title: Early Child Development and Nutrition: A Review of the Benefits and Challenges of Implementing Integrated Interventions.
abstract: Poor nutrition (substandard diet quantity and/or quality resulting in under- or overnutrition) and the lack of early learning opportunities contribute to the loss of developmental potential and life-long health and economic disparities among millions of children aged <5 y. Single-sector interventions representing either early child development (ECD) or nutrition have been linked to positive child development and/or nutritional status, and recommendations currently advocate for the development and testing of integrated interventions. We reviewed the theoretical and practical benefits and challenges of implementing integrated nutrition and ECD interventions along with the evidence for best practice and benefit-cost and concluded that the strong theoretical rationale for integration is more nuanced than the questions that the published empirical evidence have addressed. For example, further research is needed to 1) answer questions related to how integrated messaging influences caregiver characteristics such as well-being, knowledge, and behavior and how these influence early child nutrition and development outcomes; 2) understand population and nutritional contexts in which integrated interventions are beneficial; and 3) explore how varying implementation processes influence the efficacy, uptake, and cost-benefit of integrated nutrition and ECD interventions.
authors.affiliation: Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; khurley2@jhu.edu.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Hurley
authors.affiliation: Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan; and.
authors.forename: Aisha K
authors.initials: AK
authors.lastname: Yousafzai
authors.affiliation: Social Protection and Health Division, Inter-American Development Bank, Washington, DC.
authors.forename: Florencia
authors.initials: F
authors.lastname: Lopez-Boo
mesh_terms: D002657:Child Development; D015362:Child Nutrition Disorders / Q000150:complications / Q000178:diet therapy / Q000191:economics / Q000517:prevention & control*; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000191:economics; D003226:Congresses as Topic; D003362:Cost-Benefit Analysis; D019033:Delivery of Health Care, Integrated / Q000191:economics / Q000379:methods*; D003906:Developing Countries; D002658:Developmental Disabilities / Q000150:complications / Q000191:economics / Q000517:prevention & control* / Q000628:therapy; D019317:Evidence-Based Medicine; D005192:Family Health; D006694:Holistic Health; D006801:Humans; D007223:Infant; D007859:Learning Disabilities / Q000150:complications / Q000191:economics / Q000517:prevention & control / Q000628:therapy
keywords: behavior change; care; child nutrition; early child development; integrated interventions