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close this bookEarly Child Development: Investing in the Future (WB)
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The past four decades have seen unprecedented progress in health and education in developing countries. Much of this progress is associated with economic growth and the resulting improvement in living conditions. But despite tremendous progress on average, many countries— and within countries, many population groups-have failed to benefit. Every year more than 11 million children die from preventable diseases, and 130 million children-most of them girls-do not attend primary school. The students who will enter primary school in the year 2000 have already been born and are even now being prepared for their future lives. What happens to them in this stage of their lives will in large part determine the course of the coming millennium.

Children whose earliest years are blighted by hunger or disease or whose minds are not stimulated by appropriate interaction with adults and their environment pay for these early deficits throughout their lives-and so does society. Such children are far more likely than their more fortunate peers to do poorly in school, to drop out early, to be functionally illiterate, and to be only marginally employable in today's increasingly high-technology world. Collectively, these children who have been deprived in early life therefore affect labor productivity and national economic prosperity.

Yet none of this need happen. Early childhood programs have been shown to enhance school readiness, increase the efficacy of investments in primary schools and human capital formation, foster beneficial social behavior and thereby lessen social welfare costs, and promote community development. Moreover, child care arrangements that provide safe havens for preschoolers during the day allow mothers to join the work force, with benefits for all members of the family.

Programs that remedy critical early childhood deficiencies are therefore fundamental-not only to the success of each child in life, but also to the success of society as a whole. It is not surprising that policymakers and parents alike have now joined health, education, and nutrition specialists in acknowledging the importance of integrated early childhood interventions programs designed to improve children's health and nutrition and to stimulate their minds from their earliest years.

Health and education projects are central to the World Bank's strategy of poverty reduction, and the Bank has directed significant investment toward young children-the human capital of the future. Improved immunizations, basic health care, prenatal care, and nutrition services provided by Bank-supported programs have helped to reduce child mortality rates dramatically in developing countries. But to help stimulate the minds of the world's children and prepare them for a healthy and productive life, much more can and must be done.

The World Bank's chief goal is to reduce poverty, and it has regarded economic growth as the chief engine for achieving that goal. Thus, throughout its fifty years the Bank has directed both money and expertise to countries striving to achieve macroeconomic stability, an open economy, access to world markets, incentive structures that promote investment, functioning capital and labor markets, and the host of other reforms that spur economic growth.

But since the 1980s the World Bank has opened a new front in its fight against poverty by tripling its lending for health, education, nutrition, reproductive health, and other aspects of human capital development. The Bank's social service lending now averages more than US$3 billion a year substantially more than goes to support programs of economic reformmaking the Bank the largest supporter of social programs in the world.

To improve the lives of the women and children who make up the majority of the world's poor, the Bank has given special attention to efforts that improve the quality and reach of basic services in health and education. To achieve better results with these efforts, it is increasingly joining forces with the many nongovernmental organizations that have long worked in areas neglected by the formal service network.

Between 1990 and 1995 the Bank lent US$5.9 billion-about a third of its social sector lending for that period-for projects in health and education that would benefit children directly. These projects were both freestanding and incorporated in broad social sector efforts. Over the coming decade the Bank's social lending is slated to rise further, which should substantially help countries" efforts to improve the lives of their children.

This report offers the reader an overview of the many programs around the world that are targeting children from birth to the age of eight. These programs are supported and run by national governments, multinational organizations, bilateral donors, and a host of nongovernmental organizations. As part of the Bank's Directions in Development series, this report complements such other reports as Enriching Lives, an up-to-date summary of cost-effective investments in micronutrients; Building Human Capital for Better Lives, which focuses on strategies for building human capital within a sound macroeconomic environment; Investing in People, which highlights successful Bank-supported efforts across the social sector spectrum; and Private and Public Initiatives, which explores a variety of methods that governments and private entrepreneurs around the world have developed to bring basic services to the people.

The second half of the report briefly describes a variety of early child development programs now in operation. Policymakers and program managers may find these sketches useful when designing programs for preschool children. No matter the country or cultural setting of such programs, they share a single goal: improving very young children's development and therefore their prospects for the future.

To achieve this goal, some projects concentrate on educating caregivers, others on delivering services directly to the children. Still others seek to inform the public about the need for such projects in order to increase demand or about ways to improve the quality of parental care. Early childhood interventions use home visits, parental and teacher training, centerbased care, educational radio and television shows, and a host of other methods to carry out these varied purposes.

Many of the programs described here are still too new to have established a track record, but are included, along with programs tested and proved over the years, to present the full range of possibilities. This concise outline of theory, proven results, and present practice in early child development is offered with the aim of showing the world development community how investment in young children can help break the vicious intergenerational cycle of poverty in the developing world.

Armeane M. Choksi Vice President

Human Capital Development and Operations Policy