THE FIRST 1,000 DAYS OF A HUMAN LIFE
Khadija Khan
Pakistan’s population just crossed the 200 million mark and is projected to reach 400 million by 2050, under most scenarios. More than 68% of this population is under 29 years of age. What is important about this youth demographic bulge is that it happens only once in the lifetime of nations, and it is both a potential blessing and a curse, depending on how it is managed. For example, Singapore invested in its population when it was young and reaped a hefty demographic dividend, joining 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 in the Human Development Index, 124 out of 155 countries in Gender Development Index, and 125 out of the 130 countries in 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 widening gender gap. The country’s literacy rate, which stagnated at around 60% for almost a decade, has recently declined to 58%, according 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 ‘Right to Education’. 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 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. Evidence collected by UNICEF shows that nearly one in ten children die before they reach five years of age. Of these, half die in the first month of 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% per 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 leap frog and follow transformational strategies. Based on global knowledge and overwhelming national and international experience and evidence, early childhood development (ECD) is such a strategy. In particular, the first 1,000 days of a 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.).
Holistic ECD covers pre and postnatal health care, mother and child nutrition, child rearing, early learning and stimulation and monitoring of long-term milestones. The ECD programs and approaches are now recognized 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. 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. Early years of childhood form the basis of intelligence, personality, social behavior, and capacity to learn and nurture oneself as an adult.
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 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.
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 Author is an Educationist, former General Manager of Aga Khan Education Service (AKESP), GB, presently heading the Early Childhood Development Network of Pakistan (ECDNP), Khadija.khan@ecdnp.org
