The Sustainable Development Goals (SDGs) provide a historic opportunity to implement at scale interventions to promote Early Childhood Development (ECD). While the evidence base for the importance of ECD has grown, the research is distributed across sectors, populations, and settings with diversity noted in the scope and focus. In this paper, we provide a comprehensive updated analyses of ECD interventions across five sectors: health; nutrition; education; child protection; and social protection. Our review concludes that to make interventions, successful, smarter and sustainable, they need to be implemented as multi-sectoral intervention packages anchored in "nurturing care". The recommendations emphasize that intervention packages should be applied at developmentally appropriate times during the life-course, target multiple risks, and build on existing delivery platforms for feasibility of scale-up. While interventions will continue to improve with the growth of developmental science, the evidence is now strong that parents, caregivers, and families need to be supported in providing nurturing care and protection for young children to achieve their developmental potential.
Studies from both high and low-middle income (LAMI) countries have documented how being reared in poverty is linked to compromised child development. Links between poverty and development are mediated by the timing and extent of exposure to both risk factors nested under poverty and to protective influences which can attenuate the impact of risk. While children from high-, middle-, and low-income countries are exposed to similar types of developmental risks, children from low- and middle-income countries are exposed to a greater number, more varied and more intense risks. Given these contextual differences, cumulative risk models may provide a better fit than mediated models for understanding the nature of pathways linking economic insufficiency and developmental inequality in low- and middle-income countries, and for designing interventions to promote development of children from these countries. New evidence from a large scale UNICEF data set illustrates the application of a cumulative risk/protective perspective in low- and middle-income countries.
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