Rethinking development—VI Human capital begins before school

Summary Pakistan has nearly 36.5 million children below five; only 30 per cent reportedly receive adequate early stimulation, while more than half risk poor development. Lady health workers, basic health units, immunisation visits, Benazir Income Support Programme (BISP), public schools and community facilities can deliver maternal nutrition, antenatal and postnatal care, growth and developmental screening, disability referral, caregiver mental-health support and evidence-based parenting guidance. From age three, every child should receive quality early education, safe water and sanitation, nutrition support and protection from violence. Parliament and provincial assemblies should require an annual Early Childhood Budget and Outcomes Statement as part of the reporting contemplated by Article 29(3) of the Constitution. This Statement should present district-level and income-disaggregated data on maternal nutrition, birth registration, immunisation, low birth weight, stunting, wasting, developmental screening and referral, early stimulation, pre-primary access and quality, caregiver wellbeing, water and sanitation, and the gender distribution of unpaid care. AI Generated Summary Parenting support deserves to become part of Pakistan's development strategy. It cannot substitute for food security, healthcare, safe water, income, time and public early education. Equal childhood development requires a State that enables families to care. Part V argued that democracy cannot deliver inclusion while economic power determines whose capabilities are developed and whose are wasted. A joint article by Planning Minister Ahsan Iqbal and UNICEF representative Pernille Ironside moves this argument to its earliest point. 'Human capital begins at home,' they write, because care, affection, play and responsive interaction during a child's first years shape later health, learning and productivity. Their evidence is sobering. Pakistan has nearly 36.5 million children below five; only 30 per cent reportedly receive adequate early stimulation, while more than half risk poor development. A child born today is expected to realise only 41 per cent of the productivity attainable with complete education and full health. Parenting programmes supported by UNICEF have reached 627,000 caregivers across 122 districts. These numbers place development at the correct starting point. They also expose the distance between an encouraging programme and a universal public system. What the science establishes The WHO-UNICEF-World Bank Nurturing Care Framework identifies five interdependent conditions: good health, adequate nutrition, responsive caregiving, security and safety, and opportunities for early learning. Brain development is exceptionally rapid during the first three years, but the scientific lesson is not that parental technique overrides material conditions. It is that biological, emotional and social environments act together. Long-term experimental evidence gives this claim real weight. A two-year home-visiting intervention for growth-stunted toddlers in Jamaica improved adult earnings two decades later, as reported by Gertler, Heckman and their co-authors. Such studies justify early action. They do not turn the frequently quoted return of up to $13 for every dollar invested into a universal accounting coefficient. Returns depend upon the children reached, programme quality, complementary nutrition and health services, duration, labour markets and the counterfactual. Pakistan needs local longitudinal evaluation, not borrowed precision. Unequal homes cannot produce equal beginnings The National Nutrition Survey 2018 recorded 40.2 per cent of children under five as stunted, 17.7 per cent as wasted and 28.9 per cent as underweight. The World Bank's Pakistan Human Capital Review found a Human Capital Index of 0.41, below the South Asian average of 0.48, with persistent or widening differences across income, sex, rural and urban residence, and provinces. A separate World Bank study found that only 31 per cent of children aged three to five were enrolled in early-childhood education in 2022. These are not simply deficits of parental knowledge. A caregiver cannot stimulate a child out of chronic hunger, recurrent diarrhoea, polluted water, untreated maternal depression, insecure shelter or unaffordable healthcare. Nor can a daily play session repair the developmental damage created when food inflation forces a family to reduce diet quality. A policy that teaches caregiving while leaving these conditions intact mistakes adaptation to deprivation for development. Care also has a gendered political economy. The International Labour Organization reported in 2025 that around 60 per cent of Pakistani women spend more than 15 hours a week on domestic tasks, compared with fewer than 7 per cent of men. Additional expectations placed upon mothers without income security, childcare, parental leave or greater participation by fathers can deepen the inequality that early-childhood policy claims to reduce. Parenting cannot become the feminisation of public failure. The accounting contradiction Reaching 627,000 caregivers in 122 districts is a meaningful administrative achievement. Reach, however, is not coverage, and the number of caregivers cannot be compared directly with 36.5 million children. Public reporting must disclose eligible households, repeat participation, programme cost, service quality and measured child outcomes. Without denominators and independent evaluation, an impressive aggregate can conceal shallow or unequal access. Pakistan was recognised as a 'champion country' at the Global Caregivers' Forum and launched a National Early Childhood Development Policy Framework in 2025. The fiscal record tells a harder story. The Pakistan Economic Survey 2025-26 reports education expenditure at only 0.8 per cent of GDP in fiscal year 2025. Its health and nutrition chapter records the same 0.8 per cent for public health expenditure. A country cannot announce early childhood as a national priority while treating the systems that sustain it as