First 1,000 days steer course of child’s life: UN

UNICEF campaign warns failure to take action in early childhood raises risk of stunting, spurs cycle of poverty

New discoveries about brain development show investing in early childhood interventions is among the best buys for donors, and can help tackle the nearly 250 million children in developing countries at risk of stunting and poverty, according to the UN.

Before a child’s third birthday, brain cells can make up to 1,000 new connections every second – a once-in-a-lifetime speed, according to research in The Lancet, a medical journal. Greater investment in nutrition and brain stimulation from birth is therefore vital for future cognitive, social and emotional development, said the UN children’s agency, UNICEF, which launched a push in January to drive awareness of the first 1,000 days.

“We’ve long known about the importance of breastfeeding and the necessity of talking to a child to stimulate the brain, for example,” said Sam Mort, campaign lead for UNICEF’s Early Moments Matter campaign. “But we hadn’t fully understood the importance of the integrated nature of early childhood development. That’s what the science tells us – it’s not just protection from harm, or stimulation. It’s all of these things together.”

Some 9.1 million under-fives at risk of poverty and stunting live in the Middle East and North Africa, according to the Lancet. Nearly a quarter of MENA's children suffer from stunting.

Poor health, poverty and environmental stress – including from neglect or exposure to violence – can critically harm a child’s physical and mental development with lifelong repercussions. One 20-year study showed that vulnerable children who took part in quality early childhood development programmes as toddlers earned 25 per cent more as adults than those without.

“When people realise the extent to which the first 1,000 days shapes a child’s future – that they have a limited window in which to act – then we hope there will be more urgency to do something,” said Mort.

Lack of access to health services and simply knowing about the importance of early years development are key barriers for many parents, said Mort. Barely 10 per cent of children in Yemen aged 0 to 59 months have three or more children’s books at home, with this figure falling below 10 per cent in Iraq and Afghanistan, according to UNICEF data.

In Egypt, the enrolment rate of pre-primary education (4 to 5-years-old) is 28 per cent, a long way behind the country’s 80 per cent target for 2030. Moreover, 93 per cent of Egypt’s children experience violent discipline, which can also harm development, says the UN.

Part of the issue is money. Nutrition is one area where donor spending falls short of commitments, according to Hannah Bowen, director of ACTION, a network of global health nonprofits. In 2013, donors pledged $4.15bn at a global summit to tackle the challenge.

Since then, “momentum toward fully financing the interventions to meet global nutrition targets has stalled and funding has plateaued,” said Bowen.

“We know that investing $1 in nutrition results in $16 return globally” Some $7bn annually over the next 10 years is needed to tackle the four key nutrition targets on stunting, wasting, anaemia and exclusive breastfeeding, according to the World Bank.

“For 2014, the Global Nutrition Report estimates that the top 31 donors disbursed $900m on nutrition-specific interventions,” said Bowen. “Both donors and high burden country governments currently spend just above 1 per cent of [aid] and national budgetary allocations on nutrition, respectively.” 

There is plenty of low-cost, low-hanging fruit in terms of programmes that can help, according to UNICEF, ranging from encouraging breastfeeding in the earliest years to cash transfers and nutrition supplements later on. Such programmes can cost as little as $0.50 per capita per year, added UNICEF’s Mort.

The UN agency has worked with healthworkers in Belize to teach families about how to play with their children to stimulate development; and kitted out travelling yurts in Mongolia with toys and books, for example.

“We know that investing $1 in nutrition results in $16 return globally, with some country returns up to 50 times higher,” said Anushree Shiroor, policy advocacy officer at nonprofit Results UK.

The sector has made great progress in recent years collecting data on the impact of nutrition-focused projects, which should help donors decide where best to spend their money, according to Shiroor.

“We’re optimistic that [developments in the sector will make] 2017 the year everything aligns and we see momentum tick back up,” she said.