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Developmental potential in the first 5 years for children in developing countries

a , , * , b , , c , d , e , f , the International Child Development Steering Group

Lancet

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      Summary

      Many children younger than 5 years in developing countries are exposed to multiple risks, including poverty, malnutrition, poor health, and unstimulating home environments, which detrimentally affect their cognitive, motor, and social-emotional development. There are few national statistics on the development of young children in developing countries. We therefore identified two factors with available worldwide data—the prevalence of early childhood stunting and the number of people living in absolute poverty—to use as indicators of poor development. We show that both indicators are closely associated with poor cognitive and educational performance in children and use them to estimate that over 200 million children under 5 years are not fulfilling their developmental potential. Most of these children live in south Asia and sub-Saharan Africa. These disadvantaged children are likely to do poorly in school and subsequently have low incomes, high fertility, and provide poor care for their children, thus contributing to the intergenerational transmission of poverty.

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      Most cited references 141

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      Estimating wealth effects without expenditure data--or tears: an application to educational enrollments in states of India.

      Using data from India, we estimate the relationship between household wealth and children's school enrollment. We proxy wealth by constructing a linear index from asset ownership indicators, using principal-components analysis to derive weights. In Indian data this index is robust to the assets included, and produces internally coherent results. State-level results correspond well to independent data on per capita output and poverty. To validate the method and to show that the asset index predicts enrollments as accurately as expenditures, or more so, we use data sets from Indonesia, Pakistan, and Nepal that contain information on both expenditures and assets. The results show large, variable wealth gaps in children's enrollment across Indian states. On average a "rich" child is 31 percentage points more likely to be enrolled than a "poor" child, but this gap varies from only 4.6 percentage points in Kerala to 38.2 in Uttar Pradesh and 42.6 in Bihar.
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        How many child deaths can we prevent this year?

        This is the second of five papers in the child survival series. The first focused on continuing high rates of child mortality (over 10 million each year) from preventable causes: diarrhoea, pneumonia, measles, malaria, HIV/AIDS, the underlying cause of undernutrition, and a small group of causes leading to neonatal deaths. We review child survival interventions feasible for delivery at high coverage in low-income settings, and classify these as level 1 (sufficient evidence of effect), level 2 (limited evidence), or level 3 (inadequate evidence). Our results show that at least one level-1 intervention is available for preventing or treating each main cause of death among children younger than 5 years, apart from birth asphyxia, for which a level-2 intervention is available. There is also limited evidence for several other interventions. However, global coverage for most interventions is below 50%. If level 1 or 2 interventions were universally available, 63% of child deaths could be prevented. These findings show that the interventions needed to achieve the millennium development goal of reducing child mortality by two-thirds by 2015 are available, but that they are not being delivered to the mothers and children who need them.
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          Socioeconomic status and child development.

          Socioeconomic status (SES) is one of the most widely studied constructs in the social sciences. Several ways of measuring SES have been proposed, but most include some quantification of family income, parental education, and occupational status. Research shows that SES is associated with a wide array of health, cognitive, and socioemotional outcomes in children, with effects beginning prior to birth and continuing into adulthood. A variety of mechanisms linking SES to child well-being have been proposed, with most involving differences in access to material and social resources or reactions to stress-inducing conditions by both the children themselves and their parents. For children, SES impacts well-being at multiple levels, including both family and neighborhood. Its effects are moderated by children's own characteristics, family characteristics, and external support systems.
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            Author and article information

            Affiliations
            [a ]Centre for International Child Health, Institute of Child Health, University College London, UK
            [b ]London School of Tropical Medicine and Hygiene, UK
            [c ]Group for the Analyses of Development, Lima, Peru
            [d ]Department of Applied Economics, University of Minnesota, USA
            [e ]Human Sciences Research Council, South Africa
            [f ]Division of Nutritional Sciences and Department of Psychology, Cornell University, USA
            Author notes
            [* ]Correspondence to: Prof Sally Grantham-McGregor, Centre for International Child Health, Institute of Child Health, University College, London WC1N 1EH, UK s.mcgregor@ 123456ich.ucl.ac.uk
            [†]

            Lead authors

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            Steering group listed at end of the paper

            Contributors
            Journal
            Lancet
            Lancet
            Lancet
            Lancet Publishing Group
            0140-6736
            1474-547X
            6 January 2007
            6 January 2007
            : 369
            : 9555
            : 60-70
            2270351 17208643 LANCET60032 10.1016/S0140-6736(07)60032-4
            © 2007 Elsevier Ltd. All rights reserved.

            This document may be redistributed and reused, subject to certain conditions.

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            Medicine

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