HLTC05H3 Study Guide - Prenatal Development
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Worldwide, 10 million children die each year before their fifth birthday
Equally important, at least 200 million children are not achieving their full developmental potential, with
huge implications for their health and for society at large
Experiences in early childhood (defined as prenatal development to 8 years of age), and in early and
later education, lay critical foundations for the entire lifecourse. It is better for the individual child,
andfor society – in rich and poor countries alike – to provide a positive start, rather than having to
resort to remedial action later on.
The science of ECD shows that brain development is highly sensitive to external influences in early
childhood, starting in utero, with lifelong effects. The conditions to which children are exposed,
including the quality of relationships and language environment, literally ‘sculpt’ the developing brain
Educational attainment is linked to improved health outcomes, partly through its effects on adult
income, employment, and living conditions. There are strong intergenerational effects– educational
attainment of mothers is a determinant of child health, survival, and educational attainment
Children from disadvantaged backgrounds are more likely to do poorly in school and subsequently, as
adults, are more likely have lower incomes and higher fertility rates and be less empowered to provide
good health care, nutrition, and stimulation to their own children, thus contributing to the
intergenerational transmission of disadvantage
Creating the conditions for all children to thrive requires coherent policy-making across sectors.
Parents and caregivers can do a lot, but support is needed from government, civil society
organizations, and the wider community.
While environments strongly influence ECD, children are social actors who shape, and are shaped by,
Investments in ECD are one of the most powerful that countries can make – in terms of reducing the
escalating chronic disease burden in adults, reducing costs for judicial and prison systems, and
enabling more children to grow into healthy adults who can make a positive contribution to society,
socially and economically. Investment in ECD can also be a powerful equalizer, with interventions
having the largest effects on the most deprived children. Unfortunately, most investment calculus in
health and other sectors discounts such future benefits and values disproportionately those benefits
seen in the immediate to short term.
Implementing a more comprehensive approach to early life includes extending quality interventions for
child survival and physical development to incorporate social/emotional and language/cognitive
development. ECD programmes and services should comprise, but not be limited to, breastfeeding
and nutrition support, comprehensive support to and care of mothers before, during, and after
pregnancy – including interventions that help to address prenatal and postnatal maternal mental health
problems, parenting and caregiver support, childcare, and early education starting around age 3.
Interventions are most effective when they provide a direct learning experience to the children and
their caretakers and are high intensity, high quality, of longer duration, targeted towards younger and
disadvantaged children, and built onto established child survival and health programmes to make ECD
programmes readily accessible
Interventions that integrate the different dimensions of child development, among others by
incorporating stimulation (interaction between caregivers and children, which is related to brain
development) and nutrition, are particularly successful. They tend to result in sustained improvements
in physical, social/emotional, and language/ cognitive development, while simultaneously reducing the
immediate and future burden of disease, especially for those who are most vulnerable and
Younger children tend to benefit more from ECD interventions than older children, emphasizing the
importance of providing programmes and services as early in life as possible.
Within a framework of universal access, special attention to thesocially disadvantaged and children
who are lagging behind in their development will help considerably to reduce inequities in ECD. An
important reason is that ECD interventions tend to show the largest effect in these disadvantaged
groups. Unfortunately, children in the poorest households and communities are usually least likely to
have access to ECD programmes and services
An important aspect of the quality of ECD programmes and services is the promotion of gender equity.
Early gender socialization, the learning of cultural roles according to one’s sex and norms that define
‘masculine’ and ‘feminine’, can have large ramifications across the lifecourse. Girls, for example, may
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