Changing the humanitarian system for young children living in conflict and crisis

Around the world, 86.7 million children under the age of 7 have lived their entire lives amid war and chaos (UNICEF, 2016). From Syria to Bangladesh, South Sudan to Niger, these children have witnessed or experienced horrific violence, disaster and loss. Many have been forced to leave their homes, schools and communities to find shelter in temporary settlements, abandoned buildings or camps. A growing body of research points to the likely trajectory for these children. Compounding adversities inherent in conditions of war, disaster and displacement threaten healthy development and can permanently alter brain architecture, epigenetic processes and core physiological systems (Black et al., 2017). The consequences include poor learning outcomes, reduced economic earnings, increased morbidity and early mortality, which in turn affect not only the lives of individual children, but the prosperity, well-being and stability of future generations and societies at large.

The science is clear: without nurturing care, including consistent, responsive adult relationships and opportunities to learn and explore, the future for children living in conflict and crisis is bleak. The 2016 Lancet Series on Early Childhood Development highlights cost-effective, evidence-based interventions that can significantly improve the life course of disadvantaged children in a range of complex, low-resource settings (Britto et al., 2017). Perhaps most importantly, the Series presents a firm call for action to address the urgent, unmet needs of young children in adversity, drawing from the extraordinary advances that the science of early childhood development has achieved through decades of rigorous research.

In the past few years, the international humanitarian community has responded to this call to action, signalling the need for early childhood development interventions to break the cycle of poverty, inequality and disadvantage. As World Bank President Jim Yong Kim said, ‘It is clear that we can’t achieve our goals of ending extreme poverty and boosting shared prosperity unless we help every child reach his or her full potential’ (Kim, 2017: 16). Key partnerships and global networks, such as the Early Childhood Development Action Network, Scaling Up Nutrition, the Global Partnership to End Violence Against Children and the World Health Organization’s work to develop the Nurturing Care Framework all play important roles. Yet, despite the increased attention to the importance of early childhood development in disadvantaged settings, the needs of young children living in the most severe conditions of crisis and conflict continue to be neglected.

The John D. and Catherine T. MacArthur Foundation’s recent decision to award Sesame Workshop and the International Rescue Committee USD 100 million to create in the Middle East the largest early childhood development initiative in the history of humanitarian response serves as a monumental shift. This landmark investment builds upon the early financing provided by the Bernard van Leer and Open Society Foundations and will reach 9.4 million children over five years in Syria, Iraq, Jordan and Lebanon with engaging, multimedia content designed to reflect the realities of young children throughout the region. The programme will reach 1.5 million of the most vulnerable children through direct services aligned with the recommendations of the 2016 Lancet Series on Early Childhood Development, including support for caregivers delivered through home visiting, group sessions and mobile devices to help them provide the nurturing care and stimulation to mitigate the impacts of stress, violence and displacement in the first 1000 days of the child’s life; and the establishment of early learning centres within formal and informal settings to provide high- quality, play-based learning for the second 1000 days. With this extraordinary investment, our partnership will transform the language, early reading, math, and social-emotional skills of a generation of children affected by the Syrian war.

But to achieve lasting impact for young children living in crisis settings around the world, the MacArthur Foundation’s investment must be matched by radical changes to the humanitarian system. First, early childhood development must be recognised as a life-saving priority for any humanitarian response. Second, programmes must be required and funded to generate meaningful evidence on what works, why, how, in which contexts and at what cost. And third, philanthropy must continue to lead by example to drive large-scale investment from governmental and multilateral institutions.

Early childhood development as a life-saving intervention

‘The goal is simple: early childhood development as a core pillar of every response strategy in conflict and crisis settings.’

The United Nations Central Emergency Response Fund (CERF) defines life-saving and core humanitarian programmes as ‘those actions that within a short time span remedy, mitigate or avert direct loss of life, physical and psychological harm or threats to a population or major portion thereof and/ or protect their dignity’ (UN CERF, 2010). The scientific community has proven time and again that the brain is most sensitive to adversity in the first years of life; that this adversity threatens immediate and long-term health, academic achievement and economic well-being; and that evidence-based services for young children can reduce the effects of adversity. These life-saving actions can be taken to protect, mitigate and avert physical and psychological harm to young children. Nonetheless, the humanitarian system does not prioritise early childhood programming in humanitarian response. One indication is funding: of the total humanitarian funding received in 2016, less than 2% was allocated to education, of which only a small fraction was dedicated to early childhood (UNOCHA Financial Tracking Service, 2018b).

