The first 1000 days

Pakistan’s population has crossed the 200 million-mark and is projected to reach 400 million by 2050 under most scenarios. More than 68 percent of this population is under 29 years of age. These demographic bulges can be both a blessing and curse depending on how they are managed. For example, Singapore invested in its population from the outset and reaped a hefty demographic dividend. It, therefore, became a developed country within a short period after its independence. Meanwhile, 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 in the Human Development Index, 124 out of 155 countries in the Gender Development Index, and 125 out of the 130 countries in the Global Human Capital Index. Unfortunately, Pakistan has slipped to the bottom five countries in the world in terms of education and skills development, with dismal rates of school enrollment, a 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 had stood at around 60 percent for almost a decade, has recently declined to 58 percent. It is much lower in the rural and remote areas, and among women. Female participation in the labour market also stands at a paltry 22 percent or less.

The situation of the youth – the largest and ever-increasing demographic segment – is even bleaker. Article 25-A of the constitution guarantees the right to education. Yet, almost 44 percent children of school-going age – a staggering 22.6 million – 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 MDGs. It is facing an “extensive learning crises, cutting across literacy, academic performance, enrolment and attendance or dropout rates” (as per the Pakistan Education Statistics, 2015-16). Pakistan also faces multiple challenges in reaching its sustainable development goals (SDGs).

According to the State of the World’s Children report (2016), which was prepared by the Society for the Protection of the Rights of the Child (Sparc), nearly half of all children in Pakistan are chronically malnourished. This has undermined their mental and physical growth. Evidence collected by Unicef shows that nearly one in ten children die before they turn five and around half of them die in the first month of life. While child mortality has declined slowly since 1990, newborn mortality has risen.

Diseases related to water, sanitation and hygiene account for around 110 deaths of children under the age of five every day. According to the Global Nutrition Report 2016, 45 percent of children under the age of five in Pakistan are suffering from stunting. The high stunting rates have deprived around 11 million children from realising their full physical and mental potential, which negatively impacts social and economic development in the country.

Overall, only 52 percent of deliveries take place in the presence of a skilled birth attendant. Disparities exist between the 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 national and international experience and evidence, early childhood development (ECD) offers a useful strategy in this regard.

In particular, the first 1,000 days of human life – the period between conception and a person’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 an astounding rate of 700-1,000 per second – a pace that is never repeated again.

Holistic ECD programmes cover pre- and postnatal healthcare; mother and child nutrition; child rearing; early learning and stimulation; and the monitoring of long-term milestones. The ECD programmes and approaches are now recognised as being the most advantageous and effective methods that enhance a child’s natural potential in all respects: mental faculties, physical development and social/behavioural competencies. Global research shows that ECD “improves children’s cognitive abilities, helps to create a foundation for lifelong learning, makes learning outcomes more equitable, reduces poverty and improves social mobility from generation to generation” (OECD, 2012).

A good foundation in the early years makes a big 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. The early years of childhood form the basis of intelligence, personality and social behaviour. They allow children the capacity to learn and nurture themselves as adults.

ECD is also seen as one of the most cost-efficient investments in human capital, which leads to sustainable development. Economic analyses from the developed and developing world have converged on a set of conclusions. The main idea is that investing in the formative years produces some of the highest rates of return to families, societies and countries.

The investment case is not only made with respect to returns, but can also be linked to the cost of inaction. Science has demonstrated that early childhood interventions are important because they help mitigate the impact of adverse early experiences. If these experiences are not addressed, they could result in poor health (non-communicable diseases such as obesity, cardiovascular disease and diabetes); poor educational attainment; economic dependency; increased violence and crime; greater substance abuse; and depression

Investing in the first 1,000 days of every human life is critical for the holistic development of individuals and serves to promote equitable and sustainable development in Pakistan. The efforts that are made in the early years will prepare children for mainstream schooling and ensure that they are equipped with the requisite cognitive, physical and social development milestones. This will enable them to be active learners throughout their lives and contribute towards building a harmonious, sustainable and happy society.

The writer is an educationist and currently heads the Early Childhood

Development Network of Pakistan. Email: Khadija.khan@ecdnp.org