Few things in life inspire more awe or hope than the miracle of a newborn child. Whether that child fulfils her or his vast potential is largely in the hands of the family, the community and country into which she or he is born.
The early years of life are crucial. When well nurtured and cared for in their earliest years, children are more likely to survive, to grow in a healthy way, to have less disease and fewer illnesses, and to fully develop thinking, language, emotional and social skills. When they enter school, their prospects for performing well are improved. And as adolescents, they are likely to have greater self-esteem. Later in life, they have a greater chance of becoming creative and productive members of society.
In just one generation, these human gains can help break the cycles of poverty, disease and violence that affect so many countries.
It is a child’s right to have every chance to survive and thrive. Moreover, ensuring optimal conditions for a child’s early years is one of the best investments that a country can make if it is to compete in a global economy based on the strength of its human capital.
Yet, tragically, the early childhood years tend to receive the least attention and lowest investment from governments. Every year, some 132 million infants around the world attempt an extraordinary sprint – from defenceless newborns to pro-active three-year-olds. And every year, countless numbers of them are stopped in their tracks – deprived, in one way or another, of the love, care, nurturing, health, nutrition and protection that they need to survive, grow, develop and learn.
Out of 100 children born in 2000, 30 will most likely suffer from malnutrition in their first five years of life, 26 will not be immunized against the basic childhood diseases, 19 will lack access to safe drinking water and 40 to adequate sanitation, and 17 will never go to school. In developing countries, every fourth child lives in abject poverty, in families with an income of less than $1 a day.
The most egregious consequence is that nearly 11 million children each year – about 30,000 children a day – die before reaching their fifth birthday, mostly from preventable causes. Of these children, 4 million die in their first month of life. In many of the world’s poorest countries, child mortality rates have either not changed or else they have worsened. In sub-Saharan Africa, child mortality averages 173 deaths per 1,000 live births, and in South Asia 98 deaths per 1,000 – many times the industrialized country average of 7 deaths per 1,000.
But even when children do survive, they too often do not thrive. At least 10 per cent of all children – over 200 million in all – suffer some form of physical and/or mental disability or developmental delay (significantly low cognitive ability). An even larger number suffer from diminished learning capabilities and other disadvantages that limit their overall prospects for reaching their full potential.
Although it is never too late to improve the quality of a child’s life, the first three years are the most crucial for their survival and thriving. Frequent illness, unsanitary environments and poor nutrition steal a child’s potential. Overburdened families may not have the information or time to spend in stimulating play with their child. If the extraordinarily receptive brain of the child lacks the stimulation for which it is primed during the first three years, the possibility for various types of learning may be substantially reduced – during key developmental periods, some parts of a child’s brain can nearly double in size in a year.
The process of giving children the best start in life begins even before birth. Poor nutrition and ill health on the part of a mother can lead to low birth weight in her children, putting them at much greater risk of developmental delay, malnutrition and death. Moreover, poor health and nutrition multiply the risks that women will die of complications related to pregnancy or childbirth. The consequences are doubly tragic because children’s chances of survival and well-being drop dramatically when deprived of a mother’s care. Each year, more than 500,000 women die because of complications related to pregnancy or childbirth, almost all in developing countries. A woman’s lifetime risk of death during pregnancy or labour is 1 in 13 in sub-Saharan Africa and 1 in 55 in South Asia, while the average for industrialized countries is 1 in 4,100. And for each woman who dies, 30 others develop serious disabilities that may affect their ability to care for their children.
The reasons behind maternal mortality and morbidity are manifold, ranging from poverty and illiteracy to discrimination against women and girls. Breaking this cycle begins with ensuring that every infant girl receives as much attention and care as that given to a boy, that girls as well as boys think of themselves as learning individuals, and that the rights of girls and women are respected within the entire society. Especially in societies where discrimination is rampant, girls benefit more than boys from interventions that foster their physical, cognitive and emotional development. For example, in Nepal, children from disadvantaged families who had the opportunity to attend non-formal pre-school were 20 per cent more likely to attend school than those who did not. But for girls, the effect was even greater: they were 36 per cent more likely to enter school.