No one is born a good citizen; no nation is born a democracy. Rather, both are processes that continue to evolve over a lifetime. Children must be accorded the right environment right from birth as the years from conception to the first five years are critical period in laying the foundation for the child’s lifelong growth and development. It is essential that all sectors work together as there is no alternative to growth and development but to take appropriate measures to support their full development and growth of their potential. Maybe you’re wondering: Why hasn’t foreign or domestic aid had more impact on economic development and poverty reduction? One major reason is that we’ve so badly neglected Early Childhood Development (ECD). One of the biggest obstacles to this better world is our collective failure to help parents provide adequate nutrition, safe environments and sufficient stimulation to their children during the first 1,000 days of their lives. Scientific and economic evidence shows that this failure has life-long consequences. It can lead to stunting and other limitations in development, which are caused by a lack of nutrition, a lack of sufficient stimulation, and exposure to environments that cause stress among children.
Why invest in ECD?
Governments that don’t invest in a skilled, healthy, productive workforce are harming their future economic growth. Evidence suggests that an additional dollar invested in quality nutrition and preschool programs will yield a return of between $6 and $17 dollars. Parenting programs added to nutrition interventions from birth to 2 years result in higher IQ, reduced depression and violence at age 18 years and above and 50% earning at age 22. If children fail to get what they need – enough nutrition, nurturing, stimulation, and a sense of security – during the most critical years of early childhood, the impact on their lives and futures is enormous as stunting not only leaves children vulnerable to infection, but it can permanently limit their physical and cognitive capacity.
Looking forward, although survival rates of children have improved in Kenya, statistically Kenya still does not prioritize ECD with the effect that 1 in 4 children are stunted, and 1 out of 5 Children are not fully vaccinated. I’m deeply concerned that our failure to tackle this challenge is condemning millions of children to lives of exclusion lives where they won’t have the brain power to succeed in school or in an increasingly digitalized workplace. The good news is that we know the cost-effective, evidenced-based solutions that can solve this problem its early childhood development, or ECD.
What we are doing
At KANCO, we recognize early childhood development covers the physical, cognitive, linguistic, and socio-emotional development of children, starting before birth until they enter primary school. These interventions start with adequate maternal and child nutrition and include early stimulation and learning activities. Providing early childhood development is both morally right and economically smart. Without it, inequality starts at birth, meaning children risk lifelong cognitive deficits through no fault of their own. Children who are poorly nourished, who are stunted, and who do not receive adequate parenting or stimulation before their fifth birthday, are likely to learn less at school and earn less as adults, perpetuating the cycle of poverty across generations. Competing in today’s digital economy requires a workforce with well-developed brains. How do we expect employers to invest in a country if its workforce is not sufficiently developed physically and or cognitively?
One important factor is a substantial shortfall in political and financial commitment at the national level. New estimates for FY 2015/6 budgetary allocations further affirms that point in that the vote-head on School Health, Nutrition and Meals, which is an important solution to enhancing school attendance for children from poor households, reduced from KSh 2,304,070,927 to KSh 1,475,706,546, representing a 36% reduction.
We must end childhood stunting and promote optimal development of young children through delivering universal access to ECD services as quickly as possible. The time also has come for a “whole of government” approach across different ministries and multiple sectors, and coordinated and sustained engagement with the private sector, foundations and civil society to scale up ECD interventions. We also need a National plan to hold all of us accountable for our policy decisions, financing, and faster progress. Depending on the path we choose, the journey to a world where everyone has the opportunity to reach their full potential can be long and arduous, but the path has shortcuts! More investment in ECD!
 (Gertler et al., 2014
In 2009, the government acknowledged people who inject drugs as most at risk populations. Based on the findings of the Mode of Transmission study in 2009, the findings indicated that people who inject drugs account for 3.8% of new HIV infections. The prevalence of HIV infection among this population is estimated to be at 18% according to the Kenya AIDS Response report 2014.
In response to this, the government in collaboration with civil society and development partners drafted guidelines for implementation of harm reduction programs in the country. These were adopted by the government through the ministry of health, considering that implementation of harm reduction in the country is based on public health.
