The Cost of Inaction Workshop Summary |
Kimber Bogard and Maureen Mellody, Rapporteurs
Forum on Investing in Young Children Globally
Board on Children, Youth, and Families
Board on Global Health
INSTITUTE OF MEDICINE AND
NATIONAL RESEARCH COUNCIL
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
This activity was supported by contracts between the National Academy of Sciences and the Accordia Global Health Foundation; the Aga Khan Foundation (unnumbered); Autism Speaks (unnumbered award); the Bernard van Leer Foundation (222-2012-043); The Bill & Melinda Gates Foundation (OPP1084405); Grand Challenges Canada (unnumbered); The William and Flora Hewlett Foundation (2013-9204); the Inter-American Development Bank (unnumbered); the Jacobs Foundation (2013-1079); National Institutes of Health–Fogarty International Center, National Institute of Mental Health, and National Institute of Child Health and Human Development (HHSN26300051); the Nestlé Nutrition Institute (unnumbered); the Open Society Institute–Budapest (OR2013-10010); the Society for Research in Child Development (unnumbered); UNICEF (unnumbered); U.S. Centers for Disease Control and Prevention (200-2011-38807, TO #21); U.S. Department of State (SAQMMA14M0612); the Maria Cecilia Souto Vidigal Foundation (unnumbered); and the World Bank (unnumbered). The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the activity.
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Suggested citation: IOM (Institute of Medicine) and National Research Council (NRC). 2014. The cost of inaction for young children globally: Workshop summary. Washington, DC: The National Academies Press.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Victor J. Dzau is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council.
PLANNING COMMITTEE ON INVESTING IN YOUNG CHILDREN GLOBALLY: THE COST OF INACTION—A WORKSHOP1
AMINA ABUBAKAR, Centre for Geographic Medicine Research–Kenya Medical Research Institute/Wellcome Trust Research Programme
CONSTANZA ALARCÓN, Coordinator of the National Early Childhood Strategy, Presidency of the Republic, Colombia
RAQUEL BERNAL, Associate Professor and Director of the Center for Research on Economic Development, Universidad de los Andes
GILLIAN HUEBNER, Child Protection Technical Advisor, U.S. Agency for International Development
JOAN LOMBARDI, Senior Advisor, Bernard van Leer Foundation
FLORENCIA LOPEZ BOO, Social Protection Economist Senior Specialist, Inter-American Development Bank
CHLOE O’GARA, Program Officer, Global Development and Population Program, The William and Flora Hewlett Foundation
LORRAINE SHERR, Professor of Clinical and Health Psychology, University College, London
ANDY SHIH, Senior Vice President, Scientific Affairs, Autism Speaks
QUENTIN WODON, Adviser, Human Development Network, World Bank
HIROKAZU YOSHIKAWA, Courtney Sale Ross University Professor of Globalization and Education, New York University
IOM Staff
SARAH M. TRACEY, Research Associate
CHARLEE ALEXANDER, Research Assistant
JOCELYN WIDMER, Mirzayan Fellow
PAMELLA ATAYI, Administrative Assistant
RACHAEL CLARK, Duke University Intern
KIMBER BOGARD, Director, Board on Children, Youth, and Families
PATRICK W. KELLEY, Director, Board on Global Health
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1 Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
FORUM ON INVESTING IN YOUNG CHILDREN GLOBALLY1
ZULFIQAR A. BHUTTA (Co-Chair), Co-Director, SickKids Centre for Global Child Health, Toronto and Founding Director, Center of Excellence for Women and Child Health, Aga Khan University
ANN MASTEN (Co-Chair), Distinguished McKnight University Professor, Institute of Child Development, University of Minnesota, Minneapolis
J. LAWRENCE ABER, Willner Family Professor of Psychology and Public Policy, Steinhardt School of Culture, Education, and Human Development and University Professor, New York University
