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Embargoeduntil00.01GMTThursday21September2017

EarlyMomentsMatterforeverychild

Summary

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Buildingbrains,buildingfutures

Theearlymomentsoflifeofferanunparalleledopportunitytobuildthebrainsofthechildrenwhowillbuildthefuture.

Butfartoooften,itisanopportunitysquandered.

Fornations,thepriceofnotinvestinginearlymomentsischildrenwithpoorerhealth,fewerlearningskillsandreducedearningpotential.Itisaweakereconomyandagreaterburdenonhealth,educationandwelfaresystems.Itisintergenerationalcyclesofdisadvantagethathinderequitablegrowthandprosperity.

Forchildren,especiallychildrenfromdisadvantagedcommunities,thepriceofthisfailureislostpotential.

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hescienceisclear:Achild’sbrainisbuilt,notborn.1

Theprocessbeginsbeforebirthandinvolvesacomplexinterplayofneuralconnectionsthatareshapedbyexperienceand

environment.2Intheearlyyears,theseneuralconnectionsoccuratlightningspeed–aspeedneveragainrepeated.Theyestablisha

foundationofdevelopmentthatwillhelpchildrengrow,learnandthrive.Thisprocessisfuelledbyadequatenutrition,protectionfromharm

andresponsivestimulationincludingearlylearningopportunities.

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Unfortunately,manymillionsofchildrenaroundtheworldare

deprivedoftheingredientsthatfosteroptimalbraindevelopment.

Theydonothavenutritiousfoodorhealthcare;theyarenot

protectedfromviolence,extremestress,pollutionandconflict;

theyarestarvedofresponsivestimulationfromacaringadult;and

theymissoutonopportunitiestolearn.Negativeexperiencescan

slowdownandalterhowneuralconnectionsaremadeinababy’s

brain.Theycanimpactachild’sabilitytogrowandlearn,3andthey

canevenreducefutureearningsbyupto25percent.4For

example,exposuretoviolence,abuseandneglectcanproduce

toxicstress,whichwhenprolongedandextreme,caninterferewith

thedevelopmentofneuralconnections.5

Mostofthechildrenwhomissoutinearlychildhoodcomefrom

theworld’smostdeprivedcommunities.Inlow-andmiddle-income

countries,forexample,anestimated43percentofchildren

youngerthanage5areatriskofpoordevelopmentduetoextreme

povertyandstuntedgrowth.6Globally,155millionchildren

youngerthanage5havestuntedgrowthbecauseofinadequate

nutritionandhealthcare.7Incountrieswithavailabledata,mostly

low-andmiddle-incomecountries,about80percentofchildren

aged2to4areviolentlydisciplinedregularly;andthereareabout

15.5million3-and4-year-oldswithwhomanadultdoesnotread,

tellstories,countordraw.8

Thesedeprivationscanlimitchildren’sdevelopmentandharmtheir

opportunitiesinthefuture.Fornations,thelossofindividual

potentialcanturnintoanunhealthyandill-equippedworkforce.It

hamperseconomicgrowthandstrainseducation,healthand

welfaresystems.Itleadstocyclesofdeprivationanddependence

thatcancontinueforgenerations.

Reasonstoinvest

Thefinancialcaseforinvestinginchildren’searlymomentsis

strong.Therateofreturnoninvestinginearlychildhood

programmescanbe13.7percent.9Thebenefitsarereapedin

bettereducationandhealthoutcomes,lowercrimeandhigher

individualearnings.10Investmentsinchildren’searlydevelopment

canleadtobetterindividualadultincomesofupto25percent.11

Investinginearlychildhooddevelopmentalsobenefitsnations–

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supportingamoreskilledworkforcethatisbetterpreparedtotake

onthefuturechallengesofaglobalanddigitaleconomy.

Thecostofinvestinginearlychildhooddevelopmentcanbe

surprisinglyaffordablebecausemanyearlychildhoodinterventions

canbeintegratedintoexistingservices.Forexample,foran

estimatedaverageofUS$0.50perpersonannually,programmes

forfamilieswithyoungchildrencanbeaddedtoexistinghealthand

nutritionservices.12

Timetoact

Inmanypartsoftheworld,governmentsandtheirpartnersare

providingchildrenwithadequatenutrition,protectionand

stimulation–andreapingthebenefits.

Butitistimetodomore.Itistimetopickupthepaceofprogress

andtransformourknowledgeaboutearlychildhooddevelopment

intoinvestmentsandinterventionsthatsupportfamilies,

communitiesandnations.Itistimetoactbecausewearelosingthe

potentialof43percentofchildreninlow-andmiddle-income

countries–alosswecannotafford.

Morethan15yearsago,theMillenniumDevelopmentGoals

helpedspurglobalactiontosaveandimprovethelivesofmillions

ofchildren.Theseeffortshelpedreduceratesofchildmortalityby

morethanhalfbetween1990and2015.13

Now,theSustainableDevelopmentGoals(SDGs)presentan

opportunitytobuildonthatprogressbyhelpingmorechildrento

survive–andthrive.

