Investing in early child development: an imperative for sustainable development.

Patrice Lee Engle

The 18-month well-baby visit: A commentary

Early childhood development includes several aspects such as physical, motor, language, social and cognitive. Cognitive factors are important role because most learning activities are always related to thinking and remembering problems. Besides language development is very important, it is because language is a communication tool of children with their environment, with good communication it will result in good interactions. Therefore, children need to be given the right stimulus so that during the child's growth and development to the maximum. One stimulus that can be given for cognitive development and language of early childhood is by providing an interesting medium, because in the development of early childhood the way of thinking requires visualization of abstract thinking. The purpose of this research is to design an application of learning English for mobile-based early childhood which is expected to be used as an \alternative as a medium to assist cognitive development and communication of early childhood. English based learning applications for mobile children are made with Construct 2 software. The development method uses the Multimedia Development Life Cycle. While testing the application using ISO 9126, the results of testing the quality of the application using ISO 9126 which includes the Functionality and Usability characteristics obtained Functionality test results obtained value of 100%, and the Usability test results obtained value of 91.11% so it can be concluded that the design of English learning applications is appropriate to be used as a medium to assist cognitive development and communication of early childhood.

Objective: To investigate the factors related to child care environment and the association between child care environment and children's early development. Methods: Using stratified cluster random sampling, a total of 22 509 children newly enrolled to kindergarten from 187 kindergartens of 16 districts in Shanghai in 2017 were enrolled. A survey was conducted by parent-reported questionnaire. The index of child care environment (ICCE) and the early human capacity index were used to evaluate family child care environment and children's early development respectively. The sample was divided into four groups based on the ICCE score: the lowest family childcare environment (ICCE≤10 scores), lower middle (ICCE=11 scores), upper middle (ICCE=12 scores), and the highest (ICCE=13 scores). The linear regression model and Logistic regression model were used to analyze the factors related to child care environment and the association between child care environment and children's early development respectively. Results: A total of 22 067 children aged (44±7) months, including 11 425 boys (51.8%) and 10 642 girls (48.2%), participated in this study. The multnomial linear regression revealed girls, higher maternal education, higher household annual income, single-child, non-divorced parents, and early breastfeeding experience were protective factors of child care environment for children newly enrolled to kindergarten (β=0.064, 0.238, 0.119, 0.096, 0.113, and 0.032; 95% confidence interval (CI): 0.020-0.108, 0.175-0.302, 0.058-0.180, 0.046-0.146, -0.012-0.242, and -0.051-0.116; all P<0.01). The multinomial Logistic regression revealed compared with the highest child care environment group, the odds ratio of children's early development risks in upper midclle, lower middle, and the lowest child care environment groups were 1.543 (95%CI: 1.373-1.735, P<0.01), 2.537 (95%CI: 2.254-2.856, P<0.01), and 4.198 (95%CI: 3.757-4.690, P<0.01), respectively. Conclusions: The child care environment is not only significantly related to family structure and socioeconomic status, but also to early breastfeeding experience. The child care environment plays an important role in promoting childhood early development.

Sleeping position and health status of children at six-, eighteen- and thirty-six-month development

Child development in low and middle income countries (LMIC) is compromised by multiple risk factors. Reducing children’s exposure to harmful events is essential for early childhood development (ECD). In particular, preventing violence against children – a highly prevalent risk factor that negatively affects optimal child development – should be an intervention priority. We used the Child Health and Nutrition Initiative (CHNRI) method for the setting of research priorities in integrated Early Childhood Development and violence prevention programs (ECD+). An expert group was identified and invited to systematically list and score research questions. A total of 186 stakeholders were asked to contribute five research questions each, and contributions were received from 81 respondents. These were subsequently evaluated using a set of five criteria: answerability; effectiveness; feasibility and/or affordability; applicability and impact; and equity. Of the 400 questions generated, a composite group of 50 were scored by 55 respondents. The highest scoring research questions related to the training of Community Health Workers (CHW’s) to deliver ECD+ interventions effectively and whether ECD+ interventions could be integrated within existing delivery platforms such as HIV, nutrition or mental health platforms. The priority research questions can direct new research initiatives, mainly in focusing on the effectiveness of an ECD+ approach, as well as on service delivery questions. To the best of our knowledge, this is the first systematic exercise of its kind in the field of ECD+. The findings from this research priority setting exercise can help guide donors and other development actors towards funding priorities for important future research related to ECD and violence prevention.

Limited evidence is available on mechanisms linking integrated, multisector interventions with early childhood development. The Integrated Early Childhood Development program aims to improve children's development by promoting targeted caregiving behaviors beginning prenatally through age 5 years, in partnership with the Royal Government of Cambodia. This cluster stepped-wedge trial is being conducted in Cambodia among 3 cohorts, encompassing 339 villages and 1790 caregivers who are pregnant or caring for a child aged <5 years. The 12- to 15-month intervention is delivered to each cohort using a staggered stepped-wedge design. Among all cohorts, enrollment evaluations will be followed by 3 data collection waves. Targeted caregiving interventions are provided through community, group, and home-visiting platforms. Child development is measured using the Caregiver Reported Early Development Instrument and the Early Childhood Development Index 2030. The evaluation assesses mediation through targeted caregiving behaviors: responsive caregiving, nutrition, health and hygiene, and household stability and support; moderation by household wealth, caregiver education, and child birth weight; and sustainability after the intervention concludes. This protocol article describes the plans for a cluster randomized controlled trial to measure the impact of an integrated, multisector intervention on children's development. By partnering with the Royal Government of Cambodia and addressing intervention pathways and moderators, this trial will provide guidance for policies and programs to promote early childhood development using principles of implementation science and equity, including increased investment for vulnerable families.

