Platforms to Reach Children in Early Childhood

Excerpt

This chapter reports on platforms that promote early child development. The economics of early child development programs and packages are covered in chapter 24 in this volume (Horton and Black 2017). Early child development research, programs, and policies have advanced significantly in low- and middle-income countries (LMICs) during the past two decades (Black, Walker, and others 2016), spearheaded by three prominent advances.

The first advance is the recognition that the foundations of adult health and well-being are based on prenatal and early-life genetic-environmental interactions that affect brain development. This recognition has created a strong emphasis on strategies to ensure that young children reach their developmental potential (Shonkoff and others 2012).

The second advance is the urgent call for strategies to promote early child development, following estimates that more than 200 million children younger than age five years in LMICs are at risk of not reaching their developmental potential (Grantham-McGregor and others 2007), largely due to nutritional deficiencies and a lack of responsive caregiving. Recent estimates report that although the prevalence of at-risk children has declined, more than 43 percent of children in LMICs are at risk for poor development (Lu, Black, and Richter 2016). Initiatives during the first 1,000 days of life—the period from conception through age 24 months, when nutritional requirements are high and brain development is rapid—have focused attention on the need to ensure that children receive the interventions necessary to achieve their developmental potential.

Finally, global economic growth in the 1990s and the success of the Millennium Development Goals in reducing poverty and stunting and in increasing child survival have brought optimism to efforts to promote child health and development. The evidence that interventions early in life are effective in promoting early child development (Engle and others 2007; Engle and others 2011; Nores and Barnett 2010) supports the implementation of such programs at scale.

Calls from global leaders have emphasized increased investment, programs, and policies for early child development (Lake and Chan 2015) and have brought about the inclusion of early child development in the United Nations’ Sustainable Development Goals (SDGs) (UN 2015). This chapter reviews the definition of early child development; risks and protective factors related to early child development; early child development systems (rights and equity, integrated interventions and multisectoral coordination, governance, and quality improvement and accountability); and platforms needed to implement early child development programs that address children’s changing developmental skills across the continuum from infancy through early primary school. Definitions of age groupings and age-specific terminology used in this volume can be found in chapter 1 (Bundy and others 2017).