coordinate with each other when Development, and often meet with the HCMC. CSOs determining their ECD budgets. Government ministries working in child rights have an active coordination do not determine their ECD budgets in coordination with body, the Yemen National NGO Coalition for Child other ministries. Each ministry prepares its own budget Rights Care. Among other activities, the coalition without consulting other government agencies working authors shadow reports monitoring implementation of on similar issues or targeting the same populations of the UN Convention on Child Rights. children and mothers. Policy Lever 1.3: Within the MoE, the budgets for young children are Finance prepared within each sub-unit. These are combined into one plan and submitted to the Ministry of Finance for While legal frameworks and inter-sectoral approval. coordination are crucial to establishing an enabling environment for ECD, adequate financial investment is According to the MoE, it has trouble receiving adequate key to ensure that resources are available to funding for several reasons. The Ministry of Finance implement policies and achieve service provision goals. believes that ECD programs are sufficiently supported by Investments in ECD can yield high public returns, but international organizations, while international are often undersupplied without government support. organizations press the Yemeni government to Investments during the early years can yield greater contribute financially to ECD programs. A deep economic returns than equivalent investments made later in a crisis in the country in recent years means the child’s life cycle and can lead to long-lasting government’s budgets are stretched. intergenerational benefits.4 Not only do investments in The government can report expenditures and budgets ECD generate high and persistent returns, they can for early childhood education, but not for other ECD also enhance the effectiveness of other social sectors. The Ministry of Finance presented a paper at a investments and help governments address multiple conference on budgets for children’s programs in priorities with single investments. November 2012 that included a figure for total The allocation of early childhood funding does not expenditure on early childhood care and education use explicit criteria. Allocation of ECD funding in the (ECCE). education, health, nutrition, child protection, and In other sectors, reports of spending on ECD-related social protection sectors is not based on criteria or a programs are not available. Budget items are not formula. In all sectors, the government could use identified as ECD spending, so there is no way to explicit criteria to determine both national budgets distinguish ECD expenditure within the overall budget of each ministry or agency, or to track total government 4 Valerio & Garcia, 2012; WHO, 2005; Hanushek & Kimko, 2000; Hanushek spending on ECD. & Luque, 2003. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 10 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 The level of ECD finance is not adequate to meet the field. This very low wage discourages potentially qualified needs of the population. It is not clear how much of workers from seeking employment in pre-primary Yemen’s education budget is allocated for pre-primary education. Data on wages in private schools are not education. (The available figures are not consistent.) available. Spending on education comprised 19 percent of the total public budget in 2011, but it is not clear how much of The government pays some extension health service that budget went to the pre-primary level. workers a monthly salary. Others are paid by activities or daily rates. According to policy, the government is supposed to provide vaccinations for young children for free. Policy Options to Strengthen the Enabling According to UNICEF, in 2011 only 20 percent of Environment for ECD in Yemen vaccinations were in fact provided without a fee. ‡‰ƒŽˆ”ƒ‡™‘” Given the very low level of preschool enrollment, low access to healthcare, and other indicators, the level of ¾ The GoY could work to ensure that the iron spending is likely far from adequate to meet the needs of fortification policy is being fully implemented. It could young children. move forward to implement the steps outlined in the draft National Nutrition Strategy to address the issue The burden of finance for ECD is not distributed of maternal and child anemia. These include technical equitably across society. According to policy, public support and monitoring of wheat flour factories, ECCE centers are supposed to be free, but in practice, public awareness, and providing iron supplements for several types of fees are charged for preschool pregnant and lactating women. Supplements should attendance. These include tuition, matriculation, also be provided to young children. The country’s uniforms, meals, and transportation. anemia problem is likely linked to the broader issues For healthcare, many services are officially free, of low access to maternal and child healthcare, and including antenatal checkups, reproductive health the inability of many families to afford to purchase services, labor and delivery, well-child visits, and other nutritious foods. Educating families on the importance basic medical treatments for children. In practice, the of consuming a diet rich in iron will only change government does not always reimburse health behavior and improve health if people can afford to facilities for providing these services. This leaves the buy appropriate foods. burden of payment with individuals and families, who ¾ The GoY could consider studying the reasons for may not seek out healthcare knowing that they cannot the low rate of iodized salt consumption despite its afford to pay for it themselves. salt iodization policy. This may suggest that the law is not being fully implemented, that salt found in Yemeni The level of out-of-pocket expenditures as a markets are imports not required to be iodized, that percentage of total health expenditures was 73 Yemenis do not consume much salt, or other reasons. percent in 2009, which suggests that most Yemenis After identifying the causes, the GoY could take steps have to pay themselves for much of their healthcare. to address these. Remuneration of ECD professionals in public preschools ¾ The GoY could develop a comprehensive strategy is low. Monthly wages for educators at public preschools to promote breastfeeding. The plan could include start at YRl 15,000 (approximately US$ 69), and go up to measures to promote public awareness on the a maximum of YRl 20,000 (US$ 93). In contrast, the importance of the practice to promote young minimum starting wage for a primary school teacher is children’s health and address rampant malnutrition. YRl 40,000 (US$ 185), and the maximum wage is YRl Health workers should also be educated to share 80,000 (US$ 370). This means that the earnings of a messages with mothers. preschool teacher entering the field are only 37 percent of the earnings of a primary school teacher entering the ¾ The GoY could consider adopting a policy to provide orphans and vulnerable children with services SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 11 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 in education, health, nutrition, and