TheSDGs,aroadmapforcreatingabetterfuture,recognizethe

linkbetweenearlychildhooddevelopmentandequity,productivity,

wealthcreation,sustainablegrowthandamorepeacefulfuture.

EmbeddedintheSDGsaretargetsonmalnutrition,childmortality,

earlylearningandviolence–targetsthatoutlineanagendafor

earlychildhooddevelopment.14

EarlyMomentsMatterforeverychildpresentsdata,practicesand

policiesthatcanputgovernmentsonthepathtosuccessfor

childrenandsuccessinachievingtheSDGs.

Thereportsynthesizestheneuroscienceofearlychildhood

development,coveringessentialissuesincluding:theimportanceof

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nutritionandhealth;theneedforprotectionfromextreme,

prolongedandtoxicstress;thethreatofenvironmentalpollutants;

andtheneedfortheresponsivestimulationthatcomesfrom

interactiveandresponsiveparenting.

Thereportalsodrawsattentiontothemillionsofchildrenwhomiss

developmentalmilestones.Itoutlinesmethodsandapproachesfor

infusingnutrition,protectionandresponsivestimulation

interventionsintoexistingprogrammesinemergencyresponse,

health,nutrition,protection,andwater,sanitationandhygiene–

programmesthatreachthemostdisadvantagedchildrenand

families.Anditmakesthecaseforscalingupinvestment,

evaluationandmonitoringinearlychildhooddevelopment

programmes.Thereportconcludeswithasix-pointcalltoaction

thatcanplacegovernmentsandtheirpartnersonthepathtowards

amoreprosperousandsustainablefuture.

Anewglobalagendacomeswitharesponsibilitytoact.Wehave

thescience,knowledgeandexperience.Now,itisuptoustoinvest

inchildren’sbrainsandtheirfutures.Fortheirsake–andours.

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Calltoaction

Theevidenceisclear:Earlychildhooddevelopmentmustbeaglobalandnationalpriority.GovernmentsalreadyhavepledgedtoachievetheearlychildhooddevelopmenttargetsintheSustainableDevelopmentGoals.Buttheyneedtobackupthispledgewithactionandplaceearlychildhooddevelopmentatthetopoftheireconomicandpoliticalagendas.

UNICEFcallsongovernmentsandpartnersto:

1. Investurgentlyinservicesthatgiveyoungchildren,especiallythemostdeprived,thebeststartinlife.Increasingtheoverallshareofbudgetaryallocationsforearlychildhooddevelopmentprogrammingisacriticalstepgovernmentscanandshouldtake.Forexample,allocating10percentofallnationaleducationbudgetstopre-primaryeducationwillgreatlyexpandthenumberofchildrenwithaccesstoearlylearningopportunities,15whichcanimprovetheireducationalattainmentandincreasefutureearnings.Innovativefinancingcanalsohelpgovernmentsreachmorechildrenwithmoreeffectiveprogramming.Approaches

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canincludeearmarkingtaxestopayforearlychildhooddevelopmentservicesorinstituting‘paymentbyresults’frameworksthattieinvestmenttooutcomes(seeBox6.1).

2. Expandaccesstoeffectiveandessentialearlychildhooddevelopmentservicesinhomes,schools,communitiesandhealthclinics.Toreachmorechildrenandfamiliesmorecost-effectively,governmentsandtheirpartnerscanintegrateearlychildhoodinterventionsintoexistingservicessuchasroutinehealthscreeningsatpreschoolsandparentingsupportaspartofhome-healthvisitsfornewparents.Interventionsthatcanbeaddedtowell-knownandeffectiveservicessuchasantenatalcare,nutritionsupportandcommunity-basedchildcare,theseinterventionscanbeadded:breastfeedingcounselling,guidanceonresponsivestimulation,earlylearning,andparentingprogrammestoprotectchildrenfromviolence.

3. Makefamily-friendlyearlychildhooddevelopmentpoliciesanationalpriority–andaprivatesectorimperative.Policies,programmes

andothersupportthatenableparentsandcaregiverstoprovidethebeststartinlifefortheirchildrenpayoffinhealthier,bettereducatedchildren,abetterequippedworkforceandmoresustainablegrowth.Allcountriesshouldprovidetwoyearsoftuition-freepre-primaryeducation,whichiscriticalforearlycognitivedevelopment.Keyworkplacepoliciesinclude12monthsofpaidparentalleave;breastfeedingfacilitiesandremuneratedbreastfeedingbreaksforthefirstsixmonths;andonsitechildcareandearlylearningprogrammesforthechildrenofemployees.

4. Collectdataonessentialindicatorsofearlychildhooddevelopmentandtrackprogress.Toassessprogresstowardsgivingeverychildthebeststartinlife,weneedtomeasureyoungchildren’ssocial,emotional,cognitive,languageandmotordevelopmentagainstinternationallycomparabledata.AscountriestrackprogresstowardsachievingthespecifictargetsthataddressyoungchildrenintheSustainableDevelopmentGoalsonhealth,nutrition,educationandprotection,theycanalsodisaggregatedatatobettertrackequitygapssotheycanreachthechildreninthegreatestneed.

