Presentation made by government of Chile during Indonesia’s study visit to South America Social Policies on June 2012. The study tour was organized by UNDP/IPC-IG.

1. System for
Comprehensive Child
Protection Chile Crece
Contigo- ChCC
(Chile Grows with You)
June 2012

2. CONTEXT

3. Poverty Levels
Evolution of Poverty, Children Under 4 Years of Age
2000 to 2009
(percentage) There are 889.247
children under 4 years of
age
Data: CASEN 2009

4. Health Rates : Coverage
• Professional care during child birth = 99.8%
• 90% of women use the public health system for prenatal care.
•79% promptly initiate their pregnancy care (before 20 weeks of pregnancy).
Percentage of Children Younger than Four,
according to the Provisional Health System,
2009
(percentage)
81,8% of children under
four are attended to by
the public health
system.
(*) The “Other” category includes the: “Other” and “FFAA y del orden” alternatives
(**) The “None” category represents private care. Source: CASEN, 2009

5. Health Rates: Infant Mortality
2008 rate:
7,8 x 1.000 live
births

6. Health Rates: Infant Mortality

7. Even though we have vanquished malnutrition and death,
the full development of children remains a challenge.
Source: Final Report II NATIONAL SURVEY ON THE QUALITY OF LIFE AND HEALTH 2006 Division for Health Planning.
Ministry of Health.

8. Early Childhood Education Rates: Coverage
Nursery and Kindergarten Attendance, 2000 a 2009
(percentage)
Variation in percentages 2,6% 33,8% 15,3%
18,5% 87,5% 30,7%
Source: CASEN, respective years

9. Nursery Attendance by Income Quintile, 2006 -
2009
(percentage)
2006 2009
14 13,1
12
10,5
10 9,0
8,3
7,8
8 7,1
6,6
5,9
6 4,8
4 3,0
2
0
I II III IV V
Variation in
percentages
120,0% 41,4% 49,6% 14,9% -20,2%
Source: CASEN, respective years

10. Kindergarten Attendance by Income Quintile
2006 - 2009
(percentage)
2006 2009
60
50,8
50
38,2
40
29,4 31,0 29,3 28,0
30 27,2 26,3
24,1
20,2
20
10
0
I II III IV V
Variation in
percentages 12,9% 30,2% 4,8% -4,1% 33,4%
Source: CASEN, respective years

11. Reasons for Lack of Nursery Attendance in Children
Younger than Two, 2009
(percentage)
Autonomous Income Quintile
Reasons
I II III IV V
There is no need as they are taken
care of at home. 75,7 76,0 75,1 78,7 82,2
No use for them to go at this age 10,8 11,7 12,6 8,8 10,9
Distrust in the care they would
receive 3,0 2,6 1,2 3,7 1,3
They would get sick too often 1,8 1,5 4,0 1,1 2,0
There is no nursery nearby 2,3 1,1 1,1 0,4 0,5
Other reasons 6,5 7,0 6,0 7,3 3,2
Total 100,0 100,0 100,0 100,0 100,0
Source: CASEN, 2009
The “other reasons” category includes reasons such as “the schedule is not right for me”, “there
are no vacancies” “access is difficult”, “economic difficulties, “”the child is disabled”, “a special
facility is required” and “the child is not accepted”.

12. Reasons for Lack of Kindergarten Attendance in
Children Between Two and Three Years of Age, 2009
(percentage)
Autonomous Income Quintile
Reasons I II III IV V
There is no need as they are taken
care of at home. 70,5 70,0 68,7 72,9 74,8
No use for them to go at this age 8,8 7,0 13,1 9,0 10,5
Distrust in the care they would receive 2,8 5,3 2,7 3,3 2,6
They would get sick too often 2,3 1,7 2,6 3,2 5,3
There is no nursery nearby 5,3 3,7 1,7 1,1 0,1
Other reasons 10,2 12,2 11,1 10,5 6,8
Total 100,0 100,0 100,0 100,0 100,0
Source: CASEN, 2009
The “other reasons” category includes reasons such as “the schedule is not right for me”, “there
are no vacancies” “access is difficult”, “economic difficulties, “”the child is disabled”, “a special
facility is required” and “the child is not accepted”.

