Positive early experiences and interactions are also vital to preparing a quality learner. A large study in 12 Latin American countries found that attendance at day care coupled with higher levels of parental involvement that includes parents reading to young children is associated with higher test scores and lower rates of grade repetition in primary school. Evidence from the Philippines, Sri Lanka and Turkey has shown that children who participate in early intervention programmes do better in primary school than those who do not benefit from formal early child programmes, and studies from India, Morocco and Latin America demonstrate that disadvantaged children benefit the most from such programmes.
In addition to cognitive effects, the benefits of good early childhood programmes include better psychosocial development. Effective and appropriate stimulation in a child’s early years influences the brain development necessary for emotional regulation, arousal, and behavioral management. A child who misses positive stimulation or is subject to chronic stress in the pre-school years may have difficulty with psychosocial development later in life. A high level of quality in early childhood development programmes can be achieved when health and nutrition components are combined with structured psychosocial development in the pre-school years. (200)
二、將下列短文譯為漢語(50分)
According to IMFanalysis, reforming health care systems should be high on the list of priorities of governments as they continue to work on cutting deficits and debt. Many advanced economies are facing the challenge of controlling the growth of public health spending while, for many emerging economies, the reform challenge is to expand basic health care. And the good news is that governments have a number of reform options available to them.
The latest reform efforts have already begun to take shape in both advanced and emerging economies. Advanced economies are undertaking a range of reforms aimed at everything from reaping efficiency gains by enhancing competition and choice to realizing administrative efficiencies through better use of information technology.
In emerging economies, some health care systems have successfully expanded health coverage and improved health outcomes without incurring high fiscal costs. Across Asia, for example, many countries are looking to move beyond fee for service to other types of payment systems such as geographic caps, hospital global budgets, and case mix adjustments—which look at ways to base reimbursements on pre-treatment patient risk estimates.
Health care reform must balance various objectives, such as improving health outcomes, controlling spending, and achieving equity, the authors say. In Asia and elsewhere, there is often overuse of hospital care and underuse of preventive and primary care. Some countries have adopted elements of gatekeeping in primary care to ensure the right mix of service use and to improve health system performance.
In the study, the IMF recommended that cost containment reforms should minimize any potential adverse effects on the poor. Most advanced economies have achieved universal access to basic health services, and health reforms should respect this safety net. Health care reform is complex and faces the difficult task of balancing different objectives, such as improving health outcomes, controlling spending, and achieving equity. (308)