5. Providededicatedleadershipforearlychildhooddevelopmentprogrammesandcoordinateeffortsmoreeffectivelyacrosssectors.Earlychildhooddevelopmentprogrammescutacrosssectorsincludinghealth,nutrition,education,protection,andwater,sanitationandhygiene.Policiesandprogrammesalsoneedtobeintegrated.Acoordinatingministerorbodycanoverseeeffortssotheyarebetter

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integratedandmoreeffectiveandcost-effective.Similarstructuresattheprovincial,municipalandvillagelevelcanhelpreachthemostdeprivedchildren.

6. Drivedemandforhigh-qualityearlychildhooddevelopmentservices.Parentsandcaregiversarethesinglemostimportantfactoringivingchildrenthebestpossiblestartinlife.Communicationfordevelopmentprogrammingandotherpublicinformationinitiativescanbuildgreaterunderstandingofthecriticalimportanceofnutrition,protectionandstimulationinhelpingchildrenreachtheirfullpotential.Withthisunderstanding,familiesacangenerategreaterdemandforhigh-qualityearlychildhooddevelopmentservices.

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1JackP.Shonkoff,M.D.,DirectoroftheCenterontheDevelopingChildatHarvardUniversity2Shonkoff,JackP.,etal.,‘TheLifelongEffectsofEarlyChildhoodAdversityandToxicStress’,Pediatrics,vol.129,no.1,January2012,pp.232–246,<http://pediatrics.aappublications.org/content/pediatrics/129/1/e232.full.pdf>.3Britto,PiaR.,etal.,‘NurturingCare:Promotingearlychildhooddevelopment’,TheLancet,vol.389,no.10064,January2017,pp.91–102,<www.sciencedirect.com/science/article/pii/S0140673616313903>.4Gertler,Paul,etal.,‘LaborMarketReturnstoanEarlyChildhoodStimulationInterventioninJamaica’,Science,vol.344,no.6187,30May2014,pp.998–1001,<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574862>.5Shonkoff,JackP.,etal.,‘TheLifelongEffectsofEarlyChildhoodAdversityandToxicStress’,Pediatrics,vol.129,no.1,January2012,pp.232–246,<http://pediatrics.aappublications.org/content/pediatrics/129/1/e232.full.pdf>.6Black,MaureenM.,etal.,‘EarlyChildhoodDevelopmentComingofAge:Sciencethroughthelifecourse’,TheLancet,series0140-6736,no.16,4October2016,p.4,<www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)31389-7.pdf>.7UnitedNationsChildren’sFund,WorldHealthOrganizationandtheWorldBankGroup,LevelsandTrendsinChildMalnutrition:Jointchildmalnutritionestimates–Keyfindingsofthe2017edition,NewYork,Geneva,Washington,DC,March2017,<http://data.unicef.org/wp-content/uploads/2017/05/JME-2017-brochure-1.pdf>.8UNICEFglobaldatabases,2017,basedonMultipleIndicatorClusterSurveys(MICS),2005–2016.9García,JorgeLuis,etal.,’TheLife-cycleBenefitsofanInfluentialEarlyChildhoodProgram’,HumanCapitalandEconomicOpportunityGlobalWorkingGroup,WorkingPaper2016-035,Chicago,December2016,p.1,<https://heckmanequation.org/resource/lifecycle-benefits-influential-early-childhood-program>,accessed22April2017.10Ibid.11Gertler,Paul,etal.,‘LaborMarketReturnstoanEarlyChildhoodStimulationInterventioninJamaica’,Science,vol.344,no.6187,30May2014,pp.998–1001,<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574862>.12Richter,LindaM.,etal.,‘InvestingintheFoundationofSustainableDevelopment:Pathwaystoscaleupforearlychildhooddevelopment’,TheLancet, series0140-6736,vol.16,4October2016,pp.108–109,<http://thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)31698-1.pdf>.13You,Danzhen,etal.,‘Global,Regional,andNationalLevelsandTrendsinUnder-5Mortalitybetween1990and2015,withScenario-BasedProjectionsto2030:AsystematicanalysisbytheUNInter-agencyGroupforChildMortalityEstimation’,TheLancet,vol.386,no.10010,5December2015,pp.2275–2286,<www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00120-8/fulltext>.14ResolutionadoptedbytheUnitedNationsGeneralAssembly,‘TransformingOurWorld:The2030AgendaforSustainableDevelopment’,A/RES/70/1,25September2015,<www.un.org/ga/search/view_doc.asp?symbol=A/RES/70/1&Lang=E>.15Zubairi,Asma,andPaulineRose,BrightandEarly:Howfinancingpre-primaryeducationgiveseveryoneafairstartinlife–Movingtowardsqualityearlychildhooddevelopmentforall,Theirworld,London,2016,p.6,<http://theirworld.org/resources/detail/bright-and-early-report-on-financing-pre-primary-education>.