PHA-Exchange> Early childhood development: the global challenge

[Claudio]

From: Ruggiero, Mrs. Ana Lucia (WDC) 
 EQUIDAD at LISTSERV.PAHO.ORG 


Early childhood development: the global challenge

 

Richard Jolly, Institute of Development Studies, University of Sussex, UK
The Lancet, Volume 369, Number 9555, 06 January 2007

 

"... At least 200 million children aged under 5 years fail to reach their potential in cognitive and socioemotional development, because of four causes: malnutrition that leads to stunting, iodine and iron deficiency, and inadequate stimulation in their first 5 years of life. This lost potential is preventable. There are effective and mostly low-cost actions that can be taken to prevent the damage and remedy the deficiencies. Just as with ORT (and immunisation, growth monitoring, and the promotion of breastfeeding), the problem is not the lack of knowledge about what to do but the lack of professional and political commitment to mobilise action on the scale required-and for poorer communities in countries throughout the world.

 

The papers in this Lancet series and the country examples show the opportunities well. Whether they are seized will depend on the response from key groups. These groups include policymakers within countries and internationally. Will they take up the challenge-and back up their response with the necessary resources? Researchers and academics also have a critical role. Will they give new attention to the issues, provide the professional leadership and guidance required, help document experience, and explore outstanding research questions, especially to identify low-cost approaches which can be implemented by poor families and communities? Another key group is the medical and public-health community. Will they agree that these critical issues of early childhood development can and need to be put on the priority agenda, along with the mass challenges of reducing child mortality and poverty?

 

The challenge is clear. The size and nature of the problem is defined, along with the seriousness of its long-term consequences. What remains open is only the world's response, and our own..."

 

Lancet Series: Child development in developing countries

 

Developmental potential in the first 5 years for children in developing countries

Grantham-McGregor S, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B, the International Child Development Steering Group 

pages 60-70 at : http://www.thelancet.com/journals/lancet/article/PIIS0140673607600324/fulltext 
The Lancet, Volume 369, Number 9555, 6 January 2007

"...Many children younger than 5 years in developing countries are exposed to multiple risks, including poverty, malnutrition, poor health, and unstimulating home environments, which detrimentally affect their cognitive, motor, and social-emotional development. There are few national statistics on the development of young children in developing countries. We therefore identified two factors with available worldwide data-the prevalence of early childhood stunting and the number of people living in absolute poverty-to use as indicators of poor development. We show that both indicators are closely associated with poor cognitive and educational performance in children and use them to estimate that over 200 million children under 5 years are not fulfilling their developmental potential. Most of these children live in south Asia and sub-Saharan Africa. These disadvantaged children are likely to do poorly in school and subsequently have low incomes, high fertility, and provide poor care for their children, thus contributing to the intergenerational transmission of poverty...'" 

 

Child development: risk factors for adverse outcomes in developing countries

Susan P Walker, Theodore D Wachs, Julie Meeks Gardner, Betsy Lozoff, Gail A Wasserman, Ernesto Pollitt and Julie A Carter 
The International Child Development Steering Group

http://www.thelancet.com/journals/lancet/article/PIIS0140673607600762/fulltext 
The Lancet, Volume 369, Number 9556, 13 January 2007

 

"...Poverty and associated health, nutrition, and social factors prevent at least 200 million children in developing countries from attaining their developmental potential. We review the evidence linking compromised development with modifiable biological and psychosocial risks encountered by children from birth to 5 years of age. We identify four key risk factors where the need for intervention is urgent: stunting, inadequate cognitive stimulation, iodine deficiency, and iron deficiency anaemia. The evidence is also sufficient to warrant interventions for malaria, intrauterine growth restriction, maternal depression, exposure to violence, and exposure to heavy metals. We discuss the research needed to clarify the effect of other potential risk factors on child development. The prevalence of the risk factors and their effect on development and human potential are substantial. Furthermore, risks often occur together or cumulatively, with concomitant increased adverse effects on the development of the world's poorest children.."

 

Strategies to avoid the loss of developmental potential in more than 200 million children in the developing world
Engle PL, Black MM, Behrman JR, Cabral de Mello M, Gertler PJ, Kapiriri L, Martorell R, Young ME, the International Child Development Steering Group 
pages 229-242

The Lancet, Volume 369, Number 9557, 20 January 2007

http://www.thelancet.com/journals/lancet/article/PIIS0140673607601123/abstract 

 

"..This paper is the third in the Child Development Series. The first paper showed that more than 200 million children under 5 years of age in developing countries do not reach their developmental potential. The second paper identified four well-documented risks: stunting, iodine deficiency, iron deficiency anaemia, and inadequate cognitive stimulation, plus four potential risks based on epidemiological evidence: maternal depression, violence exposure, environmental contamination, and malaria. 

 

This paper assesses strategies to promote child development and to prevent or ameliorate the loss of developmental potential. The most effective early child development programmes provide direct learning experiences to children and families, are targeted toward younger and disadvantaged children, are of longer duration, high quality, and high intensity, and are integrated with family support, health, nutrition, or educational systems and services. Despite convincing evidence, programme coverage is low. To achieve the Millennium Development Goals of reducing poverty and ensuring primary school completion for both girls and boys, governments and civil society should consider expanding high quality, cost-effective early child development programmes..."

 
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