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Early Child Development for 2030 – China Post-MDG

2015-02-09

 We are much inspired and encouraged by the Gates’ 2015 Annual Letter.  The statement presents many creative ideas and optimistic estimates for the future, and the China Development Research Foundation (CDRF) recognizes and appreciates them.  Enlightened by the spirit of the letter, the CDRF is honored to propose and to share its initiative on Early Child Development for 2030 – China Post-MDG.  A major challenge for the world in the next 15 years is to assure the healthy development of all young children, as a way to achieve equity and stable societies.  China is betting on early child development and, through the CDRF initiative, is becoming a leader in this field for other countries.

The Millennium Development Goals (MDGs) 4, 5, and 6 are aimed at reducing child and maternal mortality and infectious diseases, including malaria and HIV infection.  The knowledge base that underpins and drives this MDG agenda to improve child survival rests on public health measures such as nutrition, clean water, sanitation, basic medical care, expanded immunization, oral rehydration, micronutrient supplementation, insecticide-treated bed-nets, and prevention of HIV infection. 

In neuroscience, epigenetics, and economics, recent research is now converging to yield a deeper understanding of human development, which points to the importance of early childhood for creating and launching human capabilities. Today, in developing countries, where 92 percent of children live, one in 20 children does not survive beyond the first 5 years.  By 2030, this proportion is expected to improve to one in 40 children.  But, while a larger number of children will survive, they will not have the opportunity to realize their full potential owing to deprivations in early childhood.  Poverty and undernutrition, two of the most complicating factors in early childhood, account for a loss of more than two grades in school and, later when these children become adults, a more than 30 percent loss in income (Engle and others 2007, 2011).  

Interventions in early child development are essential to overcome the deprivations that far too many children face and to assure the quality, and equality, of human development.  The emerging availability of online, interactive or mobile learning technology for young children is an attractive prospect in early child development, as these new tools could be used in home- or center-based interventions or for capacity development (e.g., instruction and information exchange among teachers and practitioners).

As development agencies look beyond the goals for 2015 and on to 2030, the fate of the world’s young children must be at the forefront of discussion.  Among the key tasks to consider are redirection of social policies to focus on young children ages 0‒6 years, expansion of public health models to incorporate the science of early human development, and collection and use of data to track how well children are doing and to quantify levels of inequality in child development across population groups.  

Population measures that are designed and used to track child development must focus on objective assessments of what children actually “look like,” as opposed to subjective appraisals of where they should be on a milestone chart.  The data obtained will provide evidence for making sound policy decisions and aligning policies with program impacts.  

Now is the time to shift emphasis from improving child survival to reducing inequality in children’s capability.  For example, countries currently and routinely collect data on rates of infant, maternal, and child mortality, as well as breastfeeding and immunization.  While these statistics have significance, governments can and should be seeking indicators of how well children are developing, beyond just their survival. 

Healthy child development enables the realization of human potential and capability.  It allows children to attain a sustainable maturity and, eventually, to participate as healthy adults in economic, social, and civic life.  The cognitive, social, emotional, and language competencies so necessary for the modern world develop interdependently in early childhood.  This development is shaped by early experiences and underlies the formation of lifelong capabilities.  

Early childhood is the foundation for human capacity—that is, the window of opportunity for resolving early inequities and for achieving inclusive and sustainable social and economic development within and across nations.  As Nobel laureate James Heckman notes, “Global development agendas should recognize the central role of human capabilities in shaping society.  Disparities in capabilities are major contributors to economic and social inequality” (Dugger, Durlauf, and Heckman 2012).   He emphasizes that investment in early child development can play an important role in reducing the effects of an “accident of birth” in determining life outcomes.  Further, the most productive investments foster parenting and parent‒child attachment and interaction.  The evidence shows that good parenting is far more important than cash (Heckman 2014).  

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China in post-MDG 2015: An Example

Like many countries that are committed to promoting social equity and that include investing in early childhood development, China has made considerable strides in reducing poverty and meeting the MDGs for 2015. The Government recognizes that concerted effort and innovation are needed to reduce poverty further and that investments in human development are necessary for both sustaining growth and reducing poverty.  It has done this. 

In December 25, 2014, China’s State Council issued a National Child Development Plan (for 2014‒2020) for Poverty-Stricken Areas, specifically to reach 40 million rural children in 680 counties.  This plan prioritizes early interventions not only to increase child survival, but also to promote healthy child development, from birth to the completion of compulsory education, through provision of quality care and comprehensive protection.  The goals are to raise the level of child development in the targeted counties to or near the national average; to reduce under-5 stunting to 10 percent of children; and to reduce the rates of infant and under-5 mortality to 12 per 1,000 children and 15 per 1,000 children, respectively. 

This directive enables national, provincial, and local governments to innovate continually (by conducting pilot studies and then evaluating and revising them);  disseminate the lessons learned; expand capacity in the “know-how” of healthy child development; apply and use data to inform policy and programs; and leverage increased funding from public and private sources. China’s success in innovation and implementation derives from its capability and flexibility to continually experiment with pilot initiatives, to leverage and translate lessons from these pilots to policy, and to scale up—as it did when introducing the reforms of the 1980s and 1990s. 

In the social sector, China’s recent National Nutrition Intervention Program is a case example of translating, leveraging, and scaling up successful pilots of nutritional supplementation provided freely to young children in remote poor counties.  This pilot-to- policy translation was led by the CDRF.  The CDRF is now piloting and evaluating a “nutrition plus parenting” intervention that builds on international research from a successful study conducted in Jamaica and is replicated in other Latin American countries.  With its emphasis on continual evaluation-feedback-revision and translation of effective programs into policy, China is uniquely positioned to share the knowledge and lessons it generates with other developing countries and, ultimately, to leverage increased investment and capacity in early child development within China and in other regions, such as Africa.

Response to Bill Gates’ 2015 Annual Letter, “Our Big Bet for the Future”

Lu Mai, Secretary General, China Development Research Foundation

Mary Young, Senior Fellow, China Development Research Foundation

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References:

Dugger, R., S. Durlauf, and J. Heckman. 2012. The Role of Human Capability in Reframing the Global Development Agenda. Working Paper. Institute for New Economic Thinking, New York. 

Engle, P. L., M. M. Black, J. R. Behrman, M. Cabral de Mello, P. J. Gertler, L. Kapiriri, R. Martorell, and M. E. Young. 2007. Strategies to Avoid the Loss of Developmental Potential in More than 200 Million Children in the Developing World. The Lancet 369 (9557): 229–242. 

Engle, P. L., L. C. Fernald, H. Alderman, J. Behrman, C. O’Gara, A. Yousafzai, M. Cabral de Mello, M. Hidrobo, N. Ulkuer, I. Ertem, S. Iltus, and the Global Development Steering Group. 2011. Strategies for Reducing Inequalities and Improving Developmental Outcomes for Young Children in Low-Income and Middle-Income Countries. The Lancet 37: 1339–1353. 

Heckman, J. 2014. Human Development and Early Childhood Development. Special Contribution. In Human Development Report 2014: Sustaining Human Progress: Reducing Vulnerabilities and Building Resilience, p. 58. New York: United Nations Development Programme.