Building on the evidence from the first paper in this Series highlighting the fundamental importance of healthy and nurturing environments for children's growth and development in the next 1000 days (ages 2–5 years), this paper summarises the benefits and costs of key strategies to support children's development in this age range. The next 1000 days build on the family-based and health-sector based interventions provided in the first 1000 days and require broader multisectoral programming. Interventions that have been shown to be particularly effective in this age range are the provision of early childhood care and education (ECCE), parenting interventions, and cash transfers. We show that a minimum package of 1 year of ECCE for all children would cost on average less than 0·15% of low-income and middle-income countries' current gross domestic product. The societal cost of not implementing this package at a national and global level (ie, the cost of inaction) is large, with an estimated forgone benefit of 8–19 times the cost of investing in ECCE. We discuss implications of the overall evidence presented in this Series for policy and practice, highlighting the potential of ECCE programming in the next 1000 days as an intervention itself, as well as a platform to deliver developmental screening, growth monitoring, and additional locally required interventions. Providing nurturing care during this period is crucial for maintaining and further boosting children's progress in the first 1000 days, and to allow children to reach optimal developmental trajectories from a socioecological life-course perspective.

中文翻译：

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未来 1000 天不投资的代价：对政策和实践的影响


基于本系列第一篇论文的证据，强调了健康和培育环境对未来 1000 天（2-5 岁）儿童生长和发育的根本重要性，本文总结了支持该年龄段儿童发展的关键策略的益处和成本。接下来的 1000 天建立在前 1000 天提供的基于家庭和卫生部门的干预措施的基础上，需要更广泛的多部门规划。已被证明在这个年龄段特别有效的干预措施是提供幼儿保育和教育 （ECCE）、育儿干预和现金转移支付。我们表明，为所有儿童提供至少 1 年的幼儿保育和教育计划，平均成本低于低收入和中等收入国家当前国内生产总值的 0·15%。不在国家和全球层面实施这一计划所造成的社会成本（即不作为的代价）是巨大的，估计损失的收益是投资于幼儿保育和教育成本的 8-19 倍。我们讨论了本系列中提供的总体证据对政策和实践的影响，强调了未来 1000 天内幼儿保育和教育计划作为干预措施本身的潜力，以及提供发育筛查、生长监测和其他当地所需干预措施的平台。在此期间提供养育照顾对于维持和进一步促进儿童在前 1000 天的进步至关重要，并从社会生态生命历程的角度让儿童达到最佳发展轨迹。