Healthy Child Development: A Global Right

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Healthy Child Development A Global Right

• Clyde Hertzman
• Knowledge Hub for ECD
• World Health Organizations
• Commission on Social Determinants of Health
• Human Early Learning Partnership of BC

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Sensitive periods in early brain development
Binocular vision
Central auditory system
Habitual ways of responding
Language
Emotional control
High
Symbol
Peer social skills
Relative quantity
Sensitivity
Low
0
1
2
3
7
6
5
4
Years
3
00-069
Health Problems Related
to Early Life
Coronary Heart Disease Non-insulin Dependent
Diabetes Obesity Blood Pressure Aging and
Memory Loss Mental Health (depression)
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International Commission on the Social
Determinants of Health

• The goal is not an academic exercise, but to
  marshal scientific evidence as a lever for policy
  change aiming toward practical uptake among
  policymakers and stakeholders in countries.

WHO Director-General LEE Jong-Wooks address to
the World Health Assembly, May 2004
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ECD as a Social Determinant of
Health
gradients (inequalities) in health start as
gradients in the 3 domains of ECD ECD is
socially determined and, in turn, is a
determinant of health across the life course
ECD is primarily influenced by nurturant
environments but programs matter, too
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Percentage of Students Vulnerable on One or More
Scales of the EDI Based on Provincial cutoffs,
Wave 2
Fact 43 of the variation in vulnerability is
associated with SES
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Background -- Starting Points

• ECD means physical, social/emotional,
  language/cognitive development
• Biological Embedding--environments get under the
  skin
• Determinants of ECD are found from the intimate
  level (family) to the broadest level (global)
• These determinants matter according to how they
  influence the transactional and nurturant
  qualities of the childs intimate environment

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Key Messages

• gt200 million children in developing countries
  alone are not reaching their potential
• parents/caregivers need support from
  community and government at all levels
• political leaders can play an important role in
  guaranteeing universal access to a range of
  ECD services
• child survival and health agendas are
  indivisible from ECD
• because of the importance of transactional
  environments for ECD, SES is not fate

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• The conditions in which children are dying are
  the same conditions in which children are
  surviving

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Final Report Recommendations

• The World Health Organizations unique
  contribution to early child development globally
• Generating the necessary commitment at multiple
  levels of society
• Structural requirements for implementation
• Strategies for implementation
• Monitoring processes and outcomes related to ECD
• Creation of a Global Alliance for Early Child
  Development

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2. Generating Commitment

• bringing the science of ECD to policy by all
  levels of government
• need to do social marketing to new audiences
  outside the usual ECD community
• Global Alliance should disseminate science of
  ECD
• use commitment to UNCRC as dissemination tool
• need funding base to incorporate science of ECD
  into policy and monitor ECD provisions of UNCRC

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Opportunity General Comment 7 on the
CRCPotential Partnership WHO UNICEF
BvL UNESCO World Bank/AKF
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3. Structural Requirements

• need for an inter-ministerial policy framework
  at the level of national government
• governments adopt child and family-friendly
  policies
• international community and governments to
  create inter-disciplinary opportunities for
  training and research in resource-poor
  countries
• government involvement of local communities

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4. Strategies for Implementation

• govt building ECD onto existing child survival
  and health platforms
• govt needs strategy for scaling up effective
  programs w/o sacrificing effective
  characteristics
• govt to ensure free, compulsory access to
  school w/o gender inequities
• UNICEF -- create global formula for calculating
  ECD expenditure and return on investment
  that works for poor countries

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5. Monitoring

• expand evidence base in resource-poor countries
• govt held accountable for universal birth
  registration
• local NGOs to monitor access to quality ECD
  services
• govt/international agencies to fund monitoring
  of programs and ECD outcomes

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One Approach -- Create an Infant Mortality Rate
of ECD

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• Philosophy
• no measurement, no data no data, no
  problem
• do not let the best be the enemy of the
  good

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Neighbourhood Vulnerable
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6. Global Alliance for ECD

• to build upon existing informal networks of
  agencies working on ECD aligning agendas to
  create a stronger, higher profile agency.
• to link ECD in a meaningful way to Millennium
  Development Goals, especially with respect to
  poverty reduction, education, gender equality,
  and child survival.
• to take the international lead in bringing
  about many of the recommendations presented here.

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I would like
To be vaccinated!
To have my Birth Registered !
To be read/told strories To sing play with
my Parents.
To be well fed and To have drinking water!
To be protected From HIV/AIDS

To be in  quality early learning programs with
other children when I am 3 and above
To sleep under an
impregnated mosquito net!
Thank you for giving me a good start in life!
Cameroun