Sure Start – investing in early childhood

WHO/Malin Bring

Investing in early childhood is the most effective way to ensure that all can reach their full developmental potential. Poverty, however, can roughen an otherwise easy road to health.
Being poor is not only a question of how much money comes into one’s bank account every month but also a fragile way of living. Only one unplanned expense can make an already tight budget collapse, just like dominoes falling.

“I mean the biggest thing, especially for poor mothers and fathers is, if anything goes wrong, you’ve had it. So if the washing machine breaks down, you don’t have the extra money to fix it,” says Naomi Eisenstadt, former director of Sure Start in the United Kingdom.

Sure Start

Sure Start children’s centres are very popular in England. They aim to support all families, regardless of their background, to help children under the age of 4 to a good start in life. Giving parents advice on parenting practices, employment, social benefits and health, at a one-stop shop located in their neighbourhood, helps families receive the right support. Local parents take part in designing and setting up the programme in their area, so it meets the local population’s specific needs. Centres vary in the range of activities on offer, according to local needs and resources.

The programme is strongest when it engages with families that are difficult to reach, as this is where the greatest impact can be achieved.

Naomi Eisenstadt comments, “I strongly believe that you should concentrate on the 30% of poorest kids, and try to shift the curve; this is where we can really make a difference.”

Combating stigma

Everyday services, such as birth registration and/or midwifery services, are based at the centres, so parents get used to going there for a variety of reasons before their children are born. The aim is to prevent families from feeling stigmatized by visiting the centres, and to help them understand that the centres are for everyone. When people go to a centre, others do not know why they are there.

History of Sure Start

Sure Start centres were originally located only in England’s most deprived areas, and offered open access to all services. To respond to their popularity and to help both privileged and underprivileged families, however, the Government expanded the centres to the rest of the country.

WHO’s strategy for child and adolescent health

The aim of “Investing in children: the European child and adolescent health strategy 2015–2020” is that: “By 2020, all Member States should have ensured access to universal, high-quality health, education and social systems for children in their early years, including infancy”.

Supporting early childhood development is a key focus for the new WHO strategy, but how do Member States best translate a strategy from paper into programmes that work in everyday life?

Sure Start is not an example of a one-size-fits-all programme, but is based on experience from which all countries can benefit. As such, it has provided inspiration for the new WHO strategy.

Sure Start recommendations to support early childhood development
Naomi Eisenstadt gives three pieces of advice, based on experience from Sure Start, to help countries implement successful programmes:

  • gather information on local needs to shed light on the main challenges in the area;
  • involve the local community in order to understand local needs;
  • gather information on successful initiatives that will address local needs and be acceptable to local parents.

She underlines the importance of the centres’ staff having sufficient skills to work with both children and adults, as well as other agencies.

Sure Start provides an example of how to invest resources to deliver evidence-based programmes and activities during early childhood that other countries can use in modelling their approaches to giving all children a healthy start in life.