How Can We Improve the Quality of Early Childhood Services? Lessons from El Salvador

The first years of life are critical for children's development and future well-being. That is why it is important to provide nurturing care, including opportunities for learning and responsive interactions, emotional support and stimulation, good health, adequate nutrition, and safety.

Early childhood services play a fundamental role in providing this care.

But how can we ensure that more children across Latin America and the Caribbean have access to quality care services? At the Inter-American Development Bank (IDB), we are working with countries across the region to develop solutions tailored to their needs, strengthen approaches that are already working, and draw lessons that can help bring them to scale.

One of these countries is El Salvador, where Child Welfare Centers (Centros de Bienestar Infantil, CBI) and Community Centers for Child and Family Care (Centros Comunitarios de Atención a Niñez y Familia, CCANF) provide daily care, meals, stimulation, early education, and growth and development monitoring for children ages one to six in urban and rural communities.

With the adoption of the Crecer Juntos Law in 2023, the country reinforced its commitment to the quality of these services. The Crecer Juntos Institute (Instituto Crecer Juntos, ICJ) oversees the centers, which operate under a co-management model with administering organizations. With technical and financial support from the IDB, the ICJ is developing tools to assess the quality of care and drive continuous improvement.

The Crecer Juntos Institute has established its Early Childhood Care Quality Framework and is working with the IDB to design a quality management and assurance system for comprehensive early childhood care. The goal is to establish clear standards to measure various dimensions of quality, assess service performance, and promote continuous improvement.

One of the central elements of this process is that the standards are grounded in a comprehensive approach to care. The system considers different areas of child development through five essential components: health and nutrition; education and care; families and enabling environments; promotion and protection of rights; and equitable access and cultural diversity.

These dimensions are translated into concrete aspects that can be observed and measured.

• In health and nutrition, standards cover children's health checkups, including weight and height measurements, oral hygiene routines at the center, follow-up for children diagnosed with malnutrition, and developmental assessments twice a year.
• In education and care, quality encompasses learning experiences, opportunities for play and exploration, caregiving practices, and interactions between adults and children. How an adult listens, responds to a child's needs, encourages participation, and builds relationships is fundamental to child development.
• In families and enabling environments, standards address aspects such as communication with and participation of families, as well as the center's capacity to contribute to environments that support child development.
• In promotion and protection of rights, standards incorporate practices that foster respectful treatment and protect children from violence and rights violations.
• From the perspective of equitable access and cultural diversity, quality means recognizing and responding to the different characteristics, needs, and circumstances of children and their families.

To translate this approach into an operational tool, the system is structured around three functions: certification, monitoring, and supervision.

• Certification verifies that centers meet the basic conditions required to provide services, including infrastructure, safety, resources, and organizational arrangements.
• Monitoring tracks center operations and compliance with standards to identify gaps and opportunities for improvement.
• Supervision provides a comprehensive assessment of the quality of care delivered and helps guide improvement efforts.

To date, 31 centers have been certified as Community Centers for Child and Family Care after demonstrating compliance with standards for infrastructure, safety, risk prevention, sanitation, furniture, equipment, educational and play materials, and daily care.

Measuring quality means not only verifying whether a center has the necessary resources and conditions, but also observing what happens when a child enters a care setting: how the adult welcomes the child, responds to their needs, creates opportunities for play and learning, and builds the interactions that support their development.

El Salvador's experience is part of broader efforts by countries across Latin America, with IDB support, to place quality at the center of early childhood policies:

• Argentina, for example, has developed the MIRAr tool to observe interactions between caregivers and children, as well as practices that promote learning in early childhood settings in Greater Buenos Aires.
• Panama has developed national quality standards for Comprehensive Early Childhood Care Centers, along with supervision mechanisms linked to results-based incentives.
• In Bogotá, Colombia has made progress in building a system that strengthens coordination, quality, and data to ensure that every child receives comprehensive care.

Ensuring quality means making sure that every child can access services that support their development, protect their rights, engage their families, and respond to their diverse needs and circumstances. In this sense, quality standards are much more than supervision tools: they help translate the commitment to comprehensive care into better experiences and greater opportunities for every child, starting in the earliest years of life.

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