social protection. It to devote more internal resources to ECD and to raise could also consider a policy to provide young children money from donors. with special needs with essential ECD services. ¾ The GoY could consider expanding child abuse Policy Goal 2: Implementing Widely tracking and reporting activities, establishing a taskforce for domestic violence prevention, training ¾ Policy Levers: Scope of Programs • Coverage healthcare workers to identify child abuse and neglect, • Equity and reviewing laws to ensure that they adequately Implementing Widely refers to the scope of ECD protect children from abuse. Public awareness that programs available, the extent of coverage (as a share child abuse is unacceptable is also necessary. of the eligible population) and the degree of equity –‡”Ǧ•‡…–‘”ƒŽ‘‘”†‹ƒ–‹‘ within ECD service provision. By definition, a focus on ECD involves (at a minimum) interventions in health, ¾ The GoY could work to ensure coordination at the nutrition, education, and social and child protection, point of ECD service delivery. High level coordination and should target pregnant women, young children and an established menu of services already in place and their parents and caregivers. A robust ECD policy are important, but coordination between the central should include programs in all essential sectors, government and local implementing actors, and providing comparable coverage and equitable access among local implementing actors themselves, is also across regions and socioeconomic status – especially crucial to delivering services to children and families. reaching the most disadvantaged young children and ‹ƒ…‡ their families. ¾ The GoY could establish a coordinated budget Policy Lever 2.1: process across ministries working on ECD. Scope of Programs Coordination on setting budgets can improve efficiency by reducing overlap and helping to ensure coverage of essential interventions to all target Effective ECD systems have programs established in all populations. The HCMC could possibly provide a essential sectors and ensure that every child and structure through which the coordination process expecting mothers have guaranteed access to the could take place. essential services and interventions they need to live healthfully. The scope of programs assesses the extent ¾ The use of explicit criteria and formulas to allocate to which ECD programs across key sectors reach all funding could promote a more efficient and equitable beneficiaries. Figure 3 presents the key sectoral use of resources. Criteria could include children’s interventions needed during the course of a child’s characteristics, such as socioeconomic status and early years, from conception to transition into primary internally displaced status. school. ¾ The GoY could put in place budgeting and information ECD programs do not cover all beneficiaries in all systems to allow for ECD-specific spending within each relevant sectors. Figure 4 presents the scope of ECD ministry and agency budget. As the government interventions in Yemen by beneficiary and sector. implements the Strategy, it will be important to know Programs in social protection, health, nutrition, and how much it currently spends on ECD and where this education are established to target young children. money goes. Information on ECD spending is also crucial Health programs for parents and pregnant women are for evaluating programs. established, as are social protection programs for ¾ The GoY could aim to allocate more financial widows and divorced women with children who are resources to ECD. The needs of young children and unable to support themselves. Nutrition programs families in Yemen are great, and more funding is target mothers in need and in conflict zones. necessary to meet them. Given the severe constraints on Yemeni government budgets, it will be a challenge SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 12 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 Table 5 shows various types of important ECD Public and private early childhood care and education interventions and their scope and coverage in Yemen. programs exist, but reach only a small fraction of Detailed information on the existence and scale of young children. Parenting and home visiting programs some of these interventions is not available. Many seem to be largely absent, as are maternal depression types of primary health care services exist, but screenings and support services. coverage is low. Several essential nutrition interventions are implemented, but generally on a small scale relative to the need for them, and only when funding is available. Programs are often suspended during periods of instability. Figure 3: Essential interventions during different periods of young children's development Figure 4: Scope of ECD interventions Yemen by sector and target population SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 13 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 Table 5: ECD programs and coverage in Yemen Scale ECD Intervention Universal Service is provided coverage EDUCATION (stimulation and early learning) Government-provided early childhood care and education yes no Privately provided early childhood care and education yes no HEALTH Prenatal healthcare yes no Labor and delivery yes no Comprehensive immunizations for infants yes no Childhood wellness and growth monitoring N/A no Capacity-building intervention on quality of child health services N/A no Maternal depression screening or services no no NUTRITION Micronutrient support for pregnant women yes no Food supplements for pregnant women N/A no Micronutrient support or food supplements for young children yes no Food fortification yes no Breastfeeding promotion programs yes no Anti-obesity programs encouraging healthy eating/exercise no no Feeding programs in pre-primary schools N/A no PARENTING Parenting integrated into health/community programs N/A no Home visiting programs to provide parenting messages N/A no ANTI-POVERTY Cash transfers conditional on ECD services or enrollment N/A no SOCIAL AND CHILD PROTECTION Programs for OVCs yes no Interventions for children with special needs yes no MULTI-SECTORAL OR COMPREHENSIVE Comprehensive system to track individual children’s needs and intervene no no Source: SABER-ECD Policy Data Collection Instrument and SABER-ECD Program Data Collection Instrument. *Note: Nearly universal coverage signifies coverage rates over 95 percent. Policy Lever: least four prenatal visits, and skilled attendants were Coverage present at only 36 percent of births. These low rates of access to essential services mean higher morbidity and mortality for mothers and their babies. A robust ECD policy should establish programs in all essential sectors, ensure high degrees of coverage and Access to essential health interventions for young reach the entire population equitably – especially the children is high on some indicators, and low on others. most disadvantaged young children – so that every Young children in Yemen face high rates of illness. child and expectant mother have guaranteed access to Fever, diarrhea, and acute respiratory illness are essential ECD services. common, particularly in remote areas and among poor families. Inadequate sanitation in rural areas Access to essential health interventions for pregnant contributes