2021 A SYSTEMS ANALYSIS OF EARLY CHILDHOOD DEVELOPMENT IN JAMAICA: FINAL Maureen Samms-Vaughan & Sydonnie Pellington Department of Child & Adolescent Health, University of the West Indies 12/22/2021 ACKNOWLEDGEMENTS As the main funder of the JA KIDS study, we would first like to thank the World Bank for their support of the first phase of the project. Special thanks to Shawn Powers and who have worked closely with the JA KIDS team in both the technical oversight and administration of this first phase of the study. In addition, we would like to thank the many administrative and academic departments at the University of the West Indies that supported the study. We would especially like to recognise the Special Projects Section – Ms. Jacqueline McLean, Ms. Shermaine Bent and Ms. LaFane Taylor – who oversaw the financial management of our projects. The JA KIDS Team would also like to acknowledge the team from the Mona Information Technology Services (MITS) – especially Damien Brown, Marlon Grant and Andrew Litchmore – for their IT support. We would especially like to thank everyone who has worked on various aspects of the study. Our administrative and auxiliary staff, research assistants, field research officers and supervisors have made indelible contributions to the study over the last 2 years. A study of this nature could not be mounted without the commitment, dedication and enthusiasm of our team. Finally, we would like to thank all of the participants of the study – all the JA KIDS and JUNIOR JAKIDS children and their families for agreeing to be a part of this journey and for sharing their lives with us. Contents ACKNOWLEDGEMENTS ............................................................................................................................ 1 LIST OF TABLES ........................................................................................................................................ 6 LIST OF FIGURES ...................................................................................................................................... 7 ABBREVIATIONS ...................................................................................................................................... 9 CHAPTER 1 ............................................................................................................................................ 10 THE IMPORTANCE OF EARLY CHILDHOOD DEVELOPMENT ..................................................................... 10 EARLY BRAIN DEVELOPMENT ............................................................................................................. 10 INVESTMENT IN EARLY CHILDHOOD .................................................................................................. 10 CHILDREN AT RISK: THE SCOPE OF THE PROBLEM .............................................................................. 10 EARLY CHILDHOOD INTERVENTIONS ACROSS THE WORLD ................................................................. 11 Model Targeted Early Childhood Interventions ............................................................................... 11 Large-scale Targeted Early Childhood Interventions ....................................................................... 11 Programmes & Services linked to Health Care Systems ................................................................... 12 Centre-Based Pre-School Education ................................................................................................ 12 Home Visiting ................................................................................................................................ 12 THE FIRST THREE YEARS ..................................................................................................................... 13 REFERENCES ...................................................................................................................................... 14 CHAPTER 2 ............................................................................................................................................ 17 REPORT BACKGROUND, OBJECTIVES AND METHODOLOGY .................................................................... 17 BACKGROUND: .................................................................................................................................. 17 OBJECTIVES: ...................................................................................................................................... 18 INTENDED APPROACH: ...................................................................................................................... 20 ADJUSTMENTS TO INTENDED APPROACH .......................................................................................... 23 A SYSTEMS APPROACH MODEL: CHILD PROTECTION.......................................................................... 24 DEFINITION OF CHILD PROTECTION ............................................................................................... 24 PROGRESS IN CHILD PROTECTION TO A SYSTEMS APPROACH ........................................................ 24 CURRENT DEFINITION OF A CHILD PROTECTION SYSTEM ............................................................... 24 PRINCIPLES FOR SYSTEMS DESIGN AND OPERATION ...................................................................... 25 COMPONENTS OF A CHILD PROTECTION SYSTEM .......................................................................... 25 BENEFITS OF A SYSTEMS APPROACH TO CHILD PROTECTION ......................................................... 26 IMPACT OF CHILD PROTECTION SYSTEMS APPROACH .................................................................... 26 A SYSTEMS APPROACH TO EARLY CHILDHOOD DEVELOPMENT .......................................................... 27 REFERENCES ...................................................................................................................................... 28 CHAPTER 3 ............................................................................................................................................ 29 A BACKGROUND TO JAMAICA................................................................................................................ 29 THE LAND .......................................................................................................................................... 29 THE ECONOMY .................................................................................................................................. 30 THE PEOPLE ....................................................................................................................................... 30 THE CHILDREN ................................................................................................................................... 30 HUMAN DEVELOPMENT .................................................................................................................... 31 THE HUMAN DEVELOPMENT INDEX ............................................................................................... 31 THE HUMAN CAPITAL INDEX .......................................................................................................... 31 REFERENCES: ..................................................................................................................................... 33 CHAPTER 4 ............................................................................................................................................ 34 A HISTORICAL BACKGROUND TO ECD JAMAICA ..................................................................................... 34 ESTABLISHMENT OF EARLY CHILDHOOD CENTRES ............................................................................. 34 INTERNATIONAL RECOGNITION OF ECD ............................................................................................. 34 THE ROLE OF THE UNIVERSITY OF THE WEST INDIES (UWI) ................................................................ 34 ORGANISED COMMUNITY SUPPORT .................................................................................................. 35 DAY CARE SERVICES ........................................................................................................................... 35 THE CONCEPT OF INTEGRATION ........................................................................................................ 35 ESTABLISHMENT OF THE EARLY CHILDHOOD COMMISSION (ECC) ...................................................... 36 IMPORTANCE OF THE HISTORY OF ECD .............................................................................................. 38 CHAPTER 5 ............................................................................................................................................ 39 LEGAL AND POLICY FRAMEWORK FOR EARLY CHILDHOOD .................................................................... 39 DEVELOPMENT ...................................................................................................................................... 39 INTERNATIONAL AGENDA: THE SUSTAINABLE DEVELOPMENT GOALS ................................................ 39 INTERNATIONAL CONVENTIONS: ....................................................................................................... 40 UN CONVENTION ON THE RIGHTS OF THE CHILD (UNCRC) AND UN CONVENTION ON THE RIGHTS OF PERSONS WITH DISABILITIES (UNCRPD) ............................................................................................. 40 UNCRC ........................................................................................................................................... 40 JAMAICA’S NATIONAL PLAN: THE VISION 2030 NATIONAL DEVELOPMENT PLAN ............................... 43 NATIONAL POLICIES: .......................................................................................................................... 44 THE NATIONAL PARENT SUPPORT POLICY ...................................................................................... 44 THE EARLY CHILDHOOD DEVELOPMENT POLICY ............................................................................. 45 JAMAICAN LAWS RELEVANT TO YOUNG CHILDREN: EARLY CHILDHOOD ACT AND DISABILITIES ACT.. 46 STRATEGIC PLANS: ............................................................................................................................. 47 EARLY CHILDHOOD COMMISSION NATIONAL STRATEGIC PLAN FOR ECD ........................................... 47 NSP FOR ECD STRATEGIC OBJECTIVES ............................................................................................ 47 REFERENCES: ..................................................................................................................................... 47 CHAPTER 6 ............................................................................................................................................ 48 INFORMATION FROM FOCUS GROUPS................................................................................................... 48 THE IMPORTANCE OF FOCUS GROUPS ............................................................................................... 48 FOCUS GROUP METHODOLOGY ......................................................................................................... 48 PARENT FOCUS GROUPS .................................................................................................................... 48 VIOLENCE ...................................................................................................................................... 48 SCHOOL READINESS ....................................................................................................................... 49 TEACHER FOCUS GROUP .................................................................................................................... 51 SCHOOL READINESS ....................................................................................................................... 51 VIOLENCE AGAINST CHILDREN ....................................................................................................... 52 CHAPTER 7 ............................................................................................................................................ 53 INFORMATION ON READINESS AND EXPOSURE TO VIOLENCE FROM A NATIONAL SURVEY : SURVEY METHODOLOGY .................................................................................................................................... 53 MATERIALS AND METHODS ............................................................................................................... 53 CHAPTER 8 ............................................................................................................................................ 57 INFORMATION ON READINESS AND EXPOSURE TO VIOLENCE FROM A NATIONAL SURVEY : PARTICIPANT DEMOGRAPHICS.................................................................................................................................... 57 HOUSEHOLD AND FAMILY STRUCTURE .............................................................................................. 57 Respondents...................................................................................................................................... 57 Household Composition .................................................................................................................... 58 Interactions with Father Figures ........................................................................................................ 58 Siblings .............................................................................................................................................. 59 SOCIO-ECONOMIC STATUS ................................................................................................................ 59 Stability of Living Arrangements ........................................................................................................ 59 Household Income and Composition ................................................................................................. 60 CHAPTER 9 ............................................................................................................................................ 62 EXPOSURE TO VIOLENCE ....................................................................................................................... 62 ADVERSE CHILDHOOD EXPERIENCE.................................................................................................... 62 Juvenile Victimization Questionnaire (JVQ-R2) (n=241) .......................................................................... 65 Overview of Findings Across Modules ................................................................................................ 65 Conventional Crimes.......................................................................................................................... 66 Child Maltreatment ........................................................................................................................... 68 Peer and Sibling Victimization ............................................................................................................ 70 Sexual Victimization........................................................................................................................... 72 Witnessing and Indirect Victimization ................................................................................................ 74 LIST OF TABLES Table 1 Frequency of Reported Adverse Childhood Experiences …………………………………………………………..62 Table 2 Proportion of Conventional Crimes Done by Relationship of Perpetrators to the Child …………….67 Table 3 Proportion of Child Maltreatment Done by Relationship of Perpetrators to the Child .………………69 Table 4 Proportion of Peer & Sibling Victimization by Relationship of Perpetrators to the Child …………..71 Table 5 Proportion of Sexual Victimization by Relationship of Perpetrators to the Child …………………… ...72 Table 6 Proportion of Witnessing and Indirect Victimization by Relationship of Perpetrators to the Child …………………………………………………………………………………………………………………………………………………………….. 74 LIST OF FIGURES Figure 3.1. Jamaica's Location in the Caribbean and the World …………………………………………………………….28 Figure 3.2 Geo-Political Map of Jamaica ………………………………………………………………………………………………. 28 Figure 3.3 Trends in Jamaica’s HDI component indices 1990-2018 ……………………………………………………….30 Figure 3.4 The Human Capital Index for Jamaica: Trends and Rankings ………………………………………………..31 Figure 3.5 Learning Adjusted Years of Schooling in Jamaica ………………………………………………………………….32 Figure 4.1 National Strategic Plan Leaflet …………………………………………………………………………………………….. 36 Figure 5.1 The Seventeen Sustainable Development Goals …………………………………………………………………..38 Figure 5.2 “We Have Rights Too“ Cover Page and Page 27, Articles No. 28 and 29 ……………………………….41 Figure 5.3 Vision 2030 Goals and Outcomes ……………………………………………………………………………………….. 42 Figure 5.4 National Outcomes for World Class Education and Training: Key Strategies and Outcomes 2009-12 ………………………………………………………………………………………………………………………………………………..43 Figure 9.1 Total Number of Adverse Childhood Experiences Reported …………………………………………………63 Figure 9.2 Summary of Reported Victimizations by Module in Descending Order ………………………………..64 Figure 9.3 Relative Frequency, Currency and Severity of Participant Experiences with Conventional Crimes ………………………………………………………………………………………………………………………………………………….66 Figure 9.4 Proportion of Perpetrators for Each Conventional Crime Disaggregated by Sex and Age group …………………………………………………………………………………………………………………………………………………………….. 68 Figure 9.5 Number of Childhood Experiences with Childhood Maltreatment ……………………………………....68 Figure 9.6 Proportion of Perpetrators for Child Maltreatment Disaggregated by Sex and Age Group …..70 Figure 9.7 Childhood Experiences with Peer and Sibling Victimization ………………………………………………….71 Figure 9.8 Proportion of Perpetrators for Peer & Sibling Victimization …………………………………………………72 Figure 9.9 Childhood experiences with Sexual Victimization …………………………………………………………………73 Figure 9.10 Proportion of Perpetrators for Sexual Victimizations Disaggregated by Sex and Age Group ………………………………………………………………………………………………………………………………………………………………74 Figure 9.11 Childhood Experiences with Witnessing & Indirect Victimization ……………………………………….75 Figure 9.12 Proportion of Perpetrators for Indirect Victimization by Sex and Age Group ……………………………………………………………………………………………………………………………………………………………..76 ABBREVIATIONS CBO - Community-Based Organisation CDC - Centres for Disease Control, USA CN - Child Neglect CPA - Child Physical Abuse CPFSA - Child Protection and Family Service Agency CRC - Committee on the Rights of the Child CSA - Child Sexual Abuse ECC - Early Childhood Commission ECD - Early Childhood Development ECI - Early Childhood Institution FBO - Faith-Based Organisation HIC - High income countries HCI - Human Capital Index HDI - Human Development Index IPV - Intimate Partner Violence LMIC - Low- and middle-income countries MDGs - Millennium Development Goals MOE - Ministry of Education, Youth & Information, Jamaica MOHW - Ministry of Health and Wellness, Jamaica MLSS - Ministry of Labour & Social Security NGO - Non-Governmental Organisation SDGs - Sustainable Development Goals UN - United Nations UNCRC - The UN Convention on the Rights of the Child UNCPD - The UN Convention on the Rights of Persons with Disabilities UNGA - The UN General Assembly UWI - The University of the West Indies WHO - World Health Organisation CHAPTER 1 THE IMPORTANCE OF EARLY CHILDHOOD DEVELOPMENT EARLY BRAIN DEVELOPMENT Early childhood is defined as the period of a child’s life from conception to age eight years and is now regarded as the most important developmental phase throughout the lifespan. It is a time of remarkable physical, cognitive, social and emotional growth. Development in these years is both highly robust and highly vulnerable (Shonkoff & Phillips, 2000). Almost every aspect of early human development is affected by the environments and experiences that are encountered beginning early in the prenatal period and extending throughout the early childhood years (Shonkoff & Phillips, 2000). Research in the fields of anthropology, education, developmental psychology, sociology and medicine indicate the critical impact of early childhood development in health, well-being and the formation of intelligence, personality, and social behaviour. Essentially, during the early years of human development the basic architecture and function of the brain are established (McCain, Mustard & Shanker, 2007). Early experiences influence the quality of that architecture by laying either a strong or fragile foundation for the health, development and learning that follow (Shonkoff, 2010). Results from developmental neurobiology studies consistently provide evidence that early neurobiological development affects physical and mental health, behaviour and learning in the later stages of life (Mustard, 2010). For example, adverse experiences in early childhood are associated with chronic health problems in adulthood, including alcoholism, depression, heart