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U.S.G. Action Plan on Children in Adversity Strategic framework for international assistance White House Launch December 2012 www.childreninadversity.org. Children in Adversity: who are they?. Poor health and nutrition. Lack of stimulation- a ttachment (< 5 years). Living outside
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U.S.G. Action Plan on Children in Adversity Strategic framework for international assistance White House Launch December 2012 www.childreninadversity.org
Children in Adversity: who are they? Poor health and nutrition Lack of stimulation- attachment (< 5 years) Living outside of family care 1.9 billion children in LMIC Exposure to violence, exploitation, abuse Adversity: Serious deprivation or danger United Nations Population Division World Population Prospects 2010 UNICEF State of the World’s Children 2012
Neural Circuits are Wired in a Bottom-Up Sequence Language Higher Cognitive Function Sensory Pathways (Vision, Hearing) FIRST YEAR -8 -7 -6 -5 -4 -3 -2 -1 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Birth (Months) (Years) Source: C.A. Nelson (2000)
Early Experiences Leave Lasting Chemical “Signatures” on Genes External Experience Epigenetic “Signature” Turns Gene On or Off Gene Regulatory Proteins
U.S.G. Framework forInternational Assistance 2 3 1 • Build Strong Beginnings • Put Family Care First • Protect Children from Violence, Exploitation, Abuse, and Neglect PRINCIPAL OBJECTIVES • Strengthen Systems • Promote Evidence-Base • Integration SUPPORTING 5 4 6
“It is easier to build strong children than to repair broken men.” Frederick Douglass • Obj 1 - Build Strong Beginnings
The global burden • 6.9 million children under the age of 5 worldwide die each year. • More than 25 times that number -- over 200 million children -- survive, but do not reach their developmental potential. • As a result, their countries have an estimated 20 percent loss in adult productivity. Grantham McGregor, S. et al., (2007). Developmental potential in the first 5 years for children in developing countries. Lancet, 369:60-70 WHO and UNICEF. Care for Development. • Obj 1 - Build Strong Beginnings
In Sub-Saharan Africa, for every 1000 children born in 2011… 891 Approximately 1/3 are not expected to reach their developmental potential Grantham-McGregor et al. Lancet. 2007 January 6; 369(9555): 60–70 109 Expected to die before their 5th birthday. Expected to live past their 5th birthday. • Obj 1 - Build Strong Beginnings
Adversity impairs development • Obj 1 - Build Strong Beginnings
Sustained results Source: Van der Gaag, J. School Performance and Physical Growth of Underprivileged Children: Results of the Bogotá Project at Seven Years. (1983). World Bank, Washington D.C. • Obj 1 - Build Strong Beginnings
“Any proposed programs should respect the primacy of the family.” James J. Heckman, Nobel Laureate in Economics • Obj2 - Put Family Care First
The global burden All children count, but not all children are counted. • Global estimates: • 17.8 million children have lost both parents • 2-8 million children may be living in institutional care • 1.1 million children are trafficked for forced labor • 1.8 million children are victims of sex trafficking or pornography • 300,000 children are associated with armed forces or groups Children outside of family care – have fallen off the statistical map. • Obj2 - Put Family Care First
Children are at high risk of growing up without a biological parent, usually their father Percentage of children under 5 living with their biological mother but w/o their biological father Percentage of children under 5 living with their biological father but without their biological mother, and Percentage of children under 5 living without both biological parents (x-axis) Note: This analysis included 40 countries. Source: UNICEF. Inequities in Early Childhood Development: What the data say - Evidence from the Multiple Indicator Cluster Surveys. February 2012. Figure 5, Page 9. • Obj2 - Put Family Care First
The effects of caregiving • Institutionalization can lead to serious developmental, cognitive, emotional delays and challenges. • Children placed in appropriate family care by age 2 recover normative growth and development by age 8. • Children removed from institutions after age 2 do not reach normative ranges. EEG level: Institutionalized childrenEEG level: Never-institutionalized children • Placing children in protective family care results in better child outcomes and is significantly less expensive than institutional care. • Obj2 - Put Family Care First
“Safety and security don’t just happen; they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear.” Nelson Mandela • Obj3 - Protect Children
The global burden • Between 133 million and 275 million children are estimated to witness domestic violence annually. • 25-30% of children experience severe forms of punishment. • 150 million girls and 73 million boys under 18 experienced forced sexual intercourse or other forms of sexual violence in one year. • 36 percent of girls and 29 percent of boys globally have been sexually abused. • 115 million children are engaged in hazardous work; 5.5 million are in forced labor. • 1.8 million children are victims of sex trafficking or pornography. • An estimated 300,000 children are associated with armed forces or groups. • Obj3 - Protect Children
The lasting effects of adversity CDC. Adverse Childhood Experiences. • Obj3 - Protect Children
APCA Roll OutThree core outcomes In six priority countries, achieve significant reductions in the number of: • Children not meeting age-appropriate growth and developmental milestones • Children living outside of family care • Children who experience violence and exploitation • Results-based Approach
Public-Private Partnership Global Alliance for Children Mission: Mobilize public and private knowledge, commitment and resources at the global and country levels to support country-driven strategies and accountability around three core outcomes that will demonstrate significant, measurable and sustainable results for children in adversity, beginning in a select number of countries. Inaugural meeting (February 2013): • 19 senior leaders and decision makers • 15 organizations • 11 nationalities • 4 regions
ExampleOutcomes for Cambodian Children • 40% reduction in the number of children under the age of five with cognitive delays • 70% reduction in the number of children living outside of family care • 30% reduction in childhood violence and exploitation