Over 182 million children lack proper care risking healthy development: Lancet

A recent Lancet study highlights the child development crisis in low and middle-income countries, focusing on the lack of access to nurturing care and early childhood education.

Child development is a global crisis affecting many low and middle-income countries. India, which comes under this category, is seeing an upsurge in child obesity, malnutrition, increase in cases of genetic disorders and stunted growth.

While many factors cause this, a new Lancet study suggests that nearly 182 million children in low—and middle-income countries, around three-fourths of those aged three or four, lack access to adequate nurture, risking healthy development.

An international team, including researchers from the Centre for Chronic Disease Control (CCDC), New Delhi, said that child development is also affected by air pollution, climate change, and exposure to chemicals, which are emerging environmental risk factors.

The Lancet series highlights the importance of the "next 1,000 days", the period between a child's second and fifth birthdays, as a critical phase for fostering nurturing care.

Building on the foundation laid during the first 1,000 days, this stage requires targeted attention, particularly in low- and middle-income countries (LMICs), where access to structured early childhood care and education (ECCE) remains limited.

According to the study, fewer than one in three children aged 3–4 in LMICs attend early childhood care and education programs. Therefore, there's a need for substantial investment in this phase, prioritising access to high-quality ECCE programs that include adequately trained teachers, manageable teacher-student ratios, evidence-based curricula, and a focus on play-based, child-centred learning.

Dr. Aditi Roy, Senior Research Scientist at CCDC, said India faces significant challenges in providing equitable access to quality ECCE. "We need a holistic approach that prioritizes activity-based curricula over rote learning, as recommended by the National Education Policy," she told news agency PTI.

India lacks comprehensive data on ECCE enrollment, and estimates often vary. According to a government task force report from 2022, around 28.6 million children aged 3–6 were enrolled in ECCE under the Integrated Child Development Scheme (ICDS).

Meanwhile, the 2018 Annual Status of Education Report (ASER) survey, conducted across 600 rural districts by the non-profit organisation Pratham, found that preschool attendance increases with age, peaking at 96% for six-year-olds.

However, Dr. Roy highlighted the unregulated growth of private preschools, often called "affordable primary schools," raising concerns about inconsistent quality.

She also noted that data collected during the National Family Health Survey-5 (2019–20) might not accurately reflect the current reality due to disruptions caused by the Covid-19 pandemic.

An analysis within The Lancet series estimates that providing one year of ECCE for all children in LMICs would cost less than 0.15% of their GDP, with potential benefits outweighing costs by 8–19 times.

"Children from LMICs should be at the forefront of research and action during this crucial phase," said Catherine Draper, co-chair of the series and a researcher at the University of the Witwatersrand, South Africa. "High-quality ECCE programs are essential to support caregivers and ensure children receive the care they need to thrive."

The series also highlights emerging environmental risks, including air pollution, climate change, and chemical exposures, as barriers to healthy child development.

Dr. Roy pointed out that air pollution, particularly in regions like Delhi-NCR, disrupts education and directly affects physical development. Extreme weather events, driven by climate change, can further impact ECCE by jeopardising food and water security, mental health, and infrastructure.

Despite these risks, policy discussions in India have yet to address the intersection of climate change and child development. "Climate action plans must integrate ECCE to mitigate these threats," Dr. Roy said.

To bridge these gaps, the authors advocate for scalable, high-quality ECCE programs that cater to diverse needs while addressing emerging challenges like environmental risks.