Peer-reviewed article
Malnutrition matters: Association of stunting and underweight with early childhood development indicators in Nepal
Manisha L. Shrestha, Kelly E. Perry, Basant Thapa, Ramesh P. Adhikari, Amy Weissman ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study used Nepal's 2019 national household survey (MICS) to look at how stunting, wasting and underweight relate to early childhood development in 2,871 children aged 36–59 months. About 35% of the children were not developmentally on track. Stunting and underweight were associated with the overall development index and with the literacy-numeracy, physical and learning domains. Wasting showed no association with any development indicator. The authors suggest adding responsive and stimulating caregiving to nutrition programmes for stunted and underweight children.
Key points
- 35% of children aged 36–59 months were not developmentally on track for the ECD index.
- Stunting was associated with the overall ECD index and with the literacy-numeracy, physical and learning domains.
- Underweight was associated with the overall ECD index, mainly in the literacy-numeracy, physical and learning domains.
- No association was observed between wasting and ECD indicators.
- The authors recommend adding ECD interventions such as responsive and stimulating caregiving to nutrition programmes.
Limitations
This is an analysis of one national survey, so it shows associations and cannot prove that malnutrition causes poorer development. The abstract describes the direction of the odds ratios as 'lower odds of not being developmentally on track', which is hard to reconcile with its conclusion that malnutrition harms development, so the full paper is needed to confirm the direction. The abstract also gives no effect sizes and does not report results for the social-emotional domain.
Abstract
AbstractMalnutrition is a threat to optimal child development, with its occurrence during foetal and infancy stages associated with poor cognitive, motor and socio‐emotional skills. However, information on the effects of various types of malnutrition on early childhood development (ECD) is limited in Nepal. To assess the association of stunting, wasting and underweight (three prominent forms of malnutrition) with the four domains of the ECD index (literacy‐numeracy, physical, social‐emotional and learning development) among children 36–59 months of age, we conducted an adjusted logistic regression using Nepal's national household Multiple Indicator Cluster Survey (MICS) 2019 data set. The study sample consisted of children aged 36–59 months (n = 2871). Children were considered developmentally on track if they met criteria in each of the four ECD domains. Regarding ECD status of children 36–59 months old, 35% of children were not developmentally on track for the ECD index. The adjusted odds ratio indicated that stunting was associated with lower odds of not being developmentally on track according to the ECD index as well as the literacy‐numeracy, physical and learning domains of the ECD index. Likewise, underweight was associated with lower odds of not being developmentally on track according to the ECD index, primarily for ECD domains of literacy‐numeracy, physical and learning. Notably, no association between wasting and ECD indicators was observed. Children's nutrition status impacts child development outcomes. Adding ECD interventions, such as responsive and stimulating caregiving, within nutrition programmes among children who are stunted and underweight could improve child development outcomes.