THE FIRST 1,000 DAYS OF A HUMAN LIFE
Pakistan’s population just crossed 200 million and, under the current scenarios, it is projected to reach 400 million by 2050. More than 68 % of this population is under 29 years of age. What is important about this demographic transition is that it happens only once in the lifetime of nations, and it is both a potential blessing and a potential curse, depending on how it is managed. The contrasting examples are Singapore, which invested in its population when it was young and reaped a hefty demographic dividend, and joined the status of a developed country within a short period after independence. In contrast, Somalia failed to do so and ended up as a failed state. Pakistan probably stands somewhere in the middle between a huge demographic dividend and a demographic time bomb.
Pakistan currently ranks 141 out of 182 countries on the Human Development Index, 124 out of 155 countries on the Gender Development Index, and 125 out of 130 countries on the Global Human Capital Index. Tragically, Pakistan has slipped to the bottom five countries in the world for education and skills development, with dismal rates of school enrollment, poor quality of pre-primary and primary education, low skill diversity among the country’s university graduates, and a widening gender gap. The country’s literacy rate, which stagnated at around 60% for almost ten years, has recently declined to 58%, according to the Economic Survey of Pakistan (2016-2017), and it is much lower in the rural and remote areas, and among women. Female participation in the labour market is a paltry 22%, or less.
The situation of the young people, the largest and growing demographic segment, and the main point of this discussion, is even bleaker. Article 25A of the Constitution of Pakistan guarantees the ‘Right to Education’: [The State shall provide free and compulsory education to all children of the age of five to sixteen years in such manner as may be determined by law.] Yet, almost 44% of the children of school-going age, a staggering 22.6 m, are currently out of school, making it the second-highest out-of-school population in the world. The country has already missed the Net Primary Enrolment (NPE) and other targets in the Millennium Development Goals (MDGs), and facing an “extensive learning crises, cutting across literacy, academic performance, enrolment and attendance or dropout rates” (Pakistan Education Statistics, 2015-16). Pakistan presently faces multiple challenges in reaching its Sustainable Development Goals (SDGs) particularly 4.2.
According to the State of the Children Report (2016), prepared by the Society for the Protection of the Rights of the Child (SPARC), nearly half of all children in Pakistan are chronically malnourished, undermining their mental and physical growth. Among other challenges, the Report highlights child labor and polio. Pakistan and Afghanistan are the only two countries left on the Polio-endemic Nations List. Evidence collected by UNICEF and other national and international organizations also shows an alarming situation. According to their research, nearly one in ten children die before they reach five years of age. Of these, half die in the first month of
1The Author is an Educationist, presently heading the Early Childhood Development Network of Pakistan (ECDNP), [email protected]
life. While child mortality has declined slowly since 1990, newborn mortality has actually risen. Diseases related to water, sanitation, and hygiene, account for 110 deaths of children under-5 every day. Only 33.6% of under-5 children are registered in Pakistan. According to the Global Nutrition Report 2016, 45% of children under age 5 in Pakistan suffer from stunting. The high stunting rate deprives around 11 million children from realizing their full physical and mental potential, which negatively impacts the future of the social and economic development of the country. Overall, only 52% of deliveries take place in the presence of a skilled birth attendant. Again, wide disparities exist between rural and urban regions of the country, and among population segments with differing socioeconomic profiles.
Given the enormity of the problem and the short window of opportunity that is available to avert a looming demographic disaster, Pakistan needs to leapfrog and follow transformational strategies. Based on global knowledge and overwhelming national and international experience and evidence, early childhood development (ECD) is such a strategic entry point.2In particular, the first 1,000 days of human life, the time spanning roughly between conception and one’s second birthday, is a unique period of opportunity when the foundations of optimum health, growth, and neurodevelopment across the lifespan are established. In the first years of life, neurons in our brain form new connections at the astounding rate of 700–1,000 per second – a pace never repeated again (UNICEF, et el.).
Early childhood is a critical and important developmental stage of a human life in which a child’s brain develops rapidly. Nero Science suggests that the brain of a child starts developing from prenatal stage and continues after birth. A child is born with 100billlion brains cells, which need proper nurturing through early stimulation and nutrition to help the child in making proper neural connections/wires and pathways. The years starting from prenatal to 8 are considered to be the critical window for optimum brain development. This period is not only critical for brain development rather children during this phase develop holistically (cognitive, physical, social, emotional, and language development) provided that they are nurtured in a scientific way. Therefore early interventions focussing on the milestones of this developmental stage of the children need to be developed and implemented. Interventions should be made to ensure proper pre and postnatal health care, mother and child nutrition, child rearing, early learning and stimulation.
