Peer-reviewed article
Exploring the Associations between Early Childhood Development Outcomes and Ecological Country-Level Factors across Low- and Middle-Income Countries
Kasim Allel, Gerard Joseph Abou Jaoude, Stavros Poupakis, Neha Batura, Jolene Skordis et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study analysed data from 68 low- and middle-income countries to identify which country-level factors are associated with better early childhood development outcomes in children aged 3-5. The researchers found that higher income status, attendance at early childhood education programmes, and having books at home were linked to better development, while low birthweight, high child and maternal mortality rates were associated with poorer outcomes. The findings suggest that investment in early-year interventions and nurturing care is important for improving child development in low- and middle-income countries.
Key points
- Upper-middle-income country status is positively associated with higher Early Childhood Development Index scores
- Attendance at early childhood education programmes is positively associated with better development outcomes
- Availability of books at home is positively associated with higher ECDI
- Low birthweight prevalence and high under-5 and maternal mortality are negatively associated with ECDI
- Low stimulation at home and lack of mandatory ECE programmes increase risk of poorer ECDI in LMICs
Limitations
This is a cross-national ecological study based on aggregate country-level data, so it cannot determine causal relationships or account for within-country variation and individual-level factors affecting early childhood development. The findings are associations between countries rather than evidence of what interventions work for individual children.
Abstract
A poor start in life shapes children's development over the life-course. Children from low- and middle-income countries (LMICs) are exposed to low levels of early stimulation, greater socioeconomic deprivation and persistent environmental and health challenges. Nevertheless, little is known about country-specific factors affecting early childhood development (ECD) in LMICs. Using data from 68 LMICs collected as part of the Multiple Indicator Cluster Surveys between 2010 and 2018, along with other publicly available data sources, we employed a multivariate linear regression analysis at a national level to assess the association between the average Early Childhood Development Index (ECDI) in children aged 3-5 and country-level ecological characteristics: early learning and nurturing care and socioeconomic and health indicators. Our results show that upper-middle-income country status, attendance at early childhood education (ECE) programs and the availability of books at home are positively associated with a higher ECDI. Conversely, the prevalence of low birthweight and high under-5 and maternal mortality are negatively associated with ECDI nationally. On average, LMICs with inadequate stimulation at home, higher mortality rates and without mandatory ECE programs are at greater risks of poorer ECDI. Investment in early-year interventions to improve nurturing care and ECD outcomes is essential for achieving Sustainable Development Goals.