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Early Childhood Development: Maternal and Child Health and Nutrition: Dugarpur, Rajasthan

In the earliest years of life, especially from pregnancy to age three, babies need nutrition, protection and stimulation for healthy brain development. Recent advances in neuroscience provide new evidence about a baby’s brain development during this time. As a result, we know a baby’s brain is constructed through a complex interplay of rapid neural connections that begin before birth. How rapid? In a 2016 Lancet series, Advancing Early Childhood Development: From Science to Scale, leading neuroscientists found that in their earliest years, babies’ brains grow at an astounding rate, creating up to 1,000 neural connections every second.

In the brain-building process, neural connections are shaped by genes and life experiences – namely good nutrition, protection and stimulation from talk, play and responsive attention from caregivers. This combination of nature and nurture establishes the foundation of a child’s future. Yet too many children are still missing out on the ‘eat, play, and love’ their brains need to develop. Put simply, we don’t care for children’s brains the way we care for their bodies.

A mix of factors determine why some children receive the nutrition, protection and stimulation they need, while others are left behind. Poverty is a common part of the equation. 250 million children under five in low- and middle-income countries risk not reaching their development potential because of extreme poverty and stunting. Often, the most disadvantaged children are least likely to have access to the essential ingredients for healthy development. For example, frequent or prolonged exposure to extreme stress – such as neglect and abuse – can trigger biological response systems that, without the buffer of a protective adult, create toxic stress, a response that can interfere with brain development. As the child grows, toxic stress can portend physical, mental and behavioural problems in adulthood.

Conflict and uncertainty also play a role as children younger than five in conflict-affected areas and fragile states face elevated risks to their lives, health and wellbeing. Oversight and inaction have a high price and long-term implications for the health, happiness and earning potential as these children become adults. They also contribute to global cycles of poverty, inequality and social exclusion. Despite the need, early childhood programmes remain severely underfunded with lacklustre execution. Government investment in early childhood development is low.There is also little public understanding of the importance of a child’s first years and slight public demand for policies, programmes and funding.

Some key facts:

Lack of nutrition in early childhood leads to stunting, which globally affects nearly one-in-four children younger than five.

Risks associated with poverty – such as undernutrition and poor sanitation – can lead to developmental delays and a lack of progress in school.

Violent discipline is widespread in many countries, and nearly 70 percent of children between two and four were yelled or screamed at in the past month.

300 million children younger than five have been exposed to societal violence.

For a child in a low- or middle-income country, poor early development could mean they earn around one-quarter less in income, as an adult.

For a country, poor early childhood development could mean economic loss; in India, the loss is about twice the gross domestic product spent on health.

Thanks to the compelling scientific evidence and sustained advocacy, governments and society are beginning to realise the criticality of investing in the earliest years of a child’s life. In 2015, early childhood development was included in the Sustainable Development Goals, reaffirming its growing status in the global development agenda. This built on earlier efforts which saw early childhood development included in the Convention on the Rights of the Child which states that a child has a right to develop to “the maximum extent possible” and recognised “the right of every child to a standard of living adequate for the child’s physical, mental, spiritual, moral and social development.”

In 2016, the Government of India, Ministry of Health and Family welfare launched the Mothers' Absolute Affection (MAA) programme to address children mortality. “Breastfeeding is the most natural and cost effective intervention and should be promoted at all levels. This is an enormous resource that every child has access to. It is our job and our privilege to promote the world’s most effective investment for human development.”

That is why advising nursing and pregnant mothers on breastfeeding and nutritional necessities of children in accordance with their age, is amongst the main area of actions of MAA programme. To encourage mothers to breastfeed and make them aware about the nutritional supplements is one way to fight malnutrition. As part of this project, SIDART under the guidance of Dr Pramila Sanjaya, is involved in the Jawahar Nagar slum area (Jaipur) where several times a week, the SIDART team and their volunteers visit different pregnant and lactating women. They try to make those women aware about all the key information on women and child nutrition and care including the importance of breast feeding and colostrum feeding. They also collect a lot of information about the child's birth (weight, size, age) to be able to follow his growth and for his good development. Those moments are also good opportunities to speak with mothers, to develop true discussions and be aware of the problems / need they could addressed.

We must act urgently to make investing in early childhood development a priority in every country to achieve the 2030 goals. Investing in early childhood development is a cost-effective way to boost shared prosperity, promote inclusive economic growth, expand equal opportunity, and end extreme poverty. For every $1 spent on early childhood development, the return on investment can be as high as $13. But parents need time and support to create a loving and safe environment to give their babies the ‘eat, play and love’ they need, and to help build their babies’ brains.That’s why SIDART is working along with UNICEF to increase investment in family-friendly policies, including paid parental leave and access to quality, affordable childcare; it makes good sense for governments because it helps economies and businesses, as well as parents and children. Investing in family-friendly policies makes good sense for businesses too; giving parents flexibility creates a happier and more productive workforce, and allows them more time to build the brains of the future. The time to act is now; together, we can make the #EarlyMomentsMatter for every child.

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