THE first 36 months, when child learns to speak, sense, walk, interact and reason, are the most critical phase of its life. This is when brain connections multiply and emotional and cognitive skills develop. This is also the most vulnerable period - one that demands the most care from society. Unfortunately, these critical early years of a child's life have received the least attention.
This is the central theme of the United Nations Children's Fund's (UNICEF) The State of the World's Children 2001 (SOWC 2001). Conclusive scientific evidence suggests that most of brain development takes place before a child turns three years old. If chi ldren do not get the right start, they may never catch up or ever reach their full potential. This "brain drain" that results from the neglect of early childhood development is real and it is invisible. It is also serious and irreversible. Neglecting ear ly childhood care has profound consequences, not only for the growth of the child but also for the progress of a nation and the prosperity of its people.
SOWC 2001 once again reminds one of the long road ahead in establishing a society where every child is assured the right to childhood. The Report reveals, for instance, that:
* almost 11 million children under the age of five died in 1999, mostly from easily preventable causes.
* the top five child killers remain perinatal conditions (20 per cent) respiratory infections (18 per cent), diarrhoeal diseases (17 per cent), vaccine preventable diseases (15 per cent) and malaria (7 per cent).
* More than 20 per cent of primary school age children in developing countries are not in school.
* Close to 20 million children have been displaced by conflict.
* More than 10 million children under 15 have lost their mothers or both parents to AIDS (Acquired Immune Deficiency Syndrome).
* About 177 million children are stunted mainly because of malnutrition in pregnant women.
Despite a reasonable growth record, India too has failed to deliver on many of its promises made to children. Misplaced priorities, faulty policies, wasteful programmes, avoidable conflicts, gross mismanagement and outright corruption have denied million s of children and their families many basic human rights, including the right to survival, the right to good health, quality education, clean water, safe environments and proper sanitation. Consider the following:
* India's under-five mortality rate (U5MR) is around 98. Japan, Norway, Singapore and Sweden report an under-five mortality rate of 4.
* Some 47 per cent of India's children under three years are malnourished. This rate is among the highest in the world and almost twice the levels of malnutrition reported in many parts of sub-Saharan Africa.
* Close to 33 per cent of children born in India have low birth weight. The proportion is 6 per cent in China and Thailand, 8 per cent in Indonesia, and 9 per cent in Malaysia.
* Only some 52 per cent of primary school entrants reach Grade 5 in India. The proportion is 98 per cent in the Maldives, 97 per cent in Sri Lanka and Thailand, and 91 per cent in China.
In matters relating to early childhood development, India boasts of a rich tradition of community and family-based childcare for the young. Over the years, however, several factors, including the break-up of the joint family, changes in labour markets, t he restructuring of business, and the increasing pressures of modern living, have imposed a severe squeeze on care, especially of young children.
Facilities for early childhood care are provided by some non-governmental organisations (NGOs) and as part of the government's Integrated Child Development Scheme (ICDS). However, these are by and large inadequate. Many families, in both rural and urban areas, are simply unable to provide the much-needed nurturing. Children of many construction workers and working women are typically neglected as there are simply not enough creches in the cities. The absence of appropriate childcare facilities forces po or families to leave infants to the care of siblings just a few years older, barely old enough to look after themselves, let alone younger children. In a society where girls and women are forced to assume almost the entire responsibility for child rearin g, under-investment in providing appropriate child care facilities unfairly denies them the freedom to pursue education, employment and other opportunities - economic, political and cultural.
SOWC 2001 makes a strong case for assuring every child the right to the best possible start in life, by investing in early childhood care. According to the Report, it is during early childhood (under three years) when the motor that fires a child's think ing and behaviour patterns for the rest of his or her life is formed. During these formative years, experiences and interactions with parents, family members and adults influence the way a child's brain develops. Cooing and the touching, piggybacking and singing among parents and children are not childish indulgences to pass time. They constitute vital emotional nourishment for the development of confidence, curiosity, self-control and the capacity to communicate and relate to others.
