Global Pathways to Thriving Children: Implementing Large-scale Multi-Component Nutrition and Child Development Programs

Thriving children are likely to develop the human capital necessary to become healthy, competent, and economically stable adults, beginning with achieving expected rates of growth and development as infants. However, millions of young children in low-and middle-income countries are not thriving, largely due to nutritional deficiencies and lack of learning opportunities, often caused by poverty. Although nutrition interventions can support children's growth and nutrition, and child development and parenting interventions can support children's learning and responsive caregiving, there are few large-scale, multi-component programs that can support both nutrition and child development. Informed by concepts of nurturing care and principles of implementation science, this paper provides rational and systems-based criteria for implementing large-scale, multi-component nutrition and child development programs for children in disadvantaged environmental conditions. The criteria include: 1) Goals. Set goals informed by theory and evidence-based interventions; 2) Equity. Reach vulnerable children. Implement developmentally and culturally appropriate program; 3) Quality. Establish workforce development. Support resources for delivery. Monitor for accountability; 4) Engagement. Engage participants, communities, and stakeholders in active roles; 5) Outcome: Implement rigorous and easy-to-use outcome assessments; and 6) Sustainability: Strive for sustained funding. Update policies, practices, and laws. The system is coordinated by a multi-component partner management team that operates in a continuous data-driven feedback loop, including government representatives and community participants. Building on the strengths of expertise in single sector nutrition and child development intervention research, the conclusion includes a call to action for the implementation of multi-component large-scale programs for young children. An increase in children thriving during early childhood increases their likelihood of achieving health and developmental potential that can lead to human capital with extensions to economic productivity, positive quality-of-life, and sustainability for children, families, and countries.