Development
Once children are assured of survival, they must be given an environment in which they can develop both physically and mentally. Malnutrition and micronutrient deficiencies are two obstacles to the development. Recent surveys show stunting, underweight, and Vitamin A deficiency are particularly high in poor Western provinces, and three times higher than in cities. The disparity is striking: The rate of sub-clinical Vitamin A deficiency is 23 percent in poor areas, but only 3.8 percent in cities. Even reasonably well-nourished populations can be devastated by “hidden hunger”—the body's unmet need for micronutrients such as iodine, folic acid, and zinc. China has been successful in reducing iodine deficiency disorders through universal salt iodization, raising iodized salt coverage from 39 percent in 1995 to 95 percent today. But some provinces, such as Qinghai and Tibet, still have low iodization rates. Many poor provinces also suffer persistent deficiencies in critical micronutrients such as Vitamins A and D, zinc, and folate (folic acid). These deficiencies increase levels of maternal mortality and the risk of lethal infection, while reducing learning capacity and impeding mental development. At the other end of the spectrum are the twin problems of overweight and obesity. This trend is fueled by changes in diet and lifestyle brought about in part by China's growing prosperity. Roughly 15 percent of Chinese men and 16 percent of women are overweight, and the percentage is higher in major cities. According to studies by the Beijing Center for Disease Control and the China Medical Association, one-third of all Beijing residents are overweight, while more than one-fifth of Shanghai residents are obese. The problem represents a particular threat to children. Studies show 18 percent of Beijing's primary and middle school students are obese, more than double the percentage 10 years ago. Disabilities represent another impediment to child development. Inadequate neonatal care (discussed above) can lead to irreversible disabilities later in life, as well as accidental injuries in the home or at school. One issue vital to early childhood development (ECD) is a lack of stimulation. A child's first three years are especially critical for establishing a foundation for pshycological development, personality, and learning abilities. To develop at this crucial period of life, children need affection, acceptance, encouragement, and mental stimulation. Insufficient play or a dearth of adult attention can slow a child's brain development, resulting in lower than average intelligence. In China, Early Childhood Development (ECD) traditionally has been perceived as pre-school reading and writing, with little attention given to children below age three. But important policy developments are beginning to change traditional attitudes, and ECD is now recognized as key part of basic education. The Ministry of Education has developed a national policy guideline on early childhood development which highlights the need for closer cooperation with the Ministry of Health to address the needs of the young child in an integrated manner.
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