Embargoed until 00.01 GMT Thursday 21 September 2017 · It is a weaker economy and a greater burden...
Transcript of Embargoed until 00.01 GMT Thursday 21 September 2017 · It is a weaker economy and a greater burden...
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Buildingbrains,buildingfutures
Theearlymomentsoflifeofferanunparalleledopportunitytobuildthebrainsofthechildrenwhowillbuildthefuture.
Butfartoooften,itisanopportunitysquandered.
Fornations,thepriceofnotinvestinginearlymomentsischildrenwithpoorerhealth,fewerlearningskillsandreducedearningpotential.Itisaweakereconomyandagreaterburdenonhealth,educationandwelfaresystems.Itisintergenerationalcyclesofdisadvantagethathinderequitablegrowthandprosperity.
Forchildren,especiallychildrenfromdisadvantagedcommunities,thepriceofthisfailureislostpotential.
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hescienceisclear:Achild’sbrainisbuilt,notborn.1
Theprocessbeginsbeforebirthandinvolvesacomplexinterplayofneuralconnectionsthatareshapedbyexperienceand
environment.2Intheearlyyears,theseneuralconnectionsoccuratlightningspeed–aspeedneveragainrepeated.Theyestablisha
foundationofdevelopmentthatwillhelpchildrengrow,learnandthrive.Thisprocessisfuelledbyadequatenutrition,protectionfromharm
andresponsivestimulationincludingearlylearningopportunities.
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Unfortunately,manymillionsofchildrenaroundtheworldare
deprivedoftheingredientsthatfosteroptimalbraindevelopment.
Theydonothavenutritiousfoodorhealthcare;theyarenot
protectedfromviolence,extremestress,pollutionandconflict;
theyarestarvedofresponsivestimulationfromacaringadult;and
theymissoutonopportunitiestolearn.Negativeexperiencescan
slowdownandalterhowneuralconnectionsaremadeinababy’s
brain.Theycanimpactachild’sabilitytogrowandlearn,3andthey
canevenreducefutureearningsbyupto25percent.4For
example,exposuretoviolence,abuseandneglectcanproduce
toxicstress,whichwhenprolongedandextreme,caninterferewith
thedevelopmentofneuralconnections.5
Mostofthechildrenwhomissoutinearlychildhoodcomefrom
theworld’smostdeprivedcommunities.Inlow-andmiddle-income
countries,forexample,anestimated43percentofchildren
youngerthanage5areatriskofpoordevelopmentduetoextreme
povertyandstuntedgrowth.6Globally,155millionchildren
youngerthanage5havestuntedgrowthbecauseofinadequate
nutritionandhealthcare.7Incountrieswithavailabledata,mostly
low-andmiddle-incomecountries,about80percentofchildren
aged2to4areviolentlydisciplinedregularly;andthereareabout
15.5million3-and4-year-oldswithwhomanadultdoesnotread,
tellstories,countordraw.8
Thesedeprivationscanlimitchildren’sdevelopmentandharmtheir
opportunitiesinthefuture.Fornations,thelossofindividual
potentialcanturnintoanunhealthyandill-equippedworkforce.It
hamperseconomicgrowthandstrainseducation,healthand
welfaresystems.Itleadstocyclesofdeprivationanddependence
thatcancontinueforgenerations.
Reasonstoinvest
Thefinancialcaseforinvestinginchildren’searlymomentsis
strong.Therateofreturnoninvestinginearlychildhood
programmescanbe13.7percent.9Thebenefitsarereapedin
bettereducationandhealthoutcomes,lowercrimeandhigher
individualearnings.10Investmentsinchildren’searlydevelopment
canleadtobetterindividualadultincomesofupto25percent.11
Investinginearlychildhooddevelopmentalsobenefitsnations–
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supportingamoreskilledworkforcethatisbetterpreparedtotake
onthefuturechallengesofaglobalanddigitaleconomy.
Thecostofinvestinginearlychildhooddevelopmentcanbe
surprisinglyaffordablebecausemanyearlychildhoodinterventions
canbeintegratedintoexistingservices.Forexample,foran
estimatedaverageofUS$0.50perpersonannually,programmes
forfamilieswithyoungchildrencanbeaddedtoexistinghealthand
nutritionservices.12
Timetoact
Inmanypartsoftheworld,governmentsandtheirpartnersare
providingchildrenwithadequatenutrition,protectionand
stimulation–andreapingthebenefits.
Butitistimetodomore.Itistimetopickupthepaceofprogress
andtransformourknowledgeaboutearlychildhooddevelopment
intoinvestmentsandinterventionsthatsupportfamilies,
communitiesandnations.Itistimetoactbecausewearelosingthe
potentialof43percentofchildreninlow-andmiddle-income
countries–alosswecannotafford.
Morethan15yearsago,theMillenniumDevelopmentGoals
helpedspurglobalactiontosaveandimprovethelivesofmillions
ofchildren.Theseeffortshelpedreduceratesofchildmortalityby
morethanhalfbetween1990and2015.13
Now,theSustainableDevelopmentGoals(SDGs)presentan
opportunitytobuildonthatprogressbyhelpingmorechildrento
survive–andthrive.
