The threat to childhood from poverty, ill health and deprivation is multifaceted. The response has to be similarly all-embracing. What is needed is an integrated approach to early childhood that will greatly improve the chances that every child will both survive and thrive, additional spending on families, incorporating a gender perspective into poverty reduction strategies, strengthening protection of children at every level and involving them in devising solutions for their problems.

The resources are available to fund a global transformation of childhood, through both increased official development assistance and improvements in the quality of national public finances. Implementing national plans of action for children with a set of specific, time-bound and measurable targets and goals, as agreed at the UN Special Session on Children, would go a long way to meet the agenda of ‘A World Fit for Children’.

Aggregate public expenditure on support for families and young people correlates closely to the incidence of relative child poverty in the countries of the Organisation for Economic Co-operation and Development (OECD).

Well-developed state interventions can prevent high rates of social exclusion and related risks for children and youth. The cost of having similar complex welfare systems is sometimes seen as prohibitive in poorer countries. However, middle income countries could clearly do more, and international assistance, federal initiatives and innovative local solutions can remove part of the cost borne by governments in developing countries.

Interventions that address child deprivation need to be designed and owned locally; families and children must also be part of the solution. The evidence reviewed underlines the importance of building interventions on sound country-based, locally-situated, gender-sensitive analyses, rather than on the basis of ‘one-size fits all’ agendas. Without a good understanding of the country conditions or local family context, for example, health or education interventions focused on children may fail to deliver the desired results.