Peer-reviewed article
Inequalities in early childhood care and development in low/middle-income countries: 2010–2018
Chunling Lu, Jorge A. Cuartas, Günther Fink, Dana Charles McCoy, Kai Liu et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study analysed data from 135 surveys across low and middle-income countries between 2010 and 2018 to measure inequalities in early childhood development. The research found that 63% of children under 5 were not exposed to stunting or extreme poverty, 39% of 3-4-year-olds attended early care programmes, and 69% received adequate home stimulation. Large gaps existed between rich and poor households, urban and rural areas, and across regions, with Sub-Saharan Africa showing the lowest outcomes. Importantly, these gaps showed no significant reduction over time, suggesting persistent inequality.
Key points
- Sub-Saharan Africa had the lowest proportion of children not exposed to stunting or extreme poverty (45%) and receiving adequate home stimulation (47%)
- Only 39% of 3-4-year-olds attended early care and education programmes
- Substantial gaps existed across household wealth categories, residential areas, and country income groups
- Available data showed no significant reduction in inequality gaps over time for countries with two survey rounds
- Study calls for focus on poorest families and rural areas in poorest countries
Limitations
The study measures exposure to risks and attendance at programmes but does not explain the causes of persistent inequalities or test interventions to reduce them. The findings reflect what surveys measured between 2010-2018 and may not capture current situations or changes after this period.
Abstract
Background: Inequalities in early childhood development (ECD) tend to persist into adulthood and amplify across the life course. To date, little research on inequalities in early childhood care and development in low/middle-income countries has been available to guide governments, donors and civil society in identifying which young children and families should be targeted by policies and programmes to improve nurturing care that could prevent them from being left behind. Methods: Using data from 135 Demographic and Health Surveys and Multiple Indicator Cluster Surveys between 2010 and 2018, we assessed levels and trends of inequalities in exposure to risks of stunting or extreme poverty (under age 5; levels in 85 and trends in 40 countries), early attendance of early care and education programmes (36-59 months; 65 and 17 countries), home stimulation (36-59 months; 62 and 14 countries) and child development according to the Early Childhood Development Index (36-59 months; 60 and 13 countries). Inequalities within countries were measured as the absolute gap in three domains-child gender, household wealth and residential area-and compared across regions and country income groups. Results: 63% of children were not exposed to stunting or extreme poverty; 39% of 3-4-year olds attended early care and education; and 69% received a level of reported home stimulation defined as adequate. Sub-Saharan Africa had the lowest proportion of children not exposed to stunting or extreme poverty (45%), attending early care and education (24%) and receiving adequate home stimulation (47%). Substantial gaps in all indicators were found across country income groups, residential areas and household wealth categories. There were no significant reductions in gaps over time for a subset of countries with available data in two survey rounds. Conclusions: Available data indicate large inequalities in early experiences and outcomes. Efforts of reducing these inequalities must focus on the poorest families and those living in rural areas in the poorest countries. Improving and applying population-level measurements on ECD in more countries over time are important for ensuring equal opportunities for young children globally.