Integrated System

"Health, education, a safe and stimulating environment at home and in public spaces...none of these is more important than the other." - Mihaela Ionescu, Program Director at ISSA

Opportunities in integrating early years services

We know that integrated early childhood systems help children and their families, particularly the most vulnerable. They benefit from a "one-stop-shop" approach, through which the widest possible range of agencies and services are able to meet their needs either directly or through referral.

They also have benefits for the personnel working with young children. By offering the workforce opportunities to work across professions, the quality of staff practice is improved immensely. When centers are integrated, expertise can be shared across sectors (between health workers and teachers, for example) and work in both sectors can be boosted.

One U.S. study investigated joint working between mental health professionals, daycare, and pre-school staff found that collaboration made teachers more empathetic and interested in the deeper meaning of behavioral problems. These teachers had a greater level of control over, and responsibility for, behavior in their classroom. Training in integrated practice also allows staff from multiple sectors to develop a common way of working, and it enhances the efficiency and cost-effectiveness of service delivery.

In short, integrated systems help practitioners, managers and policymakers accomplish more together – all the while keeping the child at the center of their work. As those working in the field will tell you, this is what we’re after.

The road to integrating services…

INTESYS is a three-year project funded by the European Commission’s Erasmus+ Programme. A consortium of partners – Aga Khan Foundation, Compagnia San Paolo, Emanuela Zancan Foundation, Calouste Gulbekian Foundation, ISSA, Learning for Well-Being Foundation, Pedagoski Institut and Centre for Innovation in the Early Years – focuses on piloting new approaches to Early Childhood Education and Care (ECEC) systems in Europe. These pilots aim to ensure children and families in vulnerable situations have access to high-quality ECEC provided by services that are better integrated across sectors and professions.

It isn’t always easy. Even the terminology is not as straightforward as one may hope. Petra Bozovičar of Step By Step Center for Quality in Education mentions a question that arose when describing integrated systems to staff members working on the pilot – it is a question that many of us may have.

“If we call each other when there is a problem that we need to solve- is this not an integrated system?”

Representatives of another pilot plainly state just how difficult the road to integration can be:

Sometimes progress is made, other times you get stuck in reverse. It has become quite clear that cooperation and integration needs strong leadership, a driving force to keep partners motivated.

And, that is just what the INTESYS project is about – cooperation. Through the INTESYS project, a consortium is working together to create a toolkit for Integrated Services. This toolkit is meant to promote integration among different sectors, using the ECEC services as an entry point for integration. The approach takes into account the participation of communities, parents and civil society actors in shaping the integration of services. The Toolkit is promoting the importance of quality in integrated services and is opening the space for dialogue among different stakeholders in the early childhood system.

As a finalization of the INTESYS Toolkit is underway, many representatives of pilot projects have been articulating its success, and just how far they’ve come. One pilot explains:

We came to know each other better and connect with each other, which opened the way for new tasks and also contributed to solving current problems. Together we are stronger and more efficient in finding ways to the common goal.

Where can you learn more…

While we await the final toolkit, the draft can be found here.

You can also hear more about the barriers to making this approach work, the crucial role of the workforce and the leadership and the opportunities that it can create for the outcomes of young children listen to the webinar "Challenges and opportunities in integrating early years services: a spotlight on the workforce." 

Or, read this interview with, ISSA’s Program Director, Mihaela Ionescu where she discusses the need for multi-sectorial, integrated interventions that enable nurturing environments and adopt an individual-child and family perspective.

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By: Dr. Mihaela Ionescu – Program Director, International Step By Step Association

The discussion around the integration of early childhood services is not new at all, but it became more heated in the recent years because of increasingly complex challenges that families with young children face in the current dynamic social, economic, cultural and political contexts they live. There are many experiences of both bottom-up and top-down initiatives for strengthening integration in various countries, but all indicate a series of barriers. And many related to a manner of thinking and working which pays tribute to a highly specialized and silo-ed approach. The barriers also point to a weak or ‘dysfunctional’ relationship between practice, research and policies, which should be meant to make services more responsive and efficient and to bring them closer to children and families, and to communities.  