AMINA ABUBAKAR, Centre for Geographic Medicine Research–Kenya Medical Research Institute/Wellcome Trust Research Programme
CONSTANZA ALARCÓN, Coordinator of the National Early Childhood Strategy, Presidency of the Republic, Colombia
NICOLE BEHNAM, Senior Orphans and Vulnerable Children Advisor, PEPFAR/Office of the U.S. Global AIDS Coordinator, U.S. Department of State
RAQUEL BERNAL, Associate Professor and Director of the Center for Research on Economic Development, Universidad de los Andes
PIA REBELLO BRITTO, Senior Advisor, Early Childhood Development Unit, UNICEF
PAMELA Y. COLLINS, Director, Office for Research on Disparities and Director, Global Mental Health and Office of Rural Mental Health Research, National Institute of Mental Health
GARY DARMSTADT, Senior Fellow, Global Development Division, The Bill & Melinda Gates Foundation
ANGELA DIAZ, Jean C. and James W. Crystal Professor, Departments of Pediatrics and Preventive Medicine, Icahn School of Medicine at Mount Sinai and Director, Mount Sinai Adolescent Health Center
RANA HAJJEH, Director, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention
JODY HEYMANN, Dean, Fielding School of Public Health, University of California, Los Angeles
GILLIAN HUEBNER, Child Protection Technical Advisor, U.S. Agency for International Development
__________________
1 Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
VENITA KAUL, Director, School of Education Studies and Director, Center for Early Childhood Education and Development, Ambedkar University, Delhi
SARAH KLAUS, Director, Early Childhood Program, London, Open Society Foundations
VESNA KUTLESIC, Director, Office of Global Health, National Institute of Child Health and Human Development
ALBERT LEE, Professor (Clinical), JC School of Public Health and Primary Care and Director, Centre for Health, Education, and Health Promotion, The Chinese University of Hong Kong
JOAN LOMBARDI, Senior Advisor, Bernard van Leer Foundation
FLORENCIA LOPEZ BOO, Social Protection Economist Senior Specialist, Inter-American Development Bank
KOFI MARFO, Professor of Educational Psychology, Department of Psychological and Social Foundations, University of South Florida and Director of the Institute for Human Development at Aga Khan University
MARK MILLER, Director, Division of International and Population Studies, Fogarty International Center
HELIA MOLINA MILMAN, Professor in Public Health, Public Health Department, Pontificia Universidad Católica de Chile and Minister of Health, Chile
TARYN MORRISSEY, Senior Advisor to the Deputy Assistant Secretary for Human Services Policy, Office of the Assistant Secretary for Planning and Evaluation
CHLOE O’GARA, Program Officer, Global Development and Population Program, The William and Flora Hewlett Foundation
ALAN PENCE, UNESCO Chair, Early Childhood, Education, Care and Development and Professor, School of Child and Youth Care, University of Victoria
RUTH PEROU, Acting CDC Mental Health Coordinator, Program Performance and Evaluation Office, U.S. Centers for Disease Control and Prevention
EDUARDO QUEIROZ, Executive Director, Maria Cecilia Souto Vidigal Foundation
JOSE SAAVEDRA, Global Chief Medical Officer, Nestlé Nutrition
LORRAINE SHERR, Professor of Clinical and Health Psychology, University College, London
ANDY SHIH, Senior Vice President, Scientific Affairs, Autism Speaks
KARLEE SILVER, President of Targeted Challenges, Grand Challenges Canada
SIMON SOMMER, Head of Research, Jacobs Foundation
REBECCA STOLTZFUS, Professor and Director, Program in International Nutrition, Program in Global Health, Cornell University
TAHA E. TAHA, Professor, Epidemiology and Population, Family and Reproductive Health Sciences, Bloomberg School of Public Health, Johns Hopkins University
