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Lancet. 2017 Jan 7;389(10064):91-102. doi: 10.1016/S0140-6736(16)31390-3. Epub 2016 Oct 4.

Nurturing care: promoting early childhood development.

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UNICEF, 3 UN Plaza, New York, NY, USA. Electronic address:
Fraser Mustard Institute for Human Development, University of Toronto, ON, Canada; Departments of Physiology, Obstetrics and Gynecology, and Medicine, University of Toronto, ON, Canada.
Fraser Mustard Institute for Human Development, University of Toronto, ON, Canada.
Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA.
Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada.
Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, CT, USA.
Faculty of Education, The University of Hong Kong, Hong Kong.
Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
School of Public Health, University of California Berkeley, Berkeley, CA, USA.
Department of Psychiatry and Behavioural Neurosciences, and Department of Pediatrics, Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada.
Institute of Developmental Sciences and NIHR Biomedical Research Centre, University of Southampton and University Hospital Southampton, UK.
Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA.
Teachers College, Columbia University, New York, NY, USA.
New York University Steinhardt, New York, NY, USA.
Department of Biology, University of Missouri, St Louis, MO, USA.
Yale Child Study Centre, Yale School of Medicine, Yale University, CT, USA.
Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan; Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada.


The UN Sustainable Development Goals provide a historic opportunity to implement interventions, at scale, to promote early childhood development. Although the evidence base for the importance of early childhood development has grown, the research is distributed across sectors, populations, and settings, with diversity noted in both scope and focus. We provide a comprehensive updated analysis of early childhood development interventions across the five sectors of health, nutrition, education, child protection, and social protection. Our review concludes that to make interventions successful, smart, and sustainable, they need to be implemented as multi-sectoral intervention packages anchored in nurturing care. The recommendations emphasise 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 now strongly suggests that parents, caregivers, and families need to be supported in providing nurturing care and protection in order for young children to achieve their developmental potential.

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