ECD is emerging as an area of focus and interest, globally. Over the last two decades, Pakistan has also seen increasing interventions in the area of early and formative education and development of children in the age group zero to eight years, especially in the private sector. However, wide variation is found in the understanding and use of ECD terminology, as it is variously known as early childhood development, early childhood care (ECE), early childhood care and education (ECCE), early childhood education (ECE) or early childhood education and development (ECED). The ECD programs and approaches are recognized world-wide as being the most advantageous and effective method that enhances the child’s natural potential in all respects; mental faculties, physical development and social/behavioural competencies. A 2012 report from the Organization of Economic Co-operation and Development (OECD) concludes that Early Childhood education “improves children’s cognitive abilities, helps to create a
2 ECD refers to programmes and provisions for children from prenatal to eight years of age, which caters for the needs of a child in all domains of (holistic) development i.e. physical, motor, language, cognitive, socio- emotional, and creative and aesthetic appreciation
foundation for lifelong learning, makes learning outcomes more equitable, reduces poverty and improves social mobility from generation to generation.”
A good foundation in the early years makes a difference through adulthood and even gives the next generation a better start. Educated and healthy people participate in, and contribute to, the financial and social wealth of their societies. Early years of childhood form the basis of intelligence, personality, social behavior, and capacity to learn and nurture oneself as an adult. There is significant evidence that links the circumstances of adversity and habits formed in early years to the non-communicable diseases of adulthood.
ECD is also seen as one of the most cost-efficient investments in human capital, which leads to a country’s sustainable development. Economic analyses from the developed and developing world is converging on a set of conclusions, with the main idea being that investing in the earliest years leads to some of the highest rates of return to families, societies and countries. The investment case is not only made with respect to returns but also with respect to the cost of inaction. Science has demonstrated that early childhood interventions, early in life are important because they help mitigate the impact of adverse early experiences which if not addressed lead to poor health (e.g., non-communicable diseases such as obesity, cardiovascular disease and diabetes), poor educational attainment, economic dependency, increased violence and crime, greater substance abuse and depression – all of which add to the cost and burden in society.
So far, ECD has not been recognized as part of formal public sector education in Pakistan. However, in recent years, the policy environment has improved. The National Education Policy (2009) has devoted a chapter for early childhood education, with a clear policy objective of reaching universal access to ECE in all public and private schools in ten years. However, there is a key policy gap in the country that limits early childhood education to only 3-5, instead of pre natal to 8, thus missing the most critical first 1,000 days in a child’s development. Other issues include lack of integration among key sectors such as health, nutrition child rights, shortage of trained personnel from practice to policy level, and absence of institutional systems for interagency planning, programming, implementation and monitoring and evaluation. The insufficient allocation of resources is another most common problem.
The investment in the first 1,000 days of every human life is critical for the holistic development of individuals and equitable and the sustainable development of Pakistan. The care and quality service in early years will enable children to be ready for mainstream schooling, equipped with the requisite cognitive, physical and social development milestones, enabling them to be active
learners throughout their life, contributing towards building a harmonious, sustainable and happy society.
The 18thamendment to the Constitution of Pakistan devolves much of the responsibility, ownership and fiscal decisions for public education to provinces. Potentially, this is a great idea, as it gives provinces, special administrative regions and professional actors within them, space to work in a variety of creative ways to promote Early Childhood Development & Education, right from early years. However, at present, very few organizations both in public and private sector and some individuals are working in ECD sector. As such, there is an unmet demand for the stream of services built around the early childhood care and development. The need is enormous, as every child in Pakistan from prenatal to age 8 should be given good quality services for their holistic development and for meeting national and international targets and commitments: Right to Education /SDGs (4-4.2).
The government both at national and provincial level has done some significant work in the area of mother & child health, nutrition and education development of pre-primary children through developing policies, curriculum and allocating resources. However these efforts are not backed by legislation and long-term multi-sector policy development. They require legislation and concerted multi-sector efforts and collective actions across key stages of child development to develop coherent policies for holistic early childhood development focusing on all the domains of ECD. In Pakistan the ministries at national and provincial level are working in isolation for ECD, child and maternal health and ECE whereas the need is to develop an integrated plan atleast for the first 1000days. Naturally, the institutional and professional capacities vary across provinces and special territories, therefore, the Ministry of Federal Education & Professional Training should support those provinces and territories to develop harmonised, multi-sector policies with common definitions and standards to take the cause of holistic ECD forward.