The global context for early child development
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The Global Context for Early Child Development. Clyde Hertzman Head, Knowledge Hub for ECD World Health Organization’s Commission on Social Determinants of Health Director, Human Early Learning Partnership of BC President, Council on Early Child Development.

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The global context for early child development

The Global Context for Early Child Development

Clyde Hertzman

Head, Knowledge Hub for ECD

World Health Organization’s Commission on Social Determinants of Health

Director, Human Early Learning Partnership of BC

President, Council on Early Child Development


International commission on the social determinants of health

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-Wook’s address to the

World Health Assembly, May 2004


The global context for early child development

What good does it do to treat people's illnesses ...

…then send them back to the conditions that made them sick?


How is the commission organized

Michael Marmot, Chair

20 members (volunteers)

Small Secretariat in Geneva

Smaller scientific team around Marmot in London.

Meetings in-person 3-4 times per year.

Pillars of work:

9 Knowledge Networks

Countries (and regions) involved

Civil society and global partners involved (World Bank, etc.)

World Health Organisation (WHO)

How is the Commission organized?


The global context for early child development

KNOWLEDGE NETWORK THEMES


Ecd knowledge network

ECD Knowledge Network


Ecd kn starting points

ECD-KN: 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 child’s intimate environment


Sensitive periods in early brain development

`Sensitive periods’ in early brain development

“Pre-school” years

School years

High

`Numbers’

Peer social skills

Symbol

Sensitivity

Language

Habitual ways of responding

Emotionalcontrol

Vision

Hearing

Low

1

2

3

4

5

6

7

0

Years

Graph developed by Council for Early Child Development (ref: Nash, 1997; Early Years Study, 1999; Shonkoff, 2000.)


The global context for early child development

Health Problems Related to Early Life

Coronary Heart Disease

Non-insulin Dependent Diabetes

Obesity

Blood Pressure

Aging and Memory Loss

Mental Health (depression)


Ecd kn starting points1

ECD-KN: 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 child’s intimate environment


The global context for early child development

Relational Community

(Social ties,Tribe,

Religion, etc.)

ECD Services

& Programs

Civil Society

Family, Cultural, Economic, &

Social Environment

Institutional/historical time

Individual Brain and Biological

Development, Genetics, Age, Sex

Family Health Status and

Dwelling Environment

Residential

Community Health

Status and Cultural, Economic, Service

& Social Environments

Regional Health Status and Ecological, Economic, Policy, Political & Social Environments

National Health Status, Ecological, Economic, Policy, Political & Social Environments

Global Ecological, Corporate/Economic, Policy, Political & Social Environments


Vulnerable on early development indicator by ses

% Vulnerable on Early Development Indicator, by SES

31.9

29.1

23.1

Canada

Kosovo

13.7

Australia

Mexico

Rich


The global context for early child development

Social Gradients by Country

360

Cuba

320

Argentina

Chile

280

Brazil

Language Score

Colombia

240

200

8

16

1

4

12

Parents' Education - Years


The global context for early child development

Overarching Messages

  • Transactional environment is the principal social determinant of healthy child development.

    2.Because of sensitive periods in brain development, early environments are the most powerful determinant of basic competencies.

    3.Early development goes on to influence health, in different ways, across the life course.

    4.Inequities in ECD have the capacity to threaten the level of competency needed for societal survival.


Key political messages

Key Political Messages

• 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


What the commission recommended

What the Commission recommended

“Equity from the start”


What the commission recommended1

What the Commission recommended

Commit to and implement a comprehensive

approach to early life, building on existing child survival programs and extending interventions in early life to include social/emotional and language/cognitive development.


What the commission recommended2

What the Commission recommended

Governments build universal coverage of a

comprehensive package of quality early child

development programs and services for

children, mothers, and other caregivers, regardless of ability to pay.


What is chile doing

What is Chile doing?


What is chile doing1

What is Chile doing?

Chile Crece Contigo

+ JUNJI

+ Junaeb

+ Income/Workplace/Neighborhood Policies

= “the Chilean System”


What is chile doing2

What is Chile doing?

Chile Crece Contigo + JUNJI

+ Junaeb

+ Income/Workplace/Neighborhood Policies

= “the Chilean System”

How does it measure up?


The global context for early child development

What the ECD-KN Recommended

The World Health Organization’s 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


2 generating commitment

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


3 structural requirements

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


4 strategies for implementation

4. Strategies for Implementation

• gov’t building ECD onto existing child survival and health platforms

• gov’t needs strategy for ‘scaling up’ effective programs w/o sacrificing effective characteristics

• gov’t 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


5 monitoring

5. Monitoring

• expand evidence base in resource-poor countries

• gov’t held accountable for universal birth registration

• local NGOs to monitor access to quality ECD services

• gov’t/international agencies to fund monitoring of programs and ECD outcomes


What do we need in monitoring

What do we need in monitoring?

Population based outcome data to tell whether or not we are making progress.

2. Data relevant to all the sectors that have responsibility.

3. Linked data that can track developmental trajectories from birth to adulthood.


The global context for early child development

The Early Development Instrument


The global context for early child development

What Does the EDI Measure?


The global context for early child development

All Children

Included in their 5th Year of Life


The global context for early child development

Not Always Equal


The global context for early child development

Greater Area Means

More Vulnerability


The global context for early child development

500

Initiatives


What are we doing post ecd kn

What are we doing post ECD-KN?


The global context for early child development

Children across the globe

thriving to the highest

level of ECD

To create and sustain a

global momentum for EHD

To build/support capacities

of countries to improve EHD

Broadening the global alliance

Providing assistance to monitor ECD-related processes

Strengthening the population health orientation of EHD

Facilitating the surveillance of CRC

Initiating Knowledge mobilization


The international consortium for population based e arly child d evelopment i ndicators

The International Consortium for Population-Based Early Child Development Indicators


The consortium can provide technical assistance in

The Consortium can provide technical assistance in:

Dissemination of results

Data Analysis and mapping

EDI Implementation

EDI adaptation and pilot-testing

Assessment of contexts


The global context for early child development

www.earlylearning.ubc.ca


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