ECD programmes can take many forms, including promotion of good
health and nutrition, support for safe and stimulating environments, protection from risks such as violence or abandonment, parenting support and early learning experiences, media, preschools and community groups.4 Poverty is the key underlying
cause of
poor child development; children living in poverty are exposed to many negative influences, including
poor physical environments, inadequate nutrition, parental stress and insufficient cognitive stimulation.5 Undernutrition can influence
brain development directly by affecting
brain structure and function, or indirectly via
poor physical or motor development, in addition to other pathways.6 — 8 Exposure to multiple co-occurring risks most likely contributes to greater disparities in developmental trajectories among children with differential exposure.9 — 12 This paper focuses on associations between specific aspects of children's physical environments — access to improved water and sanitation (W&S)-- and childhood development as measured by performance on a test of receptive language.