Parents are obsessed with measuring their children. We start when the baby is in utero – my baby is the size of a grain of rice, a grape, a lemon. After the baby is born, the key pieces of information we share are the name and 2 measurements: length and weight. We track length and weight compared to other children. Gradually, the milestones become more qualitative, but we don’t stop measuring. “My child is smiling.” “My child is walking.” “My child is acting like a teenager.”
Why do we measure? There are important practical reasons. Measurements provide an indication of our children’s health. But the act of measuring also takes on an emotional resonance. Parents take great joy in watching their children grow. Each milestone reached seems to be a testament to their limitless potential.
But this is not how millions of people in poor countries experience parenting. They don’t have access to good enough health care to establish whether their children are growing and developing normally. If they did, in many cases they would find that their children are lagging.
In poor countries, 1 in 10 babies is born preterm; 1 in 3 children falls off the standard physical growth curve; and more than 1 in 3 children miss key behavioral milestones because the brain isn’t developing properly.
In poor countries, a child’s potential doesn’t seem limitless. These children – and their communities – can be robbed of their future from the very beginning, and there is no way to get that future back.
In 2013, the Bill & Melinda Gates Foundation created the Healthy Birth, Growth, and Development program (HBGD) to ensure that all children can regain control of their futures, maximize their potential, and have the opportunity to lead a healthy and productive life.
HBGD is organized around a list of key questions, and the answers to these questions will help the Foundation and its partners cut through some of the complexity and reduce the heavy burden of preterm birth, stunting, wasting, and neurocognitive impairment. The goal of HBGDki is to promote healthy birth, growth, and development by leveraging knowledge integration to:
Accelerate learning and progress toward alleviating the global burden of preterm birth, growth faltering, wasting, and impaired neurocognitive development.
Quantify sources of within- and between-child variation, and isolate these sources of variation from normative variability in growth and development.
Generate predictive models, actionable conclusions, and new hypotheses.
Define precise strategies that will promote healthy neurocognitive development and physical growth in children who are faltering or at risk of faltering, irrespective of pregnancy and newborn outcome and gestational age.