ECD Program ReportIPA-SC Meeting 12/18/2011

Mohamad Mikati MDSC Committee Member, Representative of The

International Child Neurology Foundation

Activities in 2010-2011• April 19-21, 2010: The UNICEF New York City Head Quarters Global

Consultation on ECD research agenda April 19-21. This meeting was convened by the UNICEF in New York City and included several partner international organizations (UNICEF, WHO, World Bank), academicians, NGOs, donors, and other stake holders to make recommendations regarding the research agenda in ECD. Dr. M. Mikati contributed as IPA representative

• May 1-7, 2010: The International Congress of Child Neurology, Cairo, Egypt: Symposium on developmental interventions and another on impact of war on childhood development. Dr. M. Mikati and Dr. Hussein Bahaeddine were organizers and contributers

• August 3-7, 2010: Activities during the IPA Congress, IPA-UNICEF-WHO Workshop on Childhood Development in Johannesburg: This workshop and the activities around it highlighted a major interest of pediatrician in the New IPA Program on Early Childhood Development (ECD) and plans for the future were discussed.

Activities in 2010-2011• Beirut Activities (Sante Sud Seminair Beirut) Drs. Lama

Charafeddine and Durriyah Sinno organized a workshop ECD in the IXth Makassed Medical Congress in October 2010 and Dr. Charafeddine also gave a presentation on Developmental screen and early intervention in the Sante Sud Conference held in Beirut October 29, 2010.

• The Consultative Group on Early Childhood Care and Development (CGECCD) Zanzibar Tanzania: Dr. Mikati represented IPA and gave two talks, plans for ECDI partnership were consolidated

• Contacts for Potential Partners for ECD program: This is in preparation for subsequent steps

Rio Political Declaration on Social Determinants of Health, Rio De Janeiro, 21 October 2011

• Officials and other Stake Holders: Heads of Government, Ministers and government representatives came together

• Declaration: Expressed determination to achieve social and health equity through action on social determinants of health and well-being by a comprehensive intersectoral approach.

• ECD emphasized in the declaration on page 3 paragraph 11.2 item (xi) "Give special attention to gender-related aspects as well as early child development in public policies and social and health services;"

Activities in 2011• Care for child development: Basic science rationale and

effects of interventions. Review of basic science literature supporting ECD: Holt RL, Mikati MA. Pediatr Neurol 2011;44:239-253.

• Care for Childhood Development: Clinical Economic and Ethical Rationale. Aravindhan Veerapandiyan MBBS, Rebecca Holt MD, Mohamad A. Mikati MD, in press.

• Impact of Early Childhood Development programs: A Cost-Benefit Analysis Study Aravindhan Veerapandiyan, MBBS, Harold Alderman, PhD, Mohamad A. Mikati, MD, in preparation.

Country Intervention Difference in IQGuinea Preschool program 4.41

Cape Verde Preschool program 7.27

Kenya, Zanzibar, Uganda Madrasa Resource Center Study 2 0.40 SD/year

Bangladesh Early childhood preschool program (5 years) ~ 5%

India Anganwadi Center 10.2

West Indies Weekly or 2 weekly home visits with toys demonstration for 3 years after hospitalization

8.6

Philippines Philippine early childhood development program 0.553 SD USA Home visiting by paraprofessionals and nurses program. 3.98USA Project Care – 18 months child development center and family education 5.8USA Duration 6 yrs. Fulltime child care and job counseling and training for parents. 10USA Duration 3 yrs. Home visits monthly. Nurse provided toys and books, parental

training in cognitive stimulation of child8

USA Toddler-parent psychotherapy. Duration: 14.5 months 4.95USA Home visits (first 3 yrs), child development centers (second 2 yrs) and parent

support groups (second 2 yrs). 11.75

Norway Modified version of Mother-Infant Transaction programDuration: one week

7.2

Effect of ECD Programs: Summary

Tracked a large group of young U.S. baby boomers using national longitudinal survey (NLSY79). IQ correlated with annual income (0.3) Also correlated with net worth (0.16).Showed each point increase in IQ test scores raises income by between $234 and $616/year or 0.9-2.5% of PCGNP (mean 1.7%).

Zagorsky J. 2007. Do you have to be smart to be rich? The impact of IQ on wealth, income and financial distress. Intelligence.

Background Study: Effect of IQ on income

Background: Expenditure on Pre-Primary Education:

Percentage of PCGNP (2004)

3.75.4

7.49.6

13.4 14

22.4 23.1

0

5

10

15

20

25

30

% of PCGNP

East Asia and Pacific

Subsaharan Africa

Latin America

South and West Asia

North America and Western Europe

Developed Countries

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

0 5 10 15 20 25 30 35 40 45 50 55 60 65

Cost spent on interventions(Avg duration - 3 years)

Avg intervention, IQ effects

400x

200x

0.224182

67433 years

Age in years

Cost

% 2

010

PCG

NP

Cost-Benefit Study: Projections

1200x

1000x

800x

600x

Impact of Early Childhood Development programs: A Cost-Benefit Analysis Study. Aravind Veerapandiyan, MBBS, Harold Alderman, PhD, Mohamad A. Mikati, MD, in preparation.

$5,377

$180,504

$124,465

$68,564

$33,899

23 years

24 years

26 years

31 years

Cost-benefit Analysis

Age in years

Cost

US

$

Impact of Early Childhood Development programs: A Cost-Benefit Analysis Study. Aravind Veerapandiyan, MBBS, Harold Alderman, PhD, Mohamad A. Mikati, MD, in preparation.

Lebanon Collaborators• Dr. Lama Charaffedine:

American University of Beirut, Neontatology, Dev. Pediatrics (research, speaker, book)

• Dr. Durriyah Sinno: American University of Beirut, Developmental Pediatrics (research, speaker, book)

Lebanon Program: Identified Centers

1. UNRWA Clinic-Beirut Suburb2. RHUH Government

Hospital-Beirut Suburb3. The Karagheusian Clinic-

Mount Lebanon4. Markaz-Al-Khadamat

Alinmaia North Lebanon5. The Makassed Out Patient

Clinic-Beirut

Current Potential Global Partners

• Dr. L. Selim, Egypt• Dr. T. Cunningham, Tanzania• Dr. F. Tall, Burkina Faso

• Drs. Sinno/Charafeddin Leb• Dr. N. Khoury, Jordan• Dr. S. Sitaraman, Jaipur

India

Planned Activities 2012-2013

• Complete and publish the Economic study with the World Bank

• Participate in the UNICEF Global Consultation• Beirut workshop to Launch the Lebanon ECD

program there-Thanks to IPA budgeted $ 5,000 for the ECD program.

• ECD Workshop in Melbourne Congress-Thanks to Dr. Wigg and to ICP Scientific Committee.

• Pediatric Neurology Session in collaboration with ICNA in Melbourne Congress-Thanks Neil !!

Thank you for your attention!!