The Early Childhood Workforce Initiative led by ISSA and Results for Development Institute hosted on October 26th a webinar with a spotlight on those critical aspects of integration that are closely connected to early childhood workforce, especially to those who are in leadership positions. The two guests, Jacqueline Barnes and Jan Peeters brought their long experience from two different contexts in UK, respectively Belgium. Both pointed out a few key aspects that were revealed either through evaluations of programmes that focused on integrating services (see the Sure Start Programme in UK) or by bottom-up initiatives that emerged from inside the services which wanted to be more responsive to families, to and in the communities where they function, thus starting to build local networks and expanding and bridging their services to better align them with families’ demands (see the Ubuntu video made by VBJK in Ghent/Belgium).

Whether in a top-down approach as in UK, where funds were made available for creating the integration of services at community level, or in a bottom-up approach which enabled a more reach-out and participatory approach of those working in services, the success or failure was to a great extent linked to the competences of the workforce, including those in leadership positions (competences meaning the workforce’s knowledge, values, and attitudes that are shaping their practices).

An important prerequisite for integration often mentioned was related to the shared vision regarding children and families of those who work in and lead services and also for those who decide about early years’ policies and practice. In order to align different views, professional languages, different understandings, and different practices, a long process of dialogue (‘negotiation’) led by shared goals has to be initiated among stakeholders, accompanied by new ‘ways of doing things’, therefore a new organizational culture. Jacqueline Barnes pointed out how different professional beliefs, professional stereotypes, differing levels of qualification and experience leading to conflicting views require time for alignment. And that can be done through continuous dialogue, common professional development activities, ‘bridging activities’ among professionals/services led by common goals.

In the same context, Jan Peeters talked about the importance of creating professional learning communities (within and across services) that help build a shared vision, a collective responsibility and engage in reflective and in-depth dialogue around the meaning and outcome for children and families of the work services are doing. An interesting concept in the context of integration was the ‘de-privatisation of practice’ which points to the importance of peer-observation - ‘exposing’ your practices to be observed by peers who act as ‘critical friends’ - and learning from reflecting together with peers, as an act of bridging professions and professionals, but also as an enriching way to grow professionally, beyond the traditional role. A culture of cooperation needs to be nurtured through a visionary and participatory leadership and with supporting practices that encourage the peer and group learning, allocate time for dialogue, for planning together, for making decisions together, for reflecting on what is the right thing to do for each young child and their family in the community. Even if policies are in place, they will never ‘teach’ people about the ‘know-how’. New competences need to be nurtured in initial and continuous professional development and then an enabling professional environment needs to be created for such competences to be enacted. There are already many experiences of how such competences can be nurtured, it is time for such examples to become the mainstream way for preparing professionals.

Could the integration of services have chances only if services exist under the same roof? In some places yes, in other places no. Where a variety of services for young children and their parents exist on the level of the community, a more (cost) efficient way of integration is to create a functional network powered by a shared vision, shared and agreed responsibilities, good channels and protocols for communication, but most of all, time for common planning and decision making, especially regarding the most vulnerable children and families, who usually deserve a more comprehensive and holistic approach. A ‘one stop shop’ might be a better solution for children and families, but it requires sound, committed, reflective and shared leadership, an inclusive, cooperative and participative organizational culture driven by shared values and supportive practices. It requires commitment, time, and continuous learning.

There is no recipe for the best solution. Integration can take different shapes in different places, but important ingredients are related to the values and practices that are enacted by those in leadership positions and the competences that are nurtured in professionals. It’s not a job for one person or for a single institution. To quote Susan Kessede, UNICEF Representative in Belize: ‘No one can whistle a symphony’.
 

Listen to the webinar here.