Paul Dornan elaborates on key concepts of equality and equity embraced by the Young Lives research project based out of the University of Oxford. The research conducted by Young Lives is pivotal for understanding the impact of early life circumstances on development and the social opportunities achieved later in life. Paul highlights the importance of understanding links between household circumstances (access to resources, livelihood, etc.) and the functioning of the economy for the most marginalized populations.
Interview conducted in January 2014 via Skype || New York, NY , USA and Oxford, UK
Q: What do you think about current concepts of equity and equality? What is your perspective on these existing concepts?
A: At Young Lives we see equity as referring to fairness and being very much linked to concerns about equality of opportunity. A central question is how do early circumstances, or the background of a child (such as where they are born or the type of households and communities in which they grow), impact their individual opportunities later in life? Since there are close links between characteristics of household background and many aspects of child development, all of this is likely to impact the child’s opportunity to live up to his or her true potential.
Sometimes distinctions are drawn between equality of outcome and equality of opportunity, and accompanied by a sense that equality of outcome is not necessarily feasible. These sorts of debates feel sterile sometimes because they seek to separate things that are inextricably linked. Gross inequalities of outcome (such as access to resources) are very likely to limit the potential for equality of opportunity and so if we therefore are interested in improving life chances, I think we have to be quite conscious of gross inequalities of outcomes.
Q: From your point of view, what are the main causes of increasing inequities?
A: As a birth cohort study, we are most interested in what is happening in the lives of the cohorts of Young Lives children (born in 1994/5 and 2000/1). Our key interest is therefore how poverty and inequity affected these groups of children as they were growing up. As we see links between household circumstances (access to resources, livelihood and so on), understanding how the economy is functioning for the most marginalized is clearly important.
For children’s life chances, two particular perspectives may also be worth bearing in mind. First poverty affects the capacities that children develop. A key example is nutrition. Poverty in childhood is a risk to children’s nutrition in many countries meaning that children are less healthy, shorter and learn less than they should. In this way poverty in childhood undermines future chances. Second, there is also the question of how individuals are then in a position to take advantage of their capacities within society. Much has been invested in extending access to schooling, for example, but alongside ensuring there are positive outcomes from school, there is the question of whether better jobs or other opportunities will be available to capitalize on this learning.
A second point to think about is how inequities may be changing. For policy we can think about inequity in many different ways. Traditional ways perhaps entails thinking about access to sanitation, schooling, etc. Those inequities clearly remain entrenched and are often interconnected to children experiencing not just one form of inequity but several. But increasingly we also need to understand inequities as existing within systems, not only in exclusion from them. School provides an example where mass participation means that most children will now have an educational experience, but it may well be of low quality and it is likely to be the poorest children who also experience the lowest quality.
Q: Based on your research and from an equity perspective, what would be then three key recommendations for policy makers?
A: The first one has to do with the pattern of economic growth. In many low to middle-income countries, growth is clearly necessary to increase living standards for the very poor people, and to create fiscal space governments need to make necessary investments. But human development indicators often lag behind economic growth. Thus, making sure that economic growth is inclusive and pro-poor becomes critical in laying the foundation for widespread gains. A striking example can be found in our research here at Young Lives where, since there are two cohorts born 7 years apart, the data can be used to examine differences between these groups. One group of children who reached the age of eight by 2002, and another who reached the same age by 2009. When we compared these groups we found that overall stunting rates had been reduced. But when we disaggregated the data, we noticed that much of the reduction was coming from the most advantaged groups[1]. This raises alarm since it suggests a concentration of the problems of malnutrition with the poorest people. Ensuring that economic growth is widely spread therefore is important given that factors such as stunting, for example, further increase the risk of marginalization for the poorest of the poor.
The second issue to highlight for policy makers relates to the intersected nature of growing inequalities and inequities. What we see is that children who are doing poorly in one of the indicators of development are often doing badly on several of them. Moreover, if we look within groups, inequities are even wider. An example of this can be found in looking at nutrition in Peru. What we found there is that the poorest children (of eight years of age) in urban areas are four times more likely to be stunted than the less poor children in the same urban areas.[2] This level of inequity was much greater than that which we found when comparing stunting rates between rural and urban areas. Disaggregation is imperative to understand the ways in which these inequalities and inequities express themselves.
