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Cited by 198Child Nutrition and Water AccessEarly Childhood Education and DevelopmentPoverty, Education, and Child Welfare

The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index.

Inequalities in early childhood care and development in low/middle-income countries: 2010–2018

Open access
Lu, Chunling, Cuartas, Jorge, Fink, Günther, McCoy, Dana, Liu, Kai, Li, Zhihui, Daelmans, Bernadette, Richter, Linda·2020·BMJ Global Health
DOI 10.1136/bmjgh-2020-002314PMC PMC7042597
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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.

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Figure 1 Proportion of children not exposed to stunting or extreme poverty.
Figure 1 Proportion of children not exposed to stunting or extreme poverty.CC BY · PubMed Central
Figure 2 Proportion of children attending early care and education by wealth quintile.
Figure 2 Proportion of children attending early care and education by wealth quintile.CC BY · PubMed Central

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Research works printed but not linked: 2

  1. Grantham-McGregor S , Cheung YB , Cueto S , et al . Developmental potential in the first 5 years for children in developing countries. Lancet 2007. · DOI · Paper page
  2. 10.1353/dem.2001.0003 · DOI

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Metadata

Authors
Lu, C., Cuartas, J., Fink, G., McCoy, D., Liu, K., Li, Z., Daelmans, B., & Richter, L.
Affiliations
  • Brigham and Women's Hospital (US)
  • Harvard University (US)
  • Swiss Tropical and Public Health Institute (CH)
  • Renmin University of China (CN)
  • World Health Organization (CH)
  • University of the Witwatersrand (ZA)
Corresponding author
Lu, Chunling
ORCID
Venue
BMJ Global Health
Publisher
BMJ
Published
2020-02
Volume
5
Issue
2
Pages
e002314
ISSN
2059-7908 (ISSN-L)
DOI
10.1136/bmjgh-2020-002314
PMC
PMC7042597
OpenAlex
W3004471233
Cited by
188
References
18
Citations by year
2026: 20 · 2025: 33 · 2024: 28 · 2023: 42 · 2022: 26 · 2021: 35 · 2020: 4
FWCI
17.07
Type
journal article
Language
en
Open access
Licence
Locations
  • BMJ Global Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • edoc (University of Basel) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • edoc (University of Basel)
Funders
Countdown to 2030 for Maternal Child and Adolescent Health
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
  • Social Sciences › Education › Early Childhood Education and Development
  • Social Sciences › Development › Poverty, Education, and Child Welfare
Keywords
early childhood care and development, inequality, stunting, extreme poverty, early care and education, home stimulation, child development, household wealth, residential areas, gender inequality, urban-rural differences, low-middle income countries, sub-Saharan Africa
MeSH terms
Adult, Child, Child, Preschool, Developing Countries, Humans, Income, Infant, Poverty, Surveys and Questionnaires, Socioeconomic Factors

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