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

Chunling Lu, Jorge Cuartas, Günther Fink, Dana McCoy, Kai Liu, Zhihui Li, Bernadette Daelmans, Linda Richter

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish (US)
Article numbere002314
JournalBMJ Global Health
Volume5
Issue number2
DOIs
StatePublished - Feb 4 2020

Keywords

  • children at risk of poor development
  • early care and education
  • early childhood development
  • Early Childhood Development Index (ECDI)
  • early learning
  • home stimulation
  • inequality

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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