TheSDGs,aroadmapforcreatingabetterfuture,recognizethe
linkbetweenearlychildhooddevelopmentandequity,productivity,
wealthcreation,sustainablegrowthandamorepeacefulfuture.
EmbeddedintheSDGsaretargetsonmalnutrition,childmortality,
earlylearningandviolence–targetsthatoutlineanagendafor
earlychildhooddevelopment.14
EarlyMomentsMatterforeverychildpresentsdata,practicesand
policiesthatcanputgovernmentsonthepathtosuccessfor
childrenandsuccessinachievingtheSDGs.
Thereportsynthesizestheneuroscienceofearlychildhood
development,coveringessentialissuesincluding:theimportanceof
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nutritionandhealth;theneedforprotectionfromextreme,
prolongedandtoxicstress;thethreatofenvironmentalpollutants;
andtheneedfortheresponsivestimulationthatcomesfrom
interactiveandresponsiveparenting.
Thereportalsodrawsattentiontothemillionsofchildrenwhomiss
developmentalmilestones.Itoutlinesmethodsandapproachesfor
infusingnutrition,protectionandresponsivestimulation
interventionsintoexistingprogrammesinemergencyresponse,
health,nutrition,protection,andwater,sanitationandhygiene–
programmesthatreachthemostdisadvantagedchildrenand
families.Anditmakesthecaseforscalingupinvestment,
evaluationandmonitoringinearlychildhooddevelopment
programmes.Thereportconcludeswithasix-pointcalltoaction
thatcanplacegovernmentsandtheirpartnersonthepathtowards
amoreprosperousandsustainablefuture.
Anewglobalagendacomeswitharesponsibilitytoact.Wehave
thescience,knowledgeandexperience.Now,itisuptoustoinvest
inchildren’sbrainsandtheirfutures.Fortheirsake–andours.
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Calltoaction
Theevidenceisclear:Earlychildhooddevelopmentmustbeaglobalandnationalpriority.GovernmentsalreadyhavepledgedtoachievetheearlychildhooddevelopmenttargetsintheSustainableDevelopmentGoals.Buttheyneedtobackupthispledgewithactionandplaceearlychildhooddevelopmentatthetopoftheireconomicandpoliticalagendas.
UNICEFcallsongovernmentsandpartnersto:
1. Investurgentlyinservicesthatgiveyoungchildren,especiallythemostdeprived,thebeststartinlife.Increasingtheoverallshareofbudgetaryallocationsforearlychildhooddevelopmentprogrammingisacriticalstepgovernmentscanandshouldtake.Forexample,allocating10percentofallnationaleducationbudgetstopre-primaryeducationwillgreatlyexpandthenumberofchildrenwithaccesstoearlylearningopportunities,15whichcanimprovetheireducationalattainmentandincreasefutureearnings.Innovativefinancingcanalsohelpgovernmentsreachmorechildrenwithmoreeffectiveprogramming.Approaches
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canincludeearmarkingtaxestopayforearlychildhooddevelopmentservicesorinstituting‘paymentbyresults’frameworksthattieinvestmenttooutcomes(seeBox6.1).
2. Expandaccesstoeffectiveandessentialearlychildhooddevelopmentservicesinhomes,schools,communitiesandhealthclinics.Toreachmorechildrenandfamiliesmorecost-effectively,governmentsandtheirpartnerscanintegrateearlychildhoodinterventionsintoexistingservicessuchasroutinehealthscreeningsatpreschoolsandparentingsupportaspartofhome-healthvisitsfornewparents.Interventionsthatcanbeaddedtowell-knownandeffectiveservicessuchasantenatalcare,nutritionsupportandcommunity-basedchildcare,theseinterventionscanbeadded:breastfeedingcounselling,guidanceonresponsivestimulation,earlylearning,andparentingprogrammestoprotectchildrenfromviolence.
3. Makefamily-friendlyearlychildhooddevelopmentpoliciesanationalpriority–andaprivatesectorimperative.Policies,programmes
andothersupportthatenableparentsandcaregiverstoprovidethebeststartinlifefortheirchildrenpayoffinhealthier,bettereducatedchildren,abetterequippedworkforceandmoresustainablegrowth.Allcountriesshouldprovidetwoyearsoftuition-freepre-primaryeducation,whichiscriticalforearlycognitivedevelopment.Keyworkplacepoliciesinclude12monthsofpaidparentalleave;breastfeedingfacilitiesandremuneratedbreastfeedingbreaksforthefirstsixmonths;andonsitechildcareandearlylearningprogrammesforthechildrenofemployees.
4. Collectdataonessentialindicatorsofearlychildhooddevelopmentandtrackprogress.Toassessprogresstowardsgivingeverychildthebeststartinlife,weneedtomeasureyoungchildren’ssocial,emotional,cognitive,languageandmotordevelopmentagainstinternationallycomparabledata.AscountriestrackprogresstowardsachievingthespecifictargetsthataddressyoungchildrenintheSustainableDevelopmentGoalsonhealth,nutrition,educationandprotection,theycanalsodisaggregatedatatobettertrackequitygapssotheycanreachthechildreninthegreatestneed.