This study was to describe and quantify the relationships among family poverty, parents' caregiving practices, access to education and the development of children living in low- and middle-income countries (LAMIC). We conducted a secondary analysis of data collected in UNICEF's Multiple Indicator Cluster Surveys (MICS). Early childhood development was assessed in four domains: language-cognitive, physical, socio-emotional and approaches to learning. Countries were classified into three groups on the basis of the Human Development Index (HDI). Overall, data from 97 731 children aged 36 to 59 months from 35 LAMIC were included in the after analyses. The mean child development scale score was 4.93 out of a maximum score of 10 (95%CI 4.90 to 4.97) in low-HDI countries and 7.08 (95%CI 7.05 to 7.12) in high-HDI countries. Family poverty was associated with lower child development scores in all countries. The total indirect effect of family poverty on child development score via attending early childhood education, care for the child at home and use of harsh punishments at home was -0.13 SD (77.8% of the total effect) in low-HDI countries, -0.09 SD (23.8% of the total effect) in medium-HDI countries and -0.02 SD (6.9% of the total effect) in high-HDI countries. Children in the most disadvantaged position in their societies and children living in low-HDI countries are at the greatest risk of failing to reach their developmental potential. Optimizing care for child development at home is essential to reduce the adverse effects of poverty on children's early development and subsequent life.

Young children tend to spend most of their time at home—or nearby—actively engaged with the people and objects present in the home setting. Indeed, the properties of a child's home place penetrate every aspect of a child's development, from motivations and attitudes to health and competence. This chapter presents a rationale for looking at the conditions of the physical home environment and how those conditions are implicated in children's health, competence, and adaptive functioning. It focuses on four domains of the overall physical home environment: quality of housing, household electronic assets, household amenities, and learning materials, and how each domain may help determine children's development. The chapter establishes children's home environments in low and middle income countries (LMIC) using girls and boys in 51 LMIC in relation to specific domains of early childhood development. It explores the overall quality of the physical home environment across child gender and LMIC at different levels of national development.

Women well-being has number of socioeconomic and developmental implications. Early child development is directly linked with well-being of mothers and educated women demand lower children. However, the existing literature hardly focused this area, therefore, the current study has investigated the impact of women wellbeing on fertility and early child development. For this purpose, this study constructed women well-being index to measure the well-being of the women by using four dimensions, economic well-being of women, social well-being of women, political awareness of women and satisfaction of women in different aspects of life. Moreover, early child development index has considered as proxy for child development which covers four dimensions of early child development, literacy-numeracy of children, physical growth of children, learning of children and socio-emotional development of children. In this connection, the data was collected from thirty-six districts across the Punjab province, Pakistan. By applying descriptive and regression analysis, the study found that women well-being has positive association with all domains of early child development. However, women well-being and its dimensions have negative relationship with fertility. Therefore, improvement in well-being of women may a suitable strategy especially for developing economies to enhance early child development and to reduce demand of children.

A variety of theories of skill formation suggest that investments in schooling and other dimensions of human capital will have lower returns if children do not have adequate levels of cognitive and social skills at an early age. This paper analyzes the impact of a randomized cash transferprogram on cognitive development in early childhood in rural Nicaragua. It shows that the program had significant effects on cognitive outcomes, especially language. Impacts are larger for older pre-school age children, who are also more likely to be delayed. The program increased intake of nutrient-rich foods, early stimulation, and use of preventive health care-all of which have been identified as risk factors for development in early childhood. Households increased expenditures on these inputs more than can be accounted for by the increases in cash income only, suggesting that the program changed parents' behavior. The findings suggest that gains in early childhood development outcomes should be taken into account when assessing the benefits of cash transfer programs in developing countries. More broadly, the paper illustrates that gains in early childhood development can result from interventions that facilitate investments made by parents to reduce risk factors for cognitive development.

Setting the record straight on measuring SDG 4.2.1

BackgroundMaternal mental health is linked to early childhood development; yet there is a gap in evidence-based interventions for low-resource settings. This study estimates the impact of ‘Integrated Mothers and Babies Course and Early Childhood Development’ (iMBC/ECD), a cognitive-behavioral, group-based intervention, on maternal depression and early childhood social-emotional development in Siaya County, Kenya. MethodsThis quasi-experimental study enrolled 417 pregnant women and mothers of children under age 2 across two sub-counties in Siaya County. The intervention area had 193 women in 23 groups implementing iMBC/ECD and the control area had 224 women in 30 groups exposed to ECD only content. Mother/index child dyads were followed for two years. To estimate the causal treatment effect from the non-randomized design, we implemented the propensity score weighting method with inverse probability weights. ResultsAt baseline, 10.2% of participants endorsed moderate/severe depressive symptoms. At 14-months post-intervention, 7.4% endorsed moderate/severe depression. Overall, iMBC/ECD intervention did not have a significant impact on reducing maternal depression or improving children's social and emotional development. However, sub-group analyses revealed that iMBC/ECD was associated with lowered depressive symptoms among women with no/low education, four or more children and/or no experience of intimate partner violence in the past year. Women with high program attendance (more than half of 14 sessions) also experienced consistently fewer depressive symptoms compared to those with lower attendance. LimitationsNon-randomized study, sub-group analyses are exploratory. ConclusionsThe iMBC/ECD program may have the potential to improve maternal mental health and early child development for more targeted vulnerable populations.

Enhancing the child survival agenda to promote, protect, and support early child development

ObjectiveStimulation in early childhood can alleviate adverse effects of poverty. In a community-randomised trial, we implemented 2 home-based interventions, each serving as an attention control for the other. One group...