How consistent are associations between maternal and paternal education and child growth and development outcomes across 39 low-income and middle-income countries?

2018 ◽  
Vol 72 (5) ◽  
pp. 434-441 ◽  
Author(s):  
Joshua Jeong ◽  
Rockli Kim ◽  
S V Subramanian
Keyword(s):  
Low Income ◽  
Growth And Development ◽  
Fixed Effects ◽  
Maternal Education ◽  
Child Outcomes ◽  
Middle Income ◽  
Paternal Education ◽  
Middle Income Countries ◽  
Z Scores ◽  
Development Outcomes

BackgroundMaternal and paternal education are associated with improved early child outcomes. However, less is known about how these relative associations compare for preschool children’s growth versus development outcomes; and across country contexts.MethodsWe analysed data from 89 663 children aged 36 to 59 months in 39 low-income and middle-income countries (LMICs). We used linear regression models with country fixed effects to estimate the joint associations between maternal and paternal education and children’s growth and development outcomes. Additionally, we examined the variability in these relationships by each country and within subgroups of countries.ResultsIn the pooled sample, maternal and paternal education were independently associated with 0.37 (95% CI 0.33 to 0.41) and 0.20 (95% CI 0.16 to 0.24) higher height-for-age z-scores, and 0.31 (95% CI 0.29 to 0.34) and 0.16 (95% CI 0.14 to 0.18) higher Early Childhood Development Index z-scores, respectively (comparing secondary or higher to no education). Associations were stronger for maternal education than paternal education but comparable between child outcomes. In country-specific regressions, we found the most heterogeneity in the associations between maternal education and children’s growth; and between paternal education and children’s development. Subgroup analyses suggested that these associations may be systematically patterned by country-level adult illiteracy, infant mortality and food insecurity.ConclusionOur findings highlight variability in the statistical significance and magnitude of the associations between caregivers’ education and children’s outcomes. Further research is needed to understand the sources of variation that may promote or constrain the benefits of caregivers’ education for children’s early health and development in LMICs.

scholarly journals Efficacy of deep learning methods for predicting under-five mortality in 34 low-income and middle-income countries

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e034524
Author(s):  
Adeyinka Emmanuel Adegbosin ◽  
Bela Stantic ◽  
Jing Sun
Keyword(s):  
Neural Network ◽  
Deep Learning ◽  
Low Income ◽  
Maternal Education ◽  
Household Wealth ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Middle Income ◽  
Under Five ◽  
Middle Income Countries

ObjectivesTo explore the efficacy of machine learning (ML) techniques in predicting under-five mortality (U5M) in low-income and middle-income countries (LMICs) and to identify significant predictors of U5M.DesignThis is a cross-sectional, proof-of-concept study.Settings and participantsWe analysed data from the Demographic and Health Survey. The data were drawn from 34 LMICs, comprising a total of n=1 520 018 children drawn from 956 995 unique households.Primary and secondary outcome measuresThe primary outcome measure was U5M; secondary outcome was comparing the efficacy of deep learning algorithms: deep neural network (DNN); convolution neural network (CNN); hybrid CNN-DNN with logistic regression (LR) for the prediction of child’s survival.ResultsWe found that duration of breast feeding, number of antenatal visits, household wealth index, postnatal care and the level of maternal education are some of the most important predictors of U5M. We found that deep learning techniques are superior to LR for the classification of child survival: LR sensitivity=0.47, specificity=0.53; DNN sensitivity=0.69, specificity=0.83; CNN sensitivity=0.68, specificity=0.83; CNN-DNN sensitivity=0.71, specificity=0.83.ConclusionOur findings provide an understanding of determinants of U5M in LMICs. It also demonstrates that deep learning models are more efficacious than traditional analytical approach.

scholarly journals The contribution of grandmother involvement to child growth and development: an observational study in rural Pakistan

2020 ◽  
Vol 5 (8) ◽  
pp. e002181
Author(s):  
Esther O Chung ◽  
Ashley Hagaman ◽  
Katherine LeMasters ◽  
Nafeesa Andrabi ◽  
Victoria Baranov ◽  
...  
Keyword(s):  
Low Income ◽  
Growth And Development ◽  
Linear Models ◽  
Child Outcomes ◽  
Child Growth ◽  
Socioemotional Development ◽  
Fine Motor ◽  
Early Child ◽  
Rural Pakistan ◽  
Z Scores

IntroductionEarly childhood interventions primarily focus on the mother–child relationship, but grandmothers are often critical in childcare in low-resource settings. Prior research is mixed on how grandmother involvement influences child outcomes and there is a paucity of research on grandmother caregiving in low-income and middle-income countries. We examined the role of grandmother involvement on child growth and development in the first 2 years of life cross sectionally and longitudinally in rural Pakistan.MethodsWe used data from the Bachpan Cohort, a longitudinal birth cohort in rural Pakistan. Maternally reported grandmother involvement in daily instrumental and non-instrumental caregiving was collected at 3 and 12 months. A summed score was created and categorised into non-involved, low and high. Outcomes included 12-month and 24-month child growth, 12-month Bayley Scales of Infant and Toddler Development and 24-month Ages and Stages Questionnaire—Socioemotional. We used multivariable generalised linear models to estimate mean differences (MD) at 12 months (n=727) and 24 months (n=712). Inverse probability weighting was used to account for missingness and sampling.ResultsIn our sample, 68% of children lived with a grandmother, and most grandmothers were involved in caregiving. Greater 3-month grandmother involvement was positively associated with 12-month weight z-scores; however, greater involvement was associated with lower 24-month weight z-scores. High 12-month grandmother involvement was associated with improved 12-month cognitive (MD=0.38, 95% CI −0.01 to 0.76), fine motor skills (MD=0.45, 95% CI 0.08 to 0.83) and 24-month socioemotional development (MD=−17.83, 95% CI −31.47 to –4.19). No meaningful associations were found for length z-scores or language development.ConclusionIn rural Pakistan, grandmothers provide caregiving that influences early child development. Our findings highlight the complex relationship between grandmother involvement and child weight, and suggest that grandmothers may positively promote early child cognitive, fine motor and socioemotional development. Understanding how grandmother involvement affects child outcomes in early life is necessary to inform caregiving interventions.

