In low- and middle-income countries (LMICs), three-fourths of those aged three or four years lack — nearly 182 million children — access to adequate nurture, thereby risking healthy development, according to a new series paper, published in The Lancet journal.

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

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The series builds on the foundation of the first 1,000 days of life — referring to the time period starting conception until two years old — and highlights how the ‘next 1,000 days’ (from age two to age five) is a crucial window of opportunity for providing nurturing care to children, the researchers said.

During this stage of “next 1,000 days”, children are often not in direct regular contact with health or education services, with fewer than one in three children aged three or four attending early childhood care and education programmes in LMICs, said the researchers.

The authors called for an increased investment for this stage of child development, with a particular focus on improving access to high quality childhood care and education programmes, which should involve adequately paid and trained teachers and reasonable teacher-student ratios.

These programmes should also include child-centred play, evidence-based curricula, and warm, stimulating, and responsive classroom interactions, they said.

Author Aditi Roy, Senior Research Scientist, CCDC, told PTI, “The main concern for India is ensuring an equitable access to quality ECCE. There needs to be a holistic approach with an activity-based curriculum rather than traditional academic-focus rote learning which goes against the National Education Policy recommendations.” Further, data regarding children in India attending ECCE programmes is sketchy, with no reliable estimates of current reality, she said.

A 2022 report by a government’s task force on ECCE said that 285.82 lakh children aged 3-6 years were covered under early childhood education in 2022 under the Integrated Child Development Scheme (ICDS), with an almost equal number of boys and girls.

A 2018 Annual Status of Education Report (ASER) survey found that over 70 per cent of 3-year-olds, 85 per cent of 4-year-olds, 92 per cent of 5-year-olds and 96 per cent of 6-year-olds were attending a pre-school or school. The survey, facilitated by the non-profit ‘Pratham’, was conducted in nearly 600 rural districts.

“However, as there is no data for private entities, it is hard to provide an estimate. But clearly, there is a steady increase in the number of private pre-schools, also referred to as ‘affordable primary schools’ in India with questionable quality and no regulation,” Ms. Roy cautioned.

While in recent years, the National Family Household Survey-5 has collected data for children aged five years who attended pre-primary school during the school year 2019-20, Roy said that the data might not reflect the current reality because that was a Covid year.

“The ongoing NFHS 6 survey will (possibly) give us more recent data in the coming months,” she said.

According to a new analysis, which is included in the Lancet series, providing one year of early childhood care and education for all children would cost on average under 0.15 per cent of the current gross domestic product of LMIC countries.

The series’ authors said that the potential benefits of these programmes are 8-19 times higher than the cost of implementing them.

“This Lancet series has brought together global researchers who share a passion for early childhood development, and were keen to profile the ‘next 1,000 days’ as a crucial stage of development, especially in low- and middle-income countries (LMICs),” Catherine Draper, University of the Witwatersrand, South Africa, and co-chair of the Series said.

“Children from LMICs not only need to feature more strongly in research on the next 1,000 days, but should also be receiving the care they need to thrive. This includes supporting caregivers of young children, and ensuring that they have access to high quality early care and education programmes,” Ms. Draper said.

Children not involved in childhood care and education programmes miss crucial nurturing care opportunities as roughly 80% of interventions promoting healthy development are taking place in such settings, the authors said.

They added that the programmes offer a platform to combine yearly screening and growth monitoring, along with food assistance, nutrition supplements, and caregiver support.

Further, air pollution, climate change, and chemical exposures as emerging environmental risk factors for poor child development, the authors said.

“Air pollution can affect early child development directly through physical changes and indirectly through disruptions in education as is currently happening in Delhi-NCR,” Ms. Roy explained.

“Similarly, extreme heat, drought, heavy rainfall, and flood (driven by climate change) can affect early child development and ECCE by impacting food and water security, physical and mental health. Extreme weather events could also physically damage ECCE centres and impact families economically,” she said.

However, currently, there is no discussion at the policy level on how these climate factors are impacting children’s development and how climate action plans should incorporate ECCE to address the emerging threat to progress, Ms. Roy added.