The third point to emphasize is the life course perspective. This is important for policy discussions related to how children develop over time and what early factors affect their later development. What we see from this perspective is that the early circumstances of children are critical; early nutrition, for example. But we also see quite a lot of dynamism in the development of children as they grow older. For some children who are doing less well than they should in terms of education, for example, there is now evidence that good quality education would help them catch up.[3] In like manner, for children who are lagging behind in their height development, we now have increasing amount of evidence that they stand to gain from improved circumstances in the early periods of life.[4] The conclusion we draw from the life course perspective then is that if you are trying to minimize the development of inequity, early investments are vital but sustained investments are also important. It is never too late to invest in children if you are trying to avoid widening inequities.
Q: Do you have evidence in your area of research of “innovative best practices” in terms of policies and programs that have achieved more equity for children?
A: Aside from the importance of early and sustained investments in education and nutrition, one interesting area to highlight is that of social protection, such as access to services of early childcare and then moving on through preschool programs. Internationally, social protection has been a big policy issue, especially for low- and middle-income countries. There has been a real focus on coverage for these countries, given that if you look at high-income countries you often have very advanced social protection systems. There are also some important examples in countries where we operate. In India, for example, there is the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), which guarantees work for people in rural areas and helps buffer the effects of flooding and other environmental phenomena. In Ethiopia, there is the Productive Safety-Net Programme (PSNP) and in Peru there is now a conditional transfer scheme, the Juntos programme.
Evaluating the effects of those programs is difficult. The evidence is often mixed, but it does suggest that such protection can fulfill some very important child development objectives. But the key question is making sure these programs are well delivered and well implemented. One interesting example, outside of the Young Lives study, is that of South Africa’s Child Support Grant (CSG). This program provides the evaluative evidence by establishing the rightful foundation for the effectiveness of other policies related to nutrition, education, etc. Thus, I think in terms of innovation the question ought to be on the extent to which social protection is able to lay a foundation for the life course of the most marginalized children, therefore other programs to work more effectively. Another dimension is that of health, poor health and the costs associated with sickness are often brought up by families in qualitative interviews. In such a case, when we talk with families about their circumstances health very frequently comes up as a serious adverse event; the ill-health of a parent or sibling, for example, reduces the capacity of households to earn and thus worsens poverty. Reducing the cost of ill-health to families and extending access to better care is critical. When we look at health insurance programs in countries such as India, Peru, and Vietnam, the key question we are trying to answer is who is getting access to those programs? Moreover, are they addressing the (often primary care) health conditions that commonly intensify and worsen poverty? These are important questions to answer from the perspective of equity. Much of this depends on effective design and implementation.
Q: Can you describe more in detail your methodologies?
We collect a lot of different data, with the child as a core unit of observation. Information is gathered about the household, and communities children grow up in which they are growing up. We also collect information about institutions children experience, particularly about the school environment in which they learn. Collecting contextual information, such as household wealth and education of parents and ethnicity enables analysis of equity issues. Multiple methods are used, with survey data collected on children and their households; surveys conducted within the school environment and with detailed qualitative data collected through interviews with children and young people and care givers. Using multiple methods enables the study to be used to identify statistical links between earlier circumstances and later outcomes, as well as examining what might explain these links – how children experience disadvantages and what shapes the choices households have to make to deal with adverse circumstances. A further key advantage of an observational study like Young Lives is that analysis can be made if many research areas covering different aspects of children’s lives. The survey data is made publicly available to help support this.
[1] http://www.younglives.org.uk/files/policy-papers/growing-up-with-the-promise-of-the-mdgs (see page 6 onwards)
[2] http://www.younglives.org.uk/publications/PP/what-inequality-means-for-children (see page 11)
[3] http://www.younglives.org.uk/files/working-papers/yl-wp100_rolleston and http://www.younglives.org.uk/files/policy-papers/vietnam-school-survey-summary
[4] http://journals.cambridge.org/download.php?file=%2FPHN%2FS1368980013003017a.pdf&code=fead84f691fc9e715d1724b76fbc7feb