Published online September 23, 2011 DOI:10.1016/S0140-6736(11)61450-5
Early childhood development—global action is overdue
declared that early childhooddevelopment was a global challenge of the greatesturgency.
4 years later, we have made progress, but stillhave far to go in making early childhood developmentthe global priority it must be.The importance of early childhood developmentremains profound. As the accompanying papers
show so clearly, the prenatal and postnatalperiods are the most critical time in a child’s development,laying the foundation for physical, emotional, andintellectual wellbeing. Dietary deﬁciencies, inadequatefeeding practices, chronic infections, and low levels of stimulation during this period jeopardise a child’s chanceto reach his or her full potential and increase the riskthat poor health and poverty will follow that child intoadulthood. Exposure to multiple deprivations increasesthese terrible consequences.Not surprisingly, children in the most disadvantagedquintiles of their societies are at the greatest risk of beingdeprived during this crucial early period. As the
papers show, interventions directed at the poorestchildren can provide enormous returns on investment.
For example, home and community-based parentingand family support programmes signiﬁcantly beneﬁtthe youngest children by promoting physical, cognitive,and emotional development, especially when theyare integrated with other health, nutrition, and child-protection interventions. For children aged 3–6 years,organised early childhood learning centres not onlyimprove school readiness but also school attainment.In turn, children who remain—and succeed—in schoolare more likely to earn higher incomes as adults, andto provide better nutrition, health care, stimulation,and educational opportunities to their own children.Furthermore, early childhood development interventionshave a substantial impact on children aﬀected byviolence, disability, and developmental delays.
That is why it is so alarming that the poorest and mostvulnerable children who are most likely to beneﬁt fromearly childhood development programmes are also leastlikely to have access to them. According to the WorldBank, the Organisation for Economic Co-operation andDevelopment countries spend an estimated 1·6% of their gross domestic product (GDP) on family servicesand preschool for children aged 0–6 years, and 0·43% of GDP on preschools alone. By comparison, low-incomecountries such as Nepal, Kenya, and Tajikistan spend just0·1% of GDP on preschools, while Nicaragua and Senegalspend less than 0·02%.
Neglect of young children most in need is anoutrage—and a huge strategic mistake. Focusing onreaching these children is not only the right thing to do,it is a highly cost-eﬀective investment that countriescan and must make for their long-term growth. To cite just one example raised in the
papers, increasingpreschool enrolment rates to 25% could yield anestimated US$10·6 billion through higher educationalachievement, while a 50% increase could generate$33·7 billion.
Such investments in centre-based earlychildhood development yield even greater dividendswhen they are coupled with community-based nutritionand parenting programmes.The two
papers present new evidence on thecauses and consequences of developmental inequitiesin early childhood—and the exceptional opportunity wehave to redress them. We must not ignore this evidence.Instead, we must act on it, working together to makesafe and supportive early childhood development areality for the world’s poorest and most vulnerablechildren. Increased investment is needed in qualityparenting programmes and organised early learningcentres for the most disadvantaged children. Theseservices should also be better integrated into existingcommunity-based programmes across a broad range
September 23, 2011DOI:10.1016/S0140-6736(11)61450-5See
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