SNAPSHOT: INVESTING IN THE EARLY YEARS FOR GROWTH & PRODUCTIVITY CONTENTS: OVERVIEW 1 THE EVIDENCE 3 THE CHALLENGE 6 THE STRATEGY 8 COUNTRY RESULTS 10 PARTNERSHIPS FOR INVESTING 12 IN THE EARLY YEARS INFOGRAPHIC 14 Investing in the early years is one of the smartest things a country can do to eliminate extreme poverty, boost shared prosperity, and create the human capital needed for economies to diversify and grow. Early childhood experiences have a profound impact on brain development—affecting learning, health, behavior and ultimately, income. An increasingly digital economy places even greater premiums on the ability to reason, continually learn, effectively communicate and collaborate. Those who lack these skills will be left further behind. Yet today, millions of young children are not reaching their full potential because inadequate nutrition, a lack of early stimu- lation and learning, and exposure to stress adversely affect their development. Smart investments in the physical, cognitive, linguistic, social, and emotional development of young children —from before birth until they transition to primary school— are critical to put them on the path to greater prosperity, and to help their countries be more productive and compete more successfully in a rapidly changing global economy. 2 Photo by Dominic Chavez. Early childhood nutrition, and early stimulation THE EVIDENCE SNAPSHOT: and learning programs have been shown to INVESTING IN THE EARLY YEARS extend school completion, improve learning outcomes, and increase adult wages: ࢝࢝ A 20-year study of children in Jamaica by Nobel laureate James Heckman, Paul Gertler and others showed that early stimulation interventions for infants and toddlers increased their future earnings by 25 percent—equivalent to adults who grew up in wealthier households. ࢝࢝ Evidence suggests a potential return rate of seven to 16 percent annually from high-quality preschool programs targeting vulnerable groups. ࢝࢝ Children in a long-term study in Guatemala who were well nourished (i.e., were not stunted) were much more likely to escape poverty as adults, and earned incomes 5 to 50 percent higher than children who were stunted as children. ࢝࢝ World Bank Group analysis suggests that the per capita GDP loss a country incurs for not having eliminated stunting when today’s workers were children is 7 percent, on average, while Sub-Saharan Africa and South Asia suffer larger losses of about 9 percent and 10 percent respectively. ࢝࢝ The same analysis suggests that scaling up the key interventions to reduce chronic malnutrition to 90 percent coverage over the next decade would have a rate of return between 15 and 24 percent, with an average benefit to cost ratio of 15 to 1. Photo by the World Bank Group. 4 Improving development outcomes across the world, especially among poor families, requires investing in (i) early childhood nutrition; (ii) quality early childhood programs that support families to provide early stimu- lation and learning opportunities from birth onwards; and (iii) protecting children from the kind of stress which undermines their development. The challenge is daunting: 156 ࢝࢝ One quarter of children under age five worldwide —that’s 156 million children per 2016 estimates— evidence chronic malnutrition (are short for their age, or stunted). ࢝࢝ Even in lower middle income countries—such as MILLION India, Indonesia, and Guatemala—over one-third of children at the national level, and up to 80 percent CHILDREN of children in some areas, are stunted. UNDER 5 ࢝࢝ Only half of all three to six-year-olds have access ARE STUNTED to pre-primary education. In Sub-Saharan Africa, WORLDWIDE >30% 20-30% only 20 percent of children can access these critical learning opportunities. THE CHALLENGE SNAPSHOT: We have evidence INVESTING IN ࢝࢝ Across developing countries, fewer than half It starts with ensuring that mothers and mothers-to-be are well THE EARLY YEARS of children under five have access to three or nourished. Their newborn babies should be exclusively breastfed on what interventions more books at home, limiting their development for the first six months and receive appropriate feeding and micro- opportunities. nutrients thereafter. Families should receive quality healthcare and work, and they are immunizations, and enabled to practice good household hygiene. ࢝࢝ One in 200 children in the world are displaced, Parents also need support so that they can positively engage with exposing them to the kind of stress that can feasible and cost- their children and undertake age-appropriate learning activities with undermine their development. them. They also need to be able to protect their children from the effective to implement. kinds of stress which can harm their development, such as that due to violence or neglect, displacement, disasters or impoverishment. 