Transcript Developmental Program Progress Report IPA

ECD Program Report
IPA-SC Meeting 12/18/2011
Mohamad Mikati MD
SC 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-UNICEFWHO 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.
Effect of ECD Programs: Summary
Country
Intervention
Guinea
Preschool program
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
8.6
Philippines
Weekly or 2 weekly home visits with toys demonstration for 3 years after
hospitalization
Philippine early childhood development program
USA
Home visiting by paraprofessionals and nurses program.
USA
Project Care – 18 months child development center and family education
USA
Duration 6 yrs. Fulltime child care and job counseling and training for parents.
USA
Duration 3 yrs. Home visits monthly. Nurse provided toys and books, parental
training in cognitive stimulation of child
Toddler-parent psychotherapy. Duration: 14.5 months
USA
USA
Norway
Home visits (first 3 yrs), child development centers (second 2 yrs) and parent
support groups (second 2 yrs).
Modified version of Mother-Infant Transaction program
Duration: one week
Difference in IQ
4.41
0.553 SD
3.98
5.8
10
8
4.95
11.75
7.2
Background Study: Effect of IQ on income
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:
Expenditure on Pre-Primary Education:
Percentage of PCGNP (2004)
30
East Asia and Pacific
25
22.4 23.1
Subsaharan Africa
20
13.4 14
15
9.6
10
5
Latin America
South and West Asia
7.4
3.7
5.4
North America and
Western Europe
Developed Countries
0
% of PCGNP
Cost-Benefit Study: Projections
3,000,000
1200x
Cost spent
on
intervention
s(Avg
duration - 3
years)
2,500,000
Cost % 2010 PCGNP
1000x
2,000,000
800x
674
33 years
1,500,000
600x
1,000,000
400x
Avg
intervention,
IQ effects
500,000
200x
182
0.224
0
0
5
10
15
20
25
30
35
40
45
50
55
60
65
Age in years
Impact of Early Childhood Development programs: A Cost-Benefit Analysis Study.
Aravind Veerapandiyan, MBBS, Harold Alderman, PhD, Mohamad A. Mikati, MD, in preparation.
Cost-benefit Analysis
$180,504
23 years
$124,465
Cost US $
24 years
$68,564
26 years
31 years
$33,899
$5,377
Age in years
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
Suburb
2. RHUH Government
Hospital-Beirut Suburb
3. The Karagheusian ClinicMount Lebanon
4. Markaz-Al-Khadamat
Alinmaia North Lebanon
5. 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!!