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The realisation of human potential for development requires age-specific investment throughout the 8000 days of childhood and adolescence. Focus on the first 1000 days is an essential but insufficient investment. Intervention is also required in three later phases: the middle childhood growth and consolidation phase (5-9 years), when infection and malnutrition constrain growth, and mortality is higher than previously recognised; the adolescent growth spurt (10-14 years), when substantial changes place commensurate demands on good diet and health; and the adolescent phase of growth and consolidation (15-19 years), when new responses are needed to support brain maturation, intense social engagement, and emotional control. Two cost-efficient packages, one delivered through schools and one focusing on later adolescence, would provide phase-specific support across the life cycle, securing the gains of investment in the first 1000 days, enabling substantial catch-up from early growth failure, and leveraging improved learning from concomitant education investments.

Original publication

DOI

10.1016/s0140-6736(17)32417-0

Type

Journal article

Journal

Lancet (London, England)

Publication Date

02/2018

Volume

391

Pages

687 - 699

Addresses

Bill & Melinda Gates Foundation, London, UK. Electronic address: donald.bundy@gatesfoundation.org.

Keywords

Disease Control Priorities-3 Child and Adolescent Health and Development Authors Group