Inter-sectoral coordination in early childhood systems: the Primokiz approach

Early childhood services are provided by a wide range of progra mmes, which primarily are administered by the education, health and social welfare sectors. Although the overarching aim of all these services is to provide the best possible start to children and their families, each one of them follows and adopts different principles, values, frameworks, professional cultures and practices. This often results in instability or discontinuity of provision, and uneven quality of services.

Drawing on the above, recent policy and research initiatives call for a re- examination of our vision for children and childhood and for planning and initiating coherent efforts in order to provide both children and their families with a wide range of high-quality services that ensure the best possible start in life and conditions of nurturing care. There is a need to offer services that are aligned and coordinated, since good health, nutrition, security and safety, responsive caregiving, and opportunities for early education are all equally important in a child’s development (World Health Organization et al., 2018).

These calls are informed by research results which suggest that provision of coordinated and aligned services yields positive effects for children (such as improved behaviour, social skills and learning); for parents and families (for example, more time to look for jobs, increased employment choices, improved family finances); and for people who work with young children (improved practice and professional development) (Ionescu et al., 2017).

In addition, the call for coordinated services builds on the foundation of progressive universalism, which is considered an effective approach for tackling inequalities from early on and for enhancing equity and equality of opportunity. This approach ensures that the same services are available to all, a continuum of nurturing care is established, and intensive services are provided to families and children with additional needs. It also fosters the provision of services that span the continuum from social interventions to child protection.

One of the founding principles of the International Step by Step Association (ISSA) is that ‘it takes a village to raise a child’. In that sense, ISSA’s work has focused on the need for horizontal and vertical coordination of services in order to ensure that the needs and rights of children and families are met, and that each child is given ample opportunities for optimum development and well-being. Complementing other initiatives, ISSA has embraced the proven contribution the Primokiz approach can make in achieving a local comprehensive and aligned strategy for early childhood.

Learning from different country contexts

Coordination of services is a long process and a lasting journey. ISSA has committed to travelling the path of coordinating early childhood provision and has started contributing to learning about and informing this journey through various mechanisms. The principles that underpin the overall approach and philosophy of working in an integrated manner are central to every effort for greater coordination among sectors, in order to foster children’s optimal development through the provision of high-quality services.

Such principles have been underlined in the INTESYS Project, where ISSA played an important role in developing a toolkit for enabling actors at different levels in the early childhood system to establish a dialogue horizontally and vertically, and to co-construct their joint pathways for cooperation and coordination.

Results of the INTESYS project highlight that there is no single road towards integration. Any intervention aiming at integration may be bottom-up (front- line delivery, community, parents) and/or top-down (interagency governance, policies and strategies) but needs to be aligned and underpinned by three building blocks:

  1. a shared vision and a shared understanding among the stakeholders
  2. key factors supporting integration, and
  3. quality

Results suggest that, in order to be effective, the journey towards integration should be based on a continuous participatory process of planning, acting and reflecting which ensures that the needs of children and families are taken into account as well as the capacities and possibilities of all actors involved.

Given its role in developing capacity to nurture learning across borders about improving early years services, ISSA’s commitment to cross-sectoral coordination of early childhood systems was recently acknowledged by the Jacobs Foundation, which awarded ISSA the Primokiz licence, with the plan to make the approach available to other countries.

The Primokiz approach

In 2012, the Primokiz programme was launched by the Jacobs Foundation, with the aim of supporting municipalities, cities and cantons in developing comprehensive early childhood strategies. When the programme started, 18 small and medium-sized Swiss cities and three cantons participated. Early childhood experts worked with these cities and cantons to conduct a situation analysis and, based on the results, formulated a comprehensive strategy that aimed to link projected or existing early childhood education and care programmes in a way that would achieve the greatest possible impact and that would correspond with the various needs of children and their families living in the respective municipality or canton.

Two things are unique about this approach: it connects administrative entities with the political sphere and private actors in the field of early childhood (horizontal and vertical cooperation); and it conveys the message that early childhood is a cross-cutting issue for which the education, social services and health sectors are jointly responsible.

