Review of implementation processes for integrated nutrition and psychosocial stimulation interventions

This article reviews the implementation processes for interventions that integrate nutrition and psychosocial stimulation for children under 5 years of age in low- and middle-income countries. We examine the content of these programs, the delivery strategy, intensity and duration, personnel training and supervision, compliance, and fidelity. A systematic search of the Global Health Ovid database yielded 1020 articles, of which 29 fit the criteria, and two further studies recently completed were reported by author communication. Some of these articles describe efficacy or effectiveness studies where nutritional supplements or education along with psychosocial stimulation experiences or education were delivered directly to children or their caregivers. Other papers describe large-scale programs, such as conditional cash transfers in Latin America, Integrated Child Development Services preschools in India, and World Bank collaborations with national governments in Africa. A summary table of the implementation processes of the 31 programs is included. We conclude with a set of recommendations summarizing what we know so far regarding best practices for integrative programs.