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Investing in early childhood development is essential to helping more children thrive
by The Lancet, Unicef, WHO, agencies
12:35pm 10th Oct, 2016
October 2016
Investing in early childhood development is essential to helping more children thrive, by The Lancet, Unicef, WHO, agencies
An estimated 43 per cent – or 249 million – of children under five in low and middle-income countries are at an elevated risk of poor development due to extreme poverty and stunting, according to a new United Nations-supported series from The Lancet.
“Investing in young children is a moral, economic, and social imperative. The [Sustainable Development Goals] SDGs have provided a promising vision on children and adolescents’ health, but political will and increased investment in early childhood development are needed to ensure that the ambitious targets can be reached,” said Dr. Margaret Chan, Director-General of the UN World Health Organization (WHO), which, along with the UN Children’s Fund (UNICEF) and the World Bank, contributed and offered guidance to the series.
“Early childhood development will not only benefit the children of today, but will have a direct impact on the stability and prosperity of nations in the future,” she added.
The three agencies highlighted that the series, “Advancing Early Childhood Development: from Science to Scale,” reveals that early childhood development interventions that promote nurturing care – health, nutrition, responsive caregiving, security and safety, and early learning – may cost as little as 50 cents per child per year, when combined with existing services such as health.
The findings underscore the importance of increased global commitment to early childhood development. Individuals are estimated to suffer a loss of about a quarter of average adult income per year, while countries may forfeit up to as much as two times their current gross domestic product expenditures on health or education. Consequences of inaction impact not only present but future generations, the agencies said.
“We now know how high the cost of inaction is, and new evidence makes clear that the time to act is now. We hope the evidence in this series will help countries reach more pregnant women and young children with preventive and promotive services that have the potential to drastically improve developmental outcomes for children as well as their adult health, well-being and economic productivity,” said series co-author, Linda M. Richter, of the Centre of Excellence in Human Development at the University of the Witwatersrand in Johannesburg, South Africa.
Research shows that a child’s brain develops faster during the first two to three years of life than at any other time in life. These early years are also a critical period of adaptability and responsiveness to interventions. When young children are deprived of nutrition, stimulation and protection, the damaging effects can produce long-term detriments for families and communities, the agencies said.
“The science and economics are clearly on the side of investing in the first 1,000 days of a child’s life, starting with a woman’s pregnancy,” said Keith Hansen, Vice President of Human Development at the World Bank Group. “The Lancet research is further proof, if more is needed, of just how important this agenda is.”
The authors stress the strong position of the health sector in providing an entry point for early childhood interventions – especially in support of nurturing care. The sector’s ability to access women and children during the critical period from conception through early childhood presents an opportunity to integrate low-cost interventions, such as WHO/UNICEF’s Care for Child Development, into existing maternal and child health and nutrition services.
These have shown to help improve the quality of nurturing care and the overall development of young children, while also giving attention to the well-being of the caregiver, the agencies said.
“The science shows us that biology is not destiny – and that what children experience in the earliest days and years of life shapes and defines their futures,” said UNICEF Executive Director Anthony Lake.
“We need to turn that science into an alarm bell – because the development of millions of children is at urgent risk. Right now, 43 per cent of children in low- and middle-income countries are at risk of not achieving their cognitive potential. No country can risk losing nearly half of the brain potential of its youngest citizens – low- and middle-income countries least of all,” he added.
The series’ authors propose several ways the global community can scale up support for early childhood development services.
Among the recommendations include encouraging the adoption and implementation of policies to create supportive environments for families to provide nurturing care for young children; building capacity and strengthening coordination to promote early childhood development through existing health, nutrition, education, social and child protection services; strengthening measurement and ensuring accountability for early childhood development services; increasing research, and fostering global and regional leadership and action; and expanding political will and funding through advocacy for the SDGs.
* Access the Lancet series via the link below, see also:
Five in six children under two not getting enough nutrition for growth and brain development - UNICEF reports:
At least 385 million children live in extreme poverty, World Bank-UNICEF study highlights
Children are more than twice as likely as adults to live in extreme poverty, with at least 385 million children worldwide experiencing the condition, according to a new analysis from the World Bank Group and the United Nations Children’s Fund (UNICEF).
“Children are not only more likely to be living in extreme poverty; the effects of poverty are most damaging to children and the youngest children are the worst off of all, because the deprivations they suffer affect the development of their bodies and their minds,” said UNICEF Executive Director Anthony Lake.
“It is shocking that half of all children in sub-Saharan Africa and one in five children in developing countries are growing up in extreme poverty. This not only limits their futures, it drags down their societies,” he added.