13. The origin of Chile Crece Contigo

14. Presidential Advisory Council for the Reform of Childhood
Policies (2006)
• Extensive participation
 Hearings with both national and international experts on the
subject.
 Regional hearings with organizations and people linked to the
issue.
 Inputs of thousands of children and adults through the Website.
Committee of
Childhood
Ministers
Law 20.379
Inter-ministerial
Technical Group
Public Policy Proposal Analysis and activities for the System for the Comprehensive Institutionalize ChCC
implementation Childhood Protection
2006 2009
2006 2007
1 2 3 4

15. Its design is based on
• Scientific evidence:
• Consolidation and universalization of successful services and
experiences (national and international evidence).
• Window of opportunities (Large impact of working with early
childhood).
• Rate of return (very cost effective investment).
• Broad consensus
• Unanimous approval in Congress of Law 20.379 which
institutionalizes the Subsystem for Comprehensive Childhood
Protection, Chile Crece Contigo
• In accordance with emerging paradigms
• Social health determinants.
• Focus on child rights.
• Systemic Ecological Focus.

16. Principles and Basics

17. Crucial Periods of Development

18. Strategic Investment
For each dollar invested in
Early Childhood the
State saves up to eight
dollars.

19. Multidimensionality and Intersectoriality
• Childhood development is multidimensional.
• Assistance must be given in a timely manner that pertains to the
particular necessities of each child.
•Intersectional policies allow for the accompaniment of people’s
lifecycle, strengthening of resources, and a simultaneously impact related
factors.
• Chile Crece Contigo allows for the junction of integral services that follow
the path of child development during early childhood which strengthens
the impact of the actions taken.
Positive
Environment
Early Adequate
Stimulation Nutrition
Health and
Hygiene

20. What is Chile Crece Contigo?
• A programme that allows for the equality of opportunities
for childhood development, preventing the structural causes of
poverty and supporting social mobility.
• Allows for synergy among institutions : Provides, organises,
integrates, and generates early childhood support benefits (from
pregnancy until the child is four years old). These are provided by
various public services which allows for a follow up of the
development path of each child during their early childhood.
• Falls within the framework of the Social Protection System.

21. How does it work?

22. Support Structure
Central/National
ChCC Design with local
Communal
Network
expressions.
Municipality
Communal Level Health Education
Coord.
Governments Prov. P.S.
Provincial Level JUNJI
ChCC INTEGRA
Managers
Enc. Regional
ChCC
Health
Regional Level Services
SEREMI SEREMI SEREMI
Health Serplac Education
MINSAL MIDEPLAN MINEDUC
National Level
Committe of Ministers for Early Childhood

23. Personalized Accompaniment of development
The System is entered Any of the child’s contact points
after the 1st prenatal must activate the programe in
check-up, no matter situations of vulnerability (Health,
the week of the Municipality, Education)
pregnancy
Bio-psychosocial Development Support Program
Health control
birth
Ex: Household Visit Program
Health Inadequate living
Health Ej: FPS implementation and derivation
conditions
Identification of vulnerability from Chile Solidario
bio-psychosocial
risks according
to protocol
Social Need for
vulnerability Municipality daycare
Lag in
Education development
Differentiated Support Ex: Prioritized access to housing
improvement program

24. Chile Crece Contigo is a network of integrated
services
Public education
Public system
health
network
Unit for familial
intervention
FAMILY
Other
social
services
Stratification Office
(FPS)
Chile Crece Contigo communal network

25. What does it offer?

26. Support and Benefits offered by Chile Crece Contigo
• Bulk Educational Program with informative
and interactive spaces.
• Legislative improvements
All children in
Chile(100%)
• Bio-psychosocial
Development Support
Program (PADBS)
• Support Program for the
Vulnerable
New-born (PARN) children
(74%)
Children in the Public
Health System
(81,6%)
• Free and quality nurseries and kindergartens.
• Household visits from health teams.
• Family allowance
• Comprehensive attention to children lagging
behind
• Technical support for children with disabilities
• Preferential access to welfare programs.

