title: Leveraging paraprofessionals and family strengths to improve coverage and penetration of nutrition and early child development services.
abstract: Children need to be protected in intergenerational networks, with parents who have positive mood, resources to feed their children, and skills to promote early childhood development (ECD). Globally, more than 200 million children are raised annually without these resources. This article reviews the potential contributions of increasing coverage and penetration of services for these children, challenges to achieving penetration of services in high-risk families, opportunities created by bundling multiple services within one provider, potential leveraging of paraprofessionals to deliver care, and mobilizing communities to support children in households at high risk for negative outcomes. We end with a number of suggestions for how to ensure the equitable scale-up of integrated ECD and nutrition services that take into account current global priorities, as well as coverage and penetration of services.
authors.affiliation: Centre for Public Mental Health, Department of Psychology, Stellenbosch University, Stellenbosch, South Africa.
authors.forename: Mark
authors.initials: M
authors.lastname: Tomlinson
authors.affiliation: Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.
authors.forename: Atif
authors.initials: A
authors.lastname: Rahman
authors.affiliation: School of Public Health, University of the Western Cape, Cape Town, South Africa.
authors.forename: David
authors.initials: D
authors.lastname: Sanders
authors.affiliation: Department of Psychiatry and Behavioral Sciences and Duke Global Health Institute, Duke University, Durham, North Carolina.
authors.forename: Joanna
authors.initials: J
authors.lastname: Maselko
authors.affiliation: Global Center for Children and Families, University of California, Los Angeles, CA.
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Rotheram-Borus
mesh_terms: D002657:Child Development; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D019033:Delivery of Health Care, Integrated / Q000379:methods; D003863:Depression / Q000150:complications; D018479:Early Intervention, Educational / Q000379:methods*; D061345:Early Medical Intervention / Q000379:methods; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology; D012307:Risk Factors; D000078329:Workforce
keywords: coverage; early child development; family strengths; nutrition; penetration