6 Photo by Dominic Chavez. SCALING UP FINANCIAL SUPPORT & WORKING CONTRIBUTING TO GLOBAL KNOWLEDGE THE STRATEGY SNAPSHOT: INVESTING IN WITH COUNTRIES TO MOBILIZE ACTION: AND MAKING THE INVESTMENT CASE: THE EARLY YEARS The Bank Group will do more by supporting demand from countries, The Bank Group is helping build the evidence base so countries can and by crowding in new sources of public and private financing to better appreciate the challenge and identify the most cost-effective support investments in the early years through partnerships. opportunities to respond. The Early Learning Partnership and the Strategic Impact Evaluation Fund substantially support these efforts. The Bank Group is engaging with high burden countries to identify opportunities to expand key interventions and consider where it can The Bank Group published a new guide for policy makers and practi- best provide support through its financial and knowledge services. It tioners about how to invest in young children titled Stepping up Early is enlisting experience and expertise from its specialists in education; Childhood Development. This guide identifies 25 essential interventions health, nutrition and population; social protection, labor and jobs; that span the education, health, nutrition, water, sanitation, and social agriculture; water; gender; disaster risk management; trade and protection sectors. competitiveness; fragility, conflict and violence; poverty; macroeconomics and fiscal management; and climate change. In partnership with the Bill & Melinda Gates Foundation, the Children’s Investment Fund Foundation, Results for Development and 1000 Days, In October 2016, President Jim Kim convened country leaders at the the WBG released An Investment Framework for Nutrition with new estimates Human Capital Summit to recognize countries that are taking action to of what it will cost to achieve the global nutrition targets. The estimates ensure every child has access to the early nutrition, stimulation and show that the world needs an average annual investment of US$7 billion learning opportunities, and the nurturing and protection that over the next 10 years to reduce stunting among children and anemia in will hardwire them and their countries for success. women, increase exclusive breastfeeding rates, and mitigate the impact In response to convincing evidence It is doing so through building global knowledge, making of wasting. financing available, providing policy advice and technical on the benefits of investing in support, and strengthening partnerships at the country, Impact evaluations of programs that invest in the early years in regional, and global levels. young children, as well as growing low- and middle-income countries help inform policy decisions. For example, in Mozambique, the Bank Group’s evaluation of a demand from countries, the The priorities are threefold: (i) reduce childhood undernutrition, community-based preschool program run by Save the Children showed (ii) ensure children receive early stimulation and learning; and World Bank Group is increasing (iii) protect vulnerable children. The Bank Group is committed to that children enrolled in preschool were better prepared for the demands of schooling than children who did not attend preschool, and that they its support to countries to invest measurably scaling up its investments by 2020 in the key interventions required to deliver on these priorities. were more likely to start primary school by age six. The Government of Mozambique is now investing significantly more in young children in the early years of life. from disadvantaged families. 