Perinatal and Early Childhood Development: Education, Innovation, and Sustainable Development Goals

Introduction

Perinatal deaths continue being a challenge in the world and especially in developing countries where many interventions have been proposed(Michalow et al., 2015)(Rudan et al., 2010)(Jimenez Soto et al., 2012)with varying outcomes. The WHO and UNICEF in a bid to provide leadership in ending preventable perinatal deaths, improve child development as well as human capital, proposed the Newborn impact framework (Figure 1), (WHO & UNICEF, 2014) a reflection of similar consulted efforts to address the challenges.

Figure 1.

The framework, although good, does not depict the multiple interconnectedness and feedback mechanisms between the different components and hence may not reflect the reality of both intended and unintended consequences of the proposed interventions.

The interdependence and interconnectedness of neonatal health with other systems requires investigation in the context of a wider whole system. The dynamic complexities of contemporary health care setting, the demographic shifts and well as the demand for sustainable development demands increasingly innovative solutions in a resource constrained environment.

Decision making on neonatal health needs to be based on a deep understanding of the whole system behavior and underlying structure. The need to see both the forest and the trees in the grand scheme of things is paramount. Incorporating multiple perspectives not only creates awareness of the intended and unintended consequences of neonatal investment but also demonstrates the need for a multi-sectoral approach through feedback loops and non-linear relationships. Neonatal health’s contribution to Sustainable Development Goals(SDG) can only happen in an environment characterized by good governance, transparency, accountability and the rule of law(IISD, 2019)(Hjorth & Bagheri, 2006) (Schmidt, Gostin, & Emanuel, 2015).

System Dynamics(SD), the origin of the current trend of ‘whole systems thinking’ may provide thinking skills that help to understand the multiple interconnections of complex systems(Wolstenholme, 2005).

This chapter applies SD approach to describe the connectedness between neonatal health and selected significant subsectors: education and training, innovation, income and Universal Health Coverage(UHC) in the context of SDG. The chapter seeks to answer the following questions:

• 1.

  Is investing in neonatal care the key to attaining sustainable development goals?

• 2.

  Is it just or even fair to invest in neonatal care in the midst of competing interests?

• 3.

  What is the effect of investing in education, innovation and training on neonatal health?

• 4.

  Is there a connection between income levels and neonatal health?

• 5.

  What important aspects of neonatal health should UHC focus on?

A simplified causal loop diagram(CLD) as part of systems dynamics approach is applied in seeking to identify the intended and unintended consequences of investing in neonatal health as well as communicating crucial insights in the grand scheme of things. Investment in neonatal, child and maternal health is likely to have a high impact with Africa as a target (Friberg et al., 2010). The impact of investing in perinatal period as a smart investment in attaining sustainable development goals (SDGs) is viewed as a nexus of UHC, education and innovation and poverty eradication. SDG require systems approach in understanding the complexity of our environment, setting up sensible goals in order to improve the universe and leave a better world for generations to come. In addition, it helps to create a wealthy and prosperous society(IISD, 2019)(Hjorth & Bagheri, 2006) Public health and UHC have an enormous role to play and support SDG (Schmidt, Gostin, & Emanuel, 2015).To support the proposition of the CLD, a look into selected countries that have done well in neonatal health and the relationship with their investment in early childhood development, education and training as well as innovation is analyzed.