disease and diabetes (Shonkoff, Boyce & McEwen, 2009). INVESTMENT IN EARLY CHILDHOOD Investment in early childhood is associated with high rates of return (Heckman, 2004). Investment in these early years is a powerful economic strategy, with returns over the life course many times the size of the original expenditure (Hertzman, 2010). Recent studies of early childhood investments along with the basic principles of neuroscience indicate that providing supportive conditions for early childhood development is more cost-effective than attempting to address the consequences of early stress and adversity later on (Knudsen, Heckman, Cameron & Shonkoff, 2006). For example, results from the High/Scope Perry Preschool Study estimated a return to society of more than $17 for every dollar invested in providing high quality care and education in the early years, even after controlling for inflation (Schweinhart, 2004). These results were largely due to the continuing effect that the intervention had in reducing crime perpetrated by males. Like the High/Scope Perry Preschool Project, analyses of other early childhood interventions have revealed economic benefits to society attributed not only decreased criminal justice costs but also to increased earnings due to higher educational attainment, higher employment rates, a decreased need for special/remedial education and decreased burdens on health and welfare systems (Anderson et al., 2003; Engle et al, 2011). CHILDREN AT RISK: THE SCOPE OF THE PROBLEM More than 200 million children under 5 years living in developing countries are not fulfilling their developmental potential (Grantham-McGregor et al., 2007). The poorest and most marginalised children tend to suffer the most. Children living in poverty are at a greater risk than their more advantaged peers for being deprived and receiving lower levels of parental investments during the crucial early childhood period (Engle et al., 2011). Evaluations of ECD programmes (e.g. parent support and enrolment in preschool programmes) show that targeting the children most in need of services will deliver the best results (Engle et al., 2011). Returns are greatest for the most at-risk children. Interventions for disadvantaged children can strengthen social attachment, raise the quality of the workforce and reduce crime, teenage pregnancy, and welfare dependency (Anderson et al., 2003). EARLY CHILDHOOD INTERVENTIONS ACROSS THE WORLD Based on the evidence presented, it is no surprise that the provision of a high quality early childhood environment enhances the quality of a society’s human capital by promoting individuals’ competencies and skills for participating in civil society and the workforce (Knudsen, 2006). Overall, countries that provide high-quality, universal programmes for very young children tend to outperform countries which do not have well-organised early childhood development programmes (McCain et al., 2007). Internationally, there are many types of early childhood interventions including programmes linked to health care services, home visitation services, community based programmes, parent support programmes and preschool services. These interventions are highly varied in their methods, target group, eligibility criteria, service type and outcomes. However, they are all share a common objective – to moderate the effects of the various risk factors that may compromise healthy growth and development in the early years of life (Karoly, Kilburn & Cannon, 2005). There is a strong body of evidence to suggest that ECD programmes have positive impacts on child development, especially related to cognitive and psychosocial development, school readiness and academic achievement (Anderson et al., 2003; Engle et al., 2011). However, many of the evaluation studies have methodological and design weaknesses that make the assessment of their true impact difficult (Anderson, 2003; Geddes, Haw & Frank, 2010). Nevertheless, there are promising results from evaluations of different types of ECD interventions which suggest that early developmental opportunities create a vital foundation for children’s health, well-being and success at school (Anderson et al., 2003). Model Targeted Early Childhood Interventions Model ECD programmes have generally been of a high quality and have shown statistically significant positive results and good effect sizes (Geddes, Haw & Frank, 2010). This is mostly due to the fact that these interventions are small-scale, well implemented and intensive programmes targeted at high risk groups. For example, the Abecedarian Project tracked 111 low-income African-American families in North Carolina from infancy to age 21. Intervention groups were provided with high-quality, intensive education from infancy to five or eight years. The intervention groups displayed a number of benefits at follow-up including higher academic achievement, higher rates of high-school and college completion, better employment outcomes, delayed parenthood and lower rates of cigarette and marijuana use. Similarly, the High/Scope Perry Preschool Project demonstrated that children who participated in quality preschools at age 3 – 4 years were more likely to graduate from high school, have steady employment, have higher earnings and commit fewer crimes than children who did not attend these programmes (Schweinhart, Montie, Xiang, Barnett, Belfield, & Nores, 2005). Large-scale Targeted Early Childhood Interventions It has been difficult to determine the true impact of many of the large-scale interventions because of poor methodological and evaluation designs, attrition, as well as follow up contacts that are conducted too soon after programme implementation (Geddes, Haw & Frank, 2010). For example, the evidence on the positive impact of both the US Head Start and the UK Sure Start has been inconclusive (Anderson et al., 2003; National Evaluation of Sure Start Team, 2012). However, there have been a few large-scale interventions (e.g. Early Head Start, Nurse-Family Partnership and Chicago Child Parent Centers) which have used experimental, quasi-experimental or randomized controlled trials to measure efficacy (Geddes, Haw & Frank, 2010). The results of these studies have generally shown that experimental groups have better outcomes in both the short and long term (Geddes, Haw & Frank, 2010). Programmes & Services linked to Health Care Systems Many interventions for children in the early childhood period, particularly those under the age of three years, are linked to health care systems. This is generally because very young children are most likely to come in contact with the health sector in the first few years of life. One such programme is the WHO’s Integrated Management of Childhood Illnesses (IMCI). The main goal of IMCI is to reduce childhood mortality, illness and disability and to promote health and development among children 0 – 5 years. By adopting an integrated approach to child health and development, the IMCI focuses on the proper identification and treatment of childhood illness within the home, community and health facilities. It also provides counselling for parents and caregivers and referral services for the very sick children. Although there have been major obstacles to the successful wide scale implementation of the programme (e.g. the cost of training and training materials, poor follow-up support, and frequent attrition of trained staff), there is evidence that shows that health workers trained in IMCI provided significantly better care to children and their families than those not trained (Amaral et al., 2004). Care for Child Development (CCD) was developed through a UNICEF/WHO partnership and was designed to be incorporated into existing IMCI programmes. CCD provides information and recommendations for families to help them provide cognitive stimulation and social support to young children as part of the child health visits specified in IMCI. However, adaptations of the CCD module encourage its integration into any programmes that serve young children and their families (e.g. preschools, parenting programmes, community-based programmes for families). There is evidence to suggest that CCD is an effective means of supporting caregivers’ efforts to provide a stimulating environment for their children, improving the quality of the parent-child interaction and improving cognitive, language and motor development outcomes at 12 and 24 months of age (Engle, 2011). Centre-Based Pre-School Education Research has shown that preschool attendance can provide tremendous benefits for children, especially those children from very poor families (Geddes, Haw & Frank, 2010). These benefits include improved language, prereading and math skills. The general quality of the preschool programme, as well as factors such as the number of trained teachers and level of positive interactions with children impact child outcomes (Geddes, Haw & Frank, 2010). Home Visiting In home visiting programmes, nurses or other trained parent ‘coaches’ provide child development and parenting information to parents and families. This information is usually geared towards monitoring child development, as well as creating a safe and stimulating home environment for children. It is also an opportunity for practitioners to connect families with essential medical, educational and community services. Although the majority of programmes target newborns, there are many programmes which provide services in the antenatal period and keep families enrolled until children are 3 – 5 years. Systematic reviews of these programmes have yielded mixed results (Daro, 2006). When home visiting is well implemented, evaluators have seen a significant reduction in child-abuse risk and improvements in child and family functioning (Geeraert, Van der Noorgate, Grietens & Onghena, 2004; Sweet & Appelbaum, 2004). Evaluation research has shown that home visiting programmes can increase positive birth outcomes for children, decrease the rates of child abuse and neglect and increase children’s literacy and language skills and school completion rates (Daro, 2006). One of the most successful home visiting programmes has been the Nurse-Family Partnership (NFP; Olds et al., 1998; Olds, Henderson, Kitzman, & Cole, 1995). The main goal of the NFP is to improve outcomes for families by empowering low-income, first time mothers through evidence-based nurse home visiting. This programme provides visits ranging from weekly to monthly, beginning during pregnancy through to the child’s second birthday. One unique aspect of the NFP has been its carefully planned and well conducted randomised controlled trial evaluations. These evaluations have shown that there are benefits in all child development domains (Daro, 2006). Similar Nurse Home-Visiting programmes have had success in countries such as Kazakhstan, Turkey and Australia (Irwin, Siddiqi & Hertzman, 2007). Despite the successes reported in many of these programmes, some groups have raised concern about the efficacy of home visitation (Gomby, 2005). Some reviews have highlighted inconsistencies in programme quality and outcomes and have cautioned against dependence on a single approach to intervention. In many cases, the high expectations of home visiting impact have not been supported by research (Daro, 2006). Home visitation may be best viewed as an important aspect of a comprehensive approach to supporting families and improving a child’s developmental trajectory. Regardless, for current home visiting programmes to be effective, administrators must focus on issues of quality, training, content and supervision to ensure that programme outcomes are achieved and maintained THE FIRST THREE YEARS In recent years, there has been a renewed interest in the 0 – 3 year period. New research points to the unique vulnerability of children during particular periods of development such as gestation, infancy and very early childhood (Golding, Jones, Brune´ & Pronczuk, 2009). In the first few years of life there is rapid proliferation of neural connections in the brain – as many as 700 new neural connections per second (Shonkoff, 2009). This is to accommodate a wide range of environments and interactions. After this initial period, connections proliferate and prune in a prescribed order, with more complex brain circuits being built upon earlier, simpler circuits (Shonkoff, 2009). In other words, brain plasticity decreases with age. As the brain matures and becomes more specialized, it is less capable of reorganizing and adapting to new challenges. Consequently, the first three years of life are especially important because it is easier to influence a child’s developing brain architecture than to rewire parts of its circuitry during adolescence or adulthood (National Scientific Council on the Developing Child, 2007). The quality of a child’s early environment and the availability of appropriate experiences during sensitive periods of development are crucial in determining the strength or weakness of the brain’s architecture, which, in turn, determines health, cognitive abilities and self-regulation (National Scientific Council on the Developing Child, 2007). The evidence presented demands that researchers and policymakers pay special attention to ensuring positive outcomes for the most vulnerable young children and the most cost-effective strategies for achieving optimal development (Shonkoff & Phillips, 2000). Programmes targeted to the first three years have included parent support programmes, community based home visiting programmes and health sector linked home visiting programmes. REFERENCES Anderson, L.M., Shinn, C., Fullilove, M.T., Scrimshaw, S.C., Fielding, J.E., Normand, J., Carande-Kulis, V.G., & the Task Force on Community Preventative Services. (2003). The effectiveness of early childhood development programs: A systematic review. American Journal of Preventative Medicine, 24, 32 – 46. Daro D. Home Visitation: Assessing Progress, Managing Expectations. Chicago, Ill: Chapin Hall Center for Children. Available at: http://www.chapinhall.org. Engle, P.L., Black, M.M., Behrman, J.R. et al. (2007). Strategies to avoid the loss of developmental potential in more than 200 million children in the developing world. Lancet, 369: 229-242. Engle, P.L., Fernald, L.C.H., Alderman, H, Behrman, J, O’Gara, Yousafzai, Cabral de Mello, M., Hidrobo, M., Ulkuer, N., Ertem, I., Iltus, S., and the Global Child Development Steering Group (2011). Child Development 2: Strategies for reducing inequalities and improving developmental outcomes for young children in low –income and middle-income countries. The Lancet, 378, 1339-1353. Geddes,R., Haw, S., & Frank, J.( 2010). Interventions for promoting early childhood development for health: An environmental scan with special reference to Scotland. Scottish Collaboration for Public Health and Policy. Geeraert L, Van den Noortgate W, Grietens H, Onghena P. The effects of early prevention programs for families with young children at risk for physical child abuse and neglect: A meta-analysis. Child Maltreatment 2004;9(3): 277-291. Golding, J., Jones, R., Brune, M-N., & Pronczuk, J. Why carry out a longitudinal birth survey? Paediatric and Perinatal Epidemiology, 23 (Supp 1), 1-14. Gomby DS, Culross PL, Behrman RE. Home visiting: Recent program evaluations - Analysis and recommendations. The Future of Children 999; 9(1):4-26 Grantham-McGregor, S., Cheung, Y.B., & Cueto, S, et al. (2007). Developmental potential in the first five years for children in developing countries. Lancet, 369, 60 – 70. Heckman, J.J. (2004). Invest in the very young. In: Tremblay, R.E., Barr, R.G., & Peters. RDev., (eds.). Encyclopedia on Early Childhood Development [online]. Montreal, Quebec: Centre of Excellence for Early Childhood Development. Available at http://www.childencyclopedia.com/documents/HeckmanANGxp.pdf. Retrieved August 12, 2010 Hertzman, C. (2010). Framework for the social determinants of early child development. In: Tremblay, R.E., Barr, R.G., Peters, RDeV., Boivin, M., (eds). Encyclopedia on Early Childhood Development [online]. Montreal, Quebec: Centre of Excellence for Early Childhood Development; 2010:1-9. Available at: http://www.childencyclopedia.com/documents/HertzmanANGxp.pdf. Retrieved August 12, 2010. Howard, KS., & Brooks-Gunn, J. (2009). The role of home-visiting programs in preventing child abuse and neglect. The Future of Children, 19 (2), 119 – 146. Irwin, L.G., Siddiqi, A., & Hertzman, C. (2007). Early child development: A powerful equalizer. Final Report to the World Health Oragnization’s Social Commission on the Determinants of Health. Knudsen, E.I., Heckman, J.J., Cameron, J.L., & Shonkoff, J.P. (2006). Economic, neurobiological, and behavioral perspectives on building America’s future workforce. Proceedings of the National Academy of Sciences, 103, 27, 10155-10162. McCain, M.N., Mustard, J.F., & Shanker, S. (2007). Early years study 2: Putting science into action. Toronto, ON: Council for Early Child Development. Mustard, J.F. (2010) Early brain development and human development. In: Tremblay, R.E, Barr, R.G, Peters, RDeV, Boivin, M., (eds.). Encyclopedia on Early Childhood Development [online]. Montreal, Quebec: Centre of Excellence for Early Childhood Development, 1-5. Available at: http://www.childencyclopedia. Retrieved August 12, 2010 National Evaluation of Sure Start Team. (2012). The impact of the sure start local programmes on seven year olds and their families. Department of Education Research Report. National Scientific Council on the Developing Child (2007). The timing and quality of early experiences combine to shape brain architecture. Cambridge, MA: National Scientific Council on the Developing Child; 2007. Working Paper No. 5. Available at: http://developingchild.harvard.edu/library/reports_and_working_papers/wp5/. Retrieved August 14, 2010. Olds, D., Eckenrode, J., Henderson,C., Cole., R., Eckenrode, J., Kitzman, H., Luckey, D., Pettitt, L., Sidora, K., Morris, P., & Powers, J. (1998). Long-term effects of home visitation on maternal life course, child abuse and neglect and children’s arrests: Fifteen-year follow-up of a randomized trial. Journal of the American Medical Association, 278 (8), 637-643. Olds, D., Henderson, C.R., Kitzman, H., & Cole, R. (1995). Effects of prenatal and infancy nurse home visitation on surveillance of child maltreatment. Pediatrics, 95 (3), 365-372. Powell, C. (2004). An evaluation of the roving caregivers programme of the rural family support organization, May Pen. Clarendon, Jamaica. UNICEF, http://www.unicef. Schweinhart, L. J. (2004). The High/Scope Perry Preschool Study through age 40: Summary, conclusions, and frequently asked questions. Ypsilanti, MI: High/Scope Educational Research Foundation. Schweinhart, L. J., Montie, J., Xiang, Z., Barnett, W. S., Belfield, C. R., & Nores, M. (2005). Lifetime effects: The HighScope Perry Preschool study through age 40. (Monographs of the HighScope Educational Research Foundation, 14). Ypsilanti, MI: HighScope Press. Shonkoff, J.P. (2009). Investment in Early Childhood Development lays the foundation for a prosperous and sustainable society. In: Tremblay, R.E., Barr, R.G., & Peters. RDev., (eds.). Encyclopedia on Early Childhood Development [online]. Montreal, Quebec: Centre of Excellence for Early Childhood Development. Available http://www.childencyclopedia.com/documents/HeckmanANGxp.pdf. Retrieved August 12, 2010 Shonkoff, J.P., Boyce, W.T., & McEwen, B.S (2009). Neuroscience, molecular biology, and the childhood roots of health disparities: Building a new framework for health promotion and disease prevention. JAMA: The Journal of the American Medical Association, 301, 21, 2252-2259. Shonkoff, J.P., & Phillips, D.A. (Eds.). (2000). From neurons to neighbourhoods: The science of early childhood development. Washington, D.C.: National Academy Press. Sweet MA, Appelbaum MI. Is home visiting an effective strategy? A metaanalytic review of home visiting programs for families with young children. Child Development 2004; 75(5):1435-1456. United Nations Children’s Fund (UNICEF). (2014). The state of the world’s children 2014. Every child counts: Revealing disparities advancing children’s rights . New York: Division of Communications, UNICEF. CHAPTER 2 REPORT BACKGROUND, OBJECTIVES AND METHODOLOGY BACKGROUND: The Government of Jamaica, through the Early Childhood Commission identified readiness of children for primary school, and especially children at risk, and violence against children as two main areas of research focus in ECD. There has been concern about the performance of children at primary school in Jamaica at national exams from Grades 1 to Grade 6. In Jamaica, poor early childhood environments (home, school, community) have been considered to be significant contributors to this poor outcome. International research has linked school readiness in the general population with later positive outcomes for children. Research has also shown that children at risk, if identified and provided with necessary supports such as conditional cash transfers for those in poverty, and early intervention for those with disabilities, can have improved outcomes. School readiness for the general population of children, and also those at risk, are therefore important