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MORE AND BETTER JOBS IN SOUTH ASIA
child development programs in the world— integrates health and nutrition services, early stimulation and learning, and nonformal preschool education. Although well conceived as an approach to holistic child development, the program has not had the desired impact on promoting cognitive development or improving child nutrition. Inadequate coverage of children under three, an overemphasis on food supplementation, and substantial operational challenges (such as inadequate program stewardship and delivery capacity, weak monitoring and evaluation and supervision, and the lack of community ownership) have undermined its potential impact. There is, however, wide variation in implementation of the program across states, with some states having demonstrated good results. Several localized innovations have the potential to be scaled up. In part, the absence of programs at scale reflects still limited understanding of what constitute cost-effective designs in South Asia. Several pilot projects can serve as a laboratory for designing cost-effective programs, but many lack careful plans for evaluation. Potentially promising efforts are under way, however. Pilots run by the International Center for Diarrheal Disease Research (ICDDR) in Dhaka, for example, have stronger evaluation designs and have proven the feasibility of promoting better parenting and mother-child interactions through home visits. The Lady Health Workers Programme in Pakistan, a community-based preventive care government program, holds promise for promoting nutrition and child care through scaling up of carefully evaluated cost-effective pilot designs.
Primary and secondary education This section begins by examining constraints to—and priorities for—strengthening primary and secondary education systems in order to improve the quality of learning of graduates. It then discusses some innovative interventions that have had increased investment in primary and secondary education of disadvantaged groups.
Improving the quality of learning Improving the quality of learning in primary and secondary school calls for measures that strengthen incentives and capacity in the school system. Poor quality, particularly in public schools, can be attributed to several governance challenges. First, underdeveloped assessment systems limit monitoring by stakeholders on what children learn and the extent to which they master needed competencies. This lack of information is a serious constraint to introducing reforms to improve quality. Second, with some notable exceptions—such as the community-based management of schools in Nepal— education systems are still very centralized; decisionmaking authority, especially at the school level, is limited. Third, neither government education management nor parents hold schools accountable for education outcomes. The potential of efforts to increase local autonomy and accountability has not been fully realized, as a result of limited capacity and information of school and village management committees. Fourth, fi nancing of providers is not typically based on objective measures of performance; it tends to be historical and based on inputs. Fifth, political interference in teacher hiring and still underdeveloped career and pay incentives may be affecting teacher performance. This human resource management challenge extends beyond teachers to education management. Information, capacity, and incentives can also be important for private provision. The private sector is playing a significant role in providing even primary education in many countries; it has already contributed to significant expansion in enrollments (figure 5.16).19 Private provision offers the potential for increasing access at lower cost, often with comparable or better outcomes than public schools. A study in two states in India shows that although private schools do not always achieve higher learning outcomes than public schools (especially after controlling for observable differences in children) and achievement gaps vary between states, private schools are more cost-effective than public schools (Goyal and