27. Pragmatic and Support Tools
Main Program: Bio-psychosocial Support Program (MDS/MINSAL).
Support Program for the New-born (MDS/MINSAL).
Fund for Childhood Development Support Interventions (MDS/
Municipalities).
Competitive Fund for Childhood Initiatives (MDS/ Public/private
implementers).
Fund for Municipal Strengthening (MDS/Municipalities).
Agreements (Fono Infancia, Vulnerability Diagnosis).
Bulk Education Program
System for Registration, Derivation and Monitoring.
Regional Technical Assistance.

28. PADB: Main ChCC Program (HEALTH)
Bio-psychosocial Support Program
Primary objective:
Prevent risk situations
and promote early
childhood health
Pregnancy Birth 0 to 4 years of age
Strengthening Prenatal Personalized Attention to the Strengthening of Care for Children
Development Care during Overall the Child’s in Vulnerable
Labour Development of Overall Situations
the Hospitalized Development
Child
A B C A B A B A B A
PRIMARY CARE HOSPITALS PRIMARY CARE
A. Comprehensive
A. Strengthening of Prenatal A. Strengthening of
Care for the New- Strengthening
Care A. Personalized Care the Child’s A.
born Hospitalized in Interventions for
during Labour Neontology Health Control
for Overall Children in
Development Situations of
B. Development of the Health
Vulnerability,
Plan with a Family Focus
B. Comprehensive Lagging behind,
B. Comprehensive Care for the New- and Deficient in
born Hospitalized in B. Educational Overall
Care during the
C. Educating the Mother and her Pediatrics Interventions for Child Development
Postpartum Period
Significant Other or Companion Support

29. Personalized Health Plan

30. Childbirth Preparation
Workshops

31. Humanized Care of the Birth
Process

32. Analgesic Alternatives

33. Accompanying Support
Figure

34. Ensure Early Attachment

35. Support for the overall
development of
hospitalized children.
Toy chests
Toy carts

36. PARN (Kits)
Programa de Apoyo al Recién Nacido (Support Program for the New
Born)
Workships:
Education for Delivery of Set of
parents and the
family about PARN Materials
Mother’s discharge
from the hospital
Securely • Educational booklet
• Nursing pillow
Attached Bundle •Sling-type baby carrier
•Massage oil
New-born Care •Liquid soap
Package •Plastic changing table
•Regenerating cream
Package for an Equipped • Diapers (20)
• Crib (collapsible) equipped with: Mattress, Blanket,
Pen Cradle Set of sheets and a Down Quilt.
• Cotton diapers (3)
Baby Clothing •Bath towel
• Body rompers for up to three months(2)
Package • Rompers for 3 to 6 month old children
•Pants for 0-3 month olds (2)
• Shirts for 0-3 month olds (2)
• One-piece for 0-3 month olds(2)
• Two piece for 6 month old (2)
• Knit cap for new-borns
• Socks for 3 month olds(2)
• Diaper bag

37. DIFFERENTIATED BENEFITS

38. About Lagging
Lagging: When the child’s development process does not
correspond to the standard expected at his or her age.
Approximately 30% of children, exhibit lags or delays in their
development before they are four years old.
This amount increases to 45% when it comes to children from
more vulnerable sectors.
Scientific evidence indicates that timely detection allows for the
speedy recovery of the age appropriate level of development.

39. San Juan de la Costa
Chiloé: roaming service in
Buque Cirujano Videla
Chañaral
Mulchen

40. Doñihue
Independencia
Chañaral
Chillán

41. Ludobus - La Florida
Ludoteca Hospital of Valdivia
More than 425
arrangements
functioning in the
country
Ludobus - Rancagua

42. OTHER DIFFERENTIATED BENEFITS
Intended for more socioeconomically vulnerable children
(according to the established in law 20.379).
Require the activation of the ChCC Network within a framework
of Social Protection work.

