The First Twelve Years: Growing-Up in Low and Middle- Income Countries November 2014 Paul Dornan

AGES: YOUNGER COHORT Following 2,000 children OLDER COHORT Following 1,000 children AGES: Round 1 Round 2 Round 3 Round 4 Round Study design 2014 Same age children at different time points Study that aims to: - improve understanding of the determinants and outcomes of childhood poverty - provide evidence to improve policies & practice

AGES: YOUNGER COHORT Following 2,000 children OLDER COHORT Following 1,000 children AGES: Round 1 Round 2 Round 3 Round 4 Round Study design 2014 Same age children at different time points Study that aims to: - improve understanding of the determinants and outcomes of childhood poverty - provide evidence to improve policies & practice

Two stories Physical development, recovery and faltering -> Early investment is best, but understanding risks of faltering and potential of recovery Dominant role of the school -> widening or narrowing learning gaps? -> Potential of school to integrate policy for children? Underpinning all of this – life course understandings of how inequalities develop -> implications for SDGs and reaching most marginalised.

Physical development Child stunting caused by early (chronic) under- nutrition, with long term consequences for health and skill development High levels of stunting, concentrated among the poorest households. During infancy, poorest third of households across Young Lives samples typically have twice the risk of being stunted

High rates of stunting. Poorest have much the highest rates

Physical development Child stunting caused by early (chronic) under- nutrition, with long term consequences for health and skill development High levels of stunting, concentrated among the poorest households. During infancy, poorest third of households across Young Lives samples typically have twice the risk of being stunted But – height trajectories not totally ‘fixed’ infancy, there is change later on and that change is itself associated with learning gains

Stunting status in infancy Lundeen et al (2013) ‘Growth faltering and recovery in children aged 1-8 years in four low – and middle income countries: Young Lives’, Public Health Nutrition

Same status by 5 years? Lundeen et al (2013) ‘Growth faltering and recovery in children aged 1-8 years in four low – and middle income countries: Young Lives’, Public Health Nutrition

But considerable change in development indicators beyond the very earliest period of life Example: change in height for age status between 1 year and 5 years, Vietnam Lundeen et al (2013) ‘Growth faltering and recovery in children aged 1-8 years in four low – and middle income countries: Young Lives’, Public Health Nutrition Early stunting has profound long term consequences, but there is change in height status post infancy Recovered Faltered Why? Factors which seem important – Mothers height Household socio- economic status Policy – school feeding programmes Infrastructure

Foundations of later learning Key role of schooling as key institution in MDGs/ SDGs. Assumptions of opening up later opportunities

Dominant role of school in children’s lives Reported time-use in a typical day

Dominant role of school in children’s lives Reported time-use in a typical day

And impact of schooling? Many of the gaps well in place before children enter school, but widen after depending on the impact of school system Different patterns of overall learning and learning inequities depending on the school system: ->Vietnam, high performer and more equalising -> Andhra Pradesh, low performer and widening gaps Conclusion (a) Critical foundational role of early childhood (b) Greater focus on school effectiveness for learning (c) Capitalising on school for other policy purposes

Conclusions for SDGs 1.Children at particularly high risk of poverty. Childhood as key opportunity to intervene to reduce transmission of inequalities -> reach of social protection for households with children -> effectiveness of basic services and schooling 2.Pre-birth and early childhood foundational stage, but not only the very early years – capitalizing on later change also 3.Cohort analysis tends to show accumulating disadvantages over the early life course. ‘Lifecourse’ policy approaches – prevention plus recurrent investment as children grow up.

Thank you