| Early childhood (here defined as from birth to age eight) is a time of rapid development when physical and nutritional insults have their most profound consequences. During the later years of life, even where remediation is possible, the rate of improvement is reduced because of the relative slowing of subsequent development.
Many of the most prevalent infections and diseases -- acute diarrhea, malaria, measles and intestinal parasites-- tend to achieve their highest incidence during this phase and claim millions of young lives a year.Â
Stunted physical growth and development have been traditionally viewed as the major consequence of ill health-in early childhood, but there is now growing recognition that there are also consequences for mental and intellectual development. The long-term consequences of events in early childhood for human capital and productivity are difficult to assess directly, but associations have been shown with proxy measures such as physical growth. Short stature, a frequent outcome of many of the most prevalent infections and conditions of early childhood, is associated with late or non-enrollment in school, slow progression through school, and enhanced risk of dropping out. Stunting is also associated with reduced physiological capacity and work output, and reduced physical growth and poor educational achievement both have negative consequences for employability.
Primary prevention or remediation in early childhood is needed to avoid these constraints on physical and intellectual development and their long-term consequences for human capital development. For many of the most prevalent conditions, cheap and simple interventions of proven effectiveness (such as immunization against measles, ORT for diarrhea, and anthelminthics for parasitic infections) are already part of programmatic experience, while other interventions (such as the use of bed-nets for controling malaria) have proven to be effective at the operations research level.
A comprehensive program of care for young children, however, extends beyond disease control. The rate of recovery from measles, for example, is enhanced by Vitamin A supplementation, and over half of child mortality in low-income countries can be attributed to malnutrition. The promotion of early child development implies the need for the early delivery of a comprehensive package of interventions through a cost-effective and sustainable approach.
The World Health Organization (WHO) has developed an integrated approach to the assessment, classification, treatment, and counseling of sick children and their caretakers. The approach forms the basis for new treatment guidelines. It provides for integrated management of childhood illness (IMCI): acute respiratory infection, diarrhea, malaria, measles, and malnutrition.
The IMCI approach is discussed in greater detail under the Designing and Implementing an ECD Intervention section.
References
-
Bundy, Don. 1996. Health and Early Child Development Paper prepared for World Bank's conference on Early Child Development: Investing in the Future, April 8 & 9, 1996.
-
Claeson, Mariam. 1996. Guide for the Introduction of Integrated Management of Childhood Illness. (Support for Analysis and Research in Africa (SARA); Health and Human Resources Analysis for Africa (HHRAA); USAID, Africa Bureau, Office of Sustainable Development in collaboration with BASICS, 1996).
-
Integrated Management of the Sick Child.1995. Bulletin of the World Health Organization. 73(6):735-740.
Â
|
RSS