Operationalising nurturing care to optimise early childhood development and human capital

by Kelly Gemmel


If children are unable to fulfil their social and developmental potential, this not only harms their futures, but also the societies in which they live.”

(Advancing Early Childhood Development: from Science to Scale, The Lancet, 2016)



As Dr Black and colleagues state within their recent publication “The principles of Nurturing Care promote human capital and mitigate adversities from preconception through adolescence”, the attainment of the Sustainable Development Goals (SDGs) depends on human capital development in current and future generations, to improve health, well-being and productivity. Human capital accrues over the life course, beginning prior to conception and extending throughout childhood, adolescence, and beyond.


The importance of nurturing care for optimal early childhood development is well documented. Early childhood is a critical time and the most formative experiences of young children come from nurturing care received from parents, other family members, caregivers, and community-based services. The foundations of nurturing care include a stable environment that promotes children’s health and nutrition, protects children from threats, and gives them opportunities for early learning, through affectionate interactions and relationships. Benefits of such care are life-long, and include improved health, wellbeing, and ability to learn and earn.


Prof Mark Tomlinson, co-director of the Institute for Life Course Health Research, has been instrumental in contributing to the global conversation around the need and importance of nurturing care for optimal early childhood development and human capital. During the course of 2019 and 2020, Prof Tomlinson and other members of the Institute for Life Course Health Research team, Kelly Gemmell and Dr Christina Laurenzi, worked closely with the World Health Organization (WHO) and other partners, to author the first version of the Nurturing Care Handbook. The handbook followed on from the Nurturing Care Framework published in 2018, and is the result of collaboration, consultation and reflection with contributions from more than 60 experts in the fields of child development, public health, education, nutrition, psychology, social protection, disability, health systems planning, policy and financing. An initial, informal consultation with global experts was held at the WHO offices, Geneva in January 2019, and followed by an innovation survey, which sought to highlight the global interventions occurring to optimise early childhood development. More than 80 experts were then convened to discuss the issues at a two-day meeting in Geneva, in June 2019. Members of the Nurturing care advocacy, implementation, and monitoring and evaluation working groups were then consulted and as the handbook evolved experts were asked to contribute content in their specialist areas.


By design, the handbook is a living document with guidance and resources that will be regularly updated as more experiences are gained in the field of nurturing care. The handbook is relevant for anyone who wants to take action to help children survive and thrive. The users of the handbook can include: policy-makers and legislators, programme managers and technical staff, practitioners in health and education, responsible for child protection and welfare; funders and development partners, including the private sector, and nurturing care advocates and champions. The handbook consists of 6 downloadable, self-standing documents that kicks off with the “Start Here” guide. It provides orientation to the handbook and an overview of how the handbook works, what nurturing care is, and how to get started. The further 5 guides correspond and provide more detail about the strategic actions needed to implement nurturing care within the user’s particular setting and can be read in any order.


As the development of the handbook is fundamentally consultative, the writing team encourage readers to submit their comments and reflections on the handbook to NurturingCare@who.int. A revised version of the handbook will be released in the second half of 2021.