to these problems. women is low. According to UNICEF’s Multiple Indicator Cluster Survey, between 2007 and 2012 only 14 percent of pregnant women in Yemen attended at SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 14 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 Table 6: Level of access to essential health services for young children and pregnant women in Middle East and East Africa regions Yemen Egypt Ethiopia Iraq Sudan 1-year-old children immunized against DPT (corresponding 87% 97% 86% 65% 90% vaccines: DPT3ß) Children below 5 with diarrhea receive oral rehydration/ 48% 19% 15% 64% 56% continued feeding (2006-10) Children below 5 with suspected pneumonia receive 38% 58% 5% 82% N/A antibiotics (2006-10) Children below 5 sleeping under insecticide-treated bed net N/A N/A 33% 0% 28% (2006-10) Children below 5 with fever, receive anti-malarial drugs N/A N/A 10% 1% 54% (2006-10) Births attended by skilled attendants 36% 79% 6% 80% 49% Pregnant women receiving prenatal care (at least once) 47% 74% 28% 52% 64% Source: UNICEF Country Statistics, 2010. Yemen’s vaccination campaigns have been effective in The percentage of pregnant women who have anemia covering most young children. By age 1, 87 percent of is 58 percent, which is considered by the WHO to children are immunized for DPT. It may be useful to constitute a severe public health problem. The rate of study why vaccination efforts have been successful, and children below 5 with anemia is 68 percent, which is consider if incorporating similar strategies could help also a severe public health problem according to WHO address other gaps in the healthcare system. classifications. These figures indicate a clear need for more access to nutrition interventions targeted at On other indicators, access to basic healthcare is quite reducing iron deficiency. As discussed in Section 1.1 of low. For example, only 38 percent of young children this report, Legal Framework, addressing the country’s with suspected pneumonia are treated with antibiotics, anemia problem will likely require a combination of and only about half of children with diarrhea receive measures, including supplements, better medical care oral rehydration. and health education, and poverty alleviation for families. Table 6 shows access to selected health services for young children and pregnant women in the Middle East The stunting rate of young children is disturbingly high, and East Africa regions. On some measures, Yemen at 58 percent. Stunting is defined as having a height (or performs on par with the rest of the region, and in length)-for-age more than two standard deviations others, it is somewhat lower. below the median according to international norms. It is an indicator of chronic malnutrition. Stunting early in The level of access to essential ECD nutrition life can have long-term effects: it can damage health, interventions for young children and pregnant women and reduce an individual’s cognitive development, is low. Indicators for access to nutrition are shown in educational performance, and economic productivity. Table 7, and suggest that considerable efforts should be This has negative consequences not only for the well- taken to increase nutrition interventions. Food prices being of the individual, but also for the future success are too high for many families to be able to afford of Yemen as a country. nutritious food, and household food insecurity is common. The rate of exclusive breastfeeding in Yemen is the lowest of neighboring countries, at 12 percent. As explained in Section 1.1, Legal Framework, breastfeeding has tremendous nutritional benefits and SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 15 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 Table 7: Level of access to essential nutrition interventions for young children and pregnant women in Middle East and East Africa Yemen Egypt Ethiopia Iraq Sudan Children below 5 with moderate/severe stunting (2006-10) 58% 29% 51% 26% 40% Vitamin A supplementation coverage (6-59 months) (2010) N/A N/A 84% N/A 82% Infants exclusively breastfed until 6 months of age (2010) 12% 53% 49% 25% 34% Infants with low birth weight N/A 13% 20% 15% 31% Prevalence of anemia in pregnant women (2010) 58% 45% 63% 38% 58% Under-5 children with anemia 68% 30% 75% 56% 85% Population that consumes iodized salt (2006-10) 30% 79% 20% 28% 11% Source: UNICEF Country Statistics, WHO Global Database on Anemia. offers a number of protections against common child countries with rural populations. In Uganda, the Mobile health problems. It would likely be an effective and Vital Record System allows registration of births, inexpensive approach to reduce stunting rates. deaths, and marriage through data uploaded with a Expanding the practice should be a key component of mobile phone. Data are automatically recorded in the any nutrition strategy. central government’s records, eliminating the need for lengthy, paper-based processes. Access to early childhood care and education (ECCE) in Yemen is extremely low. The country’s gross Policy Lever 2.3: enrollment rate in pre-primary education is less than 1 Equity percent. In the 2010-2011 school year, the MoE estimated 30,127 were enrolled in preschool, out of Based on the robust evidence of the positive effects ECD more than 2 million children between ages 3-5. While interventions can have for children from disadvantaged these figures are very low, they nevertheless reflect backgrounds, every government should pay special increases over the past several years. attention to equitable provision of ECD services.5 One of In 2010, the average pre-primary enrollment rate for the fundamental goals of any ECD policy should be to the Middle East region was 22 percent. In order to provide equitable opportunities to all young children meet even average regional enrollment rates, and their families. preschool access will have to be greatly expanded. Due to limited availability of data, it is difficult to Birth registration rates are low. According to UNICEF, assess if access to ECD services is equitable across the birth registration rate in Yemen is 22 percent. Birth different areas of the country. Pre-primary enrollment registration is important for accessing healthcare, figures are not available for different regions, so it is education, and child and social protection services. It not clear how regions compare in terms of enrollment also secures a child’s rights to nationality and citizen’s rates. All public ECCE centers are in cities or large rights. From the government’s perspective, birth towns. It seems likely that preschool enrollment is registrations are crucial for planning and budgeting. concentrated in a few large cities, with extremely low enrollment in Yemen’s many rural areas. The government has taken important steps to increase birth registration, such as outreach programs targeting Boys attend preschool at higher rates than girls. rural areas and internally displaced persons, and According to enrollment figures from the MoE, the pre- eliminating birth registration fees. The government primary enrollment ratio of boys to girls is about 1.2 to could consider innovative approaches to increase birth 1. Boys also attend school at higher rates at the primary registration, such as the use of mobile technologies. and secondary levels. As the government expands Approaches using new technologies have increased birth registration in other resource-constrained 5 Engle et al, 2011; Naudeau et al., 2011. