About 182 million children in poor nations lack nurture: Lancet study

New Delhi: A staggering 182 million children aged three to four years in low- and middle-income countries (LMICs) lack access to adequate nurturing care, jeopardising their healthy development, according to a new series paper published in The Lancet. This critical gap highlights the urgent need for comprehensive early childhood care and education (ECCE) programs, said an international team of researchers, including experts from the Centre for Chronic Disease Control (CCDC), New Delhi.

The study emphasises the importance of the “next 1,000 days”—a developmental window from ages two to five—following the foundational first 1,000 days from conception to two years old. During this period, many children in LMICs are not regularly exposed to health or education services. In fact, fewer than one in three children aged three or four participate in ECCE programs, the researchers noted.

Emerging environmental challenges such as air pollution, climate change, and chemical exposures compound the risks to child development. “Air pollution directly impacts early child development through physical changes and indirectly through educational disruptions, as seen in Delhi-NCR,” said Aditi Roy, Senior Research Scientist at CCDC.

She also warned of the cascading effects of climate change. “Extreme heat, droughts, and floods not only disrupt food and water security but also damage ECCE centres and strain families economically, impacting both physical and mental health.”

The researchers called for increased investment in high-quality ECCE programs, which should feature adequately paid and trained teachers, low teacher-student ratios, and evidence-based curricula. “The main concern in India is ensuring equitable access to quality ECCE,” Roy said, advocating for activity-based learning over traditional rote methods, in line with the National Education Policy.

India’s data on ECCE remains fragmented. A 2022 government task force reported that nearly 28.6 million children aged 3-6 years were enrolled in early education under the Integrated Child Development Scheme (ICDS). Meanwhile, a 2018 survey by Pratham’s Annual Status of Education Report (ASER) showed promising attendance rates, with 70 per cent of 3-year-olds and 96 per cent of 6-year-olds in pre-school or school. However, data on private pre-schools, often of questionable quality, remains scarce. The Lancet series highlights that providing one year of ECCE for all children would cost less than 0.15 per cent of the GDP in LMICs, with potential returns up to 19 times the investment. “This underscores the importance of supporting caregivers and ensuring access to nurturing environments,” said Catherine Draper of the University of the Witwatersrand, South Africa.

With emerging risks and a fragmented approach, the researchers urged policymakers to prioritise ECCE as part of climate action plans and broader development strategies.

“Without adequate intervention, millions of children may miss the opportunity to thrive,” Roy cautioned..