factors to address for national development. Modern concepts of school readiness (Emig 2000; Kagan & Rigby, 2003) recognise that readiness is an interaction between the child's various environments and the child. School readiness therefore has three components: readiness of children for school, readiness of schools for children, and family and community readiness or supports that would be required for children to be ready for school. Further, school readiness is not limited to academic capabilities of children only, but also includes physical well-being and motor development, socio-emotional development, approaches to learning, language development and cognition and general knowledge. Evaluation of school readiness therefore requires comprehensive data collection and analysis. Jamaican children have excessive exposure to violence. Jamaica was ranked third of 23 Low and Middle Income (LMIC) countries in the prevalence of corporal punishment (UNICEF MICS Studies). Additionally Jamaica is ranked 10th in the world in child homicide (Know Violence in Childhood Global Report, 2017). The long term effects of violence on older children has been researched far more widely than that for younger children, and has shown effects on learning, behaviour and other areas of development. Additionally, the concept of polyvictimisation, or exposure to multiple forms of violence, is an emerging concept that has been shown to be detrimental to older children in Jamaica (Samms-Vaughan, 2017). This concept has not been widely researched in young children, in Jamaica or elsewhere, but could be a significant contributor to impaired early learning and other aspects of development, given the brain development that is occurring in the early childhood years. Prior research in Jamaica has primarily been operational research, which is utilised primarily by education providers; and to a lesser extent, implementation research (which is utilised primarily by programme managers). While both of these forms of research can identify systemic areas for intervention, systems research is utilised primarily by education systems managers and policy makers. At Jamaica’s current state of development of its ECD sector, systems research can best inform and advance educational goals. Systems research aims to understand and improve organisation to achieve educational goals, and implement processes to promote coverage, quality, efficiency and equity. OBJECTIVES: This research report meets two separate sets of objectives. First, it meets the overall object of the World Bank’s Early Learning Partnership (ELP) project. The ELP is a multi-donor trust fund at the World Bank, supported by the UK Department for International Development, with a focus on improving ECD in countries across the world. The overall ELP programme objectives (relevant to a number of countries) are as follows: i) To provide policy makers in a set of focus countries with actionable information to help guide the delivery of quality, equitable early learning at scale ii) To add to and build the international evidence base in the emerging field of systems research in early childhood education (development). The ELP Research Programme was designed to be conducted in two phases. In the first phase a diagnostic report is to be produced, using a systems approach, to identify the key levers of change to improve Jamaica’s early learning system. The research from the first phase will allow evidence-based interventions to be developed and implemented, increasing the likelihood of sustainable improvement in ECD. This report addresses Phase 1. As indicated above, the priority areas identified for further research in Jamaica are: i) School readiness for children at risk ii) Violence and early learning. Based on these, the main objective of the first phase of the Jamaica ELP programme is: To conduct a comprehensive system based assessment and analysis of the ECD sector in Jamaica with specific reference to school readiness for children at risk, and violence and early learning. The sub-objectives are as follows: i) To improve learning outcomes for children by a. Evaluating the current status of school readiness b. Identifying and evaluating those systems that promote and prevent school readiness, with a special focus on children at risk c. Identifying system gaps in the support for school readiness ii) To reduce the negative impact of violence on early learning by a. Assessing the current exposure of young children to violence in all its forms (Intimate Partner Violence, community violence, corporal punishment, child abuse and neglect, media violence, bullying,) b. Determining the impact of exposure to violence in all its forms on young children (0- 8 years) c. Identifying and evaluating systems that protect young children from exposure to violence, as well as those intervention systems that reduce the effect of exposure to violence. d. Identifying system gaps in the prevention of violence against children, and in the intervention supports provided for child and family victims of violence. iii) Using information obtained in i) and ii) above, identify levers of change / barriers to change, with a view to making evidence-based policy and programme recommendations to ensure coverage, quality, efficiency and equity in early learning at scale. iv) To identify requirements (financial, human resources etc) for improving and/or scaling up existing efficient and effective national programmes, and for addressing gaps and determining cost-effectiveness. Specific Research Questions Readiness 1. How is school readiness conceptualized in the Jamaican ECD sector? 2. What policies/plans/legislation/ programmes (national, community, school, home) exist to support Early Childhood School Readiness? 3. What is the nature of the content and coverage of these policies/plans/legislation/ programmes? 4. Are the national policies/plans /legislation/ programmes in keeping with current thinking on school readiness? 5. Are existing programmes aligned to the national goals for school readiness? 6. How effective is the Jamaica School Readiness Assessment (JSRA) programme? In particular how effective is the JSRA in identifying / intervening with children and families most at risk? 7. What resources are required for an effective readiness programme (national, community, school, home)? 8. How ready are Jamaican children? How ready are schools? How do parents foster readiness in the home environment? Violence 1. What policies/plans/legislation/ programmes exist to reduce the effects of exposure to violence for children 0 – 8 years? 2. What is the nature of the content and coverage of these policies/plans/legislation/ programmes? 3. Are existing projects at local / community levels aligned to national strategies for violence reduction? 4. How effective are exposure to violence reduction projects? 5. What resources are required for an effective violence prevention programme (national, community, school, home)? 6. What is the level of exposure to children in the ECD sector to violence in the home, school and community? 7. How does exposure to violence affect children’s development & behaviour? INTENDED APPROACH: The approach originally put forward for this project was similar to that used in the World Bank Systems Assessment for Better Education Results (SABER) Analyses ECD reports in general, and specifically in the SABER report for Jamaica, completed in 2013, and was indicated as follows: First, data will be collected from a variety of sources; second, the information collected will be analysed using a systems approach; third, the information will be disseminated through consultation and publications. SABER data, collected some 5 years ago at the end of the first NSP and before the second NSP, will be updated from the data collection sources below. 1. Data collection: The numerous factors that contribute to child readiness and early learning, as well as violence prevention require that data collection is comprehensive. Additionally, it is important that all stakeholders are engaged and are part of the process of ECD system evaluation. The history of early childhood development in Jamaica has resulted in a broad range of stakeholders; everyone in Jamaica is connected to an early learning centre (basic or pre-school) in some way. Early learning stakeholders therefore include policy makers, programme planners and deliverers of early learning services in the Government of Jamaica, early childhood teachers and practitioners, parents, children, academics and researchers, community members (including faith based organisations and community based organisations), the private sector, civil society and international development partners. Jamaica has a wide range of ECD data available from a variety of sources as below: i) Policy and legislative data Relevant policy and legislative data will be reviewed, including the Early Childhood Commission Act (2003), Early Childhood Act and Regulations (2005), Child Care and Protection act (2004), National Parent Support Commission Act (2012), National Parenting Policy (2012), Disability Act, Draft National Plan of Action to Prevent Violence Against Children. Policy and legislative data provide information on the existing policy and legislative framework. Analysis of this data will also identify policy and legislative gaps. ii) Administrative data Relevant and current administrative data will be collected from Government of Jamaica Ministries, Departments and Agencies, including Ministries of Health and Wellness, and Labour & Social Security, the Early Childhood Commission, teacher training colleges etc. The results of the first nationally administered school readiness evaluation in 2017 will be reviewed in detail. Teacher qualification data, school quality data, and existing standards are available from the ECC and its data systems. Cost data will also be obtained in order to evaluate cost-effectiveness. Administrative data provides information on services provided, coverage, quality and equity. iii) Existing Survey Data Jamaica’s annual household survey, the Jamaica Survey of Living Conditions will be reviewed for relevant data. Since 2008, the ECC has collected survey data on ECD, and produced an ECD chapter in the Jamaica Survey of Living Conditions. This survey data will provide information on current status of ECD and trends in the early childhood sector. Trend data will assist in identifying areas for which there have been improvements and those where there are potential barriers. iv) Existing Longitudinal Studies The second birth cohort study in Jamaica, JAKIDS, collected comprehensive national data on approximately 10,000 children born in July to September 2011, including data on children at risk and exposure to violence. These children were followed to the age of 4-5 years, with executive function assessed at 4-5 years. Data from this study will allow analysis of the impact of a wide range of early life factors on early learning. v) Existing Publications Existing international publications (e.g. Lancet Series on ECD; Nurturing Care Framework; publications from the Centre for the Developing Child; Strengthening systems for integrating ECD (Britto et al, 2014) will be reviewed). Existing publications on ECD in Jamaica include the Jamaica ECD SABER Report (World Bank, 2013); and the Jamaican Pre-School Child, will also be reviewed. Existing international publications provide policy and system information and guidance. Local publications allow for inclusion of local and cultural factors and comparison of changes over time. vi) Elite Interviews Elite interviews will be conducted with relevant policy makers (e.g. Ministers and Permanent Secretaries of relevant ministries) and programme providers, with a special focus on programmes for children at risk and those exposed to violence (e.g. ECC, PATH Programme, Early Stimulation Project, Violence Prevention Alliance, NGOs and civil society). Programmes to support at risk children and to prevent violence against children and provide services to those affected will be specially reviewed. Elite interviews allow for more in-depth information on current and future policy and programme direction, prior programme evaluations, and identification of barriers at the policy and programme level. Responses to in-depth questions on coverage, efficiency, equity and quality will also be obtained. vii) Focus Group Data Focus Group sessions will be conducted with end-users of the systems, including teachers, parents, community members and children. Focus group data allow for in depth analysis of the perception of policy and programme coverage, efficiency, equity and quality, and identification of programme gaps from the end- users. viii) Survey Data (Adults) A national sample of parents of children 2, 4, and 6 years old (n=600)will be comprehensively interviewed, to obtain information on all factors impacting children’s readiness and exposure to violence. These factors include pre-natal and birth conditions, health and nutrition, early child care and stimulation, exposure to all forms of violence, parental health and well-being and family structure and functioning. Given the status of the country (Low and Middle Income) and the prevalence of violence, the national sample is expected to include children at risk and children exposure to various levels of violence. Questionnaires previously used successfully in the JAKIDS study to assess family structure and socio-economic status will be reviewed and adjusted as necessary for use in this study. The Parent Child Conflict Tactics Scales Questionnaire will be included to assess children’s exposure to violence; there is no valid or reliable tool for assessing young children’s exposure to violence currently. The Jamaican Family Support Screening Tool and the ACES questionnaire will be added to identify family supports and stressors. This information will provide current data on the factors that contribute to children’s developmental and early learning readiness, and exposure to violence. ix) Survey Data (Children) - Developmental Assessments and Biochemical Data Developmental and behavioural assessments of children from the national sample will be conducted. The ultimate impact of policies, programmes and services is child outcome. Salivary cortisol has been found to be a valid measure of stress that is acceptable to participants. This allows for the inclusion of biochemical data (a powerful marker of impact) in analyses with social data. However, in our previous experience samples had to be shipped overseas for analysis at great cost. This may require additional budgetary consideration. This data when analysed with data obtained from viii) above will allow for co-relations to be made between family systems and child development and early learning outcomes, as well as exposure to violence. This data will contribute to information on coverage, quality and equity and will be used to inform policy and programme analysis. Where applicable and possible, all data will be disaggregated by gender and region. 2. Data analysis: Systems Framework The ECD systems to be analysed include the following: 1. Individual and Family Systems 2. School & Community Systems 3. NGO & Civil Society Systems, including public private partnerships 4. Governance (Policy & legal framework; national programmes & services) The building blocks (levers for change) that ECD systems will be analysed against are as follows: 1. Governance (legal and policy framework) 2. Human Resources 3. Physical Resources 4. Programmes and Services (standards, coverage, quality, equity, efficiency) 5. Inter-sectoral co-ordination 6. Information/Evidence Base 7. Financing 3. Dissemination A draft diagnostic report will be produced. This will be taken to consultation with stakeholders and revised based on stakeholders’ comments. A final diagnostic report will be produced; the final diagnostic report will be used to develop the Phase 2 proposal. Communication & Dissemination Plan: 1. Pre-Launch event meeting with relevant government ministers and senior policy makers to brief on the report 2. Launch event for the Final Diagnostic Report, to include representatives from all stakeholder groups and media 3. Host Twitter Chat during the launch event, linked to ECC Twitter account 4. Produce a series of Policy Briefs and circulate to ministries, departments and agencies 5. Request Editor’s Forum to discuss findings from local newspapers (Gleaner and Observer) 6. Contribute to ELP Systems Research Program website for all focus countries 7. Downloadable version of the report available on the World Bank, Ministry of Education, ECC and UWI websites 8. Notification of report to all regional (e.g. CARICOM) and international ECD-focussed organisations ADJUSTMENTS TO INTENDED APPROACH There were two major adjustments to the intended approach. First, funding was inadequate to obtain biochemical data. Funding would have been required to import the materials necessary for data collection, to transport samples to the USA for analysis and for the analytical processes. The original approach had indicated that this would likely have required additional funding. Second, there was limited information available in the existing research literature on the systems approach to ECD. However, there was a tremendous amount available on the systems approach to Child Protection. This was used as a basis for developing the systems approach to ECD. A SYSTEMS APPROACH MODEL: CHILD PROTECTION DEFINITION OF CHILD PROTECTION The definition of Child Protection is embodied in Article 19 of the UNCRC, which states that: “1. States Parties shall take all appropriate legislative, administrative, social and educational measures to protect the child from all forms of physical or mental violence, injury or abuse, neglect or negligent treatment, maltreatment or exploitation, including sexual abuse, while in the care of parent(s), legal guardian(s) or any other person who has the care of the child. 2. Such protective measures should, as appropriate, include effective procedures for the establishment of social programmes to provide necessary support for the child and for those who have the care of the child, as well as for other forms of prevention and for identification, reporting, referral, investigation, treatment and follow-up of instances of child maltreatment described heretofore, and, as appropriate, for judicial involvement.” PROGRESS IN CHILD PROTECTION TO A SYSTEMS APPROACH There have been tremendous changes in Child Protection over the last two decades, with the progress beginning with increased awareness. In overseeing the implementation of the Convention on the Rights of the Child, the Committee on the Rights of the Child (CRC) perceived the need to increase attention on the protection of children. At its twenty-third session, in January 2000, the Committee decided to devote two annual days of general discussion, rather than the usual one, to the theme of Violence against Children to ensure that there could be adequate in-depth analysis. Following the days of discussion In September 2000and 2001, the CRC made a request for an international study on violence against children. In 2003, the UN appointed an Independent Special Representative to conduct the study, Prof. Paolo Pinheiro. Thousands of people, including children and young people. contributed to the study through regional and expert consultations, questionnaires and in other ways. In August 2006, the UN Secretary- General’s Study on Violence against Children was presented to the UNGA and later published as a world report (Pinheiro, 2006) This study recommended that “all States develop a multifaceted an d systematic framework in response to violence against children, which is integrated into national planning processes.” A 2007 UNHCR Executive Committee Conclusion on Children at Risk noted that “States should promote the establishment and implementation of child protection systems….” (UNHCR, 2007). In 2008, UNICEF hosted a Global Child Protection Systems Mapping Workshop; this workshop concluded that there was need for a common understanding of Child Protection systems. These activities subsequently led to a shift away from looking at “Child Protection issues” and vulnerable children to “Child Protection Systems” by UNICEF and other UN agencies, other International Development Partners (IDPs), NGOs and others (Save the Children, 2010; World Vision 2011; Terre des Hommes; 2011). CURRENT DEFINITION OF A CHILD PROTECTION SYSTEM At a conference held in India in 2012 on the Theory and Practice of Child Protection Systems, and including experts from across the world, a definition of a child protection system was put forward as follows: “ A child protection system can be defined as: ‘Certain formal and informal structures, functions and capacities that have been assembled to prevent and respond to violence, abuse, neglect and exploitation of children. A child protection system is generally agreed to be comprised of the following components: human resources, finance, laws and policies, governance, monitoring and data collection as well as protection and response services and care management. It also includes different actors – children, families, communities, those working at subnational or