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 16 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 access to preschool, it should work to ensure While there is urban poverty in Yemen, poverty is more attendance by all children. Girls’ attendance at widespread in the country’s many remote areas. These preschool will play an important role in improving girls’ areas often lack basic infrastructure, including attendance and attainment in later stages of education. electricity and roads, and have very little access to health and education services. Figures 5 and 6 illustrate Yemen has a policy guaranteeing access to inclusive the disparities between urban and rural areas, and education for children with special needs, although it wealthier and poorer citizens. is not clear to what extent this is implemented at the pre-primary level. Yemen is a signatory of the Figure 5: Rural/Urban disparities Convention on the Rights of Persons with Disabilities. In 1997, the MoE adopted a policy to ensure the inclusion rural urban of all children with special needs in the education 94 system. The policy includes children with physical 100 disabilities, child laborers, and street children. Within 80 62 Percentage the MoE, the Inclusive Education Directorate focuses 60 38 33 26 on integrating children with special needs into public 40 16 schools. Due to limited resources, it works only in a 20 small number of schools in Yemen’s main cities, and it 0 is unclear if this includes preschools. The Social Fund population birth skilled for Development trains teachers and social workers on using registration attendant at working with children with special needs, runs improved birth programs for children, and rehabilitates schools to be sanitation able to accommodate children with physical disabilities. facilities Other NGOs also work on these issues. It is not clear that these efforts extend to preschools or to young Figure 6: Poorest/Wealthiest Disparities children. poorest 20% richest 20% The MoSAL is developing a strategy focused on citizens with special needs. A government fund, Fostering 74 80 Disabled Children Fund, provides financial support for 70 50 54 Percentage people with disabilities. The Iman Center is a 60 41 50 government-supported school for children with special 40 17 30 needs, but it is not clear that it enrolls preschool age 20 5 children. 10 0 birth skilled children under Access to ECD services between socioeconomic levels registration attendant at five with and urban and rural areas is inequitable. There are birth diarrhea receiving oral stark differences in access rates in ECD services rehydration and between the country’s wealthiest and poorest citizens. continued The ratio of birth registration comparing the richest feeding quintile with the poorest quintile is more than 9 to 1. For skilled attendants at birth, the ratio is more than 4 Source: UNICEF Multiple Indicator Cluster Survey data. to 1. There are also disparities in access to ECD services between urban and rural areas. Birth registration is more than twice as likely in urban areas, and improved sanitation facilities are almost three times as common in urban areas. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 17 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 Policy Options to Implement ECD Widely “—‹–› in Yemen ¾ As it expands preschool enrollment, the GoY could work to ensure that both girls and boys attend …‘’‡‘ˆ”‘‰”ƒ• preschool. Yemen is making a large push in girls’ education, and preschool education should be an ¾ Data suggest that Yemen lacks the breadth of ECD important part of this effort. Girls who attend programs necessary to ensure children’s healthy preschool are more likely to succeed in the primary and development. While in the future it will be important secondary school, and their attendance also likely to expand the scope of programs offered, in the near builds their families’ commitment to girls’ education. term it is likely most prudent to focus on expanding access and improving quality of existing programs. ¾ As preschool enrollment expands, the GoY could work to ensure that children with special needs can ‘˜‡”ƒ‰‡ attend school, and that staff and facilities are adequately equipped to care for them. Special needs ¾ The GoY could consider developing a comprehensive may include obvious physical and mental disabilities, strategy and plan to increase health access for but could also encompass children who have been pregnant women and young children. Many women victims of conflict, displacement and poverty. These and children do not receive basic, essential healthcare children likely require extra socio-emotional support. services, and their health is suffering as a result. The With properly trained staff, preschool can play an lack of healthcare may stem from a combination of low important role in helping children cope with stress and government capacity, particularly in rural areas; lack of trauma, which in turn aids their learning and healthy skilled healthcare workers; and inadequate funding. development. The strategy would need to address these issues to be effective. ¾ The GoY could work to address the large inequities in access to ECD services between rich and poor ¾ The GoY could consider developing a comprehensive families, and families in urban and remote areas. strategy to increase access to nutrition services for Children from poor families face numerous pregnant women and young children. This may include disadvantages from even before birth. These offering iron supplements and feeding programs, inequalities early in life widen over time if effective promoting breastfeeding, improving access to interventions are not implemented. The most effective healthcare, and poverty alleviation measures. and cost-efficient time to address inequality is early in ¾ The GoY could move forward with the National life. Investments in ECD are crucial to giving all children Strategy for Early Childhood to increase preschool the opportunity to develop their full potential. The GoY enrollment. As preschools expand, care should be given could consider conducting a study examining primary to ensure high quality learning experiences, rather than school readiness among children who have received just building classrooms and enrolling children. various ECD interventions and those who have not. ¾ The GoY could examine reasons for the low birth registration rate despite the mandatory policy. All children need to be registered at birth in order to have access to essential services, including social protection, health and education. Registration also helps governments make plans and allocate resources. The GoY could consider studying innovative efforts that have been effective in increasing birth registration in other low resource countries, including use of mobile technologies. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 18 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 Table 8: Availability of data to monitor ECD in Yemen Administrative Data Indicator Tracked Special needs children enrolled in ECCE (number of) X Children attending well-child visits (number of) X Children benefitting from public nutrition interventions (number of) X Women receiving prenatal nutrition interventions (number of) X Children enrolled in ECCE by sub-national region (number of) X Average per student-to-teacher ratio in public ECCE 9 Is ECCE spending in education sector differentiated within education budget? 