Contents

Foreword, by Kofi A. Annan, Secretary-General of the United Nations

Our promise to the world’s children, from Nelson Mandela and Graça Machel

Early childhood

Choices to be made: The opening section makes the case for investing in the earliest years of childhood, before the age of three, when brain development is most malleable and rights are most vulnerable. It sets out the options governments have about where and when to make investments to ensure that children under three have their rights protected and their needs met. And it introduces the importance of early childhood development programmes, not only for children, their parents and caregivers, but for the progress of nations as a whole.

• The importance of ages 0-3 years: "In the first moments, months and years of life, every touch, movement and emotion in a young child’s life translates into an explosion of electrical and chemical activity in the brain, as billions of cells are organizing themselves into networks requiring trillions of synapses between them."
• Choices: "Thus, the options before leaders who are striving to do what’s best for children and best for their country seem obvious...."
• ECD: "Programmes built on the fact that there is an indivisibility and unity to the rights of children hold the greatest promise for children’s health and well-being and for that of their families and communities."
• Caring for children = caring for women: "Emphasizing the care of babies and toddlers means focusing also on women whose physical and emotional condition influences their pregnancies and their babies’ development."
• A cycle of hope and change: "There is a strategic approach to realizing the rights of children and women with great potential for cutting through the cycles of deprivation, disease, violence and discrimination that currently drain the lives and spirits of children and adolescents around the globe."
• Special Session on Children: "The United Nations General Assembly’s Special Session on Children takes place in September 2001."

A necessary choice: Attention to the youngest children is most needed where it is most difficult to guarantee: in countries where the seemingly intractable grip of poverty, violence and devastating epidemics seriously challenge parents’ hopes and dreams for their children. This section argues that early childcare can act as an effective antidote to cycles of violence, conflict, poverty and HIV/AIDS.

• Challenges to ECD: "Why has the decision to invest in ECD, so seemingly the best public policy for responsible leaders, not been made in every community and every country?"
• The effects of poverty on early childhood: "When poverty engulfs a family, the youngest are the most affected and most vulnerable — their rights to survival, growth and development at risk."
• The effects of violence against women on early childhood: "As violence strikes at the rights of women in every phase of their lives, infants and young children are twice exposed."
• The effects of armed conflict on early childhood: "On any given day, more than 20 armed conflicts are being fought around the world, most in poor countries."
• The effects of HIV/AIDS on early childhood: "Today, 34.3 million people in the world live with HIV/AIDS, including 1.3 million children under 15 years of age."
• Breaking the cycles: "To break these cycles of poverty, violence and disease, interventions must come early in life, the earlier the better."

The only responsible choice: Parents struggle, often against great odds, to do right by their children. In industrialized and developing countries alike they find advice and aid from informal support networks and community agencies with innovative childcare programmes. The final section describes these experiments and experiences and makes the case why, in the long run, investment in ECD pays off.

• Programmes that work: "ECD has saved millions of lives and improved millions more."
• Costs and funding: "The cost of an ECD programme depends on the nature and extent of the services it offers."
• A costly mistake: "But choosing not to provide the earliest care for all children is the costliest mistake of all."
• So why not?: "Programmes that work, outstanding returns on investment, ways to meet legal and moral commitments all beg the question: If early childhood care is such a far-sighted and wise choice for countries, why the failure to invest adequate resources to guarantee every child the best possible start in life?"
• Fundamental changes: "ECD is the necessary first step to making life better for children but, in itself, it is not enough."
• “… no task nobler than giving children a better future.”: "The lives of children and women are the truest indicators of the strength of communities and nations."

ECD Boxes

1. Definition
2. Successful programmes
3. No single formula
4. The first step

Panels

1. Early brain development: A firestorm of creativity
2. Families, child rights and participatory research in Nepal
3. Healthy pregnancies: Protecting the rights of both women and children
4. Iniciativa Papa: Improving the lives of children, one father at a time
5. Paternity leave, baths and evils spirits
6. Guest voice — The vortex where values are worthless by Ernesto Sábato
7. Respecting the rights of the Indian child
8. Guest voice — Child survival and the agency of women by Amartya Sen

Country profiles

1. In the rural parishes of Jamaica
2. The youngest refugees in the former Yugoslav Republic of Macedonia
3. Childcare practices in Malawi
4. Effective parenting in Turkey
5. Wawa Wasi for working parents in Peru
6. Converging services in the Philippines
7. A media culture in Maldives — for and about children
8. The importance of early detection — the case of Jordan

Text figures

1. Brain development: Some critical periods
2. The rights of young children
3. The short-term and long-term effects of early nutrition
4. Effects of maternal exposure to famine
5. Early intervention reduces the disadvantage of stunting
6. Maternal literacy and child development
7. HIV and mortality among children under five years old
8. Hazards to child health in the environment
9. Third-graders’ scores on mathematics tests
10. Head Start programme conceptual framework
11. Debt overshadows basic social services

Maps

Three maps illustrating quality of life indicators for early childhood; the link between the status of women and the well-being of children; and the challenges to children’s growth and development.

Statistical tables

Eight tables with 193 countries listed alphabetically, regional summaries and world totals, present the latest data on the well-being of children. Countries are first ranked in descending order of their estimated 1999 under-five mortality rate, which is then included in each of the following tables:

1. Basic indicators
2. Nutrition
3. Health
4. Education
5. Demographic indicators
6. Economic indicators
7. Women
8. The rate of progress

References

Glossary