Lancet Series reveals Africa’s undoing

Under investment in early childhood development could be the reason for Africa’s under development, the latest new Lancet series, Advancing Early Childhood Development: from Science to Scale released Tuesday.
The Series reveals that early childhood development interventions that promote nurturing care—health, nutrition, responsive caregiving, security and safety, and early learning—may cost as little as 50 cents per child per year, when combined with existing services such as health. The World Health Organization, the World Bank, and UNICEF contributed to and offered guidance to the Series.
Failure to invest in early childhood development on other hand curtails children’s potential as adults because of stunting and extreme poverty. According to the Series, under investment in children during their most critical years – zero to three – translates into 25% less income as adults when compared to adults who received the nutrition, care and stimulation they need as children. This low-cost investment has exponential returns.
For an estimated average of $0.50 cents per person per year, LMICs could deliver two critical early childhood development interventions—enhancing nurturing care of children and supporting maternal depression—through existing health and nutrition services.
Countries with the highest prevalence of children living in extreme poverty or stunted are mostly in Africa and include Liberia 97%, Zambia 96%, DR Congo 96%, Burundi 95%, Niger 93%, Malawi 93%, Rwanda 86%, Mozambique 85%, Nigeria 85%, Tanzania 85% and Ethiopia 85%.
However, there are some bright spots. For example, in mid-September, the Government of Uganda launched an Early Childhood Development (ECD) policy; it committed to spending $350 million over the next five years to address: Maternal, child health and development; Early learning and care; Child protection; and Family strengthening and community support.
In South Africa, commitment to address poverty and inequality from the beginning of a child’s life has been a focus of the government. The government introduced Grade R, a universal pre-school year in 2005. Ten years later, in 2015, 80% of children attend a free preschool class, with the highest uptake occurring in the poorest areas of the country.
“We now know how high the cost of inaction is, and new evidence makes clear that the time to act is now. We hope the evidence in this Series will help countries reach more pregnant women and young children with preventive and promotive services that have the potential to drastically improve developmental outcomes for children as well as their adult health, wellbeing, and economic productivity,” said Series co-author, Professor Linda M. Richter, PhD, DST-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa.
The findings in the Series underscore the importance of increased global commitment to early childhood development. Individuals are estimated to suffer a loss of about a quarter of average adult income per year, while countries may forfeit up to as much as two times their current GDP expenditures on health or education. Consequences of inaction impact not only present but future generations.
“The science shows us that biology is not destiny—and that what children experience in the earliest days and years of life shapes and defines their futures,” said UNICEF Executive Director Anthony Lake. “We need to turn that science into an alarm bell—because the development of millions of children is at urgent risk. Right now, 43 percent of children in low- and middle-income countries are at risk of not achieving their cognitive potential. No country can risk losing nearly half of the brain potential of its youngest citizens—low- and middle-income countries least of all.”
According to the Series authors, interventions need to be available early. “Historically, early childhood interventions have focused on children of preschool age. But we now know that interventions encompassing the period before conception through the first two years of life can greatly reduce adverse growth and health outcomes, and help ensure young children reach their full developmental potential,” said Series co-author, Professor Stephen Lye, PhD, Executive Director, Fraser Mustard Institute for Human Development, University of Toronto, ON, Canada.
Research shows that a child’s brain develops faster in the first 2-3 years than at any other time in life. These early years are also a critical period of adaptability and responsiveness to interventions. When young children are deprived of nutrition, stimulation, and protection, the damaging effects can produce long-term detriments for families and communities.
“The science and economics are clearly on the side of investing in the first 1,000 days of a child’s life, starting with a woman’s pregnancy,” said Keith Hansen, Vice President, Human Development at the World Bank Group. “If we don’t do this, children fall behind long before they set foot in school and suffer a lifetime of disadvantage. But if we do, we can make an irrevocable difference to their ability to fully participate in the economies of tomorrow as active, productive citizens. The Lancet research is further proof, if more is needed, of just how important this agenda is.”
The Lancet Early Childhood Development Series is being launched at a stakeholder event in Washington, D.C., on October 5, just ahead of the World Bank Group / International Monetary Fund Annual Meetings.