The Lancet Series 2017 Executive Summary: Key Messages

1. The burden and cost of inaction is high. A staggering 43 percent of children under five years of age—an estimated 250 million—living in low- and middle-income countries are at risk of suboptimal development due to poverty and stunting. The burden is currently underestimated because risks to health and wellbeing go beyond these two factors. A poor start in life can lead to poor health, nutrition, and inadequate learning, resulting in low adult earnings as well as social tensions. Negative consequences impact not only present but also future generations. Because of this poor start, affected individuals are estimated to suffer a loss of about a quarter of average adult income per year while countries may forfeit up to twice their current gross domestic product (GDP) expenditures on health and education.

2. Young children need nurturing care from the start. Development begins at conception. Scientific evidence indicates that early childhood is not only a period of special sensitivity to risk factors, but also a critical time when the benefits of early interventions are amplified and the negative effects of risk can be reduced. The most formative experiences of young children come from nurturing care received from parents, other family members, caregivers, and community-based services. Nurturing care is characterized by a stable environment that promotes children’s health and nutrition, protects children from threats, and gives them opportunities for early learning, through affectionate interactions and relationships. Benefits of such care are life-long, and include improved health, wellbeing, and ability to learn and earn. Families need support to provide nurturing care for young children, including material and financial resources, national policies such as paid parental leave, and provision of population-based services in a range of sectors, including health, nutrition, education, and child and social protection.

3. We must deliver multi-sector interventions, with health as a starting point for reaching the youngest children. Interventions—including support for families to provide nurturing care and solving difficulties when they occur—target multiple risks to development, and can be integrated into existing maternal and child health services. Services should be two-pronged, considering the needs both of the child and of the primary caregiver, including concern for the child’s early development as well as for maternal and family health and wellbeing. This affordable approach is an important entry point for multi-sectoral collaborations that support families and reach very young children. Essential among these are nutrition, to support growth and health; child protection, for violence prevention and family support; social protection, for family financial stability and capacity to access services; and education, for quality early learning opportunities.

4. We must strengthen government leadership to scale up what works. It is possible to scale up projects to nationwide programs that are effective and sustainable, as indicated by four country case studies in diverse world regions. However, government leadership and political prioritization are prerequisites. Governments may choose different pathways for achieving early childhood development goals and targets, from introducing transformative government-wide initiatives to progressively enhancing existing services. Services and interventions to support early childhood development are essential to ensuring that everyone reaches their potential over the life course and into the next generation—the vision that is core to the 2030 Sustainable Development Goals

Permission to share the Series Executive Summary Key Messages with the online Early Childhood Peace Consortium (ECPC) community is granted by The Lancet Early Childhood Development Series Steering Committee.