Child Development Indicators in the Egyptian Context
by Danya Chudacoff
July 10, 2013
Development Analytics participated at a conference at Oxford University organized by the Young Lives Project (YLP) on July 8-9, 2013. Funded mainly by the Department of International Development (DFID) and coordinated at Oxford University, Young Lives is a 15-year study that tracks international childhood poverty across a sample of 12,000 in 4 countries (India, Peru, Vietnam, and Ethiopia). The conference expanded upon the direct research carried out using Young Lives Surveys as well as research on early childhood development using other surveys collection health, cognitive and socio-emotional development indicators on children from a number of countries, thus bringing the work of researchers from around the world who employ various data sources to investigate early outcomes of children. A total of 54 papers were presented at the conference, allowing researchers from a range of backgrounds and experience levels to share their findings and contribute to the expanding body of research in the connections between poverty cycles and childhood development.
Our World Bank supported study "Inequality of Opportunity in Access to Basic Services among Egyptian Children", co-authored by Meltem Aran and Lire Ersado, was one of the papers presented at the conference. Through the prism of Human Opportunity Index (HOI) measures, the study investigates inequality of opportunity among Egyptian children between 2000 ad 2008, assessing for changes in both the levels of coverage and access to services over time. As the HOI is a composite indicator (for both coverage and access), this measurement allows investigators to better understand whether access to services is related to the initial circumstance groups (such as income or education levels, or geographic location) into which a child is born.
In the context of Egypt’s national Family Health Model program and a country-wide initiative to promote the intake of iodized salt, the study calculates shifts in HOI over four services categories: health utilization, nutrition, basic infrastructure services, and school enrollment. Using Egypt’s Demographic Household Surveys from 2000 and 2008, the study finds mixed results in light of Egypt’s development policies, with improvements or little change in some categories and deterioration in others. For example, the analysis shows that in terms of healthcare services during pregnancies and in post-natal child healthcare, prevalence for antenatal care increased from 46.8% of pregnancies in 2000 to 70.6% in 2008, along with a decrease in the dissimilarity index (which measures inequality of opportunity) from 17.2 to 4.1 during that time. In terms of immunizations of the child, coverage was already high in 2000 and remained so in 2008 as well, with little change. However, indicators for malnutrition show a deterioration in HOI for Egyptian children in the eight years defined in the study. The prevalence of not being stunted decreased from 78.2% to 74% between 2000 and 2008.Wasting and underweight prevalence among Egyptian children have also increased in those years. Of note, however, is that the dissimilarity index for these indicators is very low (at around 1.49% for stunting), demonstrating that the deterioration is not strongly correlated with circumstance groups and is a problem among Egyptian children in general.
In terms of access to basic infrastructure services, the four HOI indicators measured across these categories were high (both in terms of coverage and dissimilarity indices), and all measured at above the 90% HOI levels. Still, improvements were measured, such as greater access to drinking water in the Frontier Governorates, whereby the HOI indicator rose from 54.4% in 2000 to 74.9% in 2008. A composite HOI indicator that includes services such as a child having an identity card, and living in a household with an improved water source, electricity and a non-shared toilet rose from 73.8% to 85.5% between 2000 and 2008. In terms of educational enrollment, the HOI indicators for enrollment in both the basic education level (ages 6-14) and the secondary education level (ages 15-17) increase, however, coverage remains lower and dissimilarity higher for the secondary age group category. The analysis shows that the disparities in HOI across regions (circumstance groups) in terms of enrollment decreases between 2000 and 2008, with the difference in HOI between Upper Egypt Rural (the most disadvantaged) and Lower Egypt Urban falling from 26.9% in 2000 to 19.3% in 2008.
Overall, the study showed significant improvements in terms of access and coverage of basic services for Egyptian children and mothers, with demonstrable pro-poor progress in a number of areas. This has led to a general reduction in inequality for services aiding in childhood development over the last decade, largely due to an increase in coverage of these services rather than redistribution. However, the study shows the significant room for improvement still exists, particularly in terms of post-natal care and child nutrition. With family background (particularly parents’ education levels and wealth) and geographic location being key factors in determining child development outcomes, the study shows that targeted programs aimed at these circumstance groups would be effective in promoting child development. Other areas where the dissimilarity between circumstance groups is low, such as nutrition, would benefit more from supply-side improvements nation-wide.
The paper can be downloaded at this link.