- In Latin America and the Caribbean, systematically measuring and monitoring young children’s development remains the exception rather than the rule. Without data, it is harder to identify concerns early and guide policies and services.
- The province of Cordoba, Argentina, developed a scalable, easy-to-use child development monitoring system for use in childcare settings.
- Initial data show that language is the area with the most warning signs, reinforcing the need to support development from the first months of life.
The early years lay the foundations for future learning, health, and well-being. There is broad consensus on the need for governments to invest in early childhood development. Yet one link remains weak in Latin America and the Caribbean: data collection. Systematic monitoring of young children’s development is still limited and fragmented.
Without information, early childhood services cannot know how many children show signs of developmental delay, in which domains, or at what ages these signs are most pronounced. Identifying these signs early allows for timely intervention to support a child’s developmental trajectory.
At the Inter-American Development Bank (IDB), we seek to identify and highlight initiatives that offer practical ways to close the measurement gap. One such initiative is in the province of Cordoba, Argentina, where the Office of the Ombudsperson for the Rights of Children and Adolescents developed an early childhood development monitoring system that already holds information on hundreds of children across several localities. In this blog post, we examine this initiative and what its data are beginning to reveal.
The monitoring system developed in Cordoba uses pre-PRUNAPE, a tool based on Argentina’s National Developmental Screening Test (Prueba Nacional de Pesquisa, or PRUNAPE), which was developed to detect potential developmental disorders that might otherwise go unnoticed.
Pre-PRUNAPE is a short questionnaire completed by caregivers that makes it possible to quickly identify children who need an in-depth assessment, with minimal training for those administering it. Its simplicity makes it well suited to widespread, decentralized use within childcare settings.
Unlike PRUNAPE, pre-PRUNAPE identifies warning signs but does not establish a diagnosis. A “fail” result indicates that a child needs a more comprehensive assessment, not that a developmental delay has been confirmed.
What makes Cordoba’s experience interesting is both its use of pre-PRUNAPE and the information system built around it. The Ombudsperson’s Office developed a digital tool to centralize assessment results and collect records over time. It also trains the staff who administer the tool and coordinates with municipalities, which decide where to implement it, including in infant care facilities, nurseries, and childcare centers.
The system has collected records consistently for more than two years, making it possible to begin monitoring children’s development over time.
At its core, this is a subnational public policy that emerged in response to a local need and has the potential to expand. The province plans to integrate these indicators into its child monitoring dashboard. The system has also attracted interest from other jurisdictions in Argentina, whose representatives have sought to learn about the initiative, a sign of its potential to be adapted and replicated in other contexts.
Data collected through August 2026 cover assessments of 936 children in five localities. These initial findings are beginning to demonstrate the value of measurement. Most assessments involve children ages three to five who attend preschools and, to a lesser extent, infant care facilities, reflecting the settings where the tool is most frequently used.
The main finding concerns the developmental domains with the highest concentration of warning signs. Together, language and the psychosocial domain account for nearly three-quarters of the signs identified, followed by fine motor skills, while gross motor skills account for the smallest share.
This pattern is both expected and revealing: the domains with the most warning signs are those most sensitive to the quality of early interactions between children and their caregivers, such as language, play, and bonding. In other words, the data point to the developmental domains where parenting support and high-quality stimulation can make the greatest difference in helping children reach their full developmental potential.
The data also show that children whose mothers have lower levels of education display more warning signs. This association must be interpreted carefully: maternal education serves as an indicator of the household’s socioeconomic context, rather than an explanation in itself. Promoting child development requires substantial investments of both money and time devoted to stimulation, and both resources tend to be more limited in disadvantaged households. For policymakers, what matters is that the system helps identify which groups may need greater attention.
The data also call for caution in another respect. Validation studies of pre-PRUNAPE show that its sensitivity is lower in the first months of life and increases as children grow: many signs may not yet be visible in the youngest children. This offers an important lesson: waiting for a test to flag a difficulty may mean intervening too late. That is why it is important to make developmental assessments systematic throughout early childhood, rather than conducting them at a single point in time.
These results come with another necessary caveat: each municipality independently decided where to administer the tool, often in more vulnerable settings. The figures therefore describe the children assessed, rather than Cordoba’s entire child population. They should not be interpreted as an estimate of the prevalence of developmental delays in the province. Their value lies elsewhere: they show that the system can identify warning signs and organize useful information for decision-making.
For decision-makers in provincial or municipal governments, Cordoba’s experience offers a practical approach that is straightforward to implement. Because it relies on a screening tool, childcare staff can administer it after brief training, without the need to hire specialized professionals. Getting started does not require extensive infrastructure: a validated tool such as pre-PRUNAPE, staff trained to administer it, and an agreement with childcare providers to incorporate measurement into their routines are enough. Coordination with municipalities, which know their communities, makes it possible to scale up.
It is important, however, to plan how to respond once data become available. A developmental monitoring system only fulfills its purpose if it is connected to a care pathway. Care systems must determine where a child with warning signs is referred, who conducts an in-depth assessment, and what support the child and family receive.
The Ombudsperson’s Office has two goals: to generate evidence for decision-making and to enable municipalities to develop and sustain the full continuum of care that children’s comprehensive development requires, from detection to response. Municipalities such as Salsipuedes and Despeñaderos, which pioneered the system’s implementation, are beginning to show how this approach can work in practice.
These initial data from Cordoba show that measurement provides answers: which developmental domains need more support, how the system works, and where to focus efforts. But measurement is only the first step: information becomes meaningful when it translates into timely support and guidance for families from the earliest years. Cordoba is beginning to follow this path, offering an invitation to other provinces that wish to do the same.
At the IDB, we work to support countries and provinces across the region in advancing early childhood development. If you are interested in these topics, we invite you to follow our blog and learn more about our work in the region.
Keywords:
Child Development