The Progress of Nations

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 The time to sow
 Commentary: Early childhood care

Heart of development

We squander our children’s innate capacities and stint their care in those critical early years at grave expense. In violating children’s rights by denying them the essentials they need and deserve, we harm them and ourselves, permitting and encouraging the seeds of poverty, alienation, hatred and despair to take root.

Effective early care for children lies at the very heart of human development. For those most persuaded by economic arguments, investments in services and support for children in the early years have an estimated return as high as 7 to 1. With 130 million infants born each year, this presents an enormous opportunity for social development that few leaders would want to ignore and an investment that few can afford to miss. Especially since it holds out the best promise we have for relieving poverty, which is now coiled so much more tightly around so many, and for changing the long-entrenched patterns of gender discrimination that violate girls’ and women’s rights and choke social progress.

Both poverty and gender discrimination replicate themselves from generation to generation. By ensuring children good early care, based on gender equity, we take vital and giant steps in breaking these cycles of discrimination and deprivation and unleashing new creative powers.

What does effective early childhood care entail for the vast majority of the world’s estimated 1 billion children between the ages of zero and eight years? It recognizes the interaction among health, nutrition and the emotional well-being of children and their primary caregivers. To care for a child by necessity means being concerned about the conditions a woman faces at home and in society at large. For in countries and cultures where women’s voices are muffled and poverty and discrimination limit their access to resources and services, where they have rare respite from wearying rounds of work, minimal legal protection and low status, optimal child development is impossible. Where men have little or no role in bringing up small children, yet lack respect for the women who are the caregivers, the stage is set for underachievement by all but a handful of children.

Effective early care means homes and an environment where children are protected against disease; where there is access to clean drinking water and adequate nourishment; where women can start exclusively breastfeeding their children. It also means that there is time and space for infants to grow and learn through play and exploration and to develop language through interaction with others.

For all these reasons, effective early care has to reach beyond the home into the environment and culture surrounding the immediate family.

As members of an extended family with a vital stake in human development, community and religious leaders, health and nutrition workers, teachers, employers and entire nations have an interest in and a responsibility for the care that the children in their communities and nations receive.

When children’s rights are realized, both the immediate and longer-term rewards in human development are great. Supported from the moment of birth and before, children are likely to survive and to be healthier and happier, to be better able to learn throughout life and to become productive citizens.

The results are also visible on spreadsheets, in lower costs for remedial education and curative health expenditures. And in a delayed reaction well worth waiting for, effective care leads to better grounded, better nourished, healthier and more stable and productive societies.

All over the world, millions upon millions of families do provide excellent care for their children. Many millions of others, however, are unable to do so, usually because they are among the 1.2 billion people in developing countries who live below the poverty line of $1 per day.

They wage a vast but largely unnoticed struggle against disease, unsafe water, poor sanitation, ignorance, malnutrition, gender discrimination and often war and violence. How can we continue to be surprised that 11 million children below age five die each year in this unequal contest and that millions more lose physical and intellectual potential?

It is difficult to grasp the physical and cognitive effects of malnutrition alone: Half the children of South Asia and one third of those in sub-Saharan Africa are malnourished, their motivation, attention, curiosity and cognitive abilities dulled. Malnutrition and the repeated infections that accompany it produce a lethal lethargy that can prevent a young child from enjoying the care he or she deserves. Implicated in nearly half of all child deaths and countless failures to thrive, malnutrition has been estimated to cost the world – in one year alone – the equivalent of 46 million years of productive, disability-free life.

During a child’s early years, low birthweight, recurrent illnesses, a lack of psychosocial stimulation, poor nutrition and the stresses of poverty can lead to poor health and a general lowering of intellectual, behavioral and social abilities.

Creating and revitalizing basic social services and building strong partnerships with poor communities are crucial aspects of ensuring a good start to life for children.

These are preventable losses, for which the solutions are known, available, fairly inexpensive and highly cost effective. The answer is to invest in children – time, energy, care and resources – and to do this from the earliest possible time, from birth and even before, when the investments will have the greatest impact on later human development. Creating and revitalizing basic social services and building strong partnerships with poor communities are crucial aspects of ensuring a good start to life for children.


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