OBJECTIVES: To understand key cost components for Early Childhood Development (ECD) package delivery, and contribute to the development of an affordable, feasible and scalable ECD model that can bring changes for children 0-3 years old in China, particularly in resource-limited rural poor areas, and explore possible ways of integrating the ECD model into the National Basic Public Health Services System.

METHODS: The cost survey collected data from 5 project counties and 5 comparison sites of 5 project provinces (Guizhou, Hebei, Henan, Jiangxi, Shanxi) on three types of project activities (ECD care group activities, home visits, and village clinic developmental risk screening). Costing tools were used to conduct key informant interviews with ECD project’s key personnel at the national, provincial and county level.

RESULTS: The highest proportion of cost components was training cost, followed by activity cost, project office operation cost and supervision cost, reaching 46%, 15%, 13% and 10%, respectively. The total annual per capita cost of the project counties of 2017-2020 was about 48-137 RMB per capital (median 92.0 RMB), and the average costs of home visits, village clinic parenting risk screening and ECD care group activities were 10.0,12.5, 200 RMB per time, and care group for 29.1 RMB per child per time, respectively. UNICEF project specific funding accounted for approximately 69% of the overall project.

CONCLUSIONS: The ECD project has developed a model of universal as well as targeted and indicated support for children 0-3 years old and their families through three major delivery channels. Based on the similarity of the contents and forms of activities, ECD activities are recommended to be organically integrated with existing public health service programs to form a new integrated service model for package compensation and promotion, but the funding amount should be increased by 1.9-4.1 RMB per capita per year with corresponding policy adaptation changes.