LINDA ULQINI, Senior Program Officer, Aga Khan Foundation
SUSAN WALKER, Professor of Nutrition and Director, Tropical Medicine Research Institute, Epidemiology Research Unit, University of the West Indies
KELLY S. WILLIS, Executive Director, Accordia Foundation
QUENTIN WODON, Adviser, Human Development Network, World Bank
HIROKAZU YOSHIKAWA, Courtney Sale Ross University Professor of Globalization and Education, New York University
BOARD ON CHILDREN, YOUTH, AND FAMILIES1
ANGELA DIAZ (Chair), Departments of Pediatrics and Preventive Medicine, Icahn School of Medicine at Mount Sinai
SHARI BARKIN, Monroe Carell Jr. Children’s Hospital, Vanderbilt University
THOMAS F. BOAT, College of Medicine, University of Cincinnati
W. THOMAS BOYCE, Faculty of Medicine, University of British Columbia
DAVID A. BRENT, Western Psychiatric Institute and University of Pittsburgh School of Medicine
DAVID V. B. BRITT, Retired CEO, Sesame Workshop
DEBBIE I. CHANG, Nemours Health and Prevention Services
JANET M. CURRIE, Woodrow Wilson School of Public and International Affairs, Princeton University
PATRICK H. DELEON, F. Edward Hebert School of Medicine and the Graduate School of Nursing, Uniformed Services University of the Health Sciences
GARY W. EVANS, Department of Design and Environmental Analysis and Department of Human Development, Cornell University
ELENA FUENTES-AFFLICK, University of California, San Francisco; and San Francisco General Hospital
EUGENE E. GARCIA, Mary Lou Fulton Teachers’ College, Arizona State University
J. DAVID HAWKINS, School of Social Work, University of Washington
JEFFREY W. HUTCHINSON, Uniformed Services University of the Health Sciences
JACQUELINE JONES, Early Childhood Education Specialist
ANN S. MASTEN, Institute of Child Development, University of Minnesota
VELMA McBRIDE MURRY, Peabody College, Vanderbilt University
BRUCE S. McEWEN, The Rockefeller University
PAMELA MORRIS, The Steinhardt School of Culture, Education, and Human Development, New York University
TAHA E. TAHA, Bloomberg School of Public Health, Johns Hopkins University
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1 Institute of Medicine and National Research Council boards do not review or approve individual products. The responsibility for the content of the workshop summary rests with the workshop rapporteurs and the institution.
BOARD ON GLOBAL HEALTH1
THOMAS C. QUINN (Chair), National Institute of Allergies and Infectious Diseases, National Institutes of Health; and Johns Hopkins University School of Medicine
JO IVEY BOUFFORD, New York Academy of Medicine
CLAIRE V. BROOME, Department of Global Health, Rollins School of Public Health, Emory University
JACQUELYN C. CAMPBELL, Johns Hopkins University School of Nursing
THOMAS J. COATES, UCLA Program in Global Health and Division of Infectious Diseases at UCLA
GARY DARMSTADT, Global Development Division, The Bill & Melinda Gates Foundation
VALENTIN FUSTER, Wiener Cardiovascular Institute, Kravis Cardiovascular Health Center; and Mount Sinai School of Medicine, Mount Sinai Medical Center
JACOB A. GAYLE, Community Affairs, Medtronic Foundation
GLENDA E. GRAY, South African Medical Research Council
STEPHEN W. HARGARTEN, Global Health Program, Medical College of Wisconsin
PETER J. HOTEZ, Texas Children’s Hospital; Sabin Vaccine Institute; Texas Children’s Center for Vaccine Development; and National School of Tropical Medicine, Baylor College of Medicine
CLARION JOHNSON, Private Consultant
FITZHUGH MULLAN, Department of Health Policy, George Washington University
GUY H. PALMER, School for Global Animal Health, Washington State University
__________________
1 Institute of Medicine boards do not review or approve individual products. The responsibility for the content of the workshop summary rests with the workshop rapporteurs and the institution.