Having in place a proper system of early childhood care helps inculcate in young children the daily routine of attending classes regularly. Studies suggest that a well-functioning anganwadi (childcare facility or creche) has much to contribute to ensuring universal schooling. Providing the right kind of stimulation as well as food to small children helps their healthy development. And a good pre-school programme prepares young children emotionally and intellectually to enter and enjoy school.
A good pre-school programme can also prevent children from dropping out of school. Surveys in India reveal that children often drop out of school after being beaten and terrorised by the teacher for not grasping even basic concepts. Teachers, when asked why they beat children, blame the child's lack of interest and lack of comprehension. Both the inability to concentrate in class and cope with studies may have their roots in the neglect of early childhood development. Children who have not had the benef it of good early childhood development tend to be slow learners. And slow learners going through an Indian education system, which hardly recognises their existence, are likely to be pushed out of schools.
SOWC 2001 documents several innovative ways by which parents and communities throughout the world have helped children grow and develop.
Jamaica: The Roving Caregivers programme supports teen mothers in a country where more than 20 per cent of all births are to girls aged 15 to 19. Infant day care allows young mothers to attend classes in, job training, development of self-esteem a nd academic work. The fathers of the babies and the mothers of the teenage girls attend special sessions. In rural parishes, Rovers walk from home to home, working with children under three years old and their parents.
Jordan: A main focus of the Community-based Rehabilitation programme in early childhood is early detection of disabilities in children living in communities where a culture of shame previously kept them hidden and away from the support they need.
The Maldives: In a population with high literacy and low infant mortality, a multimedia programme attempts to broaden early childcare information beyond basic survival to the social, emotional, cognitive and spiritual development of the child. The goal is to create a culture in which children are valued and encouraged to express themselves and gender stereotypes are reversed.
Peru: Wawa Wasi, or Children's Homes, is a home-based childcare programme for 150,000 children. Started in 1993, Wawa Wasi provides day care and meals for children less than three years of age in low-income working families and will eventually pro vide training and employment for as many as 19,000 caregivers.
Sweden: Local governments subsidise childcare for nearly half the children in the country. Ample resources, well-trained staff and well-maintained facilities have ensured that children who spend their earliest years in Sweden's day-care system gro w to be creative, socially confident and independent adolescents.
Cuba: A national system of day-care centres, started in 1959, today reaches almost 98 per cent of all children in the 0-6 age group. In 1992, with support from UNICEF, Cuba created the Educate Your Child programme, a national, community-based prog ramme that provides activities for children (such as outings to parks, cultural facilities and sports centres) and their families, mainly counselling and information.
All these programmes approach children's rights as an indivisible whole. They are integrated and multidimensional, and they are deeply rooted within communities and blend what is the best environment for children with an understanding of traditional chil d-rearing practices.
SOWC 2001 invokes leaders of the world to focus on the very early years of childhood by:
* ensuring that every child is registered at birth and starts life shielded from violence, with adequate nutrition, clean water, proper sanitation, primary health care and cognitive and psychosocial stimulation;
* supporting families and communities as they care for young children;
* providing resources to ensure every child the best possible start in life during the early childhood years;
* spending what is needed now to ensure that families have access to the basic good-quality services they need for their young children; and
* making the rights and well-being of children a priority.
The Report also calls for some fundamental changes to traditions that reinforce unacceptable treatment of children. For instance:
* National campaigns are needed to register all children at birth, including those of ethnic minorities and the disabled.
* Within families, dismissive attitudes of "they are only children" must be discarded.
* Laws and policies must address their possible effects on children before they are passed.
* Changes are needed in gender roles as well. Men, and fathers in particular, must begin to play a more direct role in caring for young children.
* Women must be empowered in the communities and at home, as empowered women have a far-reaching, positive effect on the upbringing of children.
* Weak leadership and accountability must not be accepted.
The unprecedented pressures of global competition are also squeezing out care in many forms. Early childhood development remains a casualty. This situation needs to be corrected. Development is not just about becoming an affluent nation. The real challen ge is to establish a caring society, a society that cares for its children, cares for its environment, cares for those who need protection, and cares as much for its past as it does for the future. Action to build such a society must begin with children.
A.K. Shiva Kumar is an economist and consultant to UNICEF.