43. Differentiated Benefits
Automatic SUF.
Nursery, kindergarten, partial or complete transport for mothers who
work, study, are looking for work, or are in a vulnerable situation.
Preferred access to welfare benefits (Levelling of studies, inclusion in
the labour force, housing, health and mental care among others.).
Technical support to children with special needs.
Guaranteed access to Chile Solidario when necessary.
For the 60% of the socioeconomically
vulnerable population, as defined by
FPS.

44. Bulk Education Program
The Bulk Education Program is the System for Comprehensive
Childhood Protection’s strategy for generating a social environment
that is favourable for early childhood care and stimulation through
sensitization, promotion, information, and education.
 Website www.crececontigo.cl
 Radial Program “Creciendo Juntos” (Growing Together).
Crece Contigo TV and audio-visual support material.
Educational pamphlets and booklets.
 Catalogue of Reproducible Efforts, “When Copying is Good”.
 Monthly Informative Bulletin, “Growing Together”.
 Social Networks.
 Fono Infancia.

45. 2011-2012 Budget Associated with the Unit

46. Progress

47. Main CHCC Evaluations
• PADBP’s Quasi-experimental evaluation (non-
concurrent cohorts over time), once the base
measurement was produced.
• Three sided experimental evaluation of the group
workshop for child skills, “No One is Perfect”.
• PADBP’s satisfaction study.
• Satisfaction and PARN usability survey.
• National Survey of Implementation (efficiency
conditions for PADBP implementation).
• Qualitative evaluation of the implementation of Bio-
psychosocial Support Program
• Quantitative and qualitative evaluacion of Chile Crece
Contigo’s communal networks.

48. Some developments
Consolidation and increase of relevant benefits in
order to support childhood development: research of risk
factors during pregnancy, household visits, prenatal education
and parental skills.
High levels of user satisfaction with Bio-psychosocial
Support Program, and Support Program for the New-born
(kits), at 81% and 94%, respectively.
Systematic increase in de CHCC budgets (up 8% in
2011), especially in terms or resources or support during
pregnancy and the benefit of preschool education.

49. Some developments
Survey of 340 CHCC communal managers: these
results will allow orientation on the use of the Funds for
Municipal Strengthening and regional technical assistance
teams.
Creation of Indicators of Key Development for 100%
of the communes, the object of which is to have indicators
that will allow us to identify how the Communal Networks
are doing and what support they might need.
Progressive increase in the use of the System for
Registration, Derivation, and Monitoring

50. Some Challenges
Permanent re-installation of work networks.
Consolidation of the management model.
The communal teams need more support and need to
learn or improve their capacity for work within a network
framework.
Quality standards ensured for all the benefits delivered
as well as access protocol of the benefits.
Untreated childhood cohorts present a high frequency
of lagging and give their primary caregivers parental
stress. One third indicates not being able to support the
child. Strengthen assistance with families.

51. LESSONS LEARNED

52. Key Concepts of the CHCC Model
A single convener address on the transformation of society.
Build on the country’s experience.
National increase in existing interventions.
Creation of new skills in the RRHH.
Elimination of program overlap.
Strengthening and formalization of network jobs on all
levels:
• Circulation of information, management and continuous
analysis of the information in order to make decisions.
• The mechanics of derivations as pa practice for work.
• Formalization of work networks beyond personal will.

53. Key Concepts of the CHCC Model
Families who are primarily responsible for the upbringing
and development of their children: offer more (and better)
information to families.
Focus on the quality of the services and benefits provided.
Focus on the personalized accompaniment of each family.
A welcoming and inclusive community that gives special
attention to small children.
Multi-professional work teams whose main efforts and
focus are on childhood development.

54. Thank you
The children’s future is always today.
Gabriela Mistral