national level and those working internationally. Most important are the relationships and interactions between and among these components and these actors within the system. It is the outcomes of these int eractions that comprise the system’ . (UNICEF, UNHCR, Save the Children & World Vision, 2013). It should be noted that there is as yet no internationally agreed definition of this systems approach to child protection. The reviewed evidence suggests there is general agreement that the main aims of a systems approach to child protection are to strengthen both the protective environment around children, as well as the capacity of children themselves to fulfil their rights to protection from abuse, neglect and other forms of violence and ensure their well-being (Joynes & Mattingly, 2018). However, there is great variation as to how this is perceived. PRINCIPLES FOR SYSTEMS DESIGN AND OPERATION Joynes and Mattingly (2018) quoted Wulczyn et al (2010) and Delaney et al (2014) as identifying a number of principles for systems design and operation. These principles include: i) Organising all systems components around a common goal or vision in order to provide the strategic direction for system implementation ii) Defining the activities of each system on the basis of a specific set of functions, structures and capacities that interact and influence each other, while also establishing clear systemic boundaries, roles and responsibilities in order to ensure accountability and good governance iii) Involving a wide range of different actors as part of the system, including across and within sectors in horizontal and vertical networks iv) Ensuring that the shape, functions and actions of the system is always grounded in the context in which it operates, and make sense to the communities who are the end users These basic principles of design are reflected in the system-based approaches to child protection services in a development context as outlined in a range of framework, guideline and programme assessment documents (Forbes et al., 2011; UNHCR, 2010; Save The Children, 2008; World Vision, 2011; Wulczyn et al., 2010; Delaney et al., 2014). COMPONENTS OF A CHILD PROTECTION SYSTEM Save the Children (2008) suggest that child protection systems are made of a set of coordinated components that work together to strengthen the protective environment around each child. These components include: i) a strong legal and policy framework for child protection that is compliant with the UNCRC and other international good practice ii) adequate budget allocation iii) multi-sectoral coordination at different levels across government and between sectors iv) effective regulation, minimum standards, and oversight v) child-friendly preventive and responsive services vi) a skilled child protection workforce, that is supervised and regulated vii) robust data on child protection issues and good practices viii) responsiveness to children’s voice and participation ix) an aware and supportive public These are similar to the seven system building priorities indicated in the UNICEF Child Protection Systems Mapping and Assessment Toolkit User Guide (UNICEF, 2010). In the User Guide, legal frameworks and regulation are a single item and there is a service delivery component and accountability component. Mapping and Assessment Toolkit aims to provide a practical and user-friendly method to enable participants in the child protection mapping process to identify the main country child protection risks within the rights framework, and to examine the scope and capacity of the existing child protection system (ranging from formal to informal), accountability mechanisms, and resource mobilization approaches. The ultimate objective of the Toolkit is to support the development of country-level comprehensive child protection systems, appropriately structured and resourced. The Toolkit is intended to help users to identify and prioritize actions which will contribute to building an integrated and strengthened child protection system. BENEFITS OF A SYSTEMS APPROACH TO CHILD PROTECTION In the last two decades, Child Protection has moved from its original position of being mainstreamed within a variety of other sectors, through issue-based programming with specific groups of vulnerable children, to the systems approach, in which there is a more comprehensive solution to meet the diverse protection needs of children. Issue-based child protection responses may deal with specific problems, but does so in a fragmented manner that fails to provide comprehensive protection for all children. A shift to a systems approach to child protection implies taking a more holistic, sustainable and long-term system-wide approach that addresses the wider vulnerabilities of children and their families and includes preventative strategies (Forbes et al. 2011). At the Theory and Practice of Child Protection Systems conference, the benefits of the systems approach to Child Protection (UNICEF, UNHCR, Save the Children & World Vision, 2013) were identified as: i) Increased coverage by serving all children, as well as focusing on particular children; ii) Recognition of the interactions of multiple child protection risks as they affect many children, and promoting the efficient review and coordination of multiple protection risks and responses; iii) Reduced fragmentation of programmes and policies and therefore increased coherence; iv) Potential for greater efficiencies, through the creation of synergies in administration and targeting, for example; v) Greater focus on prevention as compared to an issues approach focus on response to specific violations; vi) A holistic approach that allows a child and her/his problems to be seen from multiple angles; vii) Recognition of child protection as both a sector and intersectoral and thus requiring integration with other sectors, such as health and social protection; viii) Involvement of many professionals who bring different expertise and perspectives. IMPACT OF CHILD PROTECTION SYSTEMS APPROACH Joynes and Mattingly (2018) state that there are two main sets of outcomes to be considered when taking a systems approach to child protection: i) The establishment of necessary child protection mechanisms and systemic components ii) Improved child protection outcomes for children They also indicate that there is limited evidence of the impact of a systems approach on child protection in a development context. Across many contexts and national settings, the consensus is that the necessary legal and policy frameworks for child protection are in place at national level, but programme implementation and service delivery components still lag far behind partly due to capacity limitations at national level (Stuckenbruck, 2018). Much of the research and monitoring and evaluation focusses on systems-development programmes delivered by international agencies, rather than on national state-led child protection systems. In addition, there has been more focus on reporting on progress in the attainment of strengthening of systems rather than child protection outcomes (Kreuger et al, 2014). Indicators could include a quantitative increase in the reporting and/or resolution of child protection cases, qualitative or quantitative data on an increase in children’s identification of and resistance to abuse, and qualitative data indicating an increased community trust in mechanisms for the reporting and referral of child abuse. A SYSTEMS APPROACH TO EARLY CHILDHOOD DEVELOPMENT The very successful identification of systems for Child Protection was patterned to identify the set of coordinated components that work together to enable a nurturing early childhood environment that would both advance school readiness and prevent violence against children. These components expanded on the original seven building blocks or levers for change reported in the original approach and include: i) a strong legal and policy framework for child preparation for readiness and protection that is compliant with the UNCRC and other international good practice ii) adequate budget allocation iii) multi-sectoral coordination at different levels across government and between sectors iv) effective regulation, minimum standards, and oversight v) child-friendly preventive and responsive services vi) a skilled child development workforce, that is supervised and regulated vii) robust data on child readiness and violence against children, and good practices viii) responsiveness to parent’s and children’s voices and participation ix) an aware and supportive public This report provides information in these areas, followed by analyses of the existing systems and recommendations for addressing system gaps. REFERENCES Delaney S. and Quigley P., Shuteriqi M (2014). Understanding and applying a systems approach to child protection: a guide for programme staff. Terre des hommes/Child Frontiers (2014). Forbes B., Luu D., Oswald E. & Tutnjevic T. A Systems Approach to Child Protection. World Vision Discussion Paper, World Vision (2011). Joynes, C. & Mattingly, J. (2018) A systems approach to child protection. K4D Helpdesk Report. Brighton, UK: Institute of Development Studies. Katz I, Connolly M, Blunden H, Bates S, Hill T. (2018). Review of Child Protection Systems in Four Countries in South Asia. UNICEF Regional Office for South Asia: Kathmandu. Krueger, A., Thompstone, G. & Crispin,V. (2014). Learning from Child Protection Systems Mapping and Analysis in West Africa: Research and Policy Implications. University of Durham: Global Policy, Volume 5(1) 4 Pinheiro, P. S. (2006). World report on violence against children. United Nations. Save The Children (2008). A Rough Guide to Child Protection Systems (Draft). London: Save The Children. Save the Children (2010). Building Rights-based National Child Protection Systems: A concept paper to support Save the Children’s work (2010) Stuckenbruck, D. (2018). A Systems Approach to Child Protection: Reflections on process and opportunities for the future. Presentation. Oxford: Oxford Policy Management. Terre des Hommes (2011). Enhancing Child Protection Systems (2011). UNHCR EXCOM Conclusion on Children at Risk, No. 107 (LVIII) (2007). UNHCR (2010) Protecting Children of Concern through a Systems Approach: Guidance for Field Offices. UNICEF (2010) Child Protection Systems Mapping and Assessment Toolkit User Guide UNICEF, ‘Summary of Highlights (2008): UNICEF Global Child Protection Systems Mapping Workshop’ , Bucharest. UNICEF, UNHCR, Save the Children and World Vision (2013), A Better Way to Protect ALL Children: The Theory and Practice of Child Protection Systems, Conference Report, UNICEF. World Vision (2011). A Systems Approach to Child Protection: A World Vision discussion paper. Wulczyn F., Daro D., Fluke J., Feldman S., Glodek C., Lifanda K., (2010). Adapting a Systems Approach to Child Protection: Key Concepts and Considerations. New York: UNICEF. CHAPTER 3 A BACKGROUND TO JAMAICA THE LAND Jamaica is the third largest English speaking country in the Americas, behind the USA and Canada and the largest island of the Commonwealth Caribbean. Located in the Caribbean Sea, it is 140 km (90 miles) south of Cuba and 190 km (118 mi) west of Haiti (Fig. 3.1). At its greatest extent, Jamaica is 235 km (146 miles) long, and 84 km (52 miles), with an area of 10,911 km2 (4,213 square miles). Figure 3.1. Jamaica's Location in the Caribbean and the World Jamaica is a part of the Caribbean Community (CARICOM); the island gained Independence from Britain in 1962. The country is divided into 14 geo-political units known as parishes, the two most urban parishes, Kingston and St. Andrew function as a single unit. The capital city is Kingston, located in the parish of the same name, Kingston. From a mountainous interior the land descends to coastal plains with numerous rivers and beaches (Figure 3.2). The geography, along, with the tropical climate has made Jamaica a tourist attraction. The city of Montego Bay and the towns of Negril, Ocho Rios and Port Antonio are the major sites for tourism. Figure 3.2 Geo-Political Map of Jamaica THE ECONOMY The economy is Jamaica is highly reliant on the services sector, primarily consisting of a combination of remittances, tourism and mined bauxite and alumina. The economy has been growing slowly, but consistently, yet further growth is held back by the inflated public sector, and high rates of corruption, crime, and debt. Although it is less prominent now than it has been in the past, agriculture is still an important aspect of the Jamaican economy, with sugar being by far the most common export, followed by coffee, bananas, and cocoa. Jamaica’s GDP in 2018 was USD15.17 billion, and USD 5354.24 per capita. After decades of poor economic growth, Jamaica launched an economic reform programme in 2013. GDP growth moved from negative growth and below 1.0% to 1% in 2015 and 1.9% in 2018. Public debt fell below 100% of GDP in 2018/19 and the rate of unemployment also fell to a historic low of 7.2% in October 2019, which is almost half the rate at the start of the reform program. Poverty was expected to decline further with rising per-capita GDP, lower unemployment, and strengthened safety nets. However, this growth will likely be impacted by the Coronavirus epidemic currently negatively impacting world economies. THE PEOPLE The country conducts a census every ten years; the most recent was conducted in 2011. Using population projections, the population at the mid-year of 2018, based on the 2011 Census, was 2,727,503 (Statistical Institute of Jamaica). However, the World Bank World Development Indicators has the population of Jamaica at 2.93 million. A quarter of the population live in the most urban parishes of Kingston and St. Andrew. The majority of the population (96%) is of African descent, with minority groups such as Indians and Chinese, accounting for the remaining 4 %. The dominant religion is Christianity and the official language of the country is English. THE CHILDREN The population of children (i.e. those under the age of 18 years) is 718,540 or 26.3% of the total population. Children 6 years and under number 250,951 and account for 9.2% of the total population, and 34.9% of the child population (STATIN, accessed 2020). This has fallen from 10.3% of the total population in 2014, as a result of falling birth rates. There are 45,000 births per year, with 16% of births being less than 2,500g or of low birth weight (Multiple Indicator Cluster Survey, 2011). The neonatal mortality rate (deaths of children under the age of 28 days) is 10 per 1,000 live births; the infant mortality rate (deaths of children under the age of one year) is 10.9 per 1,000 live births and the under-five mortality rate is 14.4 per 1,000 live births (UNICEF, 2018). Immunisation coverage for three doses of DPT is 97% . The proportion of children 36 to 59 months attending an early childhood programme is 92%, but the adjusted net attendance rate one year before primary school is 99%. The adjusted net attendance rate for primary education is 98%, for lower secondary is 92% and for upper secondary is 76%. (Multiple Indicator Cluster Survey, 2011). HUMAN DEVELOPMENT THE HUMAN DEVELOPMENT INDEX The Human Development Index (HDI) was developed by the United Nations to measure countries' levels of social and economic development. It is composed of three principal areas of interest: education or access to knowledge (measured by mean years of schooling for adults and expected years of schooling for children), a long and healthy life (measured by life expectancy at birth) and an adequate standard of living (measured by Gross National Income (GNI) per capita). Countries/states are ranked in one of four categories: Very High, High, Medium or Low. According to the 2018 Human Development Report (United Nations Development Program,2018) Jamaica’s HDI is 0.726. This placed the country at 96 out of 189 countries on the Human Development Index (HDI) and in the high human development category, along with most other Caribbean countries. Since 1990, Jamaica’s HDI value has increased from 0.641 to 0.726, an increase of 13.2 per cent. (Figure 3.3). The main component responsible for the increase in the HDI is education. Life expectancy in 2018 was 74.4 years and there is universal access to primary school, and the early years of secondary school. Figure 3.3 Trends in Jamaica’s HDI component indices 1990-2018 THE HUMAN CAPITAL INDEX In 2018, the World Bank published the Human Capital Index (HCI) (World Bank, 2018). In contrast to the HDI, this measures the amount of human capital that a child born today can expect to attain by age 18. It conveys the productivity of the next generation of workers compared to a benchmark of complete education and full health. It is made up of five indicators: the probability of survival to age five, a child’s expected years of schooling, harmonized test scores as a measure of quality of learning, adult survival rate (fraction of 15-year olds that will survive to age 60), and the proportion of children who are not stunted. In 2017, Jamaica’s HCI was 0.54; this was slightly lower than the average for the Latin American and Caribbean (LAC region), and lower than the average for its income group. (Figure 3.4). Figure 3.4 also highlights the rankings by World Bank income status (Jamaica falls within the highlighted upper middle income countries). Figure 3.4 The Human Capital Index for Jamaica: Trends and Rankings The World Bank HCI (World Bank, 2018) indicates that 98 out of 100 children born in Jamaica will be able will survive to age 5 years, and 87% of 15-year olds will survive until 60. This statistic is a proxy for the range of fatal and non-fatal health outcomes that a child born today would experience as an adult under current conditions. Additionally, In terms of nutrition, or healthy growth, 94 out of 100 children are not stunted. However, the 6 out of every 100 children that are stunted are at risk of cognitive and physical limitations that can last a lifetime. The World Bank HCI indicators also provided additional educational statistics. A child who starts school at age 4 years in Jamaica can expect to complete 11.7 years of school by his/her 18th birthday. However, the Learning-adjusted Years of School, which factors in quality of learning, or what children actually learn, indicate the expected years of schooling to be equivalent to 7.2 years, a learning gap of 4.5 years (Figure 3. 