title: Investing in the foundation of sustainable development: pathways to scale up for early childhood development.
abstract: Building on long-term benefits of early intervention (Paper 2 of this Series) and increasing commitment to early childhood development (Paper 1 of this Series), scaled up support for the youngest children is essential to improving health, human capital, and wellbeing across the life course. In this third paper, new analyses show that the burden of poor development is higher than estimated, taking into account additional risk factors. National programmes are needed. Greater political prioritisation is core to scale-up, as are policies that afford families time and financial resources to provide nurturing care for young children. Effective and feasible programmes to support early child development are now available. All sectors, particularly education, and social and child protection, must play a role to meet the holistic needs of young children. However, health provides a critical starting point for scaling up, given its reach to pregnant women, families, and young children. Starting at conception, interventions to promote nurturing care can feasibly build on existing health and nutrition services at limited additional cost. Failure to scale up has severe personal and social consequences. Children at elevated risk for compromised development due to stunting and poverty are likely to forgo about a quarter of average adult income per year, and the cost of inaction to gross domestic product can be double what some countries currently spend on health. Services and interventions to support early childhood development are essential to realising the vision of the Sustainable Development Goals.
authors.affiliation: DST-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: linda.richter@wits.ac.za.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Richter
authors.affiliation: Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Daelmans
authors.affiliation: Bernard van Leer Foundation, Washington, DC, USA.
authors.forename: Joan
authors.initials: J
authors.lastname: Lombardi
authors.affiliation: UCLA Fielding School of Public Health and WORLD Policy Analysis Center, University of California Los Angeles, CA, USA.
authors.forename: Jody
authors.initials: J
authors.lastname: Heymann
authors.affiliation: Inter-American Development Bank, Washington, DC, USA.
authors.forename: Florencia Lopez
authors.initials: FL
authors.lastname: Boo
authors.affiliation: Departments of Economics and Sociology, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Jere R
authors.initials: JR
authors.lastname: Behrman
authors.affiliation: Division of Global Health Equity, Brigham & Women's Hospital, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
authors.forename: Chunling
authors.initials: C
authors.lastname: Lu
authors.affiliation: Consultant in International Health and Child Development, New York, NY, USA.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Lucas
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.
authors.forename: Rafael
authors.initials: R
authors.lastname: Perez-Escamilla
authors.affiliation: Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland.
authors.forename: Tarun
authors.initials: T
authors.lastname: Dua
authors.affiliation: Center for Global Child Health, Hospital for Sick Children, Toronto, Canada; Centre of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan.
authors.forename: Zulfiqar A
authors.initials: ZA
authors.lastname: Bhutta
authors.affiliation: Department of Health Systems Governance and Financing, World Health Organization, Geneva, Switzerland.
authors.forename: Karin
authors.initials: K
authors.lastname: Stenberg
authors.affiliation: Haas School of Business and the School of Public Health, University of California Berkeley, CA, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Gertler
authors.affiliation: Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Gary L
authors.initials: GL
authors.lastname: Darmstadt
mesh_terms: D002657:Child Development; D002662:Child Health Services / Q000191:economics / Q000458:organization & administration*; D000068216:Child Protective Services / Q000191:economics / Q000458:organization & administration; D002675:Child, Preschool; D003906:Developing Countries; D018479:Early Intervention, Educational / Q000191:economics / Q000458:organization & administration; D005380:Financing, Government; D006801:Humans; D008427:Maternal Health Services / Q000191:economics / Q000458:organization & administration; D011057:Politics; D011203:Poverty