The report, titled Ending Extreme Poverty: A Focus on Children, finds that in 2013, at least 19.5 per cent of children in developing countries were living in households that survived on an average of $1.90 a day or less per person, compared to just 9.2 per cent of adults. Globally, at least 385 million children were living in extreme poverty.
The youngest children are the most at risk – with more than one-fifth of children under the age of five in the developing world living in extremely poor households.
The new analysis came on the heels of the release of the World Bank Group’s study, Poverty and Shared Prosperity 2016: Taking on Inequality, which found that at least 767 million people globally were living on less than $1.90 per day in 2013, half of them under the age of 18.
“The sheer number of children in extreme poverty points to a real need to invest specifically in the early years – in services such as pre-natal care for pregnant mothers, early childhood development programs, quality schooling, clean water, good sanitation, and universal health care,” said Ana Revenga, the Senior Director responsible for poverty and equity issues at the World Bank Group.
“Improving these services, and ensuring that today’s children can access quality job opportunities when the time comes, is the only way to break the cycle of intergenerational poverty that is so widespread today,” she added.
The global estimate of extreme child poverty is based on data from 89 countries, representing 83 per cent of the developing world’s population.
Sub-Saharan Africa has both the highest rates of children living in extreme poverty at just under 50 per cent, and the largest share of the world’s extremely poor children, at just over 50 per cent. South Asia has the second highest share at nearly 36 per cent – with over 30 per cent of extremely poor children living in India alone. More than four out of five children in extreme poverty live in rural areas.
UNICEF and the World Bank are calling on governments to:
Routinely measure child poverty at the national and subnational level and focus on children in national poverty reduction plans as part of efforts to end extreme poverty by 2030;
Strengthen child-sensitive social protection systems, including cash transfer programs that directly help poor families to pay for food, health care, education and other services that protect children from the impact of poverty and improve their chances of breaking the cycle in their own lives;
Prioritize investments in education, health, clean water, sanitation and infrastructure that benefit the poorest children, as well as those that help prevent people from falling back into poverty after setbacks like droughts, disease or economic instability; and shape policy decisions so that economic growth benefits the poorest children.
(Statistics of measures of extreme poverty should be considered indicative rather than definitive, as such calculations may well be an underestimation of real circumstances)
August 2016 (Save the Children)
There are 159 million children who are stunted today.
The world has made progress in tackling malnutrition. But that progress has been far too slow. Our research shows that the world is way off eradicating malnutrition. On current trends there will still be millions of malnourished children in the world 100 years from now.
What’s more, progress has been alarmingly unequal. While many children have benefited, particular groups of children are missing out on the nutrients that are so vital to their life chances.
Unequal Portions presents the findings of new research into what makes some children more vulnerable to malnutrition than others. It analyses data from a range of sources to show how a deadly combination of poverty and discrimination is robbing certain groups of children – girls, children from ethnic minorities, those in disadvantaged regions of their country, disabled children, and children affected by war – of the healthy, balanced diet they need to survive and thrive.
Drawing on new findings and analysis, this report identifies a series of measures to ensure no child is left behind. And it calls on world leaders to address exclusion and ensure every last child gets the nutrition they need.
In September last year the United Nations adopted global development goals to end hunger and poverty by 2030. On current trends, by 2030 there will be 129 million children under five whose growth is stunted by lack of food, according to research published by Save the Children ahead of an international summit on nutrition in Brazil.
Groups most likely to miss out on progress in curbing hunger include children from ethnic minorities, those in disadvantaged regions of their country, disabled children, and children affected by war, Save the Children said.
''The world has pledged to eliminate all forms of malnutrition by 2030. But if we carry on as we are, that simply won''t happen. Unless the world dramatically changes course, malnutrition is here to stay," it said.
There are some 159 million children who are stunted today, according to U.N. agencies.
Poor nutrition - where people do not have enough of the right kinds of food - kills more children every year than AIDS, malaria and tuberculosis combined, according to the World Food Programme (WFP).
It causes nearly half of all child deaths - 3.1 million a year. Those who survive early childhood are likely to have stunted growth, and not reach their full mental and physical potential, WFP says.
Of the 115 countries studied by Save the Children, 100 have reduced stunting in children since 2000. Countries which have made the significant progress include Afghanistan, Vietnam, Nepal, Ivory Coast, Equatorial Guinea, Bolivia and Ghana. However, progress within many countries has varied depending on ethnicity.