5). There is an important sex difference; the learning gap is greater for boys who have expected years of schooling of 6.9, while girls have 7.7. Figure 3.5 Learning Adjusted Years of Schooling in Jamaica REFERENCES: Statistical Institute of Jamaica website. https://statinja.gov.jm. Accessed 22/06/2020 United Nations Development Programme. Human development report 2019. Beyond income, beyond averages, beyond today: inequalities in human development in the 21 st century. New York: UNDP; 2019. Available from: http://hdr.undp.org/en/2019-report/download World Bank. 2018. The Human Capital Project. World Bank, Washington, DC. https://openknowledge.worldbank.org/handle/10986/30498 License: CC BY 3.0 IGO. CHAPTER 4 A HISTORICAL BACKGROUND TO ECD JAMAICA The history of Early Childhood Development (ECD) in Jamaica is important to the understanding of the current context. This chapter commences its historical background begins with our current knowledge of the first known early childhood centres in Jamaica, and ends with the establishment of the Early Childhood Commission (ECC) and Jamaica’s first cross-sectoral National Strategic Plans (NSPs) for Early Childhood Development (ECD). ESTABLISHMENT OF EARLY CHILDHOOD CENTRES Roman Catholic Church records show that church “infant schools” were established from the 1800s. The first “play centre” was established by Rev. Henry Ward, in Islington, St. Mary in 1938. In the 1940s and 50s, economic realities forced women to work and play centres proliferated, providing care for the children of working women. Many schools were held in church halls on weekdays. In 1941, Rev. Ward, then a Board of Education member, submitted a proposal for the island-wide establishment of play centres and incorporation into the education programme. Guidelines for play centres were established, a government grant was recommended for centres which met minimum requirements and parents made weekly contributions. Government Support The Government accepted the report of the Ward Committee. In 1944, the Moyne Commission, which enquired into labour unrest in British Caribbean territories, recommended establishment of government infant centres. The first was established in 1946. Community schools continued to thrive, bolstered by community sponsors, and some government support and supervision. “Infant Centres” were located within two miles of primary schools; “Basic Schools” were more distant. In 1952, the first supervisor of Basic Schools was appointed by the Education Department and, in 1957, Infant and Basic Schools were first included in the Education Department’s Code of Regulations. In 1958, there were 26 Infant Schools and 336 Basic Schools. INTERNATIONAL RECOGNITION OF ECD In the 1960s, government funded pre-school education, “Head Start” programmes, was first provided to disadvantaged children in the USA, emanating from the Civil Rights Movement. In the 1970s and 1980s, research from the USA, particularly the Perry Pre-School Project, conclusively demonstrated positive social and educational impacts of a high quality EC programme for disadvantaged children, followed to the primary and teen years. This led to expansion of early childhood programmes in the USA, and significantly influenced other countries. THE ROLE OF THE UNIVERSITY OF THE WEST INDIES (UWI) In newly independent Jamaica, in the 1960s, research identified poor physical facilities at Basic Schools, but more importantly, limited teacher education. In 1966, the UWI Institute of Education, partnered with the then Ministry of Education (MOE) and the Bernard van Leer Foundation on the Programme for Early Childhood Education (PECE). Under the direction of D.R.B. Grant, this programme developed the first structured in-service training programme for Basic School teachers, a Jamaican children’s curriculum, a training programme for supervisors and established a professional teacher’s organization. Further Government Support When the PECE project ended in 1972, the EC section of the MOE continued the training programme. In 1975, salary subsidies and grants were first provided to Basic Schools. Infant Departments in primary and all-age schools were established subsequently. In 1976, Guidelines for the Management and Administration of Basic Schools, were developed by the MOE, establishing minimum criteria for recognition of schools and receipt of government subsidies. The Education Act (1980) was the first to include pre-primary schools, indicating government responsibility. This responsibility led to the upgrading of the EC section of the MOE to the Early Childhood Unit in 1990. ORGANISED COMMUNITY SUPPORT The 1976 document provided a structure for community support of individual schools by establishing local community representatives (Sponsoring Bodies), as the management arm of schools. Over time, a more organised system of community support developed. In the 1990s, basic schools were divided into zones by the MOE to facilitate teacher training sessions. Zone Action Committees (ZAC) were formed from which representatives were nominated to sit on Basic School Parish Boards, Parish Board members were selected to sit on the Jamaica Association of Basic School Parish Boards. A number of other organisations developed separately, but in 2000, these merged to form the Jamaica Early Childhood Association (JECA). Currently, there are 53 existing zones and ZAC and Parish Board structures exist under the umbrella of JECA. DAY CARE SERVICES Growing concern about the poor quality of services for children under 3 years led the Ministry of Health (MOH) to launch the National Day Care programme to provide Day Care centres in low income communities in 1975. Due to financial constraints and policy shifts, only 23 of the 50 centres were constructed, and many closed subsequently. The number of Government funded Day Care Centres decreased with time. By 2012, there were only 12 such centres in operation. THE CONCEPT OF INTEGRATION A series of research reports in 1984, 1993 and 1995 identified inadequately trained teachers, inappropriate instructional methods and unsuitable learning environments in both Day Care and Basic Schools. These findings spurred a broad group of EC advocates to form a Task Force to improve EC quality through an integrated approach. The Task Force, in 1997, became the Integration Advisory Committee (IAC) of the MOE. There was limited financial and administrative support for the integration process. Despite this, among the successes of the IAC were the 1998 transfer of Day Care Services from MOH to MOE and sensitization on the importance of quality ECD. Regionally, the 1997 CARICOM Caribbean Plan of Action for Early Childhood Care, Education and Development, provided a comprehensive framework for improving EC services. Each country was expected to develop its National Plan of Action (NPA) from this framework The Jamaican NPA was developed, but was never adopted by Parliament and was not implemented. ESTABLISHMENT OF THE EARLY CHILDHOOD COMMISSION (ECC) The Planning Institute of Jamaica (PIOJ) commissioned a Strategic Review of the EC Sector by KPMG. The 2001 review reported that all elements of a comprehensive EC programme existed, but there was poor co-ordination, duplication and inefficiency. The establishment of a national, inter-ministerial, inter- sectoral, advisory and regulatory co-ordinating body was recommended. The review findings were supported by the IAC and the MOE, and in March 2003, the Early Childhood Commission (ECC) Act was passed by Parliament. This Act established the ECC as the co-ordinating body for ECD in Jamaica. The legislated functions of the ECC include advising Cabinet on ECD policy matters; preparation, monitoring and evaluation of plans and programmes; co-ordination; consultation with stakeholders; making recommendations for budgetary allocation; identifying alternative financing; regulating ECIs; conducting research and public education. The ECC held its first meeting of Commissioners in November 2003, and began charting the way forward. All existing information was reviewed including international research, the NPA for ECD and the KPMG Strategic Review. Two new reports were also to influence the ECC. The Government’s Task Force Report on Educational Reform for ECD (2004) made recommendations for governance and management; curriculum, teaching and learning support; stakeholder participation and finance. The Profiles Project Report (2005) documented the impact of a variety of home, school and community factors on young children’s learning and behaviour and recommended that interventions needed to be comprehensive and to commence early. The National Strategic Plans (NSPs) for ECD Using all available information, and consultation with stakeholders, a comprehensive cross-sectoral NSP for ECD was developed for the period 2008-2013, with technical and financial support from the World Bank. The 2008 NSP, based on the life cycle approach, had five key processes: 1) parenting, education and support; 2) preventive health care; 3) screening early identification and referral for at-risk children and households; 4) safe, learner-centred, well-maintained ECIs; and 5) effective curriculum delivery by trained early childhood practitioners. These were supported by two organizational processes: 1) sector agencies operating together 2) information to support evidence-based decision-making. NSP implementation was governed by a results-oriented framework, with annual targets to be achieved by sector agencies. The NSP was strongly supported by local and international development partners. These processes were represented in a public education leaflet, showing how the processes would be integrated across sectors (Figure 4.1 below) Figure 4.1 National Strategic Plan Leaflet The estimated investment of the Government of Jamaica on early childhood development per year, in the health, social and education sectors prior to the NSP was USD 73 million. Full implementation of the NSP would result in an additional USD 17 million per year over the five-year period. The existence of the NSP allowed for streamlining of funding for the ECD sector in Jamaica. A World Bank loan of USD 15 million financed approximately 22% of the additional investment proposed by the NSP, through a results-based framework. Off-budget funding, external sources of funding and donor contributions were expected to account for an estimated USD 5,4 million, or 8% of the cost of the NSP. Early Successes and Challenges The establishment of the ECC has had a number of successes: the ECC is now fully recognised as the government agency for all EC matters. Standards for ECIs were established in law, with the passage of the Early Childhood Act and Regulations in 2005. This heralded the development of a system of inspection and regulatory and monitoring system for the 2,700 ECIs. This also allowed for continuous, comprehensive collection of information for planning and intervention at the ECI level. Cross-sectoral co-ordination was being effected and the NSP has allowed for focus and channelling of donor funds towards agreed ECD goals. However, there have been administrative, human resource and financial challenges that have delayed goals being achieved. Despite these, in collaboration with sector partners (MOH, MLSS,STATIN, Heart NTA, DGMT, UWI and others), the first NSP (2008-2013) had a number of accomplishments. Continued investment by the Government of Jamaica, financing by the World Bank and funding from external donors allowed funded continuation of the unfinished and follow-on work from the first NSP into 2013 to 2018. Among the accomplishments and outputs of the NSPs were the development of Jamaica’s National Parenting Policy and National Parenting Strategy (which led to the establishment of the National Parent Support Commission), the development of the Child Health and Development Passport, a health and development record which is issued to every child at birth; a nutrition strategy for children 4-6 years; development of menus, recipes and nutrition manuals for ECIs; development of a family risk screening tool for early identification of children and families at risk; development of the Child Development Therapy Programme (UWI), to provide trained professionals to support children with special needs; upgrading and development of new ECD vocational programmes and new training opportunities; development of new child centred curricula for children 0-2 years and 3-5 years with training provided to practitioners island- wide; GIS mapping of ECIs and a module for the monitoring of young children’s development included in the Jamaica Survey of Living Conditions. In the area of management, all functions of the Early Childhood Unit of the MoE were transferred to the ECC. Development Officers employed to the ECC now provide development support to ECIs specifically focused on attaining established ECI standards. IMPORTANCE OF THE HISTORY OF ECD The history of the EC sector explains the strengths and challenges today. The strengths include strong community involvement; high access rates; the supportive role of churches, the distinction between Basic and Infant Schools, and Day Care and Basic Schools; the importance of advocacy; the contribution of the UWI and the support of local and international development partners. The persisting challenges include adequate parent and development support for children 0-2 years, achieving quality in ECI for children 3- 5 years, thereby enhancing readiness for primary school, and protecting children from violence. Violence prevention was not a named main strategy of the NSP, but family violence was expected to be reduced through parenting support and identification and intervention for families at risk. The author wishes to acknowledge the use of information from “The Early Childhood Movement in Jamaica” (2004) by Daley and Thompson , especially in the contribution to the documentation of the very early history of ECD. CHAPTER 5 LEGAL AND POLICY FRAMEWORK FOR EARLY CHILDHOOD DEVELOPMENT Jamaica’s legal and policy approach to young children is documented in international agreements and conventions, national development plans, policy documents, legislation and strategic plans. INTERNATIONAL AGENDA: THE SUSTAINABLE DEVELOPMENT GOALS In September 2015, the UN General Assembly adopted the 2030 Agenda for Sustainable Development that includes 17 Sustainable Development Goals (SDGs) (Figure 5.1). The 17 goals have 169 targets and 230 individual indicators to monitor progress towards the goals. The SDGs replace the Millennium Development Goals (MDGs) and emphasise a holistic approach to achieving sustainable development for all. The SDGs and the 2030 Agenda are not legally binding, as are UN Conventions. Rather they are a political vision for a better world to be achieved by 2030. Figure 5.1 The Seventeen Sustainable Development Goals The Sustainable Development Goals will not be achieved unless significant attention is paid to ECD. While every goal has an impact on ECD, five specific goals have been identified as being critical to ECD. Goal 1, target 1.2: by 2030, reduce at least by half the proportion of men, women and children of all ages living in poverty in all its dimensions according to national definitions. Goal 2, target 2.2: By 2030, end hunger and ensure access by all people, in particular the poor and people in vulnerable situations, including infants to safe, nutritious and sufficient food all year round. Goal 3, target 3.2: By 2030, and preventable death of newborns and children under-5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1000 live births and under-5 mortality to at least as low as 25 per 1000 live births Goal 4, target 4.2 By 2030, ensure that all girls and boys have access to quality early childhood development, care and- primary education so that they are ready for primary education. In addition, Goal 4 focusses on inclusive and equitable quality education, equal access to all levels of education, including persons with disabilities; and building and upgrading education facilities that are child, disability and gender sensitive and providing safe, non-violent, inclusive and effective learning environments for all. Goal 16; target 16.2: By 2030, end abuse, exploitation, trafficking and all forms of violence against, and torture of, children. Jamaica established a national coordination mechanism, the National 2030 Agenda Oversight Committee (NAOC) in 2017 to provide policy and strategic level advice for the implementation, monitoring and evaluation of the SDGs. The NAOC is chaired by the Director General of the Planning Institute of Jamaica (PIOJ), its secretariat has been established in the PIOJ and it reports to the Cabinet. The NAOC includes Working Groups of Vision 2030 Jamaica (see below) and other sector specific committees, the 2030 Agenda SDGs Core Group and high-level representatives from government, civil society groups, private sector, academia, trade unions, political directorate and youth. Jamaica produced its first Voluntary National Review Report on the Implementation of the 2030 Agenda for Sustainable Development in June 2018. INTERNATIONAL CONVENTIONS: UN CONVENTION ON THE RIGHTS OF THE CHILD (UNCRC) AND UN CONVENTION ON THE RIGHTS OF PERSONS WITH DISABILITIES (UNCRPD) UNCRC The promotion and protection of the rights of children, including young children, is enshrined in the UN Convention on the Rights of the Child (UNCRC. Jamaica signed the Convention on January 26, 1990, and ratified it on May 14, 1991. Ratification made the UNCRC binding law in the country. and ratified by Jamaica in 1989. Jamaica signed and ratified the United Nations Convention on the Rights of Persons with Disabilities (CRPD) in March 2007. Jamaica was the first country to sign and ratify the UNCRPD. The UNCRC, does not specifically mention the rights of very young children; their rights are included in mentions of all children. However, in order to ensure awareness of the rights of very young children, General Comment 7, Implementing Child Rights in Early Childhood was produced. General Comments are documents that provide interpretations of the human rights provisions in various conventions. In 2007 Jamaica, through the Early Childhood Commission, and in collaboration with the Bernard van Leer Foundation and the UN Committee on the Rights of the Child (UNCRC) undertook a project, the goal of which was to develop an understanding of the distribution and dissemination process of General Comment 7; the mechanisms for its implementation and to determine the gaps which may exist between its intent and reality. The project produced two publications. The first was a technical report entitled “The Status of the Rights of the Young Child” which not only reported on the status of child rights for young children, but which also developed indicators for monitoring these rights. For each article, there was a Summary, an interpretation of the Article for the early childhood sector; Law, Policy and Programme Status; Gaps in Law, Policy and Programme Status and Recommended Indicators (Early Childhood Commission. The example of Article 19, Protection from Abuse & Neglect is excerpted below: Article No. 19 Protection from abuse and neglect Summary: The State shall protect the child from all forms of maltreatment by parents or others responsible for the care of the child and establish appropriate social programmes for the prevention of abuse and the treatment of victims. Interpretation for Early Childhood: Young children are frequent victims of neglect, maltreatment and abuse, including physical and mental violence. Abuse very often happens within families, which can be especially destructive. Young children are least able to avoid or resist, least able to comprehend what is happening and least able to seek the protection of others. There is compelling evidence that trauma as a result of neglect and abuse has negative impacts on development, including, for the very youngest children, measurable effects on processes of brain maturation. Bearing in mind the prevalence of abuse and neglect in early childhood and the evidence that it has long term repercussions, States parties should take all necessary measures to safeguard young children at risk and offer protection to victims of abuse, taking positive steps to support their recovery from trauma while avoiding stigmatisation for the violations they have suffered. Law, Policy and Programme Status in Jamaica The Offences Against the Persons Act and the Child Care and Protection Act together identify physical or bodily abuse, ill treatment and emotional abuse (including cruelty and neglect); sexual abuse; offences against the person (including aggravated assaults) and administrative offences (including unauthorised disclosure of reports relating to children) as offences committed against children and punishable by law. The Child Care and Protection Act also describes reporting, referral and investigative procedures and identifies the roles of professionals, State agencies and civil society. The Early Childhood Act bans corporal punishment in early childhood institutions where children under 6 years attend. Corporal punishment is also banned in children’s homes under the Child Care and Protection Act The Violence Prevention Alliance, a body bringing together experts in the area of violence prevention, was formed in 2004, under the auspices of the Ministry of Health. A draft National Plan of Action for the Prevention of Violence against Children was developed in 2005, spearheaded by the Planning Institute of Jamaica. The plan is awaiting cabinet discussions. There is a Jamaica Injury Surveillance System (JISS), under the direction of the Ministry of Health which has sentinel sites for data collection at hospitals throughout the country. Gaps in Law, Policy and Programme Status The National Plan of Action has not yet been implemented. Many parenting support and education programmes may not be sensitive to the prevention of and protection from abuse and neglect. Corporal punishment is not banned in homes or at primary level schooling where young children six to eight years attend. Recommended Indicator(s) to assess Effectiveness of Law, Policy and Programmes: Prevalence of reported cases of child physical abuse, emotional abuse and neglect Proportion of child physical abuse, emotional abuse and neglect cases seen at Child Guidance Clinics Prevalence of corporal punishment use in the home Prevalence of corporal punishment use at school Prevalence of exposure to domestic violence Prevalence of exposure to community violence Prevalence of child murders Gaps in Law, Policy and Programme Effectiveness Jamaica Injury Surveillance System (JISS) collects data on abuse and violent injuries from sentinel hospital sites. The Jamaica Constabulary Force (JCF) collects data on sexual assault, shootings and murder. There is conflicting data from these sources. Data from the JCF show decreasing numbers of victims of sexual assault 0-8 years between 2000 and 2005; data from the JISS shows no change in hospital emergency visits for sexual assault from 2002 to 2004. Child abuse (primarily cases of child sexual abuse) form 15-20% of cases seen at Child Guidance Clinics. There is no trend data available for corporal punishment use among young children at home. A cross-sectional survey reported 31% of 6 year olds being spanked and 13% beaten with an object (Samms-Vaughan, 2005). There is no available data for corporal punishment use among young children at school, but anecdotal reports suggest widespread use. There is no trend data for exposure to community and domestic violence, but a cross-sectional survey reported 70% of 6 year olds observing fighting, 36.5% observing stabbing and 24.5% observing shooting; 30.8% have observed adults hit each other at home and 29.6% have observed shouting (Samms-Vaughan, 2005). Between 12 and 15 young children are murdered each year. The existing data show huge gaps in law, policy and programme effectiveness. The second publication entitled “We have Rights Too” was a user friendly guide to effecting the rights