June 20, 2016 | By Roger Thurow

Why The First 1,000 Days Matter Most

This piece originally appeared on The New York Times' On the Ground Blog

In Northern Uganda, midwife Susan Ejang leads a nutrition class for new moms and moms-to-be on the veranda of a rural health clinic. Credit: Roger Thurow

In Northern Uganda, midwife Susan Ejang leads a nutrition class for new moms and moms-to-be on the veranda of a rural health clinic. Credit: Roger Thurow

In a recent column, Nicholas Kristof wrote about the importance of early childhood education and the crucial role of good nutrition in developing young brains.

Nutrition is not only fundamental to an individual’s cognitive and physical growth, it is also the cornerstone of all development efforts, whether improving education, health, income or equality, at home or abroad. And the most important time for good nutrition is in the 1,000 days from the beginning of a woman’s pregnancy to the second birthday of her child. What happens in those first days determines to a large extent the course of a child’s life – his or her ability to grow, learn, work, succeed – and, by extension, the long-term health, stability and prosperity of the society in which that child lives.

Maybe you’re wondering: Why hasn’t foreign or domestic aid had more impact on economic development and poverty reduction? One major reason is that we’ve so badly neglected nutrition in utero and infancy. Too many children are getting off to a lousy start in life.

Nutrition, which works silently and internally, has long been the neglected stepchild of international development – part agriculture, part health, but disdainfully disowned by both fields. Agriculture’s practitioners have often believed their main task to be the production of ever-increasing yields; concerns about the nutritious quality of the food have been dismissed as a nuisance that could only interfere with quantity.

And the health ministries of the world have been in a constant chase for dollars to combat the disease du jour and to vaccinate mothers and children. Spending on nutrition has barely registered as a blip in national budgets.

The leading development organizations did little to elevate nutrition’s profile. In past decades, less than 1 per cent of total international development aid had been spent on nutrition, resulting in an illogical imbalance: nutrition is essential to human development, but virtually invisible in development strategies.

The first 1,000 days has been similarly overlooked. World health and development organizations have usually fixated on age five and primary school as milestone targets for intervention. For example, getting children into school has long been a holy grail of successful development. But ensuring brain development in the first 1,000 days so children are actually capable of learning once they get to school has been largely ignored.

The result of this disregard of nutrition for pregnant mothers and their young children is that one in four children under five years of age in the world is stunted, physically, cognitively, or both. As I discovered while following families in India, Uganda, Guatemala and Chicago for my new book, The First 1,000 Days: A Crucial Time for Mothers and Children – And the World, stunting is a life sentence of underachievement. The costs – less education, lower productivity and income, higher health care expenses – ripple across society, from individual to family to community to nation to the entire world.  The new Global Nutrition Report estimates that sub-Saharan Africa and South Asia each lose an estimated 11 percent of gross national product annually due to malnutrition and stunting.

A 2006 World Bank report, Repositioning Nutrition as Central to Development, urgently implored: “The unequivocal choice now is between continuing to fail, as the global community did with HIV/AIDS for more than a decade, or to finally make nutrition central to development so that a wide range of economic and social improvements that depend on nutrition can be realized.”

In the decade since, nutrition has gradually moved closer to center stage. The Obama administration launched its Feed the Future initiative, aiming to reduce hunger, malnutrition and stunting through agricultural development, especially in Africa. A broad group of nations and foundations pledged to increase investments at a series of Nutrition for Growth summits. At the recent World Bank spring meetings in Washington DC, finance ministers and bankers acknowledged that investing in “gray matter infrastructure” – the brains of young children – is as important for national and global economic growth as is investing in roads, ports and buildings.

Ending hunger and malnutrition has always been seen as the moral thing to do. Now we know it is also the smart thing to do.





Digital Preview of The First 1,000 Days

In his new book, The First 1,000 Days, Council senior fellow Roger Thurow illuminates the 1,000 Days initiative to end early childhood malnutrition through the compelling stories of new mothers in Uganda, India, Guatemala, and Chicago. Get a first-look at photos and stories from the book in this new web interactive.

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» Order your copy of the book.


The First 1,000 Days

Roger Thurow’s book will tell the story of the vital importance of proper nutrition and health care in the 1,000 days window from the beginning of a woman’s pregnancy to her child’s second birthday.

The 1,000 days period is the crucial period of development, when malnutrition can have severe life-long impacts on the individual, the family and society as a whole. Nutritional deficiencies that occur during this time are often overlooked, resulting in a hidden hunger. It is a problem of great human and economic dimensions, impacting rich and poor countries alike.

Learn more »

The Last Hunger Season

In The Last Hunger Season, the intimate dramas of the farmers' lives unfold amidst growing awareness that to feed the world's growing population, food production must double by 2050. How will the farmers, Africa, and a hungrier world deal with issues of water usage, land ownership, foreign investment, corruption, GMO's, the changing role of women, and the politics of foreign aid?

Learn more »


Roger Thurow and Scott Kilman, award-winning writers on Africa, development, and agriculture, see famine as the result of bad policies spanning the political spectrum. In this compelling investigative narrative, they explain through vivid human stories how the agricultural revolutions that transformed Asia and Latin America stopped short in Africa, and how our sometimes well-intentioned strategies—alternating with ignorance and neglect—have conspired to keep the world’s poorest people hungry and unable to feed themselves.

Learn more »