What leads to policy change on family and child health and wellbeing?

A window of opportunity at the end of the dictatorship in 1989 brought in a government promoting universal, rights-driven approaches. While several social protection schemes were introduced, Chile Crece Contigo (ChCC) went further to provide a universal, integrated and comprehensive approach to improving equality of opportunity across the life-course through early child development, drawing on growing evidence of the returns from such investment. President Bachelet set a political vision for it, gathering technical, social and cross party actors to review evidence and make proposals for ChCC.  The near universal health system and existing services, supported by training and new resources, provided a means for ChCC to quickly reach communities with visible benefits, while evidence is being used and communicated to demonstrate gain and support improved practice.

A policy shift towards integrated delivery of services for young children and families followed the election of a government with a commitment to greater state involvement in early childhood care and education. Advocacy by a range of non-state agencies for integrated care and education for children for their and the country’s development was acknowledged by the government and expressed in policy. Government gave profile to the issue, with an independent department with a cabinet minister. The policy change remains in transition, partly due to traditional Catholic family values that have persisted, with successive governments reluctant to intervene in the family.

A demographic ‘shock’ of an ageing population with low fertility opened an opportunity to address work-life balance (WLB) demands that discourage female employment and family size in Japan. With a weak civil society and strong business influence, research shared in the media drew policy attention to these WLB concerns and their link to declining fertility. Japanese state actors consulted and communicated with key stakeholders on policy options. With accumulating evidence and pressure from opposition parties, Prime Minister Abe led the adoption of WLB and workplace reforms, positioning the changes as an economic investment. With various incentives for reforms, this drew support from previously opposed business interests, and systems were introduced to monitor policy uptake and performance. While changing, gender norms have been more difficult to shift and further measures are underway. 

Kenya’s laws on sexual offences, female genital mutilation and domestic violence show the strategic role of law reform in changing norms and policy in Kenya on gender based violence (GBV). An alliance across women’s movements and civil society on gender equality, a rise in legal and judicial activism on cases of GBV, Constitutional reform and inclusion of civil society activists in government opened opportunities for policy change. A National Gender and Equality Commission consulted and engaged stake-holders on law reform. As each law was passed, state and civil society supported implementation and sensitised communities, to build support for the next. The Kenya Women Parliamentary caucus and gender champions organized political support and compromises were made to enable the earlier laws to pass, for their implementation to further change awareness, practices and social norms. The experience showed the risk of reversal of gains made and the need for consistent engagement, before, during and after the policy reform.

An Ombudsman for Children and civil society organisations in Norway provide safe spaces and participatory processes for children and youth to express and report their experience with services, including in parliamentary hearings. The OCN bridged formal and informal processes. The realities that children presented to political actors were a wake-up call, triggering their support and raising cross-party political support for law reforms on children’s participation in planning in municipalities, schools, health services and the care system. The 2014 Constitution now provides a duty for this. Challenges and social debates continue and barriers remain, especially for disadvantaged children, but there is a growing understanding on the new and important insights children bring to the improved functioning of society and services.