of young children, with tips for parents and guardians, early childhood professionals, community members and policy makers on assisting young children to attain their rights. The Article 23 page is displayed below. This publication was circulated to all early childhood institutions, teachers’ colleges and all public libraries in Jamaica. Figure 5.2 “We Have Rights Too“ Cover Page and Page 27, Articles No. 28 and 29 One group of children specifically mentioned in the UNCRC is children with disabilities (CWD). Article 2, the right to non-discrimination, is one of the four articles identified as general principles, and includes disability as one of those situations for protection from discrimination. Article 23, which indicates the special efforts to be made by countries, states that children who have any kind of disability have the right to special care and support, as well as all the rights in the Convention, so that they can live full and independent lives. Articles 7 and 26 of the UNCRPD specifically address the needs of children with disabilities. Article 7, Children with Disabilities, states that countries should use all means necessary to ensure that children with disabilities fully enjoy all the human rights and fundamental freedoms on an equal basis with other children; in all actions, the best interests of the child shall be a primary consideration and that children with disabilities have the right to express their views freely on all matters affecting them, their views being given due weight in accordance with their age and maturity, on an equal basis with others. Article 26, Habilitation and Rehabilitation, states that countries should take measures to enable persons with disabilities to attain and maintain maximum independence, full physical, mental, social and vocational ability, and full inclusion and participation in all aspects of life. In order to do this, countries should organize, strengthen and extend comprehensive habilitation and rehabilitation services and programmes, particularly in the areas of health, employment, education and social services, in such a way that these services and programmes begin at the earliest stage possible, are based on multidisciplinary assessments of individual needs and strengths and support participation and inclusion in communities and all aspects of society. Countries should also promote the development of initial and continuing training for professionals and staff working in habilitation and rehabilitation services, and promote the availability, knowledge and use of assistive devices and technologies, designed for persons with disabilities, as they relate to habilitation and rehabilitation. JAMAICA’S NATION AL PLAN: THE VISION 2030 NATIONAL DEVELOPMENT PLAN Jamaica developed a National Development Plan, known as Vision 2030, aimed at transforming Jamaica into a developed nation by 2030. The National Plan has 4 goals and ten outcomes (Figure 5.3). Figure 5.3 Vision 2030 Goals and Outcomes The Vision2030 National Development Plan is housed at, and co-ordinated by the Planning Institute of Jamaica (PIOJ). It was launched in October 2007. Vision 2030 was developed when the international goals were the Millennium Development Goals (MDGs), and preceded the SDGs. However, the PIOJ has aligned the sector plans with the SDGs. While all aspects of the National Goals and Outcomes would have some impact on ECD, those most relevant to the focus of this report would be Number 2, World Class Education and Training, and Number 5, Security and Safety. The Key Actions for children 0-8 years largely mirror the strategic objectives and actions of the NSP, and would advance children’s readiness. Outcome 2 makes specific reference to the early childhood sector, and indicates the ECC as one of the responsible agencies. In Outcome 5, violence against children is not specifically mentioned; one national strategy is to strengthen the capacity of communities to participate in creating a safe and secure society. Others are focussed on youth violence and improving police responses. Figure 5.4 National Outcomes for World Class Education and Training: Key Strategies and Outcomes 2009-12 NATIONAL POLICIES: THE NATIONAL PARENT SUPPORT POLICY Jamaica’s National Parent Support Policy (NPSP, 2012), was a direct outcome of the first strategic objective of the National Strategic Plan for ECD (see below) developed by the Early Childhood Commission (ECC): “Effective parenting education and support”. The ECC acknowledged the importance of parenting to early childhood development and beyond, and in early 2005, recommended the development of a parenting policy to guide national parenting activities. The goal of the policy was to provide parents and caregivers with accessible and high-quality parenting education and support, allowing for optimal development of children Two major decisions were made: the policy would provide support to all parents, not only to those at risk, and it would not be punitive but rather, would be supportive. The NPSP articulates five specific goals:  all Jamaicans make wise choices about becoming parents and make parenting a priority;  all Jamaican children are loved, nurtured and protected instinctively and unconditionally by their parents;  each parent understands and uses or applies positive practices in effective parenting;  an enabling institutional framework exists to support parenting  ensuring that the principles and implications of effective parenting are communicated to the public in user-friendly ways that enable comprehension of the material. Goals 2 and 3 are particularly important in protection of children from violence. Additionally, the policy identifies ‘vulnerable groups’ as needing particular support. These include teen parents, single parents, parents with disabilities, parents of children with disabilities, parents experiencing high levels of stress, parents of children in the care of the state and/or who are in conflict with the law, families involving parents who have migrated or moved leaving children behind, families in extreme conditions of poverty and fathers. Though children in conflict with the law are not relevant to the early childhood age group, all other groups are in situations of higher levels of stress, when family violence and impaired readiness of children for school occur. The development of Parents’ Places was the core strategy to implement the NPSP. This strategy was the product of several consultations carried out by the ECC with a wide group of stakeholders. A ‘Parents’ place can be defined as a ‘one-stop shop’ in or near major communities, which offer a comfortable and attractive place for parents to receive information, to attend courses and workshops, to receive mentoring, participate in recreational activities and income-support training and, when possible provide parenting and family support diagnostic and therapeutic services. Parents’ places are normally set up in existing infrastructure, such as schools, health centres and libraries. The Government of Jamaica (GOJ) established the National Parent Support Commission (NPSC) in 2012 to effect the NPSP. THE EARLY CHILDHOOD DEVELOPMENT POLICY A draft Early Childhood Development Policy was developed in 2018, but has not yet completed consultations or had the approval of the Cabinet. All thirteen objectives below are relevant to preparing children to be ready for school; only one, the third, is focussed on protection from violence. The specific policy objectives are:  To enhance the physical, social, cognitive, psychological and cultural development of young children from birth to eight years of age.  To improve infant mortality and child survival rate  To ensure that children are protected from all forms of abuse and neglect and that their rights are fully observed.  To enhance the role of parents, caregivers, and families as primary caregivers and educators for children birth to eight years of age.  To enhance the capacity of families and communities to actively participate in family planned activities and programmes geared towards promoting optimal early childhood development.  To ensure that disadvantaged children and children with special needs have equal access to quality and inclusive public education, health care and social services.  To ensure the early detection, prevention, intervention treatment, care and services for children with special needs, while placing emphasis on inclusiveness as well as family/community support.  To facilitate the smooth transition of children from care and education programmes provided at home to day-care and then on to a school-based setting at the pre-primary levels and to primary levels from pre-school and through the first grades of primary school.  To enhance the quality and equity of access to preschool education across the country.  To improve the system for monitoring compliance with the provisions of this policy and any related rules and regulations established for similar purposes.  To enhance the capacity of service providers to comply with quality standards and corresponding regulations in the early childhood development sector.  To ensure that children have access to day-care services and receive adequate care to promote development.  To ensure that children get proper nutrition necessary for optimum growth and development. JAMAICAN LAWS RELEVANT TO YOUNG CHILDREN: EARLY CHILDHOOD ACT AND DISABILITIES ACT Two laws in Jamaica are directly relevant to young children with disabilities. The Early Childhood Act and its attendant Regulations (2005) indicate the functions of the ECC in the regulation of Early Childhood Institutions (ECIs), i.e. pre-schools and nurseries for children under the age of 6 years. These pieces of legislation are comprehensive, but in the context of school readiness, they specifically require early childhood professionals working in ECIs to be of good character, to be adequately trained to work with children, to be able to deliver age-appropriate developmental and educational programmes to typically developing children and children with developmental disabilities, and to engage regularly with parents. With regard to protection from violence, the Early Childhood Act bans corporal punishment in schools, and supports a classroom environment that promotes pro-social behaviours. The comprehensive Disabilities Act was passed by the Jamaican Parliament in 2014; but has not yet been implemented. The Ministry of Labour and Social Security stated its intention to implement the Disabilities Act in Financial Year 2019-2020. The Disabilities Act addresses freedom from discrimination; the rights to education and training, employment, political office and public life, health care and facilities and access to premises and housing and public passenger vehicles. The Act allows for the development of attendant Disabilities Regulations, the Codes of Practice to Protect Persons with Disabilities and establishes the Disabilities Rights Tribunal and the Jamaica Council for Persons with Disabilities (JCPD). The Disabilities Regulations are currently being finalised. The Disabilities Act, while very comprehensive, does not make any special reference to children. STRATEGIC PLANS: EARLY CHILDHOOD COMMISSION NATIONAL STRATEGIC PLAN FOR ECD Jamaica, through the Early Childhood Commission (ECC), developed its first National Strategic Plan (NSP) for ECD for the period 2008-2013. The second plan 2013-2018 continued the five strategic objectives of the first and concluded recently. The 2018-2023 plan is being finalised but generally follows the same strategic objectives. There are six strategic objectives: NSP FOR ECD STRATEGIC OBJECTIVES  Objective 1: Effective parenting education and support for early childhood development  Objective 2: Effective preventive health care and nutrition for 0-6 year olds  Objective 3: Early and effective screening, diagnosis and early intervention for at-risk children and households  Objective 4: Safe, learner-centred, well-maintained ECI facilities  Objective 5: Effective curriculum delivery by trained EC practitioners  Objective 6: The sector and sector agencies are governed by frameworks that promote achieving results in a consultative environment and all sector institutions are achieving targets  Objective 7: Timely, clear, current, appropriate, evidence-based information to support ECD All objectives are relevant to facilitating and supporting children’s readiness for school. As indicated earlier, there is no specific strategic objective that addresses violence against children. Objective 1, providing parenting support, and Objective 4, ensuring adequate ECI facilities for children and banning corporal punishment addresses aspects of violence against children. REFERENCES: Early Childhood Commission Publication. We Have Rights Too: A Guide to General Comment 7:Implementing Child Rights in Early Childhood Ed. Samms-Vaughan ME. 2008. Early Childhood Commission Publication. The Status of the Rights of the Young Child in Jamaica. A report prepared to inform the Active Dissemination Process of General Comment 7 (of the UNCRC) in Jamaica. Ed. Samms-Vaughan ME. 2008. Early Childhood Commission Publication. A Reader Friendly Guide to The National Strategic Plan for Early Childhood Development in Jamaica 2008-2013. Ed. Samms-Vaughan ME. 2007. Planning Institute of Jamaica Publication. Vision 2030: Jamaica’s National Development Plan. CHAPTER 6 INFORMATION FROM FOCUS GROUPS THE IMPORTANCE OF FOCUS GROUPS Policies are developed, usually with public consultation; laws are passed and then promulgated. Plans and programmes are then developed to give implementation and effect to laws and policies. However, how the public perceives the implementation of laws and policies is best determined by obtaining information directly. Focus groups allow for in-depth interrogation of a few carefully chosen questions, but they also allow participants to fully express themselves, as compared to questionnaires with limited opportunity for expanded responses. FOCUS GROUP METHODOLOGY Focus groups were conducted with end users of the ECD system, parents and teachers, to obtain perceptions of coverage, equity, quality and efficiency and identification of programme gaps. A total of three focus groups was held; two parent focus groups and one teacher focus groups. All focus groups were held face to face and each participant completed and signed a consent form which outlined the purpose of the focus group. The consent form highlighted that participation was voluntary, that all information obtained would be held confidential, and that participation involved minimal risk. It also sought permission to audio tape the session. Each participant was given a copy of the consent form. PARENT FOCUS GROUPS The parent focus groups were completed on September 19, 2019 and November 21, 2019. One September 19th there were four participants; three females and one male. On November 21st, there were two parents, both females. VIOLENCE Definition and Demographic Associations Most parents agreed that violence includes physical, mental and verbal abuse. A parent also commented on other forms of violence that children experience including bullying both in schools and extortion on public transportation. Parents did not think violence was innate; all felt it was a learnt behaviour. Some believed that men and women were equally violent. However, males were targeted for involvement with more violent groups such as gangs, as gangs were more interested in recruiting young men from an early age. All parents agreed on the importance of parents in raising both males and females with similar values, morals and respect for rules and societal laws. Corporal Punishment A half of parents agreed that corporal punishment was a form violence that could be counterproductive for children. The other half disagreed and argued that corporal punishment is necessary for children stating that it helps to ‘correct’ their behaviour and steer them in the right direction. A parent advised of the importance of an explanation accompanying the corporal punishment; she thought it was necessary that children understood the reason for the punishment. Media and Violence All parents agreed that the media was a negative influence on children. They believed that with the advent of the internet and less supervision of children with gadgets and devices, children are listening and watching more violent content. Consequences of exposure to violence All parents agreed on the negative and harmful effects of exposure to violence whether at school, at home or in the community. They agreed that exposure to violence negatively affects children’s self –esteem, academic performance, social life and mental health. However, they also believed that policies and programmes can be implemented to help children exposed to violence. Identification of programme gaps Most parents agreed that the government is trying and has tried to minimized children’s exposure to violence. However, they identified gaps in the system, these include: 1. Limited number of programmes 2. Limited availability of programmes. 3. Limited buy-in from parents, schools and children. 4. Lack of sustainability of good programmes. 5. Absence of mentorship of young people, especially mentorship of males. 6. Corruption within social development programmes. All parents agreed that both males and females need guidance on violence prevention. They identified programmes that could assist with this, these included: 1. Implementation of programmes by non-governmental agencies 2. Early introduction of STEM programmes e.g. robotics. 3. Introduction of entrepreneurship programme earlier in schools. 4. Incorporating a culture of discipline from home, school, church and community. 5. Introduction of mandatory skills training for all adolescents 6. Resocialization of young people. SCHOOL READINESS Definition All parents defined school readiness as the home and school being equipped for the child’s enrolment at school. They agreed that school readiness from the home perspective meant the child needed proper socialization (self-help skills, knowledge of social rules) and basic personal knowledge ( e.g. name, age and address.); and school readiness from the school perspective meant that children were exposed to an educationally sound academic curriculum by teachers who are well trained, loving, kind and gentle . Teacher Training All parents agreed that early childhood teachers needed more training. In particular, they agreed on the importance of teachers being trained in Special Education and/or being equipped to identify children with behavioural, developmental and social and emotional disabilities. The parents also agreed on the importance of learning through play. Many parents recognized schools as controlled environments that help children to be creative, investigative and curious. They agreed that teachers needed to be more relaxed with teaching younger children many concepts and thought they should focus more on learning through play. Role of the Community All parents agreed on the importance of the community members assisting the family with children. All parents commented on their own experiences during their childhood when communities were close knit and neighbours were genuinely concerned about the well-being of all children in the community. Identification of programmes gap While parents thought school readiness was important they were unable to identify any programmes being offered by governmental or non-governmental agencies to promote school readiness. This meant they were unable to identify any programme gaps. Implementation of programmes Parents would like to see more parenting programmes implemented to guide parents on supporting their children’s development throughout the period of childhood, infancy, toddlerhood, early childhood and adolescence. All parents agreed that the implementation of free parenting class would greatly assist both teenage mothers as well as older mothers. Jamaica School Readiness Assessment (JSRA) Only one parent was aware of the JSRA, the others were hearing about it for the very first time. No one reported being aware of it ; they had never ever received results and therefore they were unable to comment on its usefulness. All parents thought it was important for children to be assessed at an early age. However, they specified the following about these assessments: 1. Tests should be age appropriate. 2. Results should be returned to parents in a timely manner. 3. Results should be interpreted and written at a level that all parents would be able to understand. 