New research reveals that increasing investment in early childhood development programmes is a highly cost-effective strategy that could provide considerable returns, with the potential to promote long-term growth and significantly reduce inequalities in low and middle income countries.
"The estimated benefit of investment in improving just one component of early childhood development, preschool enrolment, suggests that increasing preschool attendance to 25% could generate US$10.6 billion while a 50% increase could generate US$33.7 billion, with a benefit-to-cost ratio estimated to range from 6.4 to 17.6 (depending on the projected percentage of children attending preschool, 25% or 50%)"*, explains Patrice Engle from California Polytechnic State University, California, USA, one of the lead authors of a new Series on child development published Online First in The Lancet.
In 2007, The Lancet reported that more than 200 million children under 5 years were failing to meet their full developmental potential because of preventable risks including poverty, malnutrition, and inadequate levels of intellectual stimulation. These problems contribute to a cycle of low educational attainment and poor health and poverty in later life.
This Series analyses new evidence on the causes of inequality in child development, assesses the effectiveness of current early child development interventions, and calculates the cost of failing to invest in the developmental potential of disadvantaged children.
According to the first paper in the Series, the most effective and cost-efficient time to prevent inequalities is prenatally and in the first years of life. Newly identified risks to development include malaria, exposure to societal violence, and maternal depression.
Breastfeeding and higher maternal education are two of the most important protective interventions for child development. Studies consistently showed associations between breastfeeding and better school grades and higher IQ scores. Additionally, there is increasing evidence that young children of educated mothers have higher levels of cognitive development and better access to interventions.
The second paper in the Series identified effective interventions including home based and community based parenting and family support that benefit children's cognitive and emotional development. For example, for children under age 3 years, interventions can improve parent-child interactions and help children develop foundations for learning through play. For children aged 3-6 years, early childhood learning centres improve readiness for school and school performance, making it more likely that children succeed in school, earn higher incomes when they become adults, and provide better education, health, nutrition, and health care for their own children.
"Our research shows that if we want to reduce the burden of poor child development, we should offer high quality, integrated programmes that target the most disadvantaged children and the multiple risks to which they are exposed"*, explain the authors of the second paper.
But, they say, although it is the poorest and most vulnerable children who are most likely to benefit from child development programmes, they are the least likely to have access to them.
Currently, child development programmes in the developing world receive very low levels of funding from governments: "A public investment of 1% of GNP is the minimum required to ensure provision of quality early child development services…[however] governments of Kenya, Nepal, and Tajikistan spend just 0.1% of GNP and Nicaragua and Senegal spend less than 0.02% of GNP on preschool education (data were not available on any other early child development services)."
"Policies and indicators are effective only if funding is available", warn the authors. "Unless governments allocate more resources to quality early child development programmes for the poorest segment of the population, economic disparities will continue to exist and widen."
In an accompanying Comment, UNICEF Executive Director Anthony Lake urges: "The two Lancet papers present new evidence on the causes and consequences of developmental inequities in early childhood—and the exceptional opportunity we have to redress them. We must not ignore this evidence. We must act on it."
He adds: "Increased investment is needed in quality parenting programmes and organised early learning centres for the most disadvantaged children. These services should also be better integrated into existing community-based programmes across a broad range of sectors including health, nutrition, education, water and sanitation, and protection."
Professor Susan Walker, The University of the West Indies, Kingston, Jamaica.
T) + 1 876 927 2471 E) susan.walker@uwimona.edu.jm
Professor Patrice Engle, California Polytechnic State University, California, USA.
T) +1 917 916 3883 or +1 805 528 4052 E) pengle@calpoly.edu
Anthony Lake, Executive Director, UNICEF, New York, USA.
Via Kate Donovan, UNICEF press office
T) +1 212 326 7452 or + 1 917 378 2128
E) kdonovan@unicef.org
Notes to Editors:
*Quote direct from authors and cannot be found in text of articles.
There is a launch event for this Series at The World Bank J Building, 701 18-th St NW, Washington DC.
The launch runs from 12.30pm to 2pm New York time on Monday 26 September.
For more information and to reserve a place, contact wbeducation@worldbank.org
Journal
The Lancet