A global call to action for early childhood

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28 Our global responsibility: The developmental potential of over 200 million young children with an early child development programme, the result would be a net increase of a year of school per child. Preschool enrollment would contribute to increases of about 5-10% in lifetime labour income. Effective ECD programmes have the following characteristics: • They are targeted towards disadvantaged children. • They provide services for younger children (children under 3). • They continue throughout early childhood. • They are of high quality, as defined by structure (e.g., child-staff ratio, staff training) and processes (e.g., responsive interactions, variety of activities). • They provide direct services to children and parents. • They are integrated into existing health, nutrition, or educational systems. Despite convincing evidence, programme coverage is low. Barriers include a lack of awareness of children’s loss of developmental potential, and its cost; lack of globally accepted indicators for child development to monitor progress or ensure accountability; difficulty of making long-term investments; multiple stakeholders for young children; and the lack of a single strategy or “package” of interventions for ECD. Efforts are underway to address some of these concerns, such as the lack of a global indicator, and systems for calculating costs are improving. But more work is urgently needed to determine what kinds of interventions are most effective in which contexts. To achieve the Millennium Development Goals of reducing poverty and ensuring primary school completion for girls and boys, governments and civil society should expand high-quality, cost-effective ECD programmes. Other policy recommendations include making child development promotion a goal in developing countries and including indicators to track progress in child cognitive and social-emotional development. Where do we go from here? Since these articles appeared in January 2007, launches and presentations have been held in Bangladesh, London, and Washington, D.C. to organisations that include the Paediatric Academic Society, the Society for Research in Child Development, and the Interamerican Development Bank; other events are planned. At the London launch in January 2007, many organisations made statements of commitment to investing in ECD, or discussed their emerging plans to work in ECD. These organisations include the UK Department of International Development (DFID), WHO, UNICEF, World Bank and UNESCO; foundations such as Bernard van Leer and Aga Khan Foundations; and NGOs including CARE, Save the Children, and Plan International. In the coming year, the International Child Development Steering Group will join with the Consultative Group to advocate for ECD programmes. Several activities are planned. With support from the Rockefeller Foundation, the International Child Development Group met with other researchers and policy advocates at the Bellagio Study and Conference Centre in October 2007 to address three goals: supporting the effort to define indicators for child development and coverage; establishing priorities for research; and evaluating components of successful programming. In two years, we hope to be able to report on the global progress made in reducing the number of young children who are not achieving their potential. The Care for Development Module of Integrated Management of Childhood Illness (IMCI) will also be revised and prepared for launching. The opportunity is here—and we need to work together now to be sure that each child not only survives, but thrives. For more information, contact: Dr. Patrice Engle, Professor Department of Psychology and Child Development, California Polytechnic State University E-mail: pengle@calpoly.edu References Engle, P. L., Black, M. M., Behrman, J. R., Cabral de Mello, M., Gertler, P. J., Kapiri, L., et al. (2007). Strategies to avoid the loss of developmental potential in more than 200 million children in the developing world. The Lancet, 369, 229-42. Grantham-McGregor, S., Cheung, Y. B., Cueto, S., Glewwe, P., Richter, L., Strupp, B., et al. (2007). Developmental potential in the first 5 years for children in developing countries. The Lancet, 369, 60-70. Jolly, R. (2007). Early childhood development: The global challenge. The Lancet, 369, 8-9. Jones, G., Steketee, R. W., Black, R. E., Bhutta, Z. A., Morris, S. S., & The Bellagio Child Survival Study Group. (2003). How many deaths can we prevent this year? The Lancet, 362, 65-71. Walker, S. P., Wachs, T. D., Gardner, J. M., Lozoff, B., Wasserman, G. A., Pollitt, E., et al. (2007). Child development: Risk factors for adverse outcomes in developing countries. The Lancet, 369, 145-57. COORDINATORS’ NOTEBOOK: ISSUE 29
Early child development: A powerful equaliser 29 Early child development: A powerful equaliser Lori G. Irwin, Arjumand Siddiqi, Clyde Hertzman The World Health Organisation set up a global Commission on Social Determinants of Health (CSDH) in March 2005 to promote better health and greater health equity for all. The CSDH is intended to draw society’s attention to the social determinants of health that are known to be among the leading causes of poor health and inequalities between and within countries. The CDSH is structured around specific themes that underpin actions on social determinants of health in a global context. The arms of the CSDH involve country work, civil society, and nine knowledge networks: Early Child Development (ECD); Measurement and Evidence; Women and Gender; Priority Public Health Conditions; Employment Conditions; Globalisation; Social Exclusion; Urban Settings; and Health Systems. These networks constitute the Commission’s primary mechanism for organising and synthesising knowledge, strengthening country practice, and supporting leadership. Twenty Commissioners who are global and national leaders from political, government, civil society, and academic fields will communicate the key messages and recommendations of the Commission in policy arenas and draw political attention to social factors that lead to ill health. The Knowledge Network on Early Child Development (KN-ECD) has informed the CSDH of opportunities towards fostering leadership, policy, action, advocacy, and the intersectoral collaboration needed to create positive change for children in a range of country contexts through two main documents: an evidence synthesis titled The Total Environment Assessment Model for ECD; and a summary of its findings and recommendations titled Early Child Development: A Powerful Equaliser. The following excerpt summarises the KN-ECD’s Final Report and the discussion and recommendations that have resulted from the work of evidence synthesis. 1 Executive Summary The principal strategic insight of the KN-ECD’s Final Report for the CSDH is that the nurturant qualities of the environments where children grow up, live, and learn matter the most for their development, yet parents cannot provide strong nurturant environments without help from local, regional, national, and international agencies. Therefore, this report proposes ways in which government and civil society actors, from local to international, can work in concert with families to provide equitable access to strong nurturant environments for all children globally. Given the powerful impact of ECD on adult life, it is imperative that governments recognise that disparities in the nurturant environments required for healthy child development will affect nations and societies differently. In some societies, inequities in ECD translate into vastly different life chances for children; in others, disparities in ECD reach a critical point where they become a threat to peace and sustainable development. As is well known, the early years are marked by the most rapid development, especially of the central nervous system. The environmental conditions to which children are exposed in the earliest years “sculpt” the developing brain. The environments that are responsible for fostering nurturant conditions for children range from the intimate realm of the family to the broader socioeconomic context shaped by governments, international agencies, and civil society. These environments and their characteristics are the determinants of ECD; in turn, ECD is a determinant of health, well-being, and learning skills across the balance of the life course. Economists now argue on the basis of the available evidence that investment in early childhood is the most powerful 1 This work was made possible through funding provided by the Public Health Agency of Canada and undertaken as work for the Early Child Development Knowledge Network established as part of the WHO Commission on the Social Determinants of Health (CSDH). The views presented in this report are those of the authors and do not necessarily represent the decisions, policy, or views of WHO, the CSDH Commissioners, or the Consultative Group on Early Childhood Care and Development. COORDINATORS’ NOTEBOOK: ISSUE 29
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A global call to action for early childhood

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