Conference Concept Note

Early Childhood Development (ECD) is the foundation to transform societies and generations. A good foundation starts right from conception, and makes a difference throughout a person’s life, and gives the next generation a better start. Educated, healthy and skilled people participate in, and contribute to the financial and social wealth of their societies. Early Childhood Development forms the basis of intelligence, personality, social behavior, and capacity to learn and nurture oneself as an adult. The years starting from conception to age 8 are not only critical for brain development, but also indispensable for the child’s holistic (cognitive, physical, social, emotional, and language) development, provided that they are nurtured in a manner that provides them with responsive care, nourishing nutrition and good health, quality early learning opportunities, safety and protection. These are all dimensions that scientific research has found to be crucial for laying sound foundations for future adult health and productivity.

Children who do not have the benefit of nurturing care in their early years are lagging behind in achieving their age-appropriate milestones due to the difficulties they face in their development and learning, which in turn limits the chances of success in life and impacting the wellbeing and prosperity of their families and societies. Current estimates are that nearly 250 million children aged under five years in low- and middle-income countries – or more than four in every ten – risk missing critical development milestones due to poverty or stunting. The situation in Pakistan is even worse because the country is faced with multiple challenges, including a serious economic downturn, political instability, adverse climate change impacts, and widening social, economic, and technological inequalities. All of these challenges are exacerbated by a once-a Century global pandemic, COVID-19, for which Pakistan was least prepared and still paying a high price. All these challenges have a direct impact on family wellbeing, particularly women and young children. Millions of children are at risk of not meeting developmental potential: an estimated 40% of the population lives below the poverty line; Maternal and child malnutrition is widespread; risk of childhood infections, mortality and stunting even before birth, lead to long-term irreversible and detrimental cognitive, motor and health impairments.

Below is a summary of the landscape of ECD in Pakistan:

Services (Basic, Targeted and Specialized Interventions)

• Health– 55/1000 (Neonatal mortality), 54% basic vaccination; mental health is not part of primary health care
• Nutrition: 40% stunting; 48% EBF and Early Initiation; 46% suffer from anemia, 96% with no Minimal Acceptable Diet
• Safety: 32% non-access to toilet facilities, lack of focus on baby WASH
• Early learning opportunities: 44% Out of School Children, 34% preschool attendance; untrained workforce
• Responsive care- missing link: 30% early stimulation, 3% with 2+books at home, 3% father engagement
• Services to children are in silos
• Coverage: Mostly on Early Childhood Education but limited services for < 3 years of age
• Huge inequities (Age, gender, geographical)

The country has slipped to the bottom five countries in the world for education and skills development, with dismal rates of school enrollment, poor quality of pre-primary and primary education, increasing poverty, rural and urban divide and widening gender gap.  Pakistan is among the top ten most vulnerable countries with high rates of malnutrition. Pakistan needs to reverse this situation and to do so it needs to implement the 2030 Transformative Agenda with a focus on the development of early childhood. ECD is critical and central component of global and national transformation but unfortunately this sector in Pakistan has not been given the due attention so far. To address this situation in an organised manner, the SUN Unit of the Ministry of Planning, Development and Special Initiatives(MoPD&SIs) and UNICEF commissioned a country-wide mapping exercise in 2018. The mapping exercise included a series of consultations with diverse stakeholders at the federal, provincial and regional levels for an insight on the status, challenges and opportunities for ECD in Pakistan. The key findings of the mapping study clearly indicated that most of the components of ECD services are ongoing in silos and they are fragmented in nature which require strategic coordination for efficiency and effectiveness of child services and interventions. The report highlights that responsive caregiving is the most important missing piece in the nurturing care framework, no data is collected on responsive care and early learning. Indicators related to ECD in Pakistan show that the country’s performance lags behind that of regional counterparts. There are also concerns related to equity, with substantial disparities based on gender, socioeconomic background, geographical location and other factors.

The report further highlights that there is no unified ECD policy framework or shared understanding of the concept in the country. With devolution of key functions following the 18th Amendment to the Constitution, provincial and area administrations have developed their own policies, and strategies. There is a strong policy and service delivery frameworks exist for nutrition, health and education at national and sub-national levels, they are not fully integrated, nor do they necessarily seek to address child development from a whole-of-early-childhood perspective, from conception till eight years of age. For example, since there is no constitutional provision for early learning, provinces and areas are at differing stages of conceptualization. Other relevant sectors, such as those related to child protection, social protection, disaster risk management and water and sanitation, are not coordinated through an ECD framework. Moreover, key components of the Nurturing Care Framework are not currently addressed. These include maternal mental health and support to families to provide responsive caregiving and support for early learning in the home.

The report recommends that the government and partners need to coordinate efforts on improving ECD systems in terms of policy, intersectoral coordination, financing, measurement and reporting, workforce and regulation. With several actors providing multisectoral services to young children from conception to eight years of age, the key recommendation was need for a regulatory overarching policy framework with clear roles and responsibilities of actors that could ensure the provision of quality integrated care for positive child development outcomes. Identifying appropriate delivery platforms to reach marginalized children at different stages of life with multisectoral services is critical to efficient and effective implementation. The study identifies existing and new delivery platforms that may be leveraged for effective ECD provision. It also identifies frontline workers, such as Lady Health Workers, vaccinators, pre pre-primary teachers, civil society representatives (such as those working on WASH programmes

or at community centres), who have been shown to improve ECD outcomes. Following the recommendations of the mapping exercise the MoPD&SIs and UNICEF developed an inclusive and multisector ECD Framework for Pakistan along with an ECD Index and standards. These key documents will be formally launched at the 4^th International Conference on ECD in November.

The government and its key allies such as the Pakistan Alliance for Early Childhood (PAFEC), UNICEF, WHO, UNESCO, JICA, Rupani Foundation, the Aga Khan Foundation, Allama Iqbal Open University, Islamabad, Foundation Open Society Institute, Plan Pakistan, AFAQ and many other key stakeholders from the private sector have been taking initiatives to promote holistic ECD in the country through different programmes and activities. These key activities included annual conferences on ECD, seminars, ECD mapping exercise, policy dialogues, advocacy sessions, mass awareness initiatives using different modes of communication, capacity building of key stakeholders, workforce development, developing & conducting courses on ECD, material development networking and knowledge management.  Continuing the same momentum, the above partners and many others who will join the carvan in the due course are going to join hands to organise the 4^th International Conference on ECD this year in November 2022.  It will be a two-day conference which will feature an opening session, plenaries, and a closing session, workshop on some key topics and exhibition of workable ECD Models focusing on multi-sector approach to promote holistic and inclusive ECD from conception to 8 years in the country.

The conference will bring together over 400 participants, including legislators and policy makers responsible for health, nutrition, child protection, education and social welfare, ECD professionals/experts from private and public national and international level, practitioners, researchers, donors, academicians, aspiring ECD professionals and parent representatives