Investing in early childhood development gives children best start in life says Lancet report

Those crucial 1000 days are when a child most needs development care including early learning, health, nutrition, play and security.

Yet many children are exposed to poor sanitation, infections, lack of nurturing care and inadequate stimulation during this period, said the findings from The Lancet’s Series on Early Childhood Development.

“Increasing numbers of children are surviving – but begin life at a disadvantage because they do not receive the nurturing care they need,” said series author Professor Linda Richter of South Africa’s University of the Witwatersrand.

“Political prioritisation, legislation and financing of early childhood development programmes are key to ensuring their success, as is creating a policy environment that supports nurturing care.”

She said providing paid maternal and paternal leave, free preschool education and support for breastfeeding were among the measures that could help.

The Lancet said the 250 million children at risk of poor development due to extreme poverty and poor nutrition make up 43% of girls and boys in low and middle-income countries.

It said evidence showed that parents, caregivers and families need to be supported in providing nurturing care. That includes:

• Free early education

Attending pre-school benefits children’s primary school performance, especially when programmes include both education and nutrition. But only 43% of countries provide at least one free year of pre-school education. Only 40 countries provide the recommended two years of free pre-school education.

• Breastfeeding

It reduces the risk of several childhood diseases and improves cognitive function. A total of 139 countries guarantee breastfeeding breaks for at least six months and in 43 countries paid breaks are guaranteed. But this does not cover the informal work sector.

• Minimum wage

Having a basic income can help provide children with basic needs including healthcare and education. Although minimum wage policies are in place in 88% of countries, many do not guarantee an income above the poverty level of $2 per day for a parent supporting a child.

The report says children who do not meet their developmental potential may forfeit up to a quarter of future adult earnings and cost some low and middle-income countries as much as twice their national expenditure on health.

The findings by The Lancet come two weeks after a major global education report by the global Education Commission called for every country in the world to provide two years of free, quality preschooling to every child.

The commission – made up of world leaders, policy-makers and experts – said nations must prioritise early childhood development and preschool to ensure the building blocks are in place for children to succeed in their education and beyond.

The children’s charity Theirworld has also been campaigning on the issue. It has produced reports and scorecards – including on the need for space spaces for young children affected by humanitarian emergencies and how the poorest African children are being left behind on nutrition and development.

Ben Hewitt, Theirworld’s Campaigns Director, said: “The Lancet report shows that around the world children from poorer and marginalised households are unable to access the support and care they need and are put at a disadvantage.

“The odds are being stacked against young children before they even arrive at school. It is time to level the playing field and give each child an equal chance at success, no matter who they are or where they are born. 

“It is time for world leaders to allocate the funds and policies needed to establish quality early child development programmes so that every child is given the best start in life.”

The authors of The Lancet report said there is good evidence supporting programmes for early childhood development. But many programmes are challenged by inadequate and uncertain funding or lack of resources.

“Our economic analysis shows that the cost of inaction is huge,and in many countries far exceeds their spending on health,” said series author Professor Gary Darmstadt of Stanford University School of Medicine.

“Supporting nurturing care is a wise investment, and one that should be prioritised in all countries.