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.

Archive



| By Roger Thurow

African Farmers: Surviving or Thriving?

It is one of Africa’s cruelest ironies that as the planting season begins, as it is now across much of the continent, so does the hunger season. The food stocks from the previous harvest are running low and it will be several months before the next harvest comes in. Whatever food remains in the household is rationed: portions shrink, meals are skipped, malnutrition rises.


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Relief to Resilience

There is little mail service in rural Africa, so the smallholder farmers there wouldn’t have received last week’s annual letter of U.S. Agency for International Development Administrator Rajiv Shah.  But they certainly would welcome his words.

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Developments at the Development Bank

I’m surprised that “surprise” is a word being used to describe President Obama’s nomination of Jim Yong Kim to head the World Bank.  Surprise, perhaps, over the specific name, because Dr. Kim hadn’t figured prominently in the speculation of who would replace current World Bank president Robert Zoellick.

| By Roger Thurow

The Rising Power of Women Farmers

The most common tool in African agriculture is also the most impractical.  Or at least it appears to be.  It is the hoe, which is used for plowing, planting, weeding and harvesting.  It is a simple tool that produces the majority of the continent’s food, and yet it has remained unchanged over the centuries, defying any technological advance.

| By Roger Thurow

Looking Back, Moving Forward

At President Obama’s first international summit, the G8 meeting in L’Aquila, Italy in July 2009, he rallied his fellow rich world leaders to commit to investing $22 billion to conquer global hunger through agricultural development.  He spoke passionately about both the moral obligation and the global security imperative of ending hunger and the despair and hopelessness such deep poverty breeds.

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Mr. Xi Goes to Iowa

Those were interesting photos from the dusty archives that appeared in various newspapers and TV reports this week, pictures of a visitor from China inspecting hogs, vegetable farms and grain processing facilities in Iowa back in 1985.  It became downright fascinating when it turned out that visitor, Xi Jinping, was now returning to the U.S., and to Iowa, as the vice president of China.  Oh, and he is presumed to be China’s next president.

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Global Collaboration

At the foot of Mount Kenya, a patch of maize stalks are defying the odds.  They are standing tall and robust in a trial field where the soil had been intentionally depleted of nitrogen, one of the essential nutrients for maize.

| By Roger Thurow

Learning by Doing

Learning by doing is the philosophy of the Pan-American agricultural school known as Zamorano in Honduras.  Students come to class every day dressed in their uniform of blue jeans and blue shirt.  They come to work, not just to study; more often than not, their classrooms are the fields and the food production plants on campus.  They plant seeds and pull weeds and milk cows and nurture fish and make ice cream and inseminate queen bees.

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Sidetracked

A not so funny thing happened on the way to the G20 meeting in Cannes last week.

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The Right Vote

We’ll keep this short:

“Vote for the Appropriations Committee recommendation for foreign operations and against any cuts that would hurt hungry and poor people.”

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Girls Grow

The teenagers of rural western Kenya I have met during the past year have no shortage of ambition.  Especially the girls.  They want to be doctors and nurses and teachers and lawyers and pilots.


Multimedia

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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.

» Learn more.
» Order your copy of the book.

Books

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 »

EnoughEnough

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 »