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.

Keywords: behavior change; care; child nutrition; early child development; integrated interventions.

FIGURE 1

Benefit-cost ratios for integrated programs to improve child development outcomes. The benefit-cost ratios are calculated by dividing the total discounted present value of the benefits of a program over the life course of an individual by the total discounted costs over the total duration of the program. Both are expressed in monetary terms.