We spoke to the WHO Press Office about enabling young children to achieve their full developmental potential in this in-depth health focus
Open Access Government spoke to the World Health Organization (WHO) Press Office about why enabling young children to achieve their full developmental potential is a human right and an essential requisite for sustainable development. In this interview, we learn why the health sector, among others, has an important role and responsibility to support nurturing care for early childhood development.
WHO’s priorities to strengthen policies and programmes to better address early childhood development are also addressed here. When it comes to families who provide the nurturing care that children need, we find out about WHO’s recommendations for caregivers, health professionals and other workers who can assist, as well as policy-makers and other stakeholders.
Tell us your thoughts on why enabling young children to achieve their full developmental potential is a human right and an essential requisite for sustainable development.
Over the last three decades, scientific findings from a range of disciplines have confirmed that the most critical elements of child, adolescent and adult health, wellbeing and productivity take shape in the early years. The period from conception to around a child’s third birthday is foundational because this is when the brain develops most rapidly and massive numbers of neural connections are made in response to stimulation, affection and comfort from caregivers.
Children need nurturing care to develop their full potential. It means providing young children with a secure environment that is sensitive to their health and nutritional needs, which protects them from danger and abuse and provides them with opportunities for early learning and interactions that are responsive, emotionally supportive, and developmentally stimulating. Children who do not experience nurturing care are more likely to grow poorly, be less healthy, learn less and complete fewer grades at school, have difficulties relating confidently to others, and be less productive in their adult life, leading to a debilitating, inter-generational cycle of poverty.
When early childhood development is compromised, it threatens economic development, security and peace as well as human wellbeing. Conversely, investments in early childhood health and development can yield benefit-to-cost ratios of around 10-to-1, boost learning, adaptability and earnings, and substantially reduce mental health disorders, violence, unintentional injuries, and non-communicable diseases later in life. Hence, the right of every child to develop their full potential is a requisite for equitable and sustainable development of societies and nations.
Due to the critical importance of enabling children to make the best start in life, tell us why the health sector, among others, has an important role and responsibility to support nurturing care for early childhood development?
The health sector has an important role in determining how children develop their intellectual capacities and socio-emotional skills. Many health and nutrition interventions important for child growth and survival have a direct impact on childhood development. Moreover, the health sector has a substantial reach to pregnant women, caregivers and families, and young children, especially in the first 1,000 days. Strengthening commonly use health and nutrition services – also referred to as touchpoints – with interventions that address responsive caregiving, early learning, safety and security, and caregiver mental health will enable caregivers and young children to feel supported in the provision of childcare.
Globally, it is estimated that at least one in six children experience developmental difficulty. Developmental monitoring and counselling in primary healthcare services will enable identification of those families and children who are at risk of suboptimal childhood development and provide them with additional support. And it will allow for early identification of children with development disorders or disabilities who, together with their families, will benefit from indicated support at a higher level of the health system.
What are the WHO’s priorities to strengthen policies and programmes to better address early childhood development?
WHO’s work on children’s health is inspired by the UN Secretary General’s Global Strategy for Women’s, Children’s and Adolescents’ Health that is oriented around the goals of survive, thrive and transform. As part of its 13th General Programme of Work 2019 – 2023, WHO contributes to the strengthening of health services, to enable all children and their families to receive support for nurturing care according to their needs. To this effect, the Organization took a lead in coordinating the development of the Nurturing Care Framework and published the guideline Improving early childhood development in 2020.
To contribute to the enabling environments that are essential for children to thrive, WHO fosters strong collaboration between units and departments across the Organization to facilitate the multiple aspects that are covered by nurturing care are given due attention and opportunities for integration in policies and service delivery are optimised. They include public health concerns related to topics such as environmental health, ending of violence against children, mental health, nutrition, immunisation, reproductive health, and childhood disabilities and rehabilitation.
To enable countries to track progress including for SDG target 4.2.1 to ensure that all boys and girls have access to quality early childhood development, care and pre-primary education so that they are ready for education, WHO is also leading a global collaboration of researchers and academic institutions to develop the Global Scales for Child Development that will be the most direct outcome of efforts to measure the development of the youngest children across all countries, and will complement the Early Childhood Development Index currently in use.
