In 2015, The United Nations General Assembly has set 2030 agenda known as Sustainable Development Goals. The UN General Assembly has set 17 goals that has to be achieved till 2030. However, a number of countries wouldn’t be able to meet these goals and will be far away from reaching there. This situation has come because the world has kept out the children from the context of developmental discourse and has forgotten their role in achieving SDGs goals. It is well known that no advances in sustainable development will occur without multiple generations contributing to societal improvement. Children’s health, learning and behaviour during the early years are the foundation of human development and their capacity to participate in community, workplace and society. When we invest in children and families, the next generation will pay that back throughout their life and in contrary we put our future at risk by not investing for them.
The period from pregnancy to age 3 is the most critical, when the brain grows faster than at any other time; 80% of a baby’s brain is formed by this age. For healthy brain development in these years, children need a safe, secure and loving environment, with the right nutrition and stimulation from their parents or caregivers. This is a window of opportunity to lay a foundation of health and wellbeing whose benefits last a lifetime – and carry into the next generation.
However, world ignore this window of opportunity where an estimated 30% or more of young children are at risk of poor learning, inadequate education and reduced adult earnings. Children all over the world are exposed to adversities that impair their optimal development. In fragile states and conditions of violence, war, disaster and displacement this condition is worst. Thus, the agenda of early childhood development is truly a global agenda.
Highlighting the importance of Early Childhood Development, World Bank Group President Jim Yang Kimon Oct 1, 2015 said that “There can be no equality of opportunity without appropriate stimulation, nurturing, and nutrition for infants and young children. Conditions of poverty, toxic stress and conflict will have produced such damage that they may never be able to make the best of any future opportunities. If your brain won’t let you learn and adapt in a fast-changing world, you won’t prosper and, neither will society.”
One in three children under 5 years of age are not thriving - that means they are not meeting their developmental potential, and in fragile contexts, this ratio is even worse. Developmental potential is the ability to think, learn, remember, relate, and articulate ideas appropriate to age and level of maturity, however an estimated 43 percent of the world’s children under age five years do not attain this potential.
Currently, children around the globe are living in darkness and are excluded from the developmental discourse. Some 250 million children are living in countries affected by armed conflict, while 160 million are very likely to suffer from famine and crises of food security. Despite this, there is a severe lack of early childhood development services in humanitarian settings. Approximately 2% of global humanitarian funding is spent on education, but early childhood development accounts for only a tiny fraction of that.3 In India also, the situation of children are not much better - where 38.4% (1 in 3) children between 0-5 years are stunted, 21% are wasted, 35.7% are underweight and 58.6 are anaemic (NFHS 4). Moreover, 34 children in every 1000 live births do not get chance to celebrate their 1st birthday (SRS 2017). Also, 1 in every 4 children of school going age is out of school in India (Census 2011).
Children who do not receive adequate health, nutrition, early stimulation, learning opportunities, care and protection, all identified as elements of ‘nurturing care’, tend to have lowered cognitive impacting language and psychosocial outcomes as well as executive functioning, which translates to lowered academic achievement in primary school and, ultimately, dropping out of school. The latest evidence indicates that early deprivation leaves a genetic mark that is expressed in future generations as well. Scientific findings from a range of disciplines have proved that the first three years after birth, lay down the critical elements of our health, well-being and productivity, which will last throughout childhood, adolescence and adulthood. Indeed, the structures of immediate, underlying as well as macro-level causes of early deprivation perpetuate cycles of poverty, inequity and the neglect of basic child rights.
Early childhood development is essential for attaining many of the ambitious SDGs and is part of the transformative agenda for 2030, making it an international priority for the 21st century. Global targets in poverty (SDG 1.2); nutrition (SDG 2.2); health (SDG 3.2); education (SDG 4.2)and protection (SDG 16.2) address key outcomes to realise young children’s developmental potential. Hence, creating enabling environment and for that investing in ECD is an essential part of the SDGs and ECD has been cited as the most cost-effective equalizer to break the vicious cycle of inequity if evidence-based interventions are provided for all children and families, especially for those most marginalised.
