A new progress report launched by the World Health Organization (WHO) and UNICEF highlights the need to step up investment in nurturing care — especially in the poorest and most fragile countries — with the first years of a child’s life providing irreplicable opportunities to improve lifelong health, nutrition and well-being.

The report tracks progress against the global nurturing care framework, a seminal guidance document for supporting the healthy physical, intellectual, and emotional development of young children. This framework promotes an integrated approach to early childhood development, covering nutrition, health, safety and security, early learning, and responsive caregiving as essential areas for interventions.

“Early childhood development provides a critical window to improve health and well-being across life — with impacts that resonate even into the next generation,” said Dr Anshu Banerjee, director of maternal, newborn, child and adolescent health and ageing at WHO. “While this report shows encouraging progress, greater investment is needed in these foundational early years so that children everywhere have the best possible start for a healthy life ahead.”

A child’s early experiences have a profound impact on their overall health and development. They affect health, growth, learning, behaviour and — ultimately — adult social relationships, well-being and earnings. The period from pregnancy to the age of three is when the brain develops fastest, with over 80 per cent of neural development happening during this time.

“Every child has the right to the best start in life,” said Dr Victor Aguayo, director of nutrition and child development at UNICEF. “This includes the right to good nutrition and stimulation, responsive care and early learning, health and a safe environment. These rights provide children with the opportunity to grow and develop to their full potential. As children thrive, entire communities grow, and a sustainable future is possible.”

According to the report, political commitment to early childhood development has increased since the framework was launched five years ago. Close to 50 per cent more countries have developed related policies or plans, and services have expanded. In a recent rapid survey, more than 80 per cent of responding countries reported training frontline workers to support families in providing early learning activities and responsive caregiving.

At the same time, increased investments are needed to scale up services and demonstrate impact, especially amongst vulnerable populations. Ensuring adequate support for children with developmental difficulties and addressing caregiver psychosocial well-being are part of this agenda.

“To improve the health of children, we must not only focus on meeting their immediate physical needs, but also ensure they are able to learn effectively, and develop positive, emotionally rewarding relations with people around them,” said Dr Bernadette Daelmans, head of child health and development at WHO. “This is the role of nurturing care — laying the foundations for healthy brain development with lifelong implications for learning, health and well-being.”

Efforts to create enabling environments for early childhood development require cohesive efforts — with dedicated financing — across a range of different sectors, the report notes, including health, education, sanitation, and protection services. Family-friendly policies supporting equitable access to affordable, high-quality childcare are also important.

Moving forward, the report highlights the significance of two new measures for improving data on progress — the early childhood development index 2030 and the global scales for early development — which can now be used to assess early childhood development starting soon after birth.

The Nurturing Care Framework was launched in 2018 by WHO, UNICEF and the World Bank Group, in collaboration with the Partnership for Maternal, Newborn and Child Health (PMNCH) and the Early Childhood Development Action Network. Its five strategic actions are: i) lead and invest; ii) focus on families and their communities; iii) strengthen services; iv) monitor progress; and v) scale up and innovate. It is complemented by a handbook, practice guide, thematic briefs, country profiles and an active website to help practitioners and policymakers support nurturing care and improve early childhood development at scale.

For more information see https://nurturing-care.org.