Beyond the dyad: making Developmental Origins of Health and Disease (DOHaD) interventions more inclusive

Abstract

Pregnant women, children under 2 and the first thousand days of life have been principal targets for Developmental Origins of Health and Disease interventions. This paradigm has been criticized for laying responsibility for health outcomes on pregnant women and mothers and through the thousand days focus inadvertently deflecting attention from other windows for intervention. Drawing on insights from the South African context, this commentary argues for integrated and inclusive interventions that encompass broader social framings. First, future interventions should include a wider range of actors. Second, broader action frameworks should encompass life-course approaches that identify multiple windows of opportunity for intervention. Using two examples – the inclusion of men, and engagement with adolescents – this commentary offers strategies for producing more inclusive interventions by using a broader social framework.