8 4 Photo by the World Bank Group. SENEGAL INDIA COUNTRY RESULTS SNAPSHOT: INVESTING IN THE EARLY YEARS In Senegal, malnutrition was highly 35 million children under the age prevalent at the start of the millennium, of 6 (with a particular focus on ages and stunting affected as many as 34 0-3 years), pregnant women, and percent of children under five. In 2001, families in 162 high-burden districts Senegal, supported by the Bank Group, are benefitting from the expansion brought nutrition services into the of India’s Integrated Child communities and into households, Development Services and improved including nutrition education, PERU breastfeeding promotion, vitamin A supplementation, a network of nutrition outcomes. The program spans across 1.4 million community-based community volunteers to support new facilities nationwide. In 2000, 31 percent of Peruvian mothers and caregivers, social cash 0-5 year olds suffered from chronic transfers, and targeted food security malnutrition. With support from the Bank Group, Peru used conditional support. The prevalence of stunting has come down to 19 percent. INDONESIA cash transfers to target low-income families with young children. In just More than half a million children eight years, the country cut its chronic aged 0-6 years in 50 poor, hard-to- malnutrition rate in half, to 14 percent. reach districts received integrated This ranks among the most successful early childhood services through a achievements in improving child range of programs between 2007 nutrition in the world. and 2013. MOZAMBIQUE MADAGASCAR 84,000 young children in 600 rural Reaching 2.1 million mothers and communities will benefit from the children under the age of five, the extension of community-based National Community Nutrition programs that focus on early attention Program delivers growth-monitoring to cognitive, linguistic, socio-emotional, activities, culinary demonstrations, and physical skills aimed at increasing and nutrition education for primary chances of success in primary school caregivers through a network of over and beyond. 7,000 rural sites. 10 SNAPSHOT: INVESTING IN PARTNERSHIPS FOR INVESTING The World Bank Group is working with THE EARLY YEARS IN THE EARLY YEARS many foundations, United Nations agencies and bilateral partners, regional development banks, and civil society organizations to increase collective efforts around investing in the early years. SCALING UP NUTRITION ECD ACTION NETWORK INNOVATIVE FINANCING The Scaling Up Nutrition (SUN) The Early Childhood Development The Global Financing Facility in global movement has signed up 56 (ECD) Action Network, launched during support of Every Woman Every Child countries, 100+ global partners, the 2016 WBG-IMF Spring Meetings and the Power of Nutrition, both of and over 3,000 CSOs worldwide. by UNICEF and the WBG, is supported which are working to scale up domestic, It has increased political commitment by foundations, multilateral and bilateral international and private resources from donors, ministers of health and organizations, regional ECD networks, for investing in children’s health. agriculture, and CSOs. NGOs, and the private sector. The Network seeks to advance progress toward the Sustainable Development Goals for ECD. 12 Photo by Dominic Chavez. INFOGRAPHIC SNAPSHOT: INVESTING IN THE EARLY YEARS INVESTING IN THE EARLY YEARS TO END EXTREME POVERTY AND BOOST SHARED PROSPERITY INCREASE COMPETITIVENESS REDUCE INEQUALITY CHILDREN REACH THEIR FULL POTENTIAL (With the physical, social and emotional capacities to learn, earn, innovate and compete) CHILDREN ARE WELL CHILDREN RECEIVE EARLY CHILDREN ARE NURTURED NOURISHED, ESPECIALLY STIMULATION & LEARNING AND PROTECTED IN THE FIRST 1,000 DAYS OPPORTUNITIES FROM STRESS • Good nutritional status of mothers • Positive and engaging interactions with • Avoid household and community stressors and expecting mothers parents/caregivers (neglect, violence, displacement, • Exclusive & continued breastfeeding • Opportunities for age-appropriate and household shocks) • Proper feeding of <5s + micronutrients play-based learning through quality • Positive emotional connections with preschool programs parents/caregivers • Immunization & Rx of childhood illnesses • Supportive discipline • Good hygiene practices DELIVERING ON THE ESSENTIAL INTERVENTIONS ABOVE REQUIRES EFFORTS ACROSS SECTORS Quality Health Quality, Educated Family Leave Care and Water Reduced Safety Nets Diverse and and and Quality, Reproductive and Income and Response Affordable Empowered Affordable Health Sanitation Poverty to Shocks Food Women Childcare Services 14 Photo by Dominic Chavez. Front and back cover photos by Dominic Chavez. Inside cover photos by the World Bank Group. World Bank Group 1818 H Street NW Washington, D.C. 20433 USA www.worldbank.org