Abstract
Given the proportion of young children experiencing disadvantages in achieving optimal health due to inequities related to race, place, and income, there is increasing attention to developing effective early childhood (EC) systems. As EC leaders embrace methods such as collective impact in driving systems change, there is a growing recognition that a one-size-fits-all approach to developing integrated EC systems may be inappropriate as systems-building efforts may differ in their "maturity." Systems maturity, as we define, refers to the ability of child-focused organizations, across disciplines and sectors, to successfully collaborate toward continuous improvement in supporting optimal child well-being. A flexible, developmental framework of systems building accounting for maturity better articulates the nuances of EC systems-building work. This article describes an emergent framework of EC systems development observed from states and communities participating in the Early Childhood Comprehensive Systems Collaborative Improvement and Innovation Network (ECCS CoIIN) and aiming to build systems for increased developmental promotion and screening. The framework depicted both acknowledges the complexity of systems building while providing a simplified frame for assessing the status of a system to drive further system development. This framework can be utilized to guide effective implementation and evaluation of EC systems-building initiatives.