9 Is ECD spending in health sector differentiated within health budget? X Survey Data Indicator Tracked Population consuming iodized salt (%) 9 Vitamin A supplementation rate for children 6-59 months (%) X Anemia prevalence amongst pregnant women (%) 9 Children below the age of 5 registered at birth (%) 9 Children immunized against DPT3 at age 12 months (%) 9 Pregnant women who attend four prenatal visits (%) 9 Children enrolled in ECCE by socioeconomic status (%) X Policy Goal 3: Monitoring and Assuring adherence to standards, and efforts to target children most in need. Quality Data availability on ECD access and outcomes is ¾ Policy Levers: Data Availability • Quality limited. Table 8 presents some of the types of Standards • Compliance with Standards indicators a country can collect to assess access to ECD services and outcomes. Monitoring and Assuring Quality refers to the existence of information systems to monitor access to ECD services and A few pieces of administrative data for Yemen are outcomes across children, standards for ECD services, and available; these figures reflect total uptake of services systems to monitor and enforce compliance with those and are gathered through a census. Available data standards. Ensuring the quality of ECD interventions is vital, include the average number of students per teacher in because evidence has shown that unless programs are of public ECCE classes, and ECCE spending in the high quality, the impact on children can be negligible, or education budget (although various figures are even detrimental. reported for this). Policy Lever 3.1: The government could consider collecting additional Data Availability important administrative indicators such as the number of special needs children enrolled in ECCE, the number Accurate, comprehensive, and timely data collection of children attending well-child visits, the numbers of can promote more effective policy-making. Well- pregnant women and children receiving nutrition developed information systems can improve decision- interventions, the number of children enrolled in ECCE making. In particular, data can inform policy choices by sub-region, and ECD spending in the health sector. regarding the volume and allocation of public financing, staff recruitment and training, program quality, SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 19 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 Survey data are more readily available, often through place systems to collect data on multiple domains of the UNICEF Multiple Indicator Cluster Survey (MICS). child development. Data for individual children could Survey data are based on sampling a specific be tracked over time to identify children with population. These kinds of data can yield useful developmental challenges. In addition to gathering data information on levels of access to key ECD services. at preschools, health centers should also collect information on individual children when delivering These types of administrative and survey data could services. provide the government with important tools as it moves forward with the National Strategy for Early Compiling these data can help the government Childhood. Data on young children’s needs and the establish a baseline, identify issues that need targeting, existing services available to them are key to planning evaluate the effectiveness of interventions, and inform effective and cost-efficient interventions. Data are also policy decisions. necessary to evaluate the effectiveness of policies and programs. As the government implements various The MoE has recently established a database on elements of the Strategy, it is important to be able to preschools. Improving sources of information on early measure progress and know if programs are effective. childhood and developing a database on preschool is a component of pillar 1 of the National Strategy for Early Data are not collected to differentiate access and Childhood. Recently the MoE included a database on outcomes by group status. The government collects preschools in its existing Education Management data to differentiate access to preschool based on Information System (EMIS). It includes basic gender. It does not track ECCE access and outcomes information on the number of pre-primary schools, based on other background characteristics, such as teachers, and students. This is an important step, and socioeconomic status, special needs status, or the system could form the basis for broader data geographic location (urban versus rural environment). collection and analysis. Tracking data according to these characteristics helps to monitor inequities. Policy Lever 3.2: Quality Standards An important group status to include in these efforts is children from the Muhamisheen (marginalized) Ensuring quality ECD service provision is essential. A populations. Mothers and young children from this focus on access – without a commensurate focus on background likely have much lower access and ensuring quality – jeopardizes the very benefits that outcomes to education and health services than other policymakers hope children will gain through ECD poor Yemenis. Many face dire poverty and interventions. The quality of ECD programs is directly discrimination, and are at the bottom of the country’s related to better cognitive and social development in social ladder. children.6 The National Strategy for Early Childhood should Curricula and learning standards are under benefit all of Yemen’s children, and gathering data that development. Currently there are no established includes children’s backgrounds will help identify learning standards for preschools, but standards are groups that need particular attention. included in the proposed bylaws for preschool Data on individual children’s development are education. The MoE and Sana’a University are collected, but only for those enrolled in preschools. cooperating to develop learning standards. In 2013 the Preschools collect indicators for individual children on government introduced an ECE Teacher Guide for their physical, cognitive, language and social Preschool Education, which will form the basis of the development. With only 1 percent of children enrolled curriculum. It covers literacy, numeracy, motor skills, in preschool, this means that data are collected only for and cognitive and socio-psychological development. a very small proportion of young children. As preschool 6 enrollment expands, the government should put in Taylor & Bennett, 2008; Bryce et al, 2003; Naudeau et al, 2011; Victoria et al, 2003. