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J Glob Health. 2017 Jun;7(1):011002. doi: 10.7189/jogh.07.011002.

Prioritizing research for integrated implementation of early childhood development and maternal, newborn, child and adolescent health and nutrition platforms.

Author information

Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada.
International Food Policy Research Institute, Washington, DC, USA.
National Academies of Sciences, Engineering, and Medicine, Washington, DC, USA.
Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.
Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan.
Maternal and Child Survival Program; Save the Children, Washington, DC, USA.
International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.
School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
Centro de Investigación para el Desarrollo Integral y Sostenible, Centro de Investigación en Salud Materna e Infantil, and School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
Fraser Mustard Institute for Human Development, University of Toronto, Toronto, Ontario, Canada.
Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA.
Aga Khan University (South-Central Asia, East Africa, UK), Nairobi, Kenya.
World Renew, Burlington, Ontario, Canada.
The Sackler Institute for Nutrition Science at the New York Academy of Sciences, New York, New York, USA.
Institute Of Psychology, Health And Society, University of Liverpool, Liverpool, UK.
Grand Challenges Canada, Toronto, Ontario, Canada.
Sinai Health System; Lunenfeld Tanenbaum Research Institute; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA.
Patan Academy of Health Sciences, Patan, Nepal.



Existing health and nutrition services present potential platforms for scaling up delivery of early childhood development (ECD) interventions within sensitive windows across the life course, especially in the first 1000 days from conception to age 2 years. However, there is insufficient knowledge on how to optimize implementation for such strategies in an integrated manner. In light of this knowledge gap, we aimed to systematically identify a set of integrated implementation research priorities for health, nutrition and early child development within the 2015 to 2030 timeframe of the Sustainable Development Goals (SDGs).


We applied the Child Health and Nutrition Research Initiative method, and consulted a diverse group of global health experts to develop and score 57 research questions against five criteria: answerability, effectiveness, deliverability, impact, and effect on equity. These questions were ranked using a research priority score, and the average expert agreement score was calculated for each question.


The research priority scores ranged from 61.01 to 93.52, with a median of 82.87. The average expert agreement scores ranged from 0.50 to 0.90, with a median of 0.75. The top-ranked research question were: i) "How can interventions and packages to reduce neonatal mortality be expanded to include ECD and stimulation interventions?"; ii) "How does the integration of ECD and MNCAH&N interventions affect human resource requirements and capacity development in resource-poor settings?"; and iii) "How can integrated interventions be tailored to vulnerable refugee and migrant populations to protect against poor ECD and MNCAH&N outcomes?". Most highly-ranked research priorities varied across the life course and highlighted key aspects of scaling up coverage of integrated interventions in resource-limited settings, including: workforce and capacity development, cost-effectiveness and strategies to reduce financial barriers, and quality assessment of programs.


Investing in ECD is critical to achieving several of the SDGs, including SDG 2 on ending all forms of malnutrition, SDG 3 on ensuring health and well-being for all, and SDG 4 on ensuring inclusive and equitable quality education and promotion of life-long learning opportunities for all. The generated research agenda is expected to drive action and investment on priority approaches to integrating ECD interventions within existing health and nutrition services.

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