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HealthWise: Neglect, domestic violence lower children’s development


Neglect, abuse, domestic violence, poor parental health, lack of support system, father’s alcoholism and lack of brain stimulation lower children’s growth and development at an early age, according to a largest population-based study done in Haryana that demonstrates children are never too young to understand and absorb what is happening around them.

Each adversity lowered the child’s growth and development by the age of 18 months, with cumulative exposure leading to developmental inequities from the start of life, found a study of 1,273 infants at 12 and 18 months in the Rewari district of Haryana.

Each child was assessed on speech and comprehension, cognitive and language, motor skills, social skills at the age of 12 months and 18 months.

Most children faced one or more adversity, with close to 50% facing four or more. “The key finding was that each extra increase in childhood adversity was associated with both poorer growth and development measured at 18 months, a crucial time for optimal brain development and a key predictor of future health and wellbeing,” said study co-author Gauri Divan, a developmental paediatrician associated with a non-governmental organisation, Sangath.

“Children can build resilience against one adversity, we know children from poor socio-economic homes with supportive families and good education can thrive. But multiple adversities can have a compounding effect on their physical, mental and social development,” said Diwan. The study was published in PLoS One.

Children with a unhealthy start in life suffer a loss of about a quarter of average adult income per year, leading to the countries they live in forfeiting up to twice their current GDP expenditures on health and education, estimated public health experts in The Lancet Early Childhood Development Series.

At least 250 million children under-5 years do not receive the appropriate care and support to become physically healthy, mentally alert and emotionally secure. These children – a staggering 43% of the global under-5 population – risk of nutrition, stunting and suboptimal brain development, which leads to lower learning and poor adult income.

“The findings of this landmark study demonstrate the astonishing levels of childhood deprivation in these rural communities, barely a three-hour drive from our national capital, with profound implications for lost potential to fulfil personal and societal development goals in later life. They point to the single greatest public health emergency this country is facing, and call for urgent, national action to promote child development and well-being”, said Vikram Patel, professor of global health, department of global health and social medicine, Harvard Medical School.

Early child development stimulates the child’s desire and ability to learn and becomes the first defence against delays in learning, growth and emotional security and is critical to ensure children reach their full learning and development potential to become productive adults that participate in economic and social growth.

“Improved child development leads to better health and wellbeing across the lifetime and increases years spent in school, which builds skills, increases income and reduces poverty. Studies of children in Jamaica who have now been followed into adulthood show the effects of early-years interventions are sustained in terms of increased employment and earnings,” said Divan.

Optimal child development starts before conception and is dependent on adequate nutrition

for mother and child, protection from threats, provision of learning opportunities, and caregiver-interactions that are stimulating, responsive, and emotionally supportive, according to the World Health Organization’s Nurturing Care Framework for Early Childhood Development.

Providing early life stimulation along with a nurturing home and community environment can help reverse early deficits. “It’s important to recognise that children are affected by these stresses but the opportunity to make amends is really early. The longer we wait, the worse will be the impact on India’s future workforce,” said Divan.