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 20 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 The Teacher Guide will only be successfully In order to expand preschool enrollment and ensure implemented in classrooms if teachers are properly high quality programs, the GoY will need to continue trained on its principles and applications. The GoY and expand these types of teacher training efforts. A should ensure educators and administrators receive strong preprimary education system should have clear adequate training to be able to use the guide in the requirements for teachers to enter the field, and should classroom. provide accessible opportunities for pre-service training and ongoing continuing professional development. The As preschool enrollment expands, the GoY should GoY could consider requiring completion of a ensure that the preschool curriculum is coherent and specialized ECD course for preschool teachers. Such a continuous with the primary education system. course must be affordable and accessible. Pre-service Children who attended preschool should enter Grade 1 and in-service training modalities would likely be with knowledge and skills that equip them to succeed necessary. To reach the country’s rural areas, courses in primary school. will need to be offered in many areas of the country, so that women educators can attend without traveling Training requirements for ECCE teachers are minimal. away from home. Training will have to be offered for Preschool teachers must have completed at minimum free or very minimal fees so that cost is not a barrier to upper secondary school. No additional courses or participation. In order to scale such programs, a certifications are required, although several options are training of trainers/cascade model is likely necessary. A available. cadre of master trainers comprised of experienced ECD Several types of training programs for preschool professionals will likely need to be developed. teachers exist. Taiz, Al Hodaida, and Ibb Universities Health workers are trained to deliver messages on offer bachelor’s degrees in preschool teaching within early childhood development. According to the Child the faculties of education. Sana’a University offers a Health Department at the MoPHP, doctors, nurses, post-graduate diploma in preschool education. The extension health services workers, and midwives are entry requirements are prohibitive for many: Entrants required to complete training on delivering information must have completed a university degree and be able on early childhood development. These messages to to pay course tuition. University faculties of education families may include developmental milestones and offer training on the developmental stages of children, early stimulation. The government should continue and but not all preschool teachers have studied at the strengthen efforts of this kind. university level. Currently there is no public authority responsible for regulating pre-service training for ECCE Service delivery and infrastructure standards are being teachers. A pre-service practicum is not offered. developed. At present there are few service delivery and infrastructure standards for ECCE facilities. The Recently the MoE began in-service training on the new proposed bylaw for preschool education outlines a Teacher Guides. The MoE aims to train all preschool number of standards. These are elaborated in the teachers on the guides, but funding is not currently recent Project on Regulations for Preschools, a available to implement this on a large scale. document developed by the MoE’s preschool The National Strategy includes a pillar to strengthen department. The proposed standards include a limit on institutions working on early childhood through 20 children per class, with one head teacher and one developing the capacities of individuals working in the assistant teacher. Preschools are open four hours per early childhood field. Recently, the MoE developed and day, five days per week. approved standards for ECCE workers. In 2012, the The Project on Regulations for Preschools is concerned MoE, the Social Development Fund, and UNESCO with a number of aspects of the function of preschools, worked together to hold 39 training sessions for 550 including administrative matters. Preschools are under preschool teachers. This included the development and the district supervisor for education. Each school is dissemination of training materials and resources. supposed to employ a social worker, a health supervisor, and a treasurer, in addition to teachers. Job SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 21 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 descriptions and lists of qualifications for each position critical that mechanisms are put in place to ensure are detailed. Parents should pay a monthly fee of YRl compliance with standards. 500 (approximately US$ 2.3). Data on compliance with teacher qualification The document says nothing about infrastructure requirements are not available. Data are not available requirements or materials, and there is little detail on on the educational attainment levels of ECCE curriculum or teaching standards. The Project on educators, so it is not clear how many have met the Regulations for Preschools is an important step towards minimum requirement of completing upper secondary ensuring standards for preschools, and similar efforts school. should continue to cover additional essential aspects of preschool quality. It is not clear how many ECCE facilities comply with various standards, and some standards are not yet in In addition to curriculum and teaching standards, place. The average child to teacher ratio in public ECCE regulations should specify adequate play and learning centers is approximately 19.2 to1. The proposed ratio is materials, so that children have developmentally 10 to 1, so the average group size will need to decrease appropriate materials to support their learning. These in order to meet the new standard. In private ECCE could come from locally available, inexpensive sources. centers, the average child to teacher ratio is 13.8 to 1. This does not meet the proposed standard, but it is Infrastructure requirements do not yet exist, but are within the bounds of good practices for children ages 3- reportedly included in the proposed bylaw. To ensure 5. children’s safety and health, these should include policies to ensure access to functional hygienic facilities The number of centers open for 20 hours per week is and potable water sources. There should also be not clear. Currently there are no infrastructure standards concerning a connection to electricity, standards, so there is no mechanism to gauge the structural soundness, building materials, windows, physical state of preschools. Anecdotally, many spaces roof, floor, cleanliness, and adequate space for each in use as preschools are not suitable for that purpose. child. Standards should apply to both public and private facilities. Monitoring mechanisms for compliance with standards are not established. The preschool Registration and accreditation procedures are not department in the MoE carries out a monitoring visit to clear for ECCE facilities. As standards concerning each preschool every year or two. It is not clear if all essential aspects of quality preschool facilities are schools are inspected and on what criteria they are developed, procedures for registration and evaluated. As additional preschools are added to the accreditation should also be developed, for both public system, monitoring structures should be in place to and private facilities. This will provide a mechanism to gauge compliance with standards. Without monitoring, help ensure that staff and facilities meet established quality is likely to be compromised, and