Dana Charles McCoy|Evan D. Peet|Majid Ezzati|Goodarz Danaei|Maureen M. Black|Christopher R. Sudfeld|Wafaie Fawzi|Günther Fink
Early Childhood Developmental Status in Low- and Middle-Income Countries: National, Regional, and Global Prevalence Estimates Using Predictive Modeling
Harvard University|Harvard Global Health Institute|Harvard Global Health Institute|Harvard University|Imperial College London|Harvard University|Harvard Global Health Institute|University of Maryland, Baltimore|RTI International|Harvard Global Health Institute|Harvard University|Harvard Global Health Institute|Harvard University|Harvard Global Health Institute|Harvard University
development cognitive socioemotional skills early life influences later health wellbeing existing estimates unmet developmental potential low middleincome countries lmics based either measures physical growth proxy measures poverty paper aim directly estimate number children lmics would reported caregivers show low cognitive andor socioemotional developmentthe present paper uses early childhood development index ecdi data collected 2005 2015 99222 3 4yold children living 35 lmics part multiple indicator cluster survey mics demographic health surveys dhs programs first estimate prevalence low cognitive andor socioemotional ecdi scores within micsdhs sample next test series ordinary least squares regression models predicting low ecdi scores across micsdhs sample countries based countrylevel data human development index hdi nutrition impact model study use crossvalidation select model best predictive validity apply model lmics generate countrylevel estimates prevalence low ecdi scores globally well confidence intervals around estimates pooled mics dhs sample 146 children low ecdi scores cognitive domain 262 low socioemotional scores 368 performed poorly either domains countrylevel prevalence low cognitive andor socioemotional scores ecdi best represented model using hdi predictor applying model lmics estimate 808 million children ages 3 4 95 ci 481 million 1136 million lmics experienced low cognitive andor socioemotional development 2010 largest number affected children subsaharan africa 2941 million 438 children ages 3 4 followed south asia 277 million 377 east asia pacific region 151 million 259 positive associations found low development scores stunting poverty male sex rural residence lack cognitive stimulation additional research using detailed developmental assessments across larger number lmics needed address limitations present studythe number children globally failing reach developmental potential remains large additional research needed identify specific causes poor developmental outcomes diverse settings well potential contextspecific interventions might promote childrens early cognitive socioemotional wellbeing