4. Results should be accompanied by activities to stimulate development. TEACHER FOCUS GROUP The focus group was held on November 22, 2019 and consisted of Education professionals, primarily Early Childhood teachers. There were four teachers, all participants were female. At the start of the focus group session, participants were asked to complete a demographic form. This form requested basic information on participants such as their name, gender, age, organization and contact information. It also elicited information on job title and function, years of experience, professional qualification and experience working with children. It also asked participants to detail any training that they had received in working with children with disabilities and their families. SCHOOL READINESS All the teachers in the focus group believed that school readiness begins at home. They believed that school readiness was more than academics; it included numeracy and literacy, but also included learning basic self-help skills. The teachers agreed that school readiness is important to children’s academic success. Principals and teachers should promote school readiness by facilitating learning, organizing the classroom space, creating an atmosphere of learning, encouraging creativity and reinforcing concepts. They all agreed that home, school and community were all responsible for aspects of school readiness. Core Aspects of School Readiness The core aspects of school readiness identified were: 1. Socialization – teaching children how to behave in different environments 2. Approach to learning – Encouraging children to be curious However, they also thought the use of behaviour modification techniques (rewards and punishment) to manage children’s behaviour, and good nutrition at home and at school were important supports to school readiness. School Policies on Readiness The teachers from the focus group were unaware of any school policies on school readiness. A few commented on a requirement for children to be toilet trained and to be able to communicate verbally prior to school entry. Participants were also unaware of any national policies governing school readiness. However, a teacher commented that the Early Childhood Commission rules were visible in her classroom. Quality and Efficiency of Early Childhood Services All teachers agreed that improvements could be made to the quality and efficiency of the services being provided by schools. The improvements that were required were as follows: 1. Need for additional classroom resources. Teachers believes materials to make charts and other learning materials should be subsidised by the government or the school board. 2. An increase in the number of teachers 3. An increase in the salary for all teachers, irrespective of level and training. 4. Reduction in the numbers of lesson plans required on a daily basis. 5. Reduction in the teacher to pupil ratio. Role of the Early Childhood Commission All the teachers were able to state the role of the Early Childhood Commission as the governing body with responsibility for setting the rules and regulations for Early Childhood Institutions. They also identified the ECC as a liaison between the Ministry of Education and the schools. However, they did not believe that some of the programmes being implemented by the ECC were culturally appropriate for the Jamaican population. VIOLENCE AGAINST CHILDREN Definitions The teachers believed that violence significantly disrupts children’s lives. They listed verbal and physical abuse as forms of violence but they also included corporal punishment as violence and stated that “it’s wrong; no form of violence should be practiced in schools.” They believe that violence is a learnt behaviour and the media, especially music played on the radio and cartoons being watched by children, contains violent content. Two teachers identified themselves as mediators within the schools; they help parents to resolve conflicts. Violence Reduction Programme A few teachers reported being aware of violence reduction programmes within their schools and communities. The teachers suggested the following components as key factors in a violence reduction programme: 1. Implementing violence reduction training programmes for everyone involved, including parents, children and teachers. 2. Censorship for the media – there should be monthly reviews of the content being aired on television and radio. 3. Implementation of restrictions of internet content. 4. Engagement of children in communities – schools could host special treats for the children in their communities. CHAPTER 7 INFORMATION ON READINESS AND EXPOSURE TO VIOLENCE FROM A NATIONAL SURVEY : SURVEY METHODOLOGY MATERIALS AND METHODS Study Design The Jamaican Birth Cohort Study 2011 (familiarly known as JA KIDS) is a comprehensive, population based, national longitudinal study of children and their parents. Mothers of children born in the period July 1 to September 30, 2011 across Jamaica were enrolled in the antenatal period and at birth, and either the entire cohort (n=9,600) or sub-samples followed at contact points at 7-9 months, 18-22 months and 4-5 years. Please see Appendix 1 attached for details of contacts of the first two phases of this study. All contacts assessed family health and well-being, family structure and function and assessed children’s development and behaviour, either through questionnaires or use of standardised tests. Biological samples (saliva) were also collected from a sub-set of parents. This ELP study, known as JA KIDS Phase 3 (JUNIOR JA KIDS) continued the longitudinal cohort study design and planned to evaluate a randomly selected 600 children of the JA KIDS parents, born after the 2011 child, specifically those between 2 and 6 years old, for exposure to violence and its impacts, and to evaluate factors promoting and preventing adequate school readiness. Study Period The study commenced enrolment of mothers/primary caregivers in June – November 2019. Data collection aspects will cease in November 2019, but administrative and academic aspects of the study will continue until June 2020. Study Population The study population included JUNIOR JA KIDS, 2-6 years old, their families and their teachers. Our data collected at our 4-5-year contact in 2017, indicated that 23.6% of our sample of 1315 mothers (n=310) had younger children. The estimated number of younger children from our total JA KIDS sample of 9,700 is 2,266. From this population, a sub-sample of 600 children and their parents will be randomly selected for detailed evaluations that are not technically or financially feasible on the full population. Study Sites The study included participants from all fourteen parishes in Jamaica. Study sites were established at major cities/towns across Jamaica, as done in the earlier phases of the JAKIDS study to facilitate participation. Survey Data Collection Recruitment / Enrolment: Study participants were recruited from our existing database. At all contacts, including the birth contact and the most recent 4-5-year contact, the consent forms indicated that the study was a longitudinal one and had specific text requesting permission to contact those enrolled or other family members for future studies. “Other family members” was included as participants were requested to provide five telephone numbers for contact, including two or three for family members that would always know where to locate them. Study participants were recruited from all those who agreed to be contacted further (over 99%). Study participants included mothers/primary caregivers, children and their teachers. Our previous research with children in Jamaica has found that the child’s biological mother is the primary caregiver in 90% of cases, with grandmother being the second most common at about 8%. On contact, study participants were advised of the study, and invited to participate. Enquiry was made of the number and ages of younger children. Families were advised of the randomisation process and that only a sub-set would be subsequently contacted. Once families provided telephone consent, the status of the original JA KID (JA KID1) was enquired of as in Section H of the questionnaire (See Appendix 2 for the questionnaire). Once the total number of eligible participants was determined, a randomisation process was undertaken to identify 600 participants. Participants were contacted and asked to attend locations across the country for interviews and child assessments, as done with the earlier phases of the JA KIDS study. Parents were asked to take behaviour questionnaires to their children’s schools/teachers for completion as is typically done in a clinical setting. Stamped self-addressed envelopes were provided for their return to the study office. Study Instruments In order to study the environments in which young children grow and develop in a comprehensive manner, a battery of instruments and questionnaires that address the areas of interest, as identified in the study objectives were administered. These areas included socio-economic status, family functioning, maternal and paternal health and well-being, parental stress, home learning environment, exposure to violence, and school readiness. Standardised tests of child development/cognitive function, academic achievement and behaviour were administered. The instruments administered are listed below, but are detailed in Appendix 3. PARENT: 1. Early Learning Project Sibling Study: Junior JA KIDS (JA KID2) Questionnaire 2. Child Behaviour Checklist (1 ½ -5 years) 3. Jamaica Family Support Screening Tool (FSST) 4. Parent Child Conflict Tactics Scale (CTSPC Family Behaviours) 5. Juvenile Victimisation Questionnaire (JVQ Caregiver Abbreviated Interview, Lifetime Form) 6. Centre for Youth Wellness Adverse Childhood Experiences Questionnaire (CYW-ACES-Q) TEACHER: 1. Caregiver Teacher Report Form for 11/2 to 5 Years (TRF) (Child Behaviour Checklist) 2. JUNIOR JAKIDS (Jr. JA KIDS) Teacher Information Form CHILD: 1. Griffiths Mental Development Scales (GMDS) 2. Wechsler Individual Achievement Test (WIAT PreK/K) 3. Peabody Picture Vocabulary Test (PPVT) Piloting of Questionnaires Questionnaires were piloted using a sample of mothers not eligible to participate in the survey, i.e. mothers with children who do not have a child born July to September 2011, and who are therefore not enrolled in the first and second phases of the JA KIDS study. This facilitated the revision and refinement of questionnaires including minor changes in language to standardised questionnaires to better reflect the language that persons understood. Data Collection Procedure Survey data was collected via interviews, standardised tests for children and self-completed forms. 1. Questionnaire Data Questionnaire data was collected using face to face contact primarily and telephone interview secondarily. Parents/primary caregivers were invited to attend specific test sites across the country, as was done in the JA KIDS study. However, if parents give permission for participation, and are unable to attend, their children will be assessed at school and interviews conducted by telephone. Computer Assisted Telephone interviewing (CATI) of parents was utilised in these situations, as was done in the JA KIDS study. This method was selected as it is the most effective way to conduct repeated follow up with a large national sample. It could also be readily implemented due to the high levels of cell phone ownership in Jamaica and the high costs that would be associated with repeated attempts at face to face follow up visits. 2. Developmental Cognitive and Achievement Tests These standardised tests were administered by trained psychologists or educators, under the supervision of the JA KIDS senior psychologist. 3. Self-Completed Forms Teacher’s reports of children’s behaviour and the teacher information questionnaire w ere sent via parents to caregivers/teachers for self-completion. Few of these were returned. Training Questionnaires were administered by a study team of interviewers, after an intensive period of training. Following in-house training, including discussion of individual questionnaires, extensive practice sessions were done to ensure an inter-observer agreement of greater than 80 per cent on questionnaires and greater than 90 per cent on cognitive tests. Statistical Analyses Data from questionnaires, standardised tests and biological samples were entered on computer and verified. Nonparametric statistics (Mann - Whitney U for skewed distributions; Chi-square statistics) were used for variables that were not normally distributed. The t-test and analysis of variance was used for continuous variables that are normally distributed. Categorical variables were analysed using chi-square statistics. Pearson’s product-moment correlation coefficients was used to examine the relation between continuous variables. Regression analyses was used to identify independently operating factors associated with child health, growth and development. Statistical analyses was performed using the Statistical Package for the Social Sciences (SPSS). Statistical significance will be achieved when p<0.05. CONFIDENTIALITY OF DATA Protecting the privacy of the participants was of high priority. All data collected was treated as confidential. De-identification procedures were used for all data collected. Any data that could potentially reveal the identity of participants will not be included in any published data. ETHICAL MATTERS Ethical approval was obtained from the UWI/UHWI Ethical Committee of the Faculty of Medical Sciences at the University of the West Indies. Informed consent was obtained from mothers, fathers and caregivers, for their participation in the study, as well as their children’s participation. At the end of the contact, parents were provided with information on their children’s developmental status, as done in previous JA KIDS studies. FAIR SELECTION OF PARTICIPANTS The participants were not selected because their ease of availability, diminished autonomy, or social bias. Participants were selected because of their previous participation in a national birth cohort study and indicated willingness to be involved in further studies. CHAPTER 8 INFORMATION ON READINESS AND EXPOSURE TO VIOLENCE FROM A NATIONAL SURVEY : PARTICIPANT DEMOGRAPHICS Some 242 participants, or 98.4% of the sample, completed the section of the questionnaire that documented household and family structure, and socio-economic status. HOUSEHOLD AND FAMILY STRUCTURE Respondents Information was provided by the birth mother on behalf of 92.6% (224/242) of the children in the cohort. The birth father was the respondent for 4.5% of the children and another primary caregiver was noted for five (5) children. Other primary caregivers included three (3) grandmothers, one (1) aunt and one (1) partner of the biological parent. The reasons given why these other relatives were the primary caregivers included  Mother’s work obligations and  House that child lived in was too crowded and Most of the respondents (80.5%, 195/242) indicated that they were currently in a relationship of which almost 75% of these relationships were with the child’s biological parent. The full breakdown of current partners of respondents were comprised of  Father of child in cohort – 69% (135/195)  Other partner (i.e. not a biological parent of child in cohort) – 26% (51/195)  Mother of child in cohort – 4% (8/195) Relationship statuses between the respondents and their current partners were as follows: -  Visiting relationship – 30.2% (59/195)  Living Together > 5 years/ Common Law – 28.7% (56/195)  Married – 27% (53/195)  Living Together < 5 years – 12% (24/195) The current relationship statuses between the birth father and birth mother were defined as  No relationship - 26% (63/242)  Living together > 5 years/ Common law – 21% (51/242)  Married - 21% (51/242)  Visiting relationship – 13% (31/242)  Separated (Prev. common law) – 11% (26/242)  Living together < 5 years – 3.7% (9/242)  Separated (Prev. married) – 1.7% (4/242)  Divorced - <1% (1/ 242) Household Composition The most common household members that also lived with the child were the child’s birth mother, other children of the respondent, the child’s birth father and children shared between the respondent and their current partner. The full breakdown of household members were:  Birth mother – 93.8% (227/ 242)  Respondent’s children – 57.9% (140/242)  Birth father – 47.5% (115/242)  Respondent’s children with current partner – 46.7% (113/242)  Other relatives – 27.7% (67/242)  Grandmother – 23.6% (57/242)  Other children (relatives) – 9.9% (24/242)  Grandfather – 9.5% (23/242) Interactions with Father Figures Half of the children in the cohort lived with their birth father (49.6% ,120/242) at the time of survey. In these cases, the father had lived in the same household as the child between 17 and 80.5 months (1.5 years to 6.7 years) with an average of 47.5 months (4 years). In most cases, the biological parent was also the parental figure in the child’s life. The child’s birth mother was the mother figure to almost all the children in the cohort (99.2%) except for 2 cases while the birth father was the father figure to 84% (202/242) of the children in the cohort. Among the children whose biological father was not the father figure in their life, this role was primarily being filled by another boyfriend/ partner (42%). A little more than a quarter of children (29%,11/38) whose birth fathers were not the father figure had no one filling this role, 21% (8/38) had another male relative, 5% (2/38) had another non-related male and in 1 case, it was the respondent’s father who was fulfilling this role. 16/38 – Another boyfriend/partner 11/38 – No one 8/38 – Another male relative 2/38 - Another male, not related 1/38 – Respondent’s father The level of involvement of the birth fathers in decisions about their child’s health or care was relatively high. It was reported that since the child’s first birthday, 71% (171/242) of birth fathers had a great deal of involvement while 13% (32/242) had limited involvement. Approximately 15% (35/242) of birth fathers were not involved in these decisions. Results were similar for financial support of the child since their first birthday. Seventy-one per cent (171/242) of birth fathers provided a lot of financial support, 18% (43/242) provided limited support and 10% did not provide any financial support. 171/242 – a great deal of involvement 32/242 – limited involvement 35/242 – no involvement 4/242 – not applicable/not known The frequency of visits with the child by their birth father was moderate. Over half (52%, 126/242) of birth fathers visited with their child daily and 11% visited 1 -3 times per week. Less than 10% (19/242) of birth fathers visited a few times per month and 18% (43/242) either rarely or never visited with their child. However, the reported frequency of play with the child by birth fathers was lower than that of visits. Thirty-eight per cent (91/242) of birth fathers played with their child daily, 16% played with them 1 – 3 times a week, 10% played with them a few times a month and less than 10% played with them 4-6 times a week. Twenty-two per cent (53/242) either rarely or never played with their child. For the children with father figures that were not their birth fathers, 67% (18/27) of these father figures saw them daily, 11% (3/27) saw them 1 -3 times per week, and 7% (2/27) saw them 4 – 6 times per week. Eleven per cent (3/27) either rarely or never saw them. Similarly to the birth fathers, the frequency of play with the child was lower than the frequency of visits. Forty-eight per cent (13/27) of the non-biological father figures played with the child daily, 19% (5/27) played with them 1 – 3 times per week, 11% (3/27) played with them 4 – 6 times a week and 7% (2/27) played with them a few times a month. Fifteen per cent (4/27) either rarely or never plays with them. Siblings The number of children that the birth mother and birth father had together ranged from 1 to 5 children with an average of 2 children. Ten per cent (25/246) of birth fathers had other children between JAKID1 and the current child of focus (JAKID2). The number of other children they had ranged from 1 to 5 but 1 other child was the most common number reported. Four per cent (10/246) of birth mothers had other children between JAKID1 and the current child of focus (JAKID2). The number of other children they had ranged between one and two (1-2) with one (1) child again being the most common number reported. Ninety-four per cent (227/242) of birth fathers had other children younger than JAKID1 and 99% (240/242) of birth mothers had other children younger than JAKID1. In both cases, the most common number of other younger children reported was one (1) child. SOCIO-ECONOMIC STATUS Stability of Living Arrangements Seventy-one per cent (172/242) of birth mothers were still living at the same address as at the time of the JAKID2 birth. Similarly, 70% (169/242) of the JAKID2 cohort were also living in the same house that they came to after they were born. Among the 73 children that were not living at the same address as after their birth, the most common number of other homes the child has lived in was two (2) homes, but the responses ranged from one to six (1 – 6). Most of the children (63%, 153/242) lived in a house with their own yard followed by 28% (67/242) who lived in a house with a shared yard. A few children also lived in a semi-detached (duplex) house (4%, 9/242), room in someone’s house (3%, 7/242) and an apartment (3%,6/242) . Over half of these living arrangements (52%, 126/242) were owned without mortgage and an additional 9% (22/242) were being bought/ mortgaged. Twenty-four per cent (57/242) were rental arrangements (either furnished or unfurnished) and 11% (27/242) were other arrangements but with no rent paid. Three (3) children were living in a squatter