|Profound nutritional and cognitive deficits early in life doom many children in developing countries to low educational achievement and low economic productivity. Research shows that investing in nutrition during the pre-school years—and as early as possible—reaps significant long-term human capital and economic dividends.|
Many children in developing countries face severe nutritional and cognitive deficits right at the beginning of life. Estimates suggest that up to one-eighth of all children in developing countries are born malnourished (weighing less than 2.5 kilograms) and that a large percentage of children—47 percent in low-income countries—continue to be malnourished before the age of five. What makes these numbers greatly troubling is that the effects of malnutrition that persist past the second year of a child’s life are difficult to reverse. Early malnutrition weakens children’s physical and cognitive potential and even their non-cognitive traits such as motivation and persistence, so it is costly for their future health, educational attainment, and socioeconomic success.
Lasting benefits of early child development (ECD)
Starting at birth, improved nutrition yields benefits that cascade through life. It is estimated that 40 percent of the $510 in economic benefits obtained from preventing one child from being born at or below 2.5 kilograms is because preventing low birth-weight leads to higher cognitive abilities and greater productivity of children.
Among pre-school children in Ecuador, better nutrition, as measured by higher hemoglobin levels, improves cognitive development, as measured by a child’s test performance. Moreover, this association is larger for an older sample of children (ages 4 1/2 and older) than for a younger sample (ages 3-4 1/2), suggesting that the association between nutrition and cognitive development becomes stronger as the child matures.
Among pre-schoolers in the Philippines, a one-standard deviation increase in height raises their achievement test scores years later, an increase that is equivalent to completing eight more months of schooling and which implies a benefit-cost ratio of three or more.
Among pre-schoolers in rural
Two additional notes on the long-term gains of ECD: First, these findings are similar to those in industrial countries which have found lasting effects not only on education levels and earnings but also on welfare participation levels, criminal records, and probability of out‑of‑wedlock births.
Second, the studies on the long-term consequences of early childhood nutrition are based on panel data that allow researchers to relate direct measurements of pre-school child health and nutrition to later measures of physical development and schooling attainment. Cross-sectional data are less useful as they often do not contain direct measurements of preschool child health and cannot distinguish whether factors that explain school outcomes or earnings have also determined early malnutrition.
Wars, famines, and economic crises imperils child development
Children who have experienced nutritional deprivations during civil wars, droughts, and economic crises suffer long-lasting effects. In
During the economic crisis in
Integrated pre-school programs show promise
A combination of income growth and nutrition programs is likely to be the most effective for achieving the Millennium Development Goal for nutrition. Feeding and nutrient supplementation programs for infants and toddlers have been shown to be effective in improving children’s health and growth. For example, two evaluations of
But a number of developing countries have adopted programs that are multifaceted, including not only feeding and micronutrient supplementation, but also immunization, child growth monitoring, child care services, mental stimulation for children, as well as training of parents in parenting skills.
Three integrated programs have been carefully evaluated:
While these three programs have led to generally positive outcomes, evidence of their impact when they are implemented on a large scale is still limited. Complex programs fail because they place large demands on implementation and financial capacity. For example, an evaluation of the Integrated Child Development Service in
Earlier is better
The returns from investing in early childhood development is the cumulative effect of early nutrition, health care, and cognitive stimulation, so interventions that start early, especially before the age of two, have the highest gain. Malnutrition tends to be most common and severe during the periods of greatest vulnerability—that is, at pregnancy and the first two to three years of life—and, if it persists into the second year of life, stunts cognitive development and is difficult to reverse.
The findings on the
These research findings reinforce the belief that investing in nutrition early reaps significant long-term dividends, mostly because a child’s physical and mental abilities develop most rapidly at this age. Impact evaluations also suggest that integrated programs—nutritional and health interventions, training in parenting skills, cognitive stimulation—although complex to implement, may produce the biggest benefits.
The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors. They do not necessarily represent the view of the World Bank, its Executive Directors, or the countries they represent.
ELIZABETH M. KING is the Research Manager for the Human Development and Public Services team of the Development Research Group. Her main researcho interests have been the determinants of investments in human capital; the linkages among dimensions of human capital, poverty and economic development; and the impact of education reforms such as decentralization in developing countries. Several of her studies have examined also the significance of gender differences in the development process. Email c/o:email@example.com
This article was based in part on a review article entitled "Early Childhood Development: A Review of Findings from a Longitudinal Study in the Philippines," by Sharon Ghuman, Jere R. Behrman, Socorro Gultiano, Graeme Armecin, Isabelita Bas, Paulita Duazo, Elizabeth M. King, and Nanette Lee, East Asian Economic Perspectives 17 (August), 2006. (Full text)
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