Cognitive capital for children in Asia and Pacific

Summary box.

• Cognitive capital is nurtured prenatally and in early childhood and has a pivotal effect on human capabilities.

• Nationwide social protection provides for the most vulnerable and, if properly designed, can assist primary caregivers to nurture cognitive capital as children grow and interact with them and their environment.

• Universal health coverage provides the basis for equitable healthcare for all and is a core part of child development.

• Research has established that violence in childhood may have long-term consequences on the well-being of individuals; and given its scale, in aggregate it significantly undermines cognitive capital.

Hosted by the Government of Malaysia with the support of UNICEF, a High Level Meeting on South-South Cooperation for Child Rights in Asia and the Pacific will be held on 7 and 8 November 2016 in Kuala Lumpur.^1–3 With nearly half the world's children living within the Asia and Pacific region, this forum will promote the sharing of best practices, enhance political commitment to the rights of children, and foster stronger cooperation between governments. There is an overarching theme—investing in the cognitive capital of the next generation. A key discussion looms—the promotion of optimal brain development so that both children and countries thrive. Cognitive capital represents the complete set of intellectual skills as well as those non-cognitive, social-emotional, and executive function skills that allow for creativity, flexibility, and ability to work collaboratively. It is nurtured prenatally and in early childhood and has a pivotal effect on human capabilities.

Early brain development may be influenced by a range of factors, such as breast feeding, nutrition, stimulation, nurturing, supportive environments and high-quality public services, including education, healthcare, and protection from abuse and neglect. Nationwide social protection provides for the most vulnerable and, if properly designed, can assist primary caregivers to nurture cognitive capital as children grow and interact with them and their environment. Policies and programmes that support these types of systems for children improve their lives—not just their lifespan and nutritional status, but their cognitive development. This is not just about individual well-being and opportunity. It is at population level about the future prosperity of nations.

The high-level meeting is underpinned by three thematic papers which are summarised in this supplement.^4–6 All three papers tackle key dimensions of creating the environments children need to develop—child-sensitive social protection, universal health coverage and preventing violence. Universality is key, as well as a disproportionate focus on the most deprived. Such efforts make a substantial contribution to the Sustainable Development Goal (SDG) agenda. It is also ‘good politics’ as the return on investment is potentially high. This represents ‘smart economics’ of the future; child-related interventions fared well in a recent analysis on social, economic and environmental returns.⁷

Stepping up investment in children is particularly important in Asia and Pacific as the approach that has secured high growth rates—channelling millions of young unskilled or semiskilled mostly agricultural labourers into industrial employment—is increasingly becoming unsustainable. Technological change demands a different type of skills in the highly connected digital age. Yet investments in technology are not maximised without increasing investment into the organic connectivity of the evolving brains of children. Achieving this at population scale means securing nutrition, healthcare and supportive caring environments for all children, especially during the first 1000 days of life when the core structures of the brain develop. This approach will require embracing and investing in child-sensitive social protection at scales not yet seen in Asia and Pacific. These programmes deliver multiple benefits and sustainable results, especially when designed and implemented systematically as an integral part of social and economic policies.

Universal health coverage provides the basis for equitable healthcare for all and is a core part of child development. The most successful countries for universal health coverage share common attributes: (1) they organise and deliver comprehensive, integrated health services, making these accessible to all; (2) they remove financial and other barriers, especially direct payments for health; (3) their health financing systems are dominated by public financing; (4) they have large risk pools to ensure sustainable cross-subsidy between the healthy and wealthy and the sick and the poor and (5) their governments use public financing to cover the informal sector and households living on or below the poverty line. Many countries spend under the 3% minimum for public expenditure on health. This needs to urgently increase so that countries spending <3% of gross domestic product (GDP) on health increase by 0.3% per year starting in 2017. Other areas remain critical—such as strengthening primary care, establishing mechanisms for clear priority-setting processes, and engaging the private sector through regulation, payment systems and partnership.

International law establishes children's right to protection from all forms of violence. Yet physical, sexual and emotional abuse and neglect remain remarkably common experiences in the lives of children in Asia and Pacific. When violence is routine, it may be socially accepted and officially condoned. Research has established that violence in childhood may have long-term consequences on the well-being of individuals; and given its scale, in aggregate it significantly undermines cognitive capital. Violence prevention is an investment that may have important socioeconomic returns, such as reducing public expenditure on crisis response services, impacting positively on health, improving educational outcomes, and preventing crime and intergenerational transmission of violence. A new violence prevention agenda has been established at global level, and there are critical steps that governments in the region can take to accelerate action.

The future for children in Asia and Pacific is bright if governments commit to finance the development of the next generation. Public investment in children reaps many rewards—protecting and advancing their rights, creating opportunities, and facilitating their contribution when adults to shared prosperity. Cognitive capital is not to be taken lightly, and the time to act is now.