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Mom_and_baby_social-impact_bondsBy Dr Susan De Witt, Programme Co-ordinator

We are ending the year on a positive note - after many delays the Departments of Health (DoH) and Social Development(DSD) have decided to split the procurement for the Impact Bond Innovation Fund. Under this agreement, DOH will contract community health workers focusing on the first 1000 days.

Ultimately what society strives for are healthy pregnant women, who give birth without complication and raise children that are well nourished, healthy and developmentally normal. Multiple indicators are required however, in order to measure whether this actually happens. A long list of potential outcome metrics has been considered and refined. These indicators:

- Reinforce existing community based NPO service package requirements;

- Catch and match pilot data capture points and the Road to Health Booklet. 

- They include ensuring adequate antenatal care (look at reducing the mother to child transmission rate of HIV, encouraging exclusive breastfeeding, adhering to full immunisation schedules, achieving correct weight and height for age and testing the impact of early stimulation).

In addition to buying services on the basis of resultsm, DOH would like to use the impact bond fund to test a robust monitoring & evaluation system, expand promising models of provision and strengthen NGOs that can take responsibility for community health workers in the field.

Meanwhile, DSD will use the impact bonds to contract organisations who provide home and community based services to children aged 2.5-5 yrs. These can include services carried out by field workers, day mothers and playgroup facilitators. 

Much of the developmental focus in the last few decades has been on education and more recently on school readiness as a key element of improving academic results. Ultimately what schools want are children entering the system that are ready to learn. Much effort has gone into the Early Learning Development Standards, which have been used to create the National Curriculum Framework for children 0-4 years old. There are numerous collaborative projects underway to create standardised tools to measure whether these standards have been reached, a number of which will be used to asses the programmes the IBIF will be funding. A long list of potential developmental assessments measuring cognitive, language, socio-emotional and motor skills has been considered and refined alongside various government, academics and practitioner working groups.Children will be assessed at the end of each year as they complete home and community based programmes designed for 3-5 year olds.

In addition to buying services on the basis of results the DSD would like to create a benchmark against which similar programmes can the tested and understand what the costs associated with this model of care are.

We are very excited to see how both of these initiatives pan out in 2016!