Reviewers
This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:
JERE R. BEHRMAN, University of Pennsylvania
ALBERT LEE, The Chinese University of Hong Kong
THEODORE D. WACHS, Purdue University
SUSAN WALKER, University of the West Indies
Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by Enriqueta Bond, President Emeritus, Burroughs Wellcome Fund. Appointed by the Institute of Medicine and the National Research Council, she was responsible for making certain that an inde-
Acknowledgments
The planning committee and project staff deeply appreciate many valuable contributions from individuals who assisted us with this project. First, we offer our profound thanks to all of the presenters and discussants at the workshop, who gave so generously of their time and expertise. These individuals are listed in full in the workshop agenda in Appendix B. We are also grateful to the many participants who attended the workshop both in person and via the live webcast. The engagement of all those in attendance was robust and vital to the success of the event.
In addition, the forum wishes to recognize the sponsors that supported this activity. Financial support for this project was provided by the Accordia Global Health Foundation; the Aga Khan Foundation; Autism Speaks; the Bernard van Leer Foundation; The Bill & Melinda Gates Foundation; Grand Challenges Canada; The William and Flora Hewlett Foundation; the Inter-American Development Bank; the Jacobs Foundation; National Institutes of Health–Fogarty International Center, National Institute of Mental Health, and National Institute of Child Health and Human Development; the Nestlé Nutrition Institute; the Open Society Institute–Budapest; the Society for Research in Child Development; UNICEF; U.S. Centers for Disease Control and Prevention; U.S. Department of State; the Maria Cecilia Souto Vidigal Foundation; and the World Bank.
A NOTE ABOUT THE COVER ART
The Forum on Investing in Young Children Globally is committed to confronting the challenges and exploring the opportunities surrounding the global nature of integrating the science of health, education, nutrition, and social protection. One of the ways the forum has committed itself to being global in scope is through the workshops that occur in different regions throughout the world. The cover design is intended to embrace the diversity in place, culture, challenges, and opportunities associated with the forum activities at each of the workshops, but this global trajectory is done keeping in mind the momentum that comes in connecting these diverse locales to one another through the work of the forum. The bright orange dot represents the location of the workshop this report summarizes, and the lighter orange dots represent workshop locations across the first 3 years of the forum. The dotted orange line suggests that the forum will link what was gleaned from the convening activities from this workshop to the next. We would like to thank Jocelyn Widmer for her contributions to the cover design.
Contents
Forum on Investing in Young Children Globally Overview
2 LINKING CHILDREN’S DEVELOPMENTAL POTENTIAL TO A NATION’S DEVELOPMENTAL POTENTIAL
3 THE SCIENCE OF DEVELOPMENTAL POTENTIAL
The Timing of Integrated Early Interventions: Nutrition, Stress, and Environmental Enrichment
Developmental Potential and Child Disability
Some Critical Gaps in the Current Science Base of Developmental Potential
4 THE STATE OF THE WORLD’S YOUNG CHILDREN
Child Development from a Global Perspective
State of Young Children in the Arab Region
The Demographic and Health Surveys (DHS) Program and Children
5 INEQUALITY AMONG CHILDREN IN REACHING THEIR DEVELOPMENTAL POTENTIAL
Inequalities and Two Generation Approaches
Child Health and Nutrition and the Loss of Human Potential in India
Growing Up Unequal: Trends in Global Inequality Among Children
6 THE CONTEXT OF FAMILIES AND CAREGIVERS
The Caregiving Context and Its Influence on Developmental Outcomes of HIV-Affected Children
Caregiving and Other Contextual Influences on Early Child Development
Early Child Development: Measuring Results Beyond 2015
Measuring Early Childhood Development in Low- and Middle-Income Countries: The MICS
“Readiness to Learn” Assessment Project
8 INVESTING IN YOUNG CHILDREN AND THEIR CAREGIVERS
Policy Approaches to Supporting Children’s Development
Investing Early and Return on Investment
Continuity of Investments into Primary School
9 BENEFIT–COST ANALYSIS OF INACTION
Costs of Inaction Versus Costs of Action for Investing in Young Children Globally
A Comprehensive Country-Level Approach to Investing in Young Children: Colombia