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There is incontrovertible evidence that early learning opportunities shape long-term development and health. Nevertheless, early childhood care and education (ECCE) is not expressly mentioned as part of the right to education in the Convention on the Rights of the Child, the International Covenant on Economic, Social and Cultural Rights, and the Convention on the Rights of Persons with Disabilities. This paper argues that the right to education can nevertheless be regarded as including ECCE. We examine the treaties, General Comments, and 264 Concluding Observations by relevant UN monitoring bodies, covering 152 countries from 2015 to 2020, to determine whether the right to ECCE is regarded as part of States’ obligations and the content of the duty. These demonstrate consistently that States must provide affordable, accessible, quality, inclusive ECCE, with adequate resources. We argue that monitoring committees should draw these obligations together in one General Comment, thereby improving States’ accountability and guiding the delivery of ECCE.

No Abstract. South African Medical Journal Vol. 96(9) (Part 2) 2006: 862-864

The aim of the present study was to evaluate the accuracy of birth notification data collected during Birth to Ten, a longitudinal birth cohort study based in the Soweto-Johannesburg Metropole. Photocopies of birth notification forms were obtained from three local health authorities (Soweto, Diepmeadow and Johannesburg) for 5 448 of the 5 460 singleton births that occurred during seven weeks between April and June 1990, to women resident in Soweto-Johannesburg. By comparing the data recorded on the three different types of notification forms used by delivery centres within the Metropole, it was possible to assess the consistency of data collected during birth notification. For 539 of the 2 120 births that occurred at Baragwanath Hospital in Soweto, it was possible to locate the original records of maternal age, gravidity, infant sex, date of birth, birth weight and gestational age at birth, contained in obstetric and neonatal hospital files. By comparing these records with information contained in the birth notification forms it was possible to assess the accuracy of birth notification data submitted for deliveries at Baragwanath Hospital. Each of the different notification forms contained a different selection of variables and failed to specify the precision with which continuous variables should be recorded. For 12 selected variables, the proportion of missing records ranged from 0.0% to 40.9%, and was highest for those variables (such as APGAR scores and parity) that were not required on all four forms. The percentage agreement between information recorded on these forms and the original hospital records was highest for the categorical variable infant sex (99.1%), while the accuracy of notification data for continuous variables ranged from 95.2% (maternal age) to 29.7% (gestational age at birth). The upper 95% confidence intervals for the mean absolute errors in gestational age at birth and birth weight were two to three times the units of measurement, at 2.4 weeks and 165 g, respectively. When these extremes of error were applied to data for all 539 children, the proportion classified as premature or post-term varied by up to 25.7%, while those classified as macrosomic, low or very low birth weight varied by 10.5%. This analysis illustrates the potential consequences of imprecise birth notification data on the apparent prevalence of premature and low birth weight babies, both of which are key indicators in maternal and child health. Improving the process of birth notification and standardising the format of birth notification forms would increase the consistency of birth notification data. Selecting variables that are established indicators of health status, and can be reliably measured, would help improve the utility and accuracy of birth notification data.