Give every child the best start in life

The PHA is committed to both innovation in, and implementation of, work that helps children and young people secure the best start in life. In particular, the PHA will progress evidence-based work that supports early childhood development. In doing so, the PHA plans to secure improved outcomes for children and families, and the prevention of early onset of poor health and wellbeing.

This approach is informed by the increase in scientific, neurological and economic knowledge that suggests the creation of appropriate conditions for early childhood development is likely to be more effective and less costly than addressing problems at a later age.  

The early years have recently been called the ‘foundation years’ because they create the foundations on which the rest of life is built. We imagine that others have had the same life experiences as us, but too many children are born into circumstances that make it harder for them to thrive.

Some of the circumstances that can create difficult or adverse conditions for a developing child include:

  • mental health problems in one or both parents;
  • alcohol or drug misuse;
  • domestic violence;
  • emotional, physical or sexual abuse;
  • a cold, damp, overcrowded home or a neglected neighbourhood where antisocial behaviour and criminality are commonplace. 

Brain development

A child’s brain develops rapidly during pregnancy, is 80% formed by three years of age and almost completely formed by the time a child is primary school age. Poor experiences can impair brain development and can have long-term detrimental effects on the growing brain.

Children who have highly adverse experiences in early childhood – with the potential for impaired brain development – are more likely to be involved as teenagers and adults in risky sexual behaviour, alcohol and drug misuse, and antisocial behaviour. They are also three times more likely to be depressed.

Health sense

In adulthood, those problems are harder to treat and are more resistant to change. Economists, including Nobel prize-winner James Heckman, have demonstrated that investment in pregnancy and the first years of life makes sense economically and in terms of health, as modest investment in those years brings a 9–10 fold return on every £1 invested.

The return comes through a more educated, skilled and motivated adult workforce, and through avoiding the costs associated with criminal behaviour, unemployment, alcohol and drug misuse, child abuse and a range of other poor health and social outcomes.

New approach needed

Northern Ireland is facing unprecedented financial challenges. Less of the same will not help us move up the league tables in any number of quality of life indicators. The international evidence from economists, psychologists, child development specialists and others suggests that we should prioritise investment in services that provide intensive support during pregnancy and the first five years of life.

We agree that investment in early years brings significant benefits later in life across areas such as health and wellbeing, education, employment, and reduced violence and crime. We are committed to pursuing strongly evidenced programmes to build resilience and promote health and wellbeing.

The PHA has introduced two programmes in particular to Northern Ireland – Family Nurse Partnership (FNP) and Roots of Empathy. It is our belief that if resources can be secured to implement these programmes across Northern Ireland, and as a minimum to 40% of our children, that strong and measurable improvements can be achieved. 

The Scandinavian countries – Sweden, Norway, Denmark and Finland – have long been the envy of other developed countries in terms of their performance on a range of indicators. We can achieve the same at modest cost and with huge benefits economically and socially. It’s time for a new approach.


RISE NI a multi-professional early intervention team available in each Trust area have developed a comprehensive online resource for teachers to address a range of needs that are impacting on a child’s ability to develop, learn and achieve. These teams work directly in the school environment delivering universal training, targeted support, and specialist intervention to address barriers to learning supporting children and young people, educational staff and the child’s parents/carers.