WHO is working with UNICEF, the World Bank Group, the Partnership for Maternal, Newborn and Child Health and the ECD Action Network and a host of other partners to develop complementary tools that can assist governments and partners in operationalising the Nurturing Care Framework. They include a Handbook that is oriented towards the five strategic actions and a practice guide for strengthening health and nutrition services. New resources will be made available on the WHO website and on www.nurturing-care.org, which is the portal for learning more about national and global efforts to support nurturing care. The WHO/UNICEF/Lancet Commission on child health and well-being, established in 2018 issued its report A Future for the World Children in 2020. The Commission brings to the foreground important challenges and threats that affect child development and need to be addressed to avoid widening gaps in equity and opportunity for optimal development in childhood. Its key messages were:
- The health and rights of all children and adolescents are under threat. Some of the most pressing harms include a rapidly changing climate, mass commercial marketing of harmful products like sugar, fast food, tobacco and alcohol, and growing inequities.
- When we invest in children, we invest in the future. Investing in a child’s health, development and their environment brings benefits throughout life, and across generations.
- We call on governments, civil society, communities and young people around the world to join a global movement that puts child and adolescent health at the centre of the Sustainable Development Goals. Threats to their health and wellbeing must be addressed, ensuring no child is left behind.
- Strong, unified action today – including stopping greenhouse gas emissions as quickly as possible – is the only way to promote children’s healthy growth and development and protect their rights.
- A global movement for children cannot take place without them at the heart. Children and youth must be invited into, meaningfully engaged, and their views respected as key stakeholders in decision making and policies that affect their health and their futures.
WHO in collaboration with UNICEF and other partners is reformulating a new vision for children’s health, also referred to as the child health redesign, which takes these messages into consideration and is built on the continuum of care, starting preconception through adolescence.
When it comes to families who provide the nurturing care that children need, what recommendations would you give to caregivers, health professionals and other workers who can assist, as well as policy-makers and other stakeholders?
It is primarily the family who provides responsive care and early learning activities. Caregivers benefit from accurate information and support to fulfil this role and to have the ability to notice, understand, and respond to the child’s signals in a timely and appropriate manner. Primary care providers can play a critical role in providing caregivers with support for nurturing care and in the amelioration of developmental difficulties. They can also help to overcome the stigma associated with disabilities in many communities and increase the access of children with development delays or disabilities (and their families) to adequate support services. And they can pick up the signals that caregivers themselves have difficulties in their mental or physical health and provide care to the caregiver as part of their efforts to optimise care for the young child.
Supporting early childhood development calls for a partnership between caregivers and care providers, starting from pregnancy or even before. When implemented well, developmental monitoring and counselling enable primary care providers to know the child’s and family’s strengths and vulnerabilities over time; to watch, appreciate and support the child’s development with the family, while also partnering to enhance strengths, address risk factors and provide additional support and specialised services when needed. It provides opportunities for anticipatory guidance, enables caregivers to strengthen their knowledge about how to support their child’s growth and development and ask for advice when needed. The broad strokes of what governments and different stakeholders can do are summarised on page 43 of the Nurturing Care Framework. WHO is striving to achieve a transformation in thinking and action around children’s healthy growth and development, from a medically oriented model to a biopsychosocial and ecological model. Because ‘if we change the beginning of the story, we will change the whole story’.
|Some data to illustrate the arguments
• One in four children under the age of five does not have their birth registered and, therefore, do not officially exist.
|• Fewer than half of the infants under six months of age are exclusively breastfed.|
|• About 21% of children under the age of five are stunted globally, whereas the number of those overweight or obese increased by almost one-third between 1990 and 2016.|
|• Fewer than half of young children in one-third of countries with data receive the benefits of early stimulation by adults in the home.|
|• Drowning is one of the top five causes of death for children aged one to 14 years for 48 of 85 countries with data meeting inclusion criteria.|
|• In a majority of countries, more than two in three children between the ages of one and 14 are subjected to violent discipline by caregivers.|
|• In half of the countries with data, less than three-quarters of children aged 36 to 59 months are developmentally on track in at least three key domains of development: literacy-numeracy, physical, social-emotional and learning.|
WHO guideline Improving early childhood development https://www.who.int/publications/i/item/97892400020986
Nurturing care for early childhood development https://www.who.int/maternal_child_adolescent/child/nurturing-care-framework/en/
Global status report on violence against children https://www.who.int/publications/i/item/9789240004191
WHO, UNICEF Lancet Commission A Future for Children https://www.who.int/news-room/detail/19-02-2020-world-failing-to-provide-children-with-a-healthy-life-and-a-climate-fit-for-their-future-who-unicef-lancet
For updates from countries and partners on implementation go to:
WHO Press Office
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