Perspectives and pragmatics: Can we restack the odds for the world’s children?
Professor Sharon Goldfeld AM
This piece was originally published by the OECD in the Key Messages from their Reducing Inequalities by Investing in Early Childhood Education and Care Report.
25 January 2025
Let’s begin with the idea of what could be. Starting Strong VIII is challenging us all to think urgently about the policies and services that will deliver for this generation of children and the adults they will become - this is what could be. But how needs perspectives. As a developmental paediatrician, a public health researcher and a seasoned health and education public servant, I see the ability to help a single child and family, and the importance of keeping populations of children healthy and developing well, as carrying equal weight. Both important, but solutions will vary because the perspectives of children, families, communities and governments matter. Considering all perspectives is vital to finding new ways to turn mere hope into more equitable outcomes for our children. This is messy but urgent.
Right now, there are sustained global inequities in young children’s health, development and well-being. This is extraordinary system failure in any rich country with dire economic ramifications. Inequities in early childhood typically persist into adulthood, at substantial cost to individuals, society and governments (across health, education and welfare budgets). Increasingly opportunities for thriving are also socially patterned. To address this, governments must weather the short-term political risk to frontend their investment in human systems despite the long lead time to impact. No countries have achieved this goal yet.
There are no silver bullets, but many real and tangible opportunities exist to “stack” the odds for children and redress the seemingly immutable socio-economic gradient. A stacking approach – combining multiple complementary interventions – is essential for closing the child equity gap and improving outcomes. This includes interventions that are already known to work, combined with optimal utilisation of existing education, health and social infrastructure. Grounding this approach in principles of proportionate universalism will ensure that an early years universal service base, especially early childhood education and care and primary health care, remains the backbone; and that this is enhanced with tailored interventions at a scale and intensity proportionate to local need. Right now, the mutual and cumulative benefits of these services are rarely considered in their design or delivery.
The road to equity must be paved with more than good intentions. The COVID-19 pandemic taught us that radical change can happen at speed and scale. This idea of radical pragmatism - a willingness to try whatever works, with an experimental mindset and commitment to empiricism and measuring results - is exactly what’s needed now. Repurposing existing services and systems (health, education, social care) will help to deliver on new approaches that we can test rapidly and at scale; but these systems will not change by themselves.
Change requires policy authorisation at the local level putting data use and the skills for improvement in the hands of the real change agents - the front-line practitioners. We can eliminate inequities in children’s development within a generation. Now, wouldn’t that be radical?
Citation: “Reducing Inequalities by Investing in Early Childhood Education and Care: Key messages from Starting Strong VIII”, OECD Publishing, Paris.