Peer-reviewed article

Determinants of developmental outcomes for children under 3 years in a rural setting, Kenya

Beatrice Oyugi, Silas Onyango, Henry Athiany, Gideon Mutie Kikuvi · 21 May 2025

Abstract

Background: Most children from low- and middle-income countries (LMICs) are at risk of poor development. Poor developmental outcomes are associated with later poor schooling and labour outcomes. Previous literature has documented a range of factors that influence children's development. However, these factors are not well established in rural settings. Aim: The current study aims at assessing the determinants of developmental outcomes among children under 3 years. Setting: Siaya County, Kenya. Methods: A cross-sectional study of children under 3 years and their caregivers, attending Child Welfare Clinic (CWC) at tier 3 health facilities in a rural setting in Kenya, was conducted. A total of 149 children were randomly selected to participate in the study and had their development assessed using the third version of the Ages and Stages Questionnaire (ASQ-3). We assessed the association between ASQ-3 scores and environmental, cultural and individual-level factors in crude and adjusted linear regression models. Results: Being married and being employed showed the strongest positive associations with child development while earning less than $100.00 per month has a negative association with children's development for individual-level factors. In addition, exposing children to opportunities for early learning had a greater effect on the child's outcomes. Also, responsive caregiving showed higher scores for children's developmental outcomes. Conclusion: The study suggests a positive association between child development outcomes and caregivers' socio-demographic characteristics. There is also an association between responsive caregiver-child interactions and child development outcomes. Programmes that create an enabling environment for caregivers to provide a stimulating environment for their children may help children to thrive, improving their development outcomes. Contribution: This study contributes to the body of knowledge on the important roles of caregivers in enhancing their children's optimal development.