arrangement. Household Income and Composition The average number of adults (i.e. >18 years), including the respondent, that lived in the child’s home was 2. The average number of children aged 12 – 18 years and 6 – 11 years living in the house with the child was one child each. The major wage earners for the household in which the child lived were the birth parents. The full breakdown noted were as follows: -  Birth father – 43% (103/242)  Birth mother – 29% (69/242)  Both birth parents – 7% (18/242)  Grandparents – 7% (17/242)  Other spouse/ partner (not the birth parent) – 6% (15/242)  My relatives (including child’s aunts, uncles, great grandparents and cousins) – 5% (13/242)  Partner’s mother - <1% (1/242) The number of adults in the household who contributed to the household income ranged between 0 and 5 but the most common number reported was two (2) adults. Four households reported that 1 child under 18 years contributed to the household income and two (2) households reported that two (2) children under 18 years contributed to the household income. Additionally, the number of adults that the household income supported ranged from one to nine (1 to 9) with the most common number reported being two (2) adults; and the number of children under 18 years that the household income supported ranged between 1 and 16 children, with the most common frequency being three (3) children. Almost 40% (95/242) of respondents indicated that the household found it either very difficult, difficult, or somewhat difficult to afford things the child needed. Twenty-nine per cent (71/242) of respondents indicated similar degrees of difficulty to afford food, 24% (57/242) with affording clothing and 12% (29/242) expressed this level of difficulty with affording the rent/ mortgage. The main sources of water for the households were  Piped in house – 54% (131/242)  Catchment/ tank – 22% (52/242)  Piped in yard – 15% (37/ 242)  Standpipe – 5% (12/242)  Stream/ river – 1% (3/242) The main types of toilet facilities that these households had were  Water closet, flushed, unshared – 75% (182/242)  Water closet, flushed, shared – 12% (28/242)  Pit latrine, unshared – 9% (21/242)  Pit latrine, shared – 4% (10/242) Gas/electric was the most common type of fuel for cooking reported by 91% (220/242) of participants whereas 7% (17/242) indicated coal and 2% (5/242) indicated wood. A little over a third of the households (37%, 89/242) were not receiving any further assistance from a government or any other agency. Thirty-four per cent (82/242) received support from PATH, 28% received support from family and friends abroad and 17% from family and friends in Jamaica. CHAPTER 9 EXPOSURE TO VIOLENCE This chapter reports on exposure to violence of children 2-6 years on the Adverse Childhood Experiences Questionnaire (ACES) and the Juvenile Victimisation Questionnaire. ADVERSE CHILDHOOD EXPERIENCE The questionnaire was administered to 238 participants, representing 96.7% of the sample. The most common adverse childhood experience reported was separation of parents (39.5%). All other adverse childhood experiences were reported by less than 10% of the participants of which emotional neglect was reported by 8.3% of participants and physical abuse was noted by 7.6% of respondents. Sexual abuse was the least reported adverse childhood experience with one participant indicating this event. Table 1 Frequency of Reported Adverse Childhood Experiences Were your parents separated or divorced? 94 39.50% Did you often feel that ... No one in your family loved you or thought you were 20 8.30% important or special? or Your family did not look out for each other, feel close to each other, or support each other? Did a parent or other adult in the household often .. Push, grab, slap, or throw 18 7.60% something at you? or Ever hit you so hard that you had marks or were injured? Was your mother or stepmother: Often pushed, grabbed, slapped, or had 17 7.00% something thrown at her? or Sometimes or often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife? Parent (or other adult) swear at you or act in a way that made you afraid that 13 5.50% you might be physically hurt? Did a household member go to prison? 10 4.10% Did you live with anyone who was a problem drinker or alcoholic or who used 7 2.90% street drugs? Was a household member depressed or mentally ill or did a household member 4 1.70% attempt suicide? Did you often feel that ... You didn't have enough to eat, had to wear dirty 2 0.80% clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it? Did an adult or person at least 5 years older than you ever... Touch or fondle 1 0.40% you or have you touch their body in a sexual way? or Try to or actually have oral, anal, or vaginal sex with you? The total number of adverse childhood experiences reported by any one participant corresponded to the total sore received. Participants’ scores ranged between 0 – 5 (out of a possible total of 10 events). Most participants (85.3%) reported having experienced either none of the adverse childhood events in this test (47.9%) or one (1) adverse childhood experience (37.4%). Nine percent (9%) of respondents reported experiencing two events, three percent (3%) reported experiencing 3 events and one percent (1%) of participants each reported surviving 4 and 5 experiences. Common ACE Scores of Participants (n=238) 10 9 8 7 ACE Score 6 5 4 3 2 1 0 0 10 20 30 40 50 60 70 80 90 100 % of Participants with Score Figure 9.13 Total Number of Adverse Childhood Experiences Reported Juvenile Victimization Questionnaire (JVQ-R2) (n=241) Two hundred and forty-one participants were administered this questionnaire corresponding to 97.6% of the sample. Overview of Findings Across Modules The figure below shows the reported victimizations across each module of the scale in descending order. Across all modules, peer and sibling assault was the most frequently reported victimization (29%), followed by the top conventional crimes of vandalism (25%), theft of something child carried or wore taken by force (22%), and assault without weapons (15%). Most of the participants experiences with these offences included recent exposure in the past year. Additionally, the majority of offences across all the modules together (80%) were done by persons who were personally known by the child, of which most were also members of their households. The most common perpetrator indicated was a sibling (or another child in the house). Males were also the most common sex of perpetrators noted, with boys being the most frequently reported age group among them. Figure 9.14 Summary of Reported Victimizations by Module in Descending Order Conventional Crimes The top three victimization experiences reported under Conventional Crimes were vandalism, robbery and assault without a weapon which were also among the highest reported experiences across all the modules. These crime experiences were reported by 25%, 22% and 15% of respondents respectively. One participant noted that they had almost been kidnapped and no participant reported being attacked based on a form of discrimination. Apart from the attempted kidnapping experience, most participants who had experiences with these conventional crimes included recent experiences that occurred within the past year (see figure 9.2 below). The proportion of those that were seriously hurt by these experiences were relatively low though except for when the assault was with a weapon. Childhood Experiences with Conventional Crimes (n=241) 70 60 Number of Participants 50 40 30 20 10 0 Attack Assault Personal Threat of Attempted Attempted Vandalism Robbery without with Bias Attack theft Assault assault kidnapping weapon weapon Experienced 60 53 35 24 13 12 5 1 0 Recent Experience 55 40 27 15 11 11 5 0 0 Seriously Hurt by Experience 6 5 8 3 1 9 0 0 0 Figure 9.15 Relative Frequency, Currency and Severity of Participant Experiences with Conventional Crimes A sibling (or other child living in the house) was the most common offender noted in most of the conventional crimes with the exception of ‘theft of something from child that was never given back’ and ‘attacking child with an object or weapon’ which were both primarily conducted by other known persons outside of the household or family (i.e. such as friend, teacher or neighbour etc.). Attempted kidnapping of a child (which was experienced by one respondent) was the only Conventional Crime where a stranger was the offender. None of the conventional crimes were conducted by a father or by a girlfriend/ boyfriend/ ex. Table 2 Proportion of Conventional Crimes Done by Relationship of Perpetrators to the Child* Other Other Child's Known Relative but Father Mother Sibling Household boyfriend Person (i.e. Stranger Other Nonhouseholder (%) (%) (%) Member /girlfriend/ neighbour, (%) (%) (%) (%) ex (%) teacher, friend) (%) Vandalism 0 0 50 15 20 0 15 0 0 Robbery 0 15 53 11 6 0 13 0 2 Assault without weapon 0 11 31 17 17 0 26 3 0 Personal theft 0 0 13 0 13 0 54 17 4 Threat of Assault 0 15 31 15 0 0 23 15 0 Assault with weapon 0 8 8 0 25 0 42 17 0 Attempted assault 0 0 60 0 20 0 20 0 0 Attempted kidnapping 0 0 0 0 0 0 0 100 0 Bias Attack 0 0 0 0 0 0 0 0 0 *The highlighted cells showcase the most frequent relation of perpetrators to the child reported for that crime Boys were the most common perpetrators noted for almost all of the Conventional Crimes except for ‘theft of something that child wore or carried taken by force’ where there was a tie between the boys and girls; and the attempted kidnapping which was done by a woman. Proportion of Perpetrators for Each Crime Disaggregated by Sex and Age Group (n=241) 100 Proportion of Perpetrators 90 80 Men Boys 70 60 Women Girls 50 40 30 20 10 0 Assault Assault Attempted Personal Threat of Attempted with without Vandalism Robbery Bias Attack assault theft Assault kidnapping weapon weapon Men 8 6 0 0 0 2 23 0 0 Boys 75 63 63 60 50 40 39 0 0 Women 17 20 2 0 0 19 23 1 0 Girls 8 23 37 40 33 40 23 0 0 Figure 9.16 Proportion of Perpetrators for Each Conventional Crime Disaggregated by Sex and Age group Child Maltreatment The four areas under Child Maltreatment were emotional abuse, physical abuse, custodial interference/family abduction, and neglect which were reported by eight percent (8%), five percent (5%), three percent (3%) and one percent (1%) of respondents respectively. Childhood Experiences with Maltreatment by Caregivers (n=241) 20 18 Number of Participants (#) 16 14 12 10 8 6 4 2 0 Psychological/ Custodial Physical abuse by emotional abuse Interference/ Neglect caregiver by caregiver Family Abduction Experienced 18 10 7 3 Recent Experience 15 10 5 2 Seriously Hurt by Experience 3 1 0 Figure 9.17 Number of Childhood Experiences with Childhood Maltreatment Another relative living in the household was the primary perpetrator for physical abuse, a known person that was not related to or living with the child (such as a friend, teacher, or neighbour etc.) was the main group implicated in the emotional abuse of the participants. and the father (or stepfather or live-in boyfriend) was the key perpetrator reported for custodial interference and neglect. Table 3 Proportion of Child Maltreatment Done by Relationship of Perpetrators to the Child* Other Other Child's Known Relative but Father Mother Sibling Household boyfriend Person (i.e. Stranger Other Nonhouseholder (%) (%) (%) Member /girlfriend/ neighbour, (%) (%) (%) (%) ex (%) teacher, friend) (%) Physical abuse by adult 20 30 0 40 30 0 0 0 0 Emotional abuse by adult 17 17 0 11 22 0 39 0 0 Neglect 67 33 0 0 0 0 0 0 0 Family Abduction 57 43 0 14 0 0 0 0 0 *The highlighted cells showcase the most frequent relation of perpetrators to the child reported for that offence. Women were the leading demographic for physical abuse of children whereas men were the leading demographic associated with the other three areas of Child Maltreatment. Proportion of Perpetrators for Child Maltreatment Disaggregated by Age Group and Sex (n=241) 100 90 Men Women Proportion of Perpetrators (%) 80 70 60 50 40 30 20 10 0 Psychological/ Custodial Interference/ Physical abuse Neglect emotional abuse Family Abduction Men 40 61 67 71 Women 70 39 33 43 Figure 9.18 Proportion of Perpetrators for Child Maltreatment Disaggregated by Sex and Age Group Peer and Sibling Victimization The most common experience under this module was peer or sibling assault where 29% of respondents indicated that they had been ‘hit by another child at home or in public’. This was also the highest reported offence across all the modules. Additionally, similar proportions of respondents indicated that they had experienced bullying (10%) and emotional bullying (9%). Three percent (3%) of respondents reported having been attacked by a gang and one percent (1%) reported that another child had tried to hurt their private parts. No respondent (over 12 years old) indicated having been hit by a partner or romantic interest. Childhood Experiences with Peer & Sibling Victimization (n=241) 160 140 Number of Participants (#) 120 100 80 60 40 20 0 Peer or Nonsexual Emotional Gang Dating sibling Bullying genital bullying assault violence assault assault Experienced 141 23 21 6 3 0 Recent Experience 116 18 17 6 3 0 Seriously Hurt by Experience 16 2 2 1 0 Figure 9.19 Childhood Experiences with Peer and Sibling Victimization As suggested by the module name, siblings were the primary perpetrator for these victimizations. The exception was for emotional bullying where a ‘child felt humiliated by other kids’ harassment’. ‘Other known persons that were not related to or living with the child’ were the most common group accused of inflicting the emotional bullying. Table 4 Proportion of Peer & Sibling Victimization by Relationship of Perpetrators to the Child* Other Other Child's Known Relative but Father Mother Sibling Household boyfriend Person (i.e. Stranger Other Nonhouseholder (%) (%) (%) Member /girlfriend/ neighbour, (%) (%) (%) (%) ex (%) teacher, friend) (%) Peer or Sibling Assault 0 0 87 4 4 0 4 0 0 Nonsexual genital assault 0 0 67 0 0 0 33 0 0 Bullying 0 0 87 4 4 0 4 0 0 Emotional bullying 0 0 33 5 14 0 52 0 0 *The highlighted cells showcase the most frequent relation of perpetrators to the child reported for that offence. Boys were again the primary sex and age group indicated as the attackers in peer or sibling assault, as well as bullying even though it is worth noting that the gap between boys and girls for peer/sibling assault was small (i.e. 56% vs. 49%1); and girls were the primary culprits for emotional bullying and hurting (or attempting to hurt) another child’s private parts. Proportion of Perpetrators for Peer & Sibling Victimization Disaggregated by Age Group and Sex (n=241) 100 Proportion of Perpetrators (%) 90 80 70 60 Boys Girls 50 40 30 20 10 0 Peer or sibling Nonsexual genital Bullying Emotional bullying Dating violence assault assault Boys 56 61 57 33 0 Girls 49 44 67 67 0 Figure 9.20 Proportion of Perpetrators for Peer & Sibling Victimization Sexual Victimization The number of respondents that reported having experienced sexual victimization were low. ‘Being forced to do sexual acts’ was reported by two percent (2%) of respondents followed by ‘forced to do any kind of sexual intercourse’ (1%) and ‘verbal or written sexual harassment’ (1%). One respondent (which corresponds to less than one per cent) reported that they were forced to look at private parts of attacker. No participant reported experiencing statutory rape or having their genitals touched by either a peer or adult. 1 Responses to ‘who did this’ were not mutually exclusive. Therefore, participants could have indicated more than one sex or age group which is why the frequencies exceed 100%. Childhood Experiences with Sexual Victimization (n=241) 10 9 Number of Participants (#) 8 7 6 5 4 3 2 1 0 Verbal/ Sexual Sexual Forced Flashing/ Sexual written assault by Statutory assault by sexual Sexual assault by sexual adult rape peer intercourse Exposure known adult harassment stranger Experienced 4 3 2 1 0 0 0 Recent Experience 2 2 2 1 0 0 0 Seriously Hurt by Experience 1 0 0 0 0 0 0 Figure 9.21 Childhood experiences with Sexual Victimization The main perpetrators of the forced sexual acts, the forced sexual intercourse and the verbal or written sexual harassment were from other known persons that were not related to or living with the child such as a friend, teacher, or neighbour. The child that was forced to look on the private parts of attacker received this attack from a relative that did not live with the child. Table 5 Proportion of Sexual Victimization by Relationship of Perpetrators to the Child* Other Other Child's Known Relative but Father Mother Sibling Household boyfriend Person (i.e. Stranger Other Nonhouseholder (%) (%) (%) Member /girlfriend/ neighbour, (%) (%) (%) (%) ex (%) teacher, friend) (%) Sexual assault by peer 0 0 0 0 25 0 75 0 0 Rape/ Forced sexual 0 0 0 0 33 0 67 0 0 intercourse of any kind Flashing/ Sexual exposure 0 0 0 0 100 0 0 0 0 Verbal/ Written sexual 0 0 0 0 0 0 100 0 0 harassment *The highlighted cells showcase the most frequent relation of perpetrators to the child reported for that offence. Boys again represented the primary sex and age group indicated as attackers in the sexual victimizations although, given the small numbers, it may be worth noting that girls were also indicated in two instances. There was also a tie between boys and men for verbal or written sexual harassment. Proportion of Perpetrators for Sexual Victimization Disaggregated by Sex and Age Group (n=241) Proportion of Perpetrators (%) 100 90 80 Men Boys 70 Women Girls 60 50 40 30 20 10 0 Verbal/ Sexual Sexual Forced Flashing/ Sexual written assault by Statutory assault by sexual Sexual assault by sexual adult rape peer intercourse Exposure known adult harassment stranger Men 0 0 50 0 0 0 0 Boys 75 67 50 100 0 0 0 Women 0 0 0 0 0 0 0 Girls 25 33 0 0 0 0 0 Figure 9.22 Proportion of Perpetrators for Sexual Victimizations Disaggregated by Sex and Age Group Witnessing and Indirect Victimization The most common exposure to indirect victimization was exposure to bombs going off, persons being shot or street riots, which was reported by 14% of participants. This was followed by 13% of the respondents indicating having witnessed attacks on others without a weapon. Twelve percent (12%) of participants had experienced loss of a close family friend or member by murder and had witnessed an attack of someone else in public with a weapon. The witnessing and indirect victimization also occurs within the child’s home. Nine percent (9%) of participants had witnessed a parent abuse a sibling, and 8% had witnessed a parent getting physically abused. Six percent (6%) of respondents had experienced burglary of household and five percent (5%) have been exposed to conflict situations with gun fights or bombs. Childhood Experiences with Witnessing & Indirect victimization (n=241) 40 Number of Participants (#) 35 30 25 20 15 10 5 0 Child Witnessed Witnessed exposed to Child has Child someone Someone someone Witnessed bombs witnessed exposed to being close to being parent going off, parent Burglary of war with physically family has physically physically persons getting Household gun fights attacked been attacked abuse a being shot physically and without a murdered with child or street abused bombings weapon weapon riots Experienced 34 31 30 28 22 20 14 11 Recent Experience 31 27 16 22 15 17 11 11 Seriously Hurt by Experience 0 0 0 0 0 0 0 Figure 9.23 Childhood Experiences with Witnessing & Indirect Victimization This module is the only one where the perpetrator noted most often was a stranger except for the questions that looked at physical abuse by and to the parental figures in the household. The primary offender for physical abuse of a sibling was the mother but of abuse of a parent was the father. Men were the dominant demographic of the offender for these types of victimizations. Table 6 Proportion of Witnessing and Indirect Victimization by Relationship of Perpetrators to the Child* Other Other Child's Known Relative but Father Mother Sibling Household boyfriend Person (i.e. Stranger Other Nonhouseholder (%) (%) (%) Member /girlfriend/ neighbour, (%) (%) (%) (%) ex (%) teacher, friend) (%) Witnessed parent 85 10 0 0 0 5 0 0 0 getting physically abused Witnessed parent physically abuse 23 77 0 0 0 0 0 0 5 sibling Witnessed someone getting attacked 0 4 0 4 14 0 36 43 4 with weapon Witnessed someone getting attacked 0 0 3 3 26 0 29 32 7 without weapon Burglary in household 7 0 0 7 7 0 21 43 14 Someone close to family 3 0 3 0 7 0 7 50 30 murdered *The highlighted cells showcase the most frequent relation of perpetrators to the child reported for that offence. Proportion of Perpetrators for Indirect Victimization Disaggregated by Age Group and Sex (n=241) 100 Proportion of Perpetrator (%)s 80 60 40 20 0 Witnessed Child has Witnessed someone being witnessed Witnessed someone being Someone close physically Burglary of parent getting parent physically physically to family has attacked Household physically abuse a child attacked with been murdered without a abused weapon weapon Men 95 27 79 65 46 96 Boys 0 0 7 16 15 0 Women 10 82 14 23 0 4 Girls 0 0 0 3 0 0 Figure 9.24 Proportion of Perpetrators for Indirect Victimization by Sex and Age Group