5. Providededicatedleadershipforearlychildhooddevelopmentprogrammesandcoordinateeffortsmoreeffectivelyacrosssectors.Earlychildhooddevelopmentprogrammescutacrosssectorsincludinghealth,nutrition,education,protection,andwater,sanitationandhygiene.Policiesandprogrammesalsoneedtobeintegrated.Acoordinatingministerorbodycanoverseeeffortssotheyarebetter
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integratedandmoreeffectiveandcost-effective.Similarstructuresattheprovincial,municipalandvillagelevelcanhelpreachthemostdeprivedchildren.
6. Drivedemandforhigh-qualityearlychildhooddevelopmentservices.Parentsandcaregiversarethesinglemostimportantfactoringivingchildrenthebestpossiblestartinlife.Communicationfordevelopmentprogrammingandotherpublicinformationinitiativescanbuildgreaterunderstandingofthecriticalimportanceofnutrition,protectionandstimulationinhelpingchildrenreachtheirfullpotential.Withthisunderstanding,familiesacangenerategreaterdemandforhigh-qualityearlychildhooddevelopmentservices.
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1JackP.Shonkoff,M.D.,DirectoroftheCenterontheDevelopingChildatHarvardUniversity2Shonkoff,JackP.,etal.,‘TheLifelongEffectsofEarlyChildhoodAdversityandToxicStress’,Pediatrics,vol.129,no.1,January2012,pp.232–246,<http://pediatrics.aappublications.org/content/pediatrics/129/1/e232.full.pdf>.3Britto,PiaR.,etal.,‘NurturingCare:Promotingearlychildhooddevelopment’,TheLancet,vol.389,no.10064,January2017,pp.91–102,<www.sciencedirect.com/science/article/pii/S0140673616313903>.4Gertler,Paul,etal.,‘LaborMarketReturnstoanEarlyChildhoodStimulationInterventioninJamaica’,Science,vol.344,no.6187,30May2014,pp.998–1001,<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574862>.5Shonkoff,JackP.,etal.,‘TheLifelongEffectsofEarlyChildhoodAdversityandToxicStress’,Pediatrics,vol.129,no.1,January2012,pp.232–246,<http://pediatrics.aappublications.org/content/pediatrics/129/1/e232.full.pdf>.6Black,MaureenM.,etal.,‘EarlyChildhoodDevelopmentComingofAge:Sciencethroughthelifecourse’,TheLancet,series0140-6736,no.16,4October2016,p.4,<www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)31389-7.pdf>.7UnitedNationsChildren’sFund,WorldHealthOrganizationandtheWorldBankGroup,LevelsandTrendsinChildMalnutrition:Jointchildmalnutritionestimates–Keyfindingsofthe2017edition,NewYork,Geneva,Washington,DC,March2017,<http://data.unicef.org/wp-content/uploads/2017/05/JME-2017-brochure-1.pdf>.8UNICEFglobaldatabases,2017,basedonMultipleIndicatorClusterSurveys(MICS),2005–2016.9García,JorgeLuis,etal.,’TheLife-cycleBenefitsofanInfluentialEarlyChildhoodProgram’,HumanCapitalandEconomicOpportunityGlobalWorkingGroup,WorkingPaper2016-035,Chicago,December2016,p.1,<https://heckmanequation.org/resource/lifecycle-benefits-influential-early-childhood-program>,accessed22April2017.10Ibid.11Gertler,Paul,etal.,‘LaborMarketReturnstoanEarlyChildhoodStimulationInterventioninJamaica’,Science,vol.344,no.6187,30May2014,pp.998–1001,<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574862>.12Richter,LindaM.,etal.,‘InvestingintheFoundationofSustainableDevelopment:Pathwaystoscaleupforearlychildhooddevelopment’,TheLancet, series0140-6736,vol.16,4October2016,pp.108–109,<http://thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)31698-1.pdf>.13You,Danzhen,etal.,‘Global,Regional,andNationalLevelsandTrendsinUnder-5Mortalitybetween1990and2015,withScenario-BasedProjectionsto2030:AsystematicanalysisbytheUNInter-agencyGroupforChildMortalityEstimation’,TheLancet,vol.386,no.10010,5December2015,pp.2275–2286,<www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00120-8/fulltext>.14ResolutionadoptedbytheUnitedNationsGeneralAssembly,‘TransformingOurWorld:The2030AgendaforSustainableDevelopment’,A/RES/70/1,25September2015,<www.un.org/ga/search/view_doc.asp?symbol=A/RES/70/1&Lang=E>.15Zubairi,Asma,andPaulineRose,BrightandEarly:Howfinancingpre-primaryeducationgiveseveryoneafairstartinlife–Movingtowardsqualityearlychildhooddevelopmentforall,Theirworld,London,2016,p.6,<http://theirworld.org/resources/detail/bright-and-early-report-on-financing-pre-primary-education>.