Mapping the landscape of early childhood development services: a global scoping review.

Abstract

Early childhood development (ECD) services are essential for supporting children's health, functioning and developmental potential, yet their components and delivery models remain highly diverse across settings. This scoping review aimed to map the global evidence on ECD services for children under 5 years of age, including healthy children, those at risk of developmental difficulties and children with established disorders, to inform policy and programme design. Scoping review conducted in accordance with Arksey and O'Malley's framework and its subsequent methodological refinements. PubMed/MEDLINE, Scopus, ScienceDirect, Web of Science, Scientific Information Database, Magiran, IranMedex and the Barakat Knowledge Network System were searched. Grey literature was retrieved from OpenGrey, the WHO website and Google Scholar. Clinical trial registries, including ClinicalTrials.gov, the International Standard Randomised Controlled Trial Number registry, the WHO International Clinical Trials Registry Platform and the UK Clinical Research Network Study Portfolio, were also searched. The final search was conducted on 31 December 2024, as specified in the published protocol; this was subsequently updated to 31 December 2025 prior to finalisation of this review. No restrictions were applied regarding time or language. Studies of any design addressing ECD services for children under 5 years across health and non-health sectors were included. No restrictions were applied regarding time or language. Of 10 598 records identified, 5627 were screened after duplicate removal, and 386 full-text articles were assessed for eligibility. Data were extracted independently by two reviewers using a standardised form and synthesised descriptively. Findings were organised into service components, delivery models, barriers, facilitators and recommendations. No formal quality appraisal was undertaken, consistent with scoping review methodology. A total of 271 studies were included. Most evidence originated from high-income countries, with sparse representation from low-income settings. Hybrid delivery approaches were most common, and interventions were typically multicomponent and delivered by multidisciplinary teams involving health professionals and community health workers. 10 core service components were identified, with family-centred and integrated approaches prominent across populations. Eight thematic categories of barriers and facilitators emerged, spanning workforce, organisational processes, infrastructure, policy and cultural factors. Across this heterogeneous evidence base, interventions were frequently reported to be associated with improvements in child developmental outcomes, caregiver well-being and knowledge, provider competencies and intersectoral coordination; however, these findings are descriptive and should not be interpreted as causal. ECD services are delivered through diverse but increasingly integrated models. Strengthening workforce capacity, contextual adaptation, and policy support is essential to enhance equitable implementation and scale-up, particularly in low-resource settings. The descriptive nature of this scoping review precludes direct comparisons or causal inferences. The mapped evidence provides a foundational resource for policymakers and programme planners to identify service gaps, prioritise context-specific adaptations, and guide the design of comprehensive ECD service packages.