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How can investing in early childhood development enhance lifelong outcomes in health, education, and economic productivity while addressing global inequities in access to nurturing care?

This study, which is part of The Lancet’s Early Childhood Development Series and written by CID Faculty Affiliate Dana McCoy and co-authors, synthesizes decades of scientific progress to argue that investing in early childhood development (ECD) is a global imperative. The authors document how early adversity impairs brain development and long-term wellbeing, while nurturing care in the first years of life yields sustained benefits in education, health, and earnings. Despite increasing recognition of its importance, access to high-quality ECD services remains fragmented and inequitable, especially for children under three. 

Key Findings:

• The scale of the challenge is immense: As of 2010, around 250 million children under five in low- and middle-income countries were at risk of not reaching their developmental potential due to poverty and stunting.
• Development starts before birth and continues across the life course: The paper presents a life course framework showing how early influences (biological, environmental, and social) shape brain architecture and human capital formation across generations.
• Nurturing care is essential: Children's development depends on health, nutrition, responsive caregiving, early learning, and safety. These domains are interlinked and must be supported through family, community, and systemic interventions.
• Timing matters: Interventions are most effective during sensitive periods, particularly from conception to age two, but benefits can also accrue into early childhood and beyond.
• Progress is uneven and governance is weak: Although global interest and funding for ECD have grown, implementation is often fragmented across sectors, and younger children—especially those under three—are frequently underserved.

Impact and Relevance:

This paper emphasizes how early childhood development (ECD) is understood as both a scientific and policy priority. By consolidating evidence from neuroscience, economics, and developmental psychology, it established that the first years of life—especially from conception to age three—are not just formative but determinative for lifelong outcomes. The concept of “nurturing care” as an integrated framework for child wellbeing now underpins many global ECD strategies, emphasizing the importance of combining health, nutrition, early learning, responsive caregiving, and protection from violence or neglect. 
 
The study’s influence goes far beyond academic insight. It helps elevate ECD within global development agendas, informing policies aligned with the Sustainable Development Goals and catalyzing major funding commitments from multilateral institutions, bilateral donors, and national governments. The evidence that early adversity leads to permanent biological, cognitive, and economic costs reframes ECD from a social service to a development investment. It is essential for breaking intergenerational poverty cycles, promoting gender equity, and building human capital at scale. It also draws attention to the vast inequities in service provision, especially for children under three, and the need to reform governance structures that often fail to coordinate across health, education, and social protection sectors. 
 
More broadly, the paper advances a life course and multigenerational perspective that places child development at the heart of sustainable development. It highlights how early childhood influences ripple across lifespans, affecting not just individuals but societies—from economic productivity to public health burdens and social cohesion. This study provides a blueprint for moving from siloed interventions to coordinated national strategies that center nurturing care, not only to ensure that children survive, but that they thrive.