Building Momentum for the World’s Youngest Children
Allison Grossman, Senior Advisor, Global Policy and Advocacy October 18, 2016
At the World Bank Annual Meetings earlier this month, an unexpected group took center stage – the world's youngest children. Together, a pair of events on October 5th and 6th highlighted the challenges faced by young children on their path to healthy, productive lives and marked the beginning of a potentially historic conversation on how countries will support their children to thrive.
New Evidence to Drive Action
On October 5th here in Washington, DC, the British medical journal the Lancet released their latest Series, Advancing Early Childhood Development: from Science to Scale. Together, the papers that make up the Series revealed new and alarming evidence on the state of child development in the world; provided guidance on high-impact, cost-effective interventions to address the challenges; and issued a strong, clear call to action to the world's leaders to change their approach to our world's youngest people.
The Lancet reported that 43 percent all children under the age of five in low and middle income countries, or 250 million children, are at risk of not reaching their development potential. The numbers are even higher in Sub-Saharan Africa (66 percent) and South Asia (53 percent). The reasons are clear: poor nutrition, poverty, lack of learning opportunities, and unsafe or toxic environments all hinder the brain development of young children. The effects are similarly clear, and can be devastating for a child, including poorer performance at school and lower wages in the workforce, perpetuating the cycle of poverty and inequality to the next generation.
But there are solutions, and cost-effective ones at that. In addition to basic healthcare, children need nurturing care in order to thrive – proper nutrition, responsive caregiving, safety, and opportunities for early learning. Because brain development happens faster from conception to age two or three than at any other time in life, intervening in the earliest years is critical. That means programs should build off of the systems that already reach young children, such as the health system, to provide support and resources for parents and caregivers to providing nurturing care. Packages like Care for child development, created by the World Health Organization and UNICEF to guide health workers to support families build the communication and supportive relationships with children necessary for optimal brain development, and interventions to address maternal depression cost on average 50 cents per person per year, and work through existing systems that reach moms and kids.
The cost of not supporting our youngest children is stark. A child with suboptimal development faces the loss of roughly a quarter of his or her earning potential as an adult, is more likely to suffer from chronic disease, and is more likely to have children who also face poverty and social exclusion. There are other opportunities throughout the course of a life to address development, but the earliest years are both the most effective and the most cost-effective.
In a comment in the Lancet Series, Graca Machel eloquently summarizes the clarion call that emerges from the new data, writing, "Investing in early childhood development, integrated with basic family and child health and nutrition, and doing so early, will see individuals and nations overcome poverty and exclusion and progress towards their development goals. All stakeholders must reflect on how seriously they take the cost of inaction."
Country Demand and World Bank Leadership
On October 6th, the World Bank heeded the call to action in the Lancet Series. World Bank President Jim Kim hosted Heads of State and Minsters of Finance from nine countries – Cameroon, Cote d’Iovire, Ethiopia, Indonesia,
In his opening remarks, Dr. Kim warned the audience that investments in the physical, mental, and emotional development of young children are critical for the future productivity of individuals and for the economic competitiveness of nations. In other words, if we fail to support children in their earliest years, they won't be ready to participate in the economy – and entire countries will be left behind.
At the Summit, each country representative stood up (that's the Minister of Finance of Madgascar above) and described how they will bring these lessons back to their country and their children. The statements were diverse and ranged from identifying specific interventions to increasing budgets to changing policy. For instance, the government of Cameroon described their committment to reducing chronic malnutrition from 32 percent to 25 percent by 2019, while the government of Tanzania spoke about their program to provide conditional cash transfers to the poorest households to promote pre-primary school enrollment. It was a powerful event in part because Ministers of Finance, who hold the purse strings in many countries, took time out of their day to speak to the importance of programs that address the development needs of young children – a first.
In addition to the country leaders, Dr. Kim also pledged to increase World Bank investments for programs that support child development and committed to holding similar events at World Bank Annual Meetings in the future.
This is where rubber will really meet the road. New data from the Lancet, Dr. Kim's leadership and commitment to this issue, the depth of the World Bank's resources, and the demand from countries to address the early years creates the potential for a sea change in how the world invests in its youngest children. But this cannot be a one-off moment for young children. Governments and the World Bank must be held accountable for increasing investments in evidence-based, integrated programs that will truly support children and families. And new partners – particularly donor governments like the United States – must step up their support and fill the demand created by partner countries. With a new change in administration coming soon in the United States, the opportunity has never been greater.