Inequality in access to early childhood care and education programs among 3-to 4-year-olds: Trends and variations across low- and middle-income countries

Despite growing acknowledgment of the role of early childhood care and education (ECCE) in reducing social inequality, there is limited understanding of the relation between ECCE expansion and inequality in access to ECCE in low- and middle-income countries. This study explored the relation between national enrollment rates in ECCE and inequality in access to ECCE in 30 low- and middle-income countries, using enrollment data among 3and 4-year-olds (N=303,344) from the Multiple Indicator Cluster Survey and Demographic and Health Survey collected between 2001 and 2021. We found that higher ECCE enrollment rates were associated with lower inequality in access to ECCE, measured by concentration indices (r = -.31). Among 20 countries with significant increases in ECCE enrollment rate over time, six countries demonstrated a significant reduction in access inequality to ECCE. However, 13 countries did not show substantial changes. In addition, we demonstrated how four factors related to income-related inequality in access to ECCE, such as family wealth, maternal education, gender, and urbanicity, were associated with increases in ECCE use. A review of policies in selected countries provides a more nuanced understanding of the findings. Implications of our findings for ECCE expansion in lowand middle-income countries are discussed.