Out of 48 countries with available data on ethnicity, children in the most disadvantaged ethnic groups had on average 2.8 times higher rates of stunting and six times higher rates of wasting than their more advantaged peers, the report said.
In some countries the disparity was even greater. In Nigeria, 52 percent of Hausa children were stunted, compared with 14 percent of Igbo children.
Children in rural areas were more likely to be stunted than those in towns and cities, as were children living in marginalised regions with fewer basic services.
Another major challenge to progress in ending hunger is the huge number of children being forced to flee violence. They make up more than half of the world''s 60 million displaced people.
"All those children on the move have to be protected. These situations are also endangering the goal of nutrition," Roberto Cabrera, Save the Children''s country director for Guatemala, said.
Countries should incorporate international obligations on the right to food and development into national laws, and address inequalities based on gender, ethnicity, poverty, disability or where a child lives, Save the Children said.
A few Key stunting facts:
Good nutrition is essential for the development of a healthy immune system and is the key to unlocking every child’s physical and cognitive potential. The failure to provide children with adequate nutrition, especially in the first 1,000 days after conception, throws away human potential that cannot be recovered.
Children who are poorly nourished are more likely to fall ill, and can die as a result. Nearly half of all deaths in children under five are attributable to under-nutrition.
Malnutrition costs countries billions of dollars every year in lost productivity and holds back economic development, which affects everyone.
The countries with the highest numbers of malnourished children include India, Pakistan, Nigeria, Indonesia and China.
The poorest 20% of children are more than twice (2.26 times) as likely to be stunted as the richest (in our sample of 56 countries)
Overall, inequalities in malnutrition are widening between different regions within countries, between the richest and the poorest, and between rural and urban areas. Discrimination and exclusion help to create these inequalities.
* Save the Children Unequal Portions report (88 page):
* Save the Children report- Urban Disadvantage (80 page):
What is early childhood development and why does it matter? (Theirworld)
The first five years of a child’s life are vital – because 90% of their brain has already developed during that time. If a child receives the right amount of care, stimulation and sensory education, their chance of a more successful life increases dramatically.
Children from poorer and marginalised homes who are unable to access support are put at a distinct disadvantage. If they start school at five without early years’ support, they will have a limited vocabulary and ability to learn.
This is why early child development (ECD) has become a global priority in the fight to help children and families out of poverty and deprivation.
The importance of nurturing care, including healthcare, nutrition, play, learning and protection for young children has been thoroughly proven – but investment in the zero to five age group is still far too small.
Researchers have shown that investing in the early years is one of the smartest investments a country can make to break the cycle of poverty, address inequality and boost productivity later in life. That was backed up by in-depth research published by the medical journal The Lancet.
The recent influential Education Commission report highlighted that “total returns on early education are very high – in some cases up to $7 for every $1 spent— and returns on early nutrition can be many times higher. Early interventions provide the best chance to give each child an equal chance at success, no matter who they are or where they are born.”
That’s why Theirworld cares passionately about early childhood development and why we have launched the #5for5 campaign.
It aims to raise awareness of early child development and put pressure on world leaders to take urgent action to make sure all children have access to the full range of nurturing care.
Sarah Brown, President of Theirworld said: “Whether or not children have access to the best start possible in life is determined by two important factors — sheer chance and political will and resources. The political leaders and those with deep pockets need to follow up and urgently begin to establish the effort and funding to make this happen.“
Early child development supports children’s development from birth to five. It includes programmes and services that every child needs to thrive and get the best start in life.
Nurturing care includes the following areas:
Nutrition support for babies and toddlers, nursing mothers and pregnant women. Access to health care and clean water and sanitation – starting with ante- and postnatal visits for pregnant women, a skilled birth attendant and vaccinations. A child with access to pre-primary learning has a much better chance of continuing to learn in later life.
Opportunities for play and early learning are just as important to healthy development as physical support. Child protection for ensuring healthy early development. This starts with registration at birth, so that children have proper legal standing and are guaranteed access to services such as education.
Theirworld’s #5for5 campaign aims to raise awareness of early childhood development and put pressure on world leaders to take urgent action to make sure all children have access to nutrition, health, learning, play and protection.
Promises have been made. The Sustainable Development Goals – a set of global targets agreed by world leaders to be achieved by 2030 – include ensuring all children “have access to quality early childhood development, care and pre-primary education”.
To achieve this goal, the international community needs to commit to a dramatic increase in funding and take action to support health, nutrition, learning, play and care programmes to make sure all children – especially the poorest and most marginalised – are given the best start in life.
* Gaps and Inequities in Early Childhood Development across Africa:

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