The ongoing crisis in Myanmar and Bangladesh serves as a vivid example of this. Since August 2017, approximately 670,000 Rohingya refugees, 60% of whom are children, have fled to Bangladesh from Myanmar (Inter Sector Coordination Group, 2018). Massive displacement, violence, disease and destruction have wreaked havoc on the lives of these children. The humanitarian response plan includes commitments to shelter, food and basic health services – essential services to ensure the short-term survival of these children. It also includes commitments and strategies for emergency telecommunications, coordination and logistics. Yet, despite what we know about the life-threatening effects of neglecting young children, the humanitarian response plan makes no explicit commitment to early childhood development. As of February 2018, the education sector had received less than 6% of the funding it requested (UNOCHA Financial Tracking Service, 2018a). A staggering 332,650 children – nearly 75% of all children in need – are not being reached by education services (Inter Sector Coordination Group, 2018). Early childhood development is life-saving and delivers long-term benefits and yet the story of the Rohingya children proves that the humanitarian community and its donors view early childhood development and education services as low priority programmes in a humanitarian response. This can and must change.

Evidence for early childhood development in emergencies

Boosting investment in early childhood development in the acute stages of an emergency requires a much stronger body of evidence in these contexts, giving proof such programmes are indeed possible and effective. A recent review of evaluation studies conducted within the past 17 years identified only four studies of early childhood impact evaluations and a complete absence of implementation research in humanitarian contexts (Murphy et al., in press). This highlights the vast disparity between investments in research in stable contexts compared to research of early childhood programmes in crisis settings.

Despite significant complexities in crisis-affected places like Bangladesh, Niger, South Sudan and the Middle East, the International Rescue Committee (IRC) has proven that rigorous research of this kind is both essential and feasible.

The IRC currently has 28 rigorous studies of our programmes, and we carried out the world’s first randomised controlled trials of parenting programmes and social-emotional learning programmes in post-conflict and refugee settings (Sim et al., 2014; Aber et al., 2017). Through this experience we have learned that for research to be useful for programmes and policymakers it must answer questions about impact – did the programme work – as well as how programmes are effective, for whom they are effective and what it costs to have an impact. Research must start before a project begins, to assess the needs and resources of children and families and rapidly test and adjust existing strategies so they are practical and feasible within a specific humanitarian setting. Once programme models and content have been adapted and refined, implementation research will capture whether the programme is being delivered with high quality and at what cost. Rigorous impact evaluations can then determine whether programmes have indeed been effective. For early childhood development in crisis settings – a sector so lacking in actionable, policy-relevant evidence – this combination of rapid testing, rigorous implementation and cost analysis and impact evaluation is essential.

The role of philanthropy

‘For early childhood development in crisis settings, this combination of rapid testing, rigorous implementation and cost analysis and impact evaluation is essential.’

Philanthropists have a unique opportunity to be leaders both in early childhood development investment and advocacy and in reshaping the humanitarian response. The goal is simple: early childhood development as a core pillar of every response strategy in conflict and crisis settings. The MacArthur Foundation has shown that philanthropy can provide massive investment and reach, surpassing the scale of any single existing early childhood programme in a humanitarian response. This investment will not only reach an unprecedented number of children, it will catalyse public institutions to prioritise and take action themselves. At the same time, philanthropic organisations must build upon current momentum and identify practical strategies that will lead to systemic change. Important steps to achieving this goal include the convening of global leaders and experts in early childhood development and humanitarian programming; advocating for and investing in research on early childhood development in crisis and conflict settings; disseminating research and translating evidence for policymakers and practitioners; and pushing for replication and scaling of early childhood development in emergency and humanitarian settings around the world.

Conclusion

The MacArthur Foundation has done something remarkable. In five years, Sesame Workshop and the International Rescue Committee will have delivered transformational services for 1.5 million children affected by the Syrian crisis and 9.4 million children and caregivers will experience world-class multimedia educational programming. Together with New York University’s Global TIES for Children Center, we will generate actionable evidence on early childhood development programming in conflict and crisis; and we will use this evidence to inform the adaptation and replication of programmes for crisis and conflict settings throughout the world. This must be just the beginning. Success will be when early childhood development programming is included in the first days of an emergency response; when cost-effective programme models are implemented across a range of crisis, conflict, post-conflict and fragile settings; when programmes are longer than 18 months; and when investment in programme research results in the establishment of a robust and continually growing evidence base on how to change the trajectory for millions of young children living in conflict and crisis around the world. Success will be when every young child affected by conflict or crisis has access to the early childhood services they need to survive and thrive.

References can be found in the PDF version of the article.