We review the development of the Jamaican home visiting intervention for children under 4 years and its evidence base. The intervention has focused on supporting mothers to promote the development of their children through interacting in a responsive way, labelling the environment and activities. The curriculum is structured and cognitively orientated. It has been used in 13 studies in 4 countries, 7 in Jamaica, 6 in Bangladesh, one each in Colombia and Peru. In all studies some benefit to children’s cognitive and language development has been found. Different types of children from severely malnourished to children living in poverty have benefited. Three long term follow ups have found sustained benefits to cognition; the longest study went to 22 years and found comprehensive benefits, to behaviour, school attainment and achievement, IQ, depression and wages. The curriculum is currently being used in 8 different countries and different delivery strategies are being evaluated including mother and child groups with meetings of different frequencies. A web package, Reach Up, to facilitate training with manuals and demonstration videos has been developed. Some unanswered questions include, what is the most effective age and duration for the intervention to have sustained benefits? Research is needed to find cost-effective implementation models and how to monitor and maintain intervention quality when going to scale.

Key Take Away Points

1. The Jamaican home visiting intervention has benefited children’s development in 13 studies, and had comprehensive benefits to IQ, education and wages in one follow up at 22 years of age.

2. The intervention is currently being used in 8 countries and a web package, Reach Up, has been developed to assist organizations in implementing the intervention.

3. The key questions are when is the appropriate age to begin, how long is needed to attain sustainability and what are the most effective implementation models for going to scale?

Author Biography

Prof. Sally Grantham-McGregor, graduated in medicine from Imperial College London , then worked at the University of West Indies for over 30 years where she began a research group studying the effect of nutrition and socio-economic disadvantage on mental development in children and designed interventions to improve their development. She joined the Institute for Global Health at the University College London in 1995, where she is presently Emerita Professor of International Child Health. She has continued working on the issue in Bangladesh, India, Peru, Colombia, and Jamaica. She was the chair of the Steering committee for the first Lancet series on Child Development in Developing Countries, and was a co-author in the two subsequent ones and the series on nutrition and . She was a founding member of the Global Child Development Group, Chairman of the Subcommittee of the International Union of Nutritional Sciences on Nutrition and Mental Development, Board member of the Early Childhood Program of Open Society Foundation and a member of the Advisory Panel on Early Childhood and Readiness to Learn for the Inter-American Development Bank. She has published extensively in peer reviewed journals on the development of disadvantaged children in low and middle income countries. Dr. Joanne Smith is a Lecturer in Child Development at the Caribbean Institute for Health Research of the University of the West Indies, Mona, Jamaica. She began her research career focusing on the influence of energy metabolism on changes in body composition. She graduated with a PhD in Nutrition in 2014 from the University of the West Indies. Currently she is project coordinator for the Reach Up: An early childhood parenting program, where she assists in the training and implementation of the projects in the various user countries.


Footnote: The Caribbean Institute for Health Research, The University of the West Indies, Mona, Jamaica or email: info@reachupandlearn.com