Summarized by: Neha Naithani

 Interventions to benefit early childhood development are essential to ensure children around the globe reach their lifetime potential in terms of dignity and equality and pass on benefits to the next generation. This is at the heart of the Sustainable Development Goals. Scientific evidence shows conception to age 3 is where the most harm or benefit can occur. Successful early childhood development interventions which can be integrated into existing health and education systems are available. This paper argued that there were risk factors apart from stunting and poverty which led to poor childhood development, so the issue was more widespread than estimated. The study described steps for successful expansion and “scale up” so that these interventions could be delivered to a larger number of children. Action and financing.

The researchers studied the underestimation of poor childhood development by analyzing data from 15 countries. With added low maternal schooling and child maltreatment, the risk of children being stunted or in extreme poverty increased from 63% to 75%. There were additional factors which impacted childhood development, such as armed conflict, displaced families, parents living with HIV, and mothers with depression. Interventions required consistent delivery from preconception to early childhood to have the greatest impact – there was a conceptual
framework identifying key interventions needed to achieve this. The authors identified steps for successful expansion of childhood development programs. The first was political prioritization and financing. After reviewing ten programs from developed and developing countries, they concluded that successful programs needed political concerns about inequality and poverty, scientific and economic evidence, wide-ranging services for children and families, and funding and leadership from a government agency working with other departments.

The second step was passing laws and policies which increased access to and quality of health and other services, money, and time for parents to care for their children. The third step was creating effective delivery systems.

The paper identified points in health services at which interventions had been effectively incorporated. Local adaptation of services, adequate staff training, ensuring quality of care by careful expansion, and continuous improvement were essential. The fourth step was monitoring and supervising the coordination between various
departments. The authors suggested the designation of a UN Advisor for Early Childhood Development to make the issue important and promote accountability. The last step was affordability.

The authors estimated the costs for integrating two childhood development interventions into existing healthcare packages to be about $34 billion. They also estimated the cost of not protecting children or promoting their development – in middle and low income societies, 43% of these at-risk children would grow up to earn about a quarter less average adult income yearly. At country level, that could be a loss of up to 2 times the gross domestic product spent on health.



Richter, Linda M., et al. "Investing in the foundation of sustainable development: pathways to scale up for early childhood development." The Lancet 389.10064 (2017): 103-118