in some requirements. situations, children’s safety could even be at risk. Currently, supervisory mechanisms do not seem to be In contrast with ECCE facilities, construction standards in place. According to an MoE document, at present exist for health centers and hospitals. neither the MoE nor local authorities pay much attention to supervising preschools, for lack of Policy Lever 3.3: expertise and/or interest in this level of education. Compliance with Supervisory and monitoring mechanisms will need to Standards be established in order to ensure quality. This will likely Establishing standards is essential to providing quality include training both MoE and local education ECD services and to promoting the healthy development authorities on how to monitor quality in preschools. of children. Once standards have been established, it is SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 22 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 Policy Options to Monitor and Assure ECD ¾ The GoY could move forward to pass regulations for service delivery and infrastructure standards for ECCE Quality in Yemen facilities. Regulations should include aspects such as ƒ–ƒ˜ƒ‹Žƒ„‹Ž‹–› construction and building standards, learning materials, and teacher-student ratios. These are necessary to ¾ Data collection and monitoring are important ensure children’s safety and quality of the educational features of a strong ECD system, and are necessary for experience. identifying needs and assessing programs. The GoY ¾ The GoY could set clear procedures and standards could expand the administrative data and survey data it for preschool registration and accreditation. This will collects to include important indicators such as the increase the likelihood of schools adhering to minimum number of children enrolled in ECCE by sub-region, the standards, and will help the government to monitor number of children and pregnant women receiving facilities. nutrition interventions, ECCE spending in the health sector, and the percentage of children enrolled in ‘’Ž‹ƒ…‡™‹–Š–ƒ†ƒ”†• preschool by socioeconomic status. Quality standards are only valuable if they are ¾ As preschool enrollment expands, the GoY could implemented, and monitoring is necessary to ensure ensure that schools track individual children’s physical, compliance. As standards for preschool teachers, cognitive, linguistic and social development. The infrastructure, and service delivery are developed, the database on preschools recently established in the MoE government could develop mechanisms to monitor might be one mechanism to help gather this compliance with standards. This will likely require information. This could facilitate early identification training MoE and local education officials on ECD and interventions for any developmental difficulties, principles, and developing their commitment to and help ECD service providers tailor their actions supervision based on an understanding of the according to individual children’s needs. Through importance of these programs. compiling existing data, the GoY could consider undertaking regular analysis of outcomes of all young Comparing Official Policies with Outcomes children in the database, which could help identify strengths and weaknesses in the system and inform The existence of laws and policies alone does not policy. Healthcare providers could also track outcomes always guarantee a given correlation with desired ECD for individual children. outcomes. In many countries, policies on paper and the reality of access and service delivery on the ground are —ƒŽ‹–›–ƒ†ƒ”†• not aligned. Table 10 compares several ECD policies with outcomes in Yemen. ¾ The GoY could move forward to pass bylaws for preschool education that include learning standards. The government has been successful in implementing its Standards for what children should know and be able to policy mandating immunizations for young children, do help guide teachers in classroom instruction. Ideally, resulting in high levels of coverage throughout the these standards should be aligned with the curriculum. country. Birth registration rates are low, despite a mandatory policy, and exclusive breastfeeding is rare, in ¾ The GoY could continue its efforts to provide in- spite of laws complying with international best practice. service training to preschool teachers on the new According to policy, preschool is free and an essential part Teacher Guide. It could also develop other teacher of the educational system. In reality, there are few training options, including pre-service and in-service preschools in the country, and fees mean that only those courses. Courses should be affordable and accessible. who can afford them can attend. The GoY could consider requiring completion of a specialized ECD course to become a preschool teacher. Table 11 summarizes key policy provisions in the Middle Clear standards for teachers will help ensure children’s East and North Africa, along with related outcomes. learning. Jordan and Egypt have universal birth registration, and have both made progress in increasing preschool SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 23 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 enrollment in recent years. Yemen and Ethiopia both have very low preschool enrollment, and Ethiopia has very low birth registration rates. Despite the fact that its laws do not comply with the Code of Marketing of Breast Milk Substitutes, Ethiopia has quite a high rate of exclusive breastfeeding. Table 10: Comparing ECD policies with outcomes in Yemen Policy Outcomes Rate of exclusive breastfeeding until 6 months: Laws comply with the International Code of 12% Marketing of Breast milk Substitutes Children with DPT (12-23 months): Comprehensive immunization policy mandates a 87% complete course of childhood immunizations Birth registration rate: Mandatory birth registration 22% Pre-primary education is free Gross pre-primary school enrollment (3-5 years): 1% Table 11: Comparing policy intent with ECD outcomes in Yemen and other countries in the region Yemen Jordan Egypt Ethiopia Salt Iodization Salt Iodization Policy mandatory mandatory mandatory mandatory Population Consuming Iodized Salt 30% 88% 79% 20% Appropriate Infant Feeding and Breastfeeding Promotion Compliance, Code of Marketing of All provisions law Many provisions Many provisions Few provisions law Breast Milk Substitutes law law Exclusive Breastfeeding Until 6 12% 22% 53% 49% Months Pre-primary Education in theory free, not not free, not not free, not Pre-primary School Policy mandatory mandatory not mandatory mandatory Pre-primary School Enrollment Rate 1% 32% 29% 5% Birth Registration Birth Registration Policy mandatory mandatory mandatory not clear Birth Registration Rate 22% 99% 99% 7% SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 24 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 Preliminary Benchmarking and International Monitoring and Assuring Quality policy goal, Yemen’s level of development is classified as “Emerging.” Comparison of ECD in Yemen Table 13 presents the status of ECD policy Table 12 presents the classification of ECD policy in development in Yemen alongside a selection of OECD Yemen within each of the nine policy levers and three countries and Tajikistan, which has a similar income policy goals. For