In 2011, KANCO, in partnership with the ministry of health rolled out the first pilot needle and syringe program in Kenya. The initial focus of the program was Nairobi and coast regions, where data indicated had the biggest populations of people who inject drugs. This has since expanded to include Nyanza and central regions as a response to evidence pointing towards expanding PWID presence. Needle and syringe programs work towards reduction of risk of HIV infection by ensuring that people who inject drugs have access to clean injecting equipment and thereby reducing the potential of sharing used equipment.
Methadone piloting has also recently been rolled out in Kenya. Methadone is one of the medically assisted treatments available for managing opiate addiction. The program has been ongoing since late 2014, and has so far been rolled out in Nairobi, Mombasa and Malindi. There are plans to expand to Kwale and Nyanza.
Needle and syringe programs and methadone are considered among the most important interventions among the 9 recommended set of interventions for responding to drug use. These have been implemented alongside other HIV response interventions that have been contextualized to respond to the needs of people who inject drugs. Currently, both active and recovering PWID have access to a range of HIV prevention services including HIV testing and counseling, condom provision and Antiretroviral therapy.
Those still using heroin get their services predominantly from outreach projects- which are based in areas accessible to people using drugs. KANCO so far works directly with seven harm reduction partners in Nairobi, coast, Nyanza and central, and runs a drop in center that provides services specific to PWID in Ukunda, and another one for key populations in Mariakani.
Significant milestones have been made in response to reducing the negative health and social consequences of drug use among people who use drugs in Kenya. While acknowledging these, there are some areas that still need to be looked into to ensure that current responses can have lasting impacts. Among the key issue mentioned by people who use drugs, those who are still using heroin and those on methadone, is the limited space for economic opportunities, coupled with idleness and lack of spaces to engage. Supporting access to economic opportunities, be it through linkage to employment opportunities or support for income generating activities would significantly support the outcomes of harm reduction interventions. In addition law enforcers still need more sensitization on the principles of harm reduction to be more supportive in the process
Kenya is ranked no 18 globally in malnutrition and this is a crisis in the country that requires quick actions to address. Malnutrition is a condition that occurs when people consistently do not consume or absorb the right amounts and types of food and essential nutrients. This leads to poor physical growth and brain development among children preventing them from thriving and living up to their full potential. This also interferes with performance in school, the country’s future labour force the Gross Domestic Product and human development index. Globally, this contributes to nearly half of all child deaths, approximately more than 3 million children each year. According to the Ministry of Health, this translates to 45% of child deaths in the country as a result of poor nutrition.
The development of Kenya’s future generation lies in the hands of policy and decision makers. Civil Society Organizations (CSOs) in the health sector need to have a common goal on scaling up the work of proper nutrition in the country. They however also require more support from the government to be able to achieve sustainable development goals. KANCO organized a TICAD VI conference breakfast meeting on Friday 26th August with various stakeholders in the health sector ahead of its official opening. The goal of this breakfast meeting was to rally stakeholders in the health sector to push for more comprehensive nutrition efforts in Kenya at the TICAD VI conference if significant progress in better nutrition is to be achieved. KANCO’s Director, Mr Allan Ragi stated that it is important to work with governments and other CSOs so as to register significant gains and to sustain any progress made in achieving better nutrition levels.
In line with this, great efforts were seen at the TICAD VI with the launch of “Initiative for Food and Nutrition Security in Africa (IFNA)” by The Japan International corporation Agency (JICA). This is seen as a new framework for accelerating international/global efforts to alleviate hunger and malnutrition in the African Continent which will focus on implementing practical activities as well as advocacy work; synergy of multi-sectorial activities such as collaboration of agriculture, health and education sectors; evidence-based approach for rational decision-making and monitoring & evaluation; and mid/long terms vision to enhance resilience of the target groups while coping even with emergency aid.
Successfully addressing malnutrition in Kenya will save the lives of 50,000 children and is a more than worthy cause and investment on the future generation. As CSOs focus on tackling Malaria, HIV and TB especially with the latest funding announcements made during the TICAD VI conference, it is imperative that the issue of malnutrition is not overshadowed.