CORRESPONDENCE to: Black, M. M., & Richter, L. M. (2022). "Different is not deficient: respecting diversity in early childhood development." The Lancet Child & Adolescent Health, 6(12), e26. ; https://doi.org/10.1016/S2352-4642(22)00276-0
An estimated 250 million children under 5 years in low-income and middle-income countries (LMICs) are considered to be at risk of not achieving their full developmental potential because of inadequate care. 1 This assessment was crucial for establishing the Nurturing Care Framework, a roadmap for improving early childhood development globally. Although the number is still based on proxy measures (stunting and poverty rates), newer research draws directly on indicators of nurturing care, provided by UNICEF's Multiple Indicator Cluster Surveys. On the basis of these data, in The Lancet Child & Adolescent Health Dana McCoy and colleagues 2 claimed that the problem is even bigger: they calculated that 74·6% of children in LMICs aged 3–4 years do not even receive minimally adequate nurturing care. This figure increases to 92·1% for sub-Saharan Africa and to 99·5% in Chad. 2