Importance of Early Childhood Development Interventions
In the early ages of life, the brain develops most rapidly, where neurons form new connections at the astounding rate of up to 1,000 per second. The science underlines that while genes provide the blueprint for the brain, it is a child’s environment that shapes brain development. And this shaping occurs in a relatively short period of time – to establish the capacity to learn, adapt to change and develop psychological resilience. During this period, the brain requires multiple inputs: it requires stimulation and care to spark neural connections across multiple regions of the brain, to increase its capacity and function for early cognitive and language skills, social competency and emotional development; it requires good health and nutrition at the right time to feed and nourish not only the body but also the brain; it requires safety and protection to buffer against stress and pollution and allow absorption of nutrients for the growth and development of the nervous system, including the brain. All these aspects of the environment must work together to build a better brain during the early childhood period of life. Without intervention, adults who experience adversity in early childhood are estimated to earn close to a third less than their peers’ average annual income.
Early childhood development is the key to upholding the right of every child to survive and thrive because this is the time when a child gain optimum and rapid physical, emotional, social and cognitive developments especially in the first 3 years. Scientific findings from neuroscience and developmental psychology shows that development in early ages has long-lasting effects. Moreover, investing in ECD is cost effective: For every $1 spent on early childhood development interventions, the return on investment can be as high as $13.
A multi-sectoral framework to promote the development of young children across the life course -
Child development is part of the life course, including pre-conceptual health and wellbeing of adolescents and continuing into the next generation of young people who grow up and become parents. Care before pregnancy improves women’s physical and mental health and reduces the chances of their children being born prematurely, with low birthweight, birth defects or other birth-related conditions that could hinder optimal development. Studies show that trans-generational transmission can be mitigated by interventions to improve the parents’ health before conception and to support infants’ health in the post-natal period and thus adolescence is considered a critical window of opportunity for promoting and supporting care before pregnancy.
Promotion of health and wellbeing across the life course requires interventions through services and programmes of several sectors, most notably health and nutrition, education, and child and social protection, in the context of a supportive environment of policies, cross-sectoral coordination, and financing. These multiple inputs create a framework within which actions to promote early childhood development can be initiated and expanded (figure 5). At the heart of this framework is the nurturing care of young children, provided by parents, families, and other caregivers.8
The nurturing framework around these multi-sectoral and multi-generational life course requires to act on five important components - 1. Investment; 2. Intervention with Families & Communities; 3. Strengthening the government services & programmes; 4. Monitoring the progress; and 5. Use of data and innovating new strategies on the basis of data.
There is an urgent need to integrate nurturing care/early childhood framework into humanitarian policies, programmes and services. It is sad that only a tiny fraction of humanitarian budget is spent on Early Childhood framework. Hence, it is time to act now and invest more on ECD programmes making it a priority in every country, every community and every family so that the global vision of 2030 - leavingno child behind.
We need to take an holistic approach to families’ and children’s well-being by paying attention to protecting them, so that they survive and ensuring mental health, nutrition and opportunities for learning. Also, families and children feeling the worst adversity and stress may need more intensive services.
The holistic nature of early childhood development calls for a comprehensive approach that includes governments, civil society, academic institutions, the private sector, families, and everyone involved in providing care for young children. Moving from policy to action demands a concerted effort. It demands the engagement of all sectors of society, at the local, national, regional and global levels. Joint ownership and shared responsibility will ensure that well designed and cost-effective interventions have the desired reach and impact.
The future of any society depends on its ability to foster the health and well-being of the next generation.
References
1. Murphy KM, Rodrigues K, Costigan J, Annan J. Raising children in conflict: An integrative model of parenting in war. Peace and Conflict: Journal of Peace Psychology. 2017;23:46
2. Advancing Early Childhood Development: from Science to Scale. Lancet ECD Series 1, 2016
3. Nurturing care for early childhood development: a framework for helping children survive and thrive to transform health and human potential (WHO, 2018)
4. The United Nations Convention of the Rights of the Child. New York: United Nations; 1989
5. Transforming our World: The 2030 Agenda for Sustainable Development. New York: United Nations; 2015)
6. Murray L, Andrews E. The social baby. London: The Children’s Project; 2002
7. Shonkoff JP, Garner AS, Committee on Psychosocial Aspects of, Child Family, Health et al. The lifelong effects of early childhood adversity and toxic stress. Pediatrics. 2012;129(1):e232–46
8. Advancing Early Childhood Development: from Science to Scale. Lancet ECD Series 3, 2016