Improving the quality of early childhood care at scale: The effects of "From Zero to Forever".

Highlights • We study a large-scale expansion of integrated center-based care in Colombia. • We find large positive effects on receptive vocabulary that persist after 5 years. • The impact implies a reduction of 35% in the cognitive socioeconomic gap. • We report positive but less robust effects on children's nutritional status. • Integrated early childhood care can be effective and sustainable at large-scale. Abstract The focus in developing countries is shifting from increasing access to early childhood care services to improving its quality. In light of the inclusion of early childhood development in the UN Sustainable Development Goals, there has emerged a global call for early childhood programs that integrate nutrition, health and development components. However, large-scale studies of integrated early childhood interventions are scarce in developing countries, and thus, little is known about its effectiveness and sustainability. In this paper we study the immediate and medium-run effects of a large-scale expansion of an integrated package of services including care, education, health and nutrition on child growth and development, by analyzing the expansion of the Colombian national early childhood strategy known as " From Zero to Forever " between 2011 and 2013. The results indicate that the increased access to integrated center-based care had a large immediate effect on vocabulary that persists five years into the intervention, and less robust effects on nutritional status. [ABSTRACT FROM AUTHOR]