Put Children - Especially Girls - High on the Global Agenda

This year, one billion children around the world will experience a form of violence and around 200 million children will not meet their developmental potential. That's not only a humanitarian crisis — it's an economic one. Adults who suffered from abuse, neglect, malnutrition, or homelessness in childhood contribute less to households, communities, and society at large. In an article published on June 16 in the National Academy of Medicine Perspectives, I joined other experts in public health, international development, and related disciplines to make the case that the ability of children around the world to thrive merits widespread attention and urgent policy action. Addressing early childhood development must be a global priority, so that children can live the lives they deserve and nations can realize the full potential of all their citizens.

The past two decades have seen unprecedented improvements in child survival, with annual child deaths halving from almost 13 million in 1990 to just under six million in 2015. Many of the acute causes of child mortality, such as malnutrition , have also dropped significantly. These gains are the unmistakable impact of coordinated global action, strategic investment, evidence-based programming, and rigorous monitoring and evaluation. We are on the right track, but we have a lot more work to do. There remains an enormous gap between securing a child's ability to survive, and supporting that child's full social, cognitive, emotional, and economic development.

That gap widens appreciably when the child at risk is a girl.

Gender is an especially valuable lens to approach early childhood development and to explore the stark inequalities that remain. In many countries, girls are disadvantaged even before they are born. UNFPA estimates that 117 million females are "missing" from demographic records in countries with strong son preference and where sex-selective abortion is common. Girls are typically valued less than boys culturally, and often legally, with fewer inheritance and land ownership rights in many countries, higher expectations of unpaid labor, reduced access to employment, lower wages, limited opportunities for political and even domestic decision-making, and restricted mobility. That disparity sets girls up for economic hardship from the start of their lives.

Because they are valued less, girls are given less. The gender gap in school enrollment has narrowed in recent years, but a third of countries have still not achieved parity in primary and secondary education. When forced to choose, parents with insufficient incomes nearly always choose to invest in their son's education over than their daughter's.

Given their exclusion, girls are frequently considered a "burden" to their parents, leading to neglect, and in many cases, forced marriage. In several countries, this burden is symbolized by a dowry or bride price — the exchange of assets or money for marriage. School drop out, early pregnancy, and monetary calculations all influence high global rates of child marriage , and in turn, married girls are more likely to drop out of school and become pregnant. Of all married women alive today, 720 million were wedded as children, compared to 156 million men; and an additional 15 million girls are married every year. These same girls and women are frequently deprived of the opportunity to learn about their bodies or make informed decisions about reproductive health. In the developed world, we've seen the correlation between reproductive freedom and economic opportunity — a connection that's even more pronounced in resource-limited settings.

Girls are also at a high risk of experiencing gender-based violence. More than one third of women worldwide have experienced physical and/or sexual violence, mostly from intimate partners; in some countries, this figure climbs as high as 70 percent. Transgender and gender-nonconforming individuals also face high rates of violence and social exclusion . Rape, abuse, harassment, and exploitation can have dire acute and long-term consequences for physical and mental health.

Childhood is an especially sensitive period, and even non-violent but simply negligent care-taking risks disrupting the development of brain circuits, which are crucial for intellectual and emotional intelligence.

These grim trends warrant immediate, coordinated, well resourced, and sustained action. Indeed, the fifth goal of the Sustainable Development Goals (SDGs), which constitutes the world's development agenda until 2030, is to "achieve gender equality and empower all women and girls." Its targets include much of what I've discussed here, such as ending discrimination and violence against women and girls, ending harmful practices like forced marriage, and ensuring economic and decision-making opportunities for women. Although it is not embedded within this gender equality goal, ensuring access to quality early childhood development for girls and boys is another SDG target.

These goals are a heartening achievement in an often disheartening story. In order to fulfill these goals, we need policymakers who are aware of the science and willing to consider the intersection of gender and childhood. Early childhood development is the place to start and 200 million children's futures count on us getting it right.