In response to the success of Primokiz and the high demand for the programme, the Jacobs Foundation decided in 2016 to introduce an expanded version called Primokiz, for which it partnered with the Roger Federer Foundation and the RADIX Swiss Health Foundation as the implementing partner. Primokiz is being implemented in around 30 sites in Switzerland so far, and aims to have up to 50 additional sites participating in the programme. The sites are assisted in developing comprehensive early childhood strategies to put in place appropriate structural conditions and programmes according to the needs of the children and their families.

Scaling-up the Primokiz approach

In 2015, the Primokiz approach was successfully introduced in Switzerland’s neighbouring country, Germany, as part of the nationwide programme ‘Qualität vor Ort’ (Quality at the Local Level), Germany being similar to Switzerland in its political and societal structures. Supported by the German Federal Ministry for Family Affairs, Senior Citizens, Women and Youth as well as the Jacobs Foundation, the programme is implemented by the Deutsche Kinder- und Jugendstiftung (German Children and Youth Foundation). Besides boosting quality in early childhood settings and organising ‘Dialogues on Early Childhood Education’, the programme offers support to 20 German municipalities to develop comprehensive early childhood strategies based on the Primokiz approach.

A year after concluding the first phase of the Primokiz programme in Switzerland, an evaluation showed that in almost all participating sites positive decisions were obtained from the political decision makers, welcoming the strategy and agreeing to suggested measures and funds for implementation.

Furthermore, it was reported that networking and coordination between the education, health and social services sectors were established, as well as among the actors in the field. Through the participatory process, there developed   among all the actors involved a general awareness and a deeper understanding of the importance and the comprehensiveness of early childhood.

Unanimously, the continuous support and involvement of political decision makers was found to be crucial for successful strategy development. Similar positive effects have been seen in the German municipalities which are still in the process of finalising their strategies.

Romania Grows with You

Drawing on long-standing experience in the early childhood field, the recent results from the INTESYS project and the additional well-established knowledge brought by the Primokiz approach, ISSA continues to raise awareness on the importance of developing a coordinated policy and service delivery for early childhood. Currently, ISSA partners with the Jacobs Foundation, the Step by Step Center for Education and Professional Development and UNICEF to implement a four-year initiative in Romania for piloting new ways of designing, planning and delivering early childhood services for the youngest children and their families through enhanced cooperation and coordination at community or municipality level.

This initiative, called ‘Romania Grows with You’, aims to create a paradigm shift, pushing forward the agenda in early childhood policies and practices in the country, while making the case for the importance of high-quality early years services. Among other models and methodologies, the Primokiz approach will be used in order to foster the development of a strong and comprehensive network of administrative, professional and private actors who will work together to analyse the current situation, develop a vision of future early years services provision, and build links between health, social care and education and across all relevant institutions and interest groups, vertically and horizontally.

Primokiz will be used in two pilot counties in Romania and in one district in Bucharest. The two counties selected to be part of Romania Grows with You expressed great interest in the project and a growing concern for high-quality early childhood services to better cater to local needs. The project will build on previous local efforts, experience and knowledge of strengthening early childhood services, as well as the expertise of UNICEF and the Step by Step Center for Education and Professional Development, in supporting quality early childhood services for the youngest children.

The lessons learned and the key insights from both counties will support the aim to scale-up a comprehensive approach to early childhood services at national level. At its inception, the project will be implemented in close to 60 services for children from birth to 6 years of age. The project aspires to reach, during its four years of implementation, up to 100 early years services, both traditional (such as kindergartens and creches) and complementary services. Future plans in the partnership between the Jacobs Foundation and ISSA include continuing the partnership in Romania and exploring the implementation of the Primokiz approach in two more countries.


Konstantina Rentzou, Senior Programme Manager, The International Step by Step Association (ISSA), Leiden, Netherlands

Mihaela Ionescu, Programme Director, The International Step by Step Association (ISSA), Leiden, Netherlands

Philine Zimmerli, Program Manager, Jacobs Foundation, Zurich, Switzerland

Cristiana Boca, Coordinator of Early Childhood Education Department, Step by Step Center for Education and Professional Development, Bucharest, Romania

Source: Early Childhood Matters 2019: a round-up of important advances, innovations, best practice and scalable solutions in early childhood around the world, published by Bernard van Leer Foundation