From silos to systems: Multi-sectoral coordination for optimal child development
What does it take to ensure that every young child has the nurturing care they need?
That question was at the heart of a recent cross-country dialogue convened by Results for Development (R4D), bringing together government officials and practitioners from Kenya, Mozambique, and Tanzania. As part of an ongoing virtual learning series focused on strengthening primary health care (PHC) to promote optimal child development, the conversation surfaced lessons about what makes multi-sectoral coordination work in practice at national and decentralized levels.
For government officials navigating these challenges, hearing that a counterpart in another country faced the same obstacle and found a way through, can shift what feels impossible into what feels achievable.
The silo problem
In most countries, young children’s health care, nutrition, responsive caregiving and early learning, safety and security are supported by different government ministries, each with its own budget, reporting systems, and priorities. As a result, this support is fragmented.
“The sectors have been working in silos and the funding streams and everything is also in silos,” said Mr. Godwin Mongi of Tanzania’s Ministry of Community Development, Gender, Women, and Special Groups, describing the landscape in his country. He explained how the flagship National Multi-Sectoral Early Childhood Development Programme (NM-ECDP) was designed to address longstanding fragmentation in the field.
The sectors have been working in silos and the funding streams and everything is also in silos.”
Dr. Filimone Zibia from Maputo Province’s Department of Health shared concerns about the lack of alignment between sectors and partners supporting early childhood development as well as the absence of budgets that prioritize young children. In response, key stakeholders came together to develop a dedicated, multi-sectoral plan for early childhood development at the provincial level.
Dr. Carol Ngunu explained how Nairobi County set up a multi-sectoral working group and developed an integrated workplan, co-led by health and education authorities, to address similar coordination challenges.
Despite their different governance structures and past experience with early child development, officials from all three countries pointed to the same three factors:
1. Champions are needed at every level
One of the clearest lessons is that multi-sectoral coordination must be intentional, with champions at every level of government, from community leaders to ministers.
In Maputo Province, extensive consultations with district administrators, community leaders, traditional healers, religious organizations, and local businesses contributed to the development of the provincial early childhood development plan. Dr. Filimone explained how when leaders understand early childhood development and feel ownership over the plan, they become more proactive about seeking funding and partnerships.
Tanzania’s experience points to a similar insight at the national level. Mr. Mongi highlighted mindset shifts among decision-makers as one of the priorities for the next phase of the NM-ECDP: “When the mindset of the decision-makers shifts…they start to see more opportunities rather than challenges.” Building that shared understanding of the importance of multi-sectoral coordination is part of what sustains it over time. Within each sector, the question becomes how to incorporate nurturing care into existing systems, guidelines, and service delivery.
“When the mindset of the decision-makers shifts…they start to see more opportunities rather than challenges.”
2. Tracking progress across sectors is essential
Multi-sectoral platforms need shared indicators embedded in each sector’s planning, reporting, and supervision systems. Without this, it is difficult to know whether coordination is translating into better outcomes for children.
Tanzania has developed an integrated dashboard and scorecard that allow decision-makers across sectors to visualize the full early childhood landscape. Guided by a multi-sectoral coordination guideline endorsed by Prime Minister’s Office, using existing decision-making structures, the picture presented by dashboard and scorecard becomes one of key agenda and when leaders can see the whole picture, progress and gaps become visible, and accountability improves.
Representatives from Kenya noted the importance of clear terms of reference for multi-sectoral platforms that define who is responsible for what, which indicators are being tracked, and how data from different sectors feeds into monitoring systems. Without this clarity, coordination risks becoming good intentions without accountability.
3. Coordination can create efficiencies
A common objection to multi-sectoral approaches is that they are too complex, too time-consuming, and too costly to sustain.
The experience from Maputo Province offers a useful counter-narrative. Dr. Filimone described how aligning different departments’ plans can create efficiencies and reduce duplication in service delivery.
In one striking example, the province brought together departments of health, public works, and water and sanitation to establish community gardens near maternity homes so that pregnant women from remote areas could stay close to health facilities before giving birth. This was a challenge the health sector alone could not solve. The gains from coordination come from the whole system functioning together.
A similar logic applies in Tanzania, where coordinators from different sectors go out to visit services in the community together, supporting joint service delivery as well as monitoring. As Mr. Mongi put it, the goal is for coordination structures “from the grassroots to the national level” to enable decision-makers to “see and visualize the implementation holistically.”
The goal is for coordination structures “from the grassroots to the national level” to enable decision-makers to “see and visualize the implementation holistically.”
What’s Next
Although the sheer scale of reaching every child holistically in every community remains a significant challenge, this dialogue among leaders in Kenya, Mozambique, and Tanzania makes clear that multi-sectoral coordination for early childhood development is possible.
For practitioners and policymakers looking to go deeper on this issue, R4D and its partners recently finalized a global toolkit, Strengthening Primary Health Care to Promote Optimal Child Development, that offers practical, evidence-based guidance for national and subnational leaders working to support young children and their caregivers through primary health care systems. Stay tuned for its release on June 17.
