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<DIV><B>From:</B> <A title=ruglucia@PAHO.ORG
href="mailto:ruglucia@PAHO.ORG">Ruggiero, Mrs. Ana Lucia (WDC)</A> </DIV>
<DIV style="FONT: 10pt arial">
<DIV> <A title=EQUIDAD@LISTSERV.PAHO.ORG
href="mailto:EQUIDAD@LISTSERV.PAHO.ORG">EQUIDAD@LISTSERV.PAHO.ORG</A>
</DIV></DIV>
<DIV><FONT face=Arial size=2></FONT><BR></DIV>
<DIV class=Section1>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><B><FONT face=Arial color=#993300
size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: #993300; FONT-FAMILY: Arial">Early
childhood development: the global challenge<o:p></o:p></SPAN></FONT></B></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=2><SPAN style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">Richard
Jolly, <st1:PlaceType w:st="on"><SPAN
class=ja50-ce-textfn7>Institute</SPAN></st1:PlaceType><SPAN
class=ja50-ce-textfn7> of <st1:PlaceName w:st="on">Development</st1:PlaceName>
Studies, <st1:place w:st="on"><st1:City w:st="on">University of
Sussex</st1:City>, <st1:country-region
w:st="on">UK</st1:country-region></st1:place></SPAN><BR><B><SPAN
style="FONT-WEIGHT: bold"><A
href="http://www.thelancet.com/journals/lancet/article/PIIS0140673607600075/fulltext"><FONT
color=#333399><SPAN style="COLOR: #333399">The Lancet, Volume 369, Number 9555,
06 January 2007</SPAN></FONT></A><o:p></o:p></SPAN></B></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=1><SPAN style="FONT-SIZE: 9pt; COLOR: #333399; FONT-FAMILY: Arial">“….. 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.<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=1><SPAN
style="FONT-SIZE: 9pt; COLOR: #333399; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=1><SPAN style="FONT-SIZE: 9pt; COLOR: #333399; FONT-FAMILY: Arial">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?<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=1><SPAN
style="FONT-SIZE: 9pt; COLOR: #333399; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=1><SPAN style="FONT-SIZE: 9pt; COLOR: #333399; FONT-FAMILY: Arial">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…..”<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><B><FONT face=Arial color=#333399
size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">Lancet
Series: Child development in developing
countries<o:p></o:p></SPAN></FONT></B></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><B><FONT face=Arial color=#993300
size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: #993300; FONT-FAMILY: Arial">Developmental
potential in the first 5 years for children in developing
countries<o:p></o:p></SPAN></FONT></B></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">Grantham-McGregor S,
Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B, the International Child
Development Steering Group <o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal
style="MARGIN-BOTTOM: 12pt; MARGIN-LEFT: 0.5in; MARGIN-RIGHT: 0in; mso-margin-top-alt: 0in"><FONT
face=Arial color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">pages 60-70
at : <A
href="http://www.thelancet.com/journals/lancet/article/PIIS0140673607600324/fulltext"><FONT
color=#333399><SPAN
style="COLOR: #333399">http://www.thelancet.com/journals/lancet/article/PIIS0140673607600324/fulltext</SPAN></FONT></A>
</SPAN></FONT><FONT face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><BR>The Lancet, Volume
369, Number 9555, <B><SPAN style="FONT-WEIGHT: bold">6 January
2007<o:p></o:p></SPAN></B></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=1><SPAN style="FONT-SIZE: 9pt; COLOR: #333399; FONT-FAMILY: Arial">“…..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 <st1:place w:st="on">Africa</st1:place>. 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…..’” <o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><B><FONT face=Arial color=#993300
size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: #993300; FONT-FAMILY: Arial">Child
development: risk factors for adverse outcomes in developing
countries<o:p></o:p></SPAN></FONT></B></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=navy
size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Susan P
Walker, Theodore D Wachs, Julie Meeks Gardner, Betsy Lozoff, Gail A Wasserman,
Ernesto Pollitt and Julie A Carter <BR></SPAN></FONT><FONT face=Arial
color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">The International
Child Development Steering Group<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=2><SPAN style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial"><A
href="http://www.thelancet.com/journals/lancet/article/PIIS0140673607600762/fulltext"><FONT
color=#333399><SPAN
style="COLOR: #333399">http://www.thelancet.com/journals/lancet/article/PIIS0140673607600762/fulltext</SPAN></FONT></A></SPAN></FONT><FONT
face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"> <BR>The Lancet, Volume
369, Number 9556, <B><SPAN style="FONT-WEIGHT: bold">13 January
2007</SPAN></B><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">“…….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….”<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><B><FONT face=Arial color=#993300
size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: #993300; FONT-FAMILY: Arial">Strategies
to avoid the loss of developmental potential in more than 200 million children
in the developing world<BR></SPAN></FONT></B><FONT face=Arial color=#333399
size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">Engle PL,
Black MM, Behrman JR, Cabral de Mello M, Gertler PJ,
Kapiriri L, Martorell R, Young ME, the International Child
Development Steering Group <I><SPAN style="FONT-STYLE: italic"><BR><!-- #directive class=eslo.core.output.HTMLKeywordHighlighter highlight=false -->pages 229-242<o:p></o:p></SPAN></I></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><B><FONT face=Arial color=#333399
size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">The
Lancet, Volume 369, Number 9557, 20 January
2007<o:p></o:p></SPAN></FONT></B></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=2><SPAN style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial"><A
href="http://www.thelancet.com/journals/lancet/article/PIIS0140673607601123/abstract"><FONT
color=#333399><SPAN
style="COLOR: #333399">http://www.thelancet.com/journals/lancet/article/PIIS0140673607601123/abstract</SPAN></FONT></A>
<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=2><SPAN style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">“….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. <o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=#333399
size=2><SPAN style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">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…..”<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT face=Arial color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P></DIV></BODY></HTML>