residual spending. Children are citizens, not future inputs 'Human capital' is useful because it makes neglect visible in economic accounts. It is also incomplete. A child does not acquire a claim to nutrition, safety, affection, play and learning only because these may increase adult productivity. Amartya Sen's capability approach treats these freedoms as constituents of development itself. The UN Committee on the Rights of the Child similarly affirms that young children are rights holders, not unfinished adults waiting to become economically valuable. Pakistan's constitutional design contains a revealing gap. Article 25A of the Constitution makes free and compulsory education a fundamental right from ages five to sixteen, precisely when much developmental inequality has already formed. Children below five are not outside constitutional protection: Articles 9, 14 and 25 protect life, dignity and equality; Article 35 specifically requires protection of the mother and child; Articles 37 and 38 impose social obligations concerning education, health, welfare and basic necessities. The Constitution supplies foundations for an early-childhood guarantee even though Article 25A begins too late. From programme to guarantee Pakistan should convert scattered initiatives into a universal Early Childhood Guarantee covering pregnancy to age five. The National Economic Council (NEC) can agree common outcomes and a financing path; provincial legislatures must establish entitlements and service standards; grants-in-aid recommended through the National Finance Commission (NFC) can equalise provincial capacity; and elected local governments under Article 140A should organise delivery closest to families. Existing platforms should be joined rather than multiplied. Lady health workers, basic health units, immunisation visits, Benazir Income Support Programme (BISP), public schools and community facilities can deliver maternal nutrition, antenatal and postnatal care, growth and developmental screening, disability referral, caregiver mental-health support and evidence-based parenting guidance. From age three, every child should receive quality early education, safe water and sanitation, nutrition support and protection from violence. Paid parental leave, workplace and community childcare, and deliberate engagement of fathers must redistribute the time required for nurturing care. A World Bank costing exercise offers a usable baseline. It estimated that universal, quality early-childhood education by 2035 would require increasing ECE's share of the education budget from 5.3 to 10.4 per cent, with the allocation rising from Rs. 71 billion in 2022 to Rs. 418 billion in 2035—an average annual increase of 14 per cent. These estimates require updating for inflation, population and provincial costs, but they replace rhetorical commitment with an auditable financing question. Parliament and provincial assemblies should require an annual Early Childhood Budget and Outcomes Statement as part of the reporting contemplated by Article 29(3) of the Constitution. This Statement should present district-level and income-disaggregated data on maternal nutrition, birth registration, immunisation, low birth weight, stunting, wasting, developmental screening and referral, early stimulation, pre-primary access and quality, caregiver wellbeing, water and sanitation, and the gender distribution of unpaid care. Expenditure must be reported in real per-child terms, not merely as nominal allocations. The same test should apply to every IMF-supported programme and domestic fiscal plan. A social-spending floor is inadequate if inflation, indirect taxation, energy costs or compressed provincial transfers reduce the food, time and services actually available to a child. Macroeconomic adjustment that improves a balance sheet while weakening early capabilities transfers today's liabilities into bodies and minds—and records the damage nowhere. The State cannot replace parental affection. It can ensure that affection is not required to perform miracles against hunger, disease, exhaustion and insecurity. The home is a child's first developmental institution, but it cannot be the only one. Human capital begins before school; equal citizenship begins before five. References Alam, Abdullah, Amer Hasan and Elizabeth Hentschel. 2024. 'Ensuring an Equal Start for All Pakistani Children: What Will It Cost?' World Bank Policy Research Working Paper 10763. Black, Maureen M., et al. 2017. 'Early Childhood Development Coming of Age: Science through the Life Course.' The Lancet 389(10064). Finance Division, Government of Pakistan. 2026. 'Education' and 'Health and Nutrition.' Pakistan Economic Survey 2025-26. Gertler, Paul, et al. 2014. 'Labor Market Returns to an Early Childhood Stimulation Intervention in Jamaica.' Science 344(6187). Iqbal, Ahsan, and Pernille Ironside. 2026. 'Human Capital Begins at Home.' The News, September 2. International Labour Organization. 2025. 'ILO Calls for Greater Recognition and Investment in Pakistan's Care Economy.' October 30. Ministry of National Health Services, Regulations and Coordination and UNICEF. 2019. 'National Nutrition Survey 2018.' National Assembly of Pakistan. 2025. 'Constitution of the Islamic Republic of Pakistan,' as amended up to November 21, 2025. Sen, Amartya. 1999. Development as Freedom. Oxford University Press. UN Committee on the Rights of the Child. 2006. 'General Comment No. 7: Implementing Child Rights in Early Childhood.' CRC/C/GC/7/Rev.1. WHO, UNICEF and World Bank Group. 2018. Nurturing Care for Early Childhood Development. Geneva: World Health Organization. World Bank. 2023. Pakistan Human Capital Review: Building Capabilities Throughout Life. Washington, DC. (To be continued) Dr. Ikramul Haq, Advocate Supreme Court, writer, literary critic, Adjunct Faculty at Lahore University of Management Sciences (LUMS), member Advisory Board and Visiting Senior Fellow of Pakistan Institute of Development Economics (PIDE), holds an LLD in tax laws. He was full-time journalist from 1979 to 1984 with Viewpoint and Dawn. He also served Civil Services of Pakistan from 1984 to 1996.