the Establishing an Enabling level to Yemen. Sweden is home to one of the world’s Environment policy goal, Yemen’s level of most comprehensive and developed ECD policies and development is classified as “Emerging.” For the achieves a benchmarking of “Advanced” in all nine Implementing Widely policy goal, Yemen’s level of policy levers. Additional regional comparisons of ECD development is classified as “Latent.” For the policy goals and levers are forthcoming. Table 12: Benchmarking Early Childhood Development Policy in Yemen Level of ECD Policy Goal Level of Development Policy Lever Development Legal Framework Establishing an Enabling  Inter-sectoral Coordination Environment   Finance Scope of Programs  Implementing Widely  Coverage Equity  Data Availability  Monitoring and Assuring Quality  Quality Standards  Compliance with Standards  Latent Emerging Established Advanced Legend: Table 13: International Classification and Comparison of ECD Systems Level of Development ECD Policy Goal Policy Lever Yemen Australia Chile Sweden Turkey Tajikistan Legal Framework Establishing an       Enabling Coordination       Environment Finance      Scope of Programs       Implementing Coverage Widely       Equity     Data Availability       Monitoring and Quality Standards Assuring Quality       Compliance with Standards       Latent Emerging Established Advanced Legend: SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 25 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 Conclusion options to strengthen ECD are offered. Yemen’s National Strategy for Early Childhood shows a The SABER-ECD initiative is designed to enable ECD commitment to improving services for young children in policymakers and development partners identify the country. The challenge to address malnutrition, poor opportunities for further development of effective access to healthcare, low preschool enrollment, and other ECD systems. The SABER-ECD classification system barriers to children’s healthy development will be does not rank countries according to any overall implementation. As the country moves through political scoring; rather, it is intended to share information on transition, promoting early childhood development how different ECD systems address the same policy should be an important part of Yemen’s progression to a challenges. This Country Report presents a framework civic state that serves all of its citizens. Investing in its to compare Yemen’s ECD system with other countries youngest citizens is crucial to the country’s future success. in the region and internationally. Each of the nine Table 14 offers policy recommendations and options that policy levers are examined in detail and some policy the government could consider to strengthen ECD. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 26 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 Table 14: Summary of policy options to improve ECD in Yemen Policy Policy Options and Recommendations Dimension x Ensure that the iron fortification policy is being fully implemented. x Identify the reasons behind the low rate of consumption of iodized salt, and work to address them. x Develop a comprehensive plan to promote breastfeeding as a cost-effective way to address malnutrition in young children. This could include public awareness campaigns, educating health workers, and engaging Establishing an religious and community leaders to promote the practice. x Adopt a policy to provide orphans, vulnerable children, and children with special needs with ECD services. Enabling x Promote public awareness that child abuse is unacceptable. Expand child abuse monitoring and services for Environment abused children. x Coordinate interventions at the point of service delivery. x Establish systems to identify and track ECD spending within government budgets. x Establish a coordinated budget process across ministries and agencies working on ECD. x Allocate more financial resources to ECD. x Develop a strategy and plan to increase healthcare access for pregnant women and young children. This may require addressing limited government capacity, lack of skilled health workers, and inadequate funding. x Develop a strategy and plan to increase access to nutrition services for pregnant women and young children. This may include offering iron supplements, feeding programs, increasing breastfeeding rates, improving access to healthcare, and poverty alleviation. Implementing x Move forward with the National Strategy for Early Childhood goal to increase preschool enrollment. x Examine reasons for the low birth registration rate, and consider using innovative approaches to register Widely births. x As preschool enrollment increases, vigorously promote girls’ attendance to ensure gender equity. x Ensure that children with special needs can attend preschool. This includes children requiring extra socio- emotional support to cope with the stress and trauma of poverty and conflict. x Invest strongly in the most disadvantaged young children to reduce inequalities and give these children opportunities to develop their full potential. x Expand the types of administrative and survey data collected to include important ECD indicators, such as ECD spending in the health sector, number of children enrolled in preschool by region, and the percentage of children enrolled in preschool by socioeconomic status. Some of this information could be housed on the database on preschools in the MoE. x As preschool enrollment increases, continue to track individual development outcomes of children attending preschool. Healthcare providers could also track individual children’s health outcomes. Monitoring and x Pass bylaws for preschool education that include learning standards. x Expand in-service teacher training on the Teacher Guide. Consider additional pre-service and in-service Assuring Quality teacher training modalities. Consider requiring preschool teachers to complete a course on ECD, as long as the course is accessible and affordable. x Pass regulations for service delivery and infrastructure standards for preschools to ensure children’s learning and safety. x Set clear procedures and standards for preschool registration and accreditation. x Establish monitoring and supervisory mechanisms for preschools to ensure compliance with standards as they are developed. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 27 YEMEN ۣ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2013 www.worldbank.org/education/saber The Systems Approach for Better Education Results (SABER) initiative produces comparative data and knowledge on education policies and institutions, with the aim of helping countries systematically strengthen their education systems. SABER evaluates the quality of education policies against evidence-based global standards, using new diagnostic tools and detailed policy data. The SABER country reports give all parties with a stake in educational results—from administrators, teachers, and parents to policymakers and business people—an accessible, objective snapshot showing how well the policies of their country's education system are oriented toward ensuring that all children and youth learn. This report focuses specifically on policies in the area of Early Childhood Development. This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS THE WORLD28 BANK