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Child Development in Developing Countries 1/2

Jolly, R. (2007). Early childhood development: the global challenge. The Lancet, 369 (Jan),8-9.

This commentary emhasizes the relevance of the three Lancet papers that outline the challenges faced by over 200 million children aged under five in developing nations and the strategic actions required for prevention.The possibility of responding to this challenge based on Jim Grant’s ten commandments is articulated. The role and response of stakeholders is a critical determinant of how effectively this challenge will be dealt with.

Grantham-McGregor, S., Cheung,Y.B., Cueto,S., Glewwe,P., Richter,L., Strupp,B, and the International Child Development Steering Group.(2007).Development potential in the first five years for children in developing countries. The Lancet, 369, 60-70.

Many children younger than 5 years in developing countries are exposed to multiple risks, including poverty, malnutrition,poor health, and unstimulating home environments, which detrimentally aff ect their cognitive, motor, and socialemotional development. There are few national statistics on the development of young children in developing countries.We therefore identifi ed two factors with available worldwide data—the prevalence of early childhood stunting and the number of people living in absolute poverty—to use as indicators of poor development. We show that both indicators are closely associated with poor cognitive and educational performance in children and use them to estimate that over 200 million children under 5 years are not fulfi lling their developmental potential. Most of these children live in south Asia and sub-Saharan Africa. These disadvantaged children are likely to do poorly in school and subsequently have low incomes, high fertility, and provide poor care for their children, thus contributing to the intergenerational transmission of poverty.

Walker, S.P., Wachs, T.D, Meeks Gardner, J., Lozoff, B., Wasserman, G.A., Pollitt, E., Carter, J.A., and the International Child Development Steering Group. (2007).Child development: risk factors for adverse outcomes in developing countries. The Lancet, 369, 145-157.

Poverty and associated health, nutrition, and social factors prevent at least 200 million children in developing countries from attaining their developmental potential. We review the evidence linking compromised development with modifiable biological and psychosocial risks encountered by children from birth to 5 years of age. We identify four key risk factors where the need for intervention is urgent: stunting, inadequate cognitive stimulation, iodine deficiency,and iron deficiency anaemia. The evidence is also sufficient to warrant interventions for malaria, intrauterine growth restriction, maternal depression, exposure to violence, and exposure to heavy metals. We discuss the research needed to clarify the eff ect of other potential risk factors on child development. The prevalence of the risk factors and their effect on development and human potential are substantial. Furthermore, risks often occur together or cumulatively,with concomitant increased adverse effects on the development of the world’s poorest children.

Engle, P.L., Black, M.M., Behrman, J.R., Cabral de Mello, M., Gertler, P.J., Kapiriri, L., Reynaldo Martorell, Mary Eming Young, and the International Child Development Steering Group. (2007).Strategies to avoid the loss of developmental potential in more than 200 million children in the developing world. The Lancet, 369, 229-42.

This paper is the third in the Child Development Series. The first paper showed that more than 200 million children under 5 years of age in developing countries do not reach their developmental potential. The second paper identified four well-documented risks: stunting, iodine defi ciency, iron defi ciency anaemia, and inadequate cognitive stimulation,plus four potential risks based on epidemiological evidence: maternal depression, violence exposure, environmental contamination, and malaria. This paper assesses strategies to promote child development and to prevent or ameliorate the loss of developmental potential. The most eff ective early child development programmes provide direct learning
experiences to children and families, are targeted toward younger and disadvantaged children, are of longer duration,high quality, and high intensity, and are integrated with family support, health, nutrition, or educational systems andservices. Despite convincing evidence, programme coverage is low. To achieve the Millennium Development Goals of reducing poverty and ensuring primary school completion for both girls and boys, governments and civil society should consider expanding high quality, cost-eff ective early child development programmes.