scholarly journals Are inequities decreasing? Birth registration for children under five in low-income and middle-income countries, 1999–2016

2019 ◽  
Vol 4 (6) ◽  
pp. e001926
Author(s):  
Amiya Bhatia ◽  
Nancy Krieger ◽  
Jason Beckfield ◽  
Aluisio J D Barros ◽  
Cesar Victora
Keyword(s):  
Low Income ◽  
Maternal Education ◽  
Vital Statistics ◽  
Birth Registration ◽  
Middle Income ◽  
Children Under Five ◽  
Under Five ◽  
Rural Location ◽  
Middle Income Countries ◽  
Urban Rural

IntroductionAlthough global birth registration coverage has improved from 58% to 71% among children under five globally, inequities in birth registration coverage by wealth, urban/rural location, maternal education and access to a health facility persist. Few studies examine whether inequities in birth registration in low-income and middle-income countries have changed over time.MethodsWe combined information on caregiver reported birth registration of 1.6 million children in 173 publicly available, nationally representative Demographic Health Surveys and Multiple Indicator Cluster Surveys across 67 low-income and middle-income countries between 1999 and 2016. For each survey, we calculated point estimates and 95% CIs for the percentage of children under 5 years without birth registration on average and stratified by sex, urban/rural location and wealth. For each sociodemographic variable, we estimated absolute measures of inequality. We then examined changes in non-registration and inequities between surveys, and annually.Results14 out of 67 countries had achieved complete birth registration. Among the remaining 53 countries, 39 countries successfully decreased the percentage of children without birth registration. However, this reduction occurred alongside statistically significant increases in wealth inequities in 9 countries and statistically significant decreases in 10 countries. At the most recent survey, the percentage of children without birth registration was greater than 50% in 16 out of 67 countries.ConclusionAlthough birth registration improved on average, progress in reducing wealth inequities has been limited. Findings highlight the importance of monitoring changes in inequities to improve birth registration, to monitor Sustainable Development Goal 16.9 and to strengthen Civil Registration and Vital Statistics systems.

scholarly journals Burden, risk factors and outcomes of hyperemesis gravidarum in low-income and middle-income countries (LMICs): systematic review and meta-analysis protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025841 ◽  
Author(s):  
Mesfin Tadese Dinberu ◽  
Mohammed Akibu Mohammed ◽  
Tesfalidet Tekelab ◽  
Nigus Bililign Yimer ◽  
Melaku Desta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Low Income ◽  
Fixed Effects ◽  
Hyperemesis Gravidarum ◽  
Meta Analysis ◽  
Primary Data ◽  
Middle Income ◽  
Middle Income Countries ◽  
Patient Consent

IntroductionHyperemesis gravidarum (HG) is a pregnancy condition characterised by excessive nausea and vomiting resulting in dehydration, weight loss and serious adverse pregnancy outcomes including termination of pregnancies. Even though evidence in low-income and middle-income countries (LMICs) is limited, the prevalence of HG in pregnancy ranges from 0.3% to 10.8%. With this systematic review and meta-analysis, we aim to determine the prevalence/burden, risk factors, and maternal and perinatal outcomes of HG in LMICs.MethodsPubMed, CINAHL, EMBASE, EBSCO, Ovid maternity and infant care databases, Cochrane Database of Systematic Reviews, Web of Science and SCOPUS databases will be searched. Reference lists of selected articles will be assessed in order to identify other potential studies of interest. Observational studies and (non) randomised controlled trials conducted from January 2000 to September 2018 in LMIC will be included. A weighted inverse-variance meta-analysis using fixed-effects and random-effects model will be done to generate a pooled estimate. Funnel plot and Egger’s regression statistical test will be applied to check publication bias. Heterogeneity among studies will be checked using Τ2 to determine dispersion. Moreover, meta-regression analysis will be performed to investigate the source of heterogeneity. STATA V.14 will be used to analyse the data.Ethics and disseminationFormal ethical approval and patient consent are not required; as primary data collection will not be employed. The result will be published in a peer-reviewed scientific journal and will be presented at scientific conferences and public press.PROSPERO registration numberCRD42018096284.

scholarly journals Systematic Review of Early Child Care Centers in Low- and Middle-Income Countries and Health, Growth, and Development Among Children Aged 0–3 Years (P11-052-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Farah Behbehani ◽  
Eileen Dombrowski ◽  
Maureen Black
Keyword(s):  
Child Care ◽  
Low Income ◽  
Growth And Development ◽  
Care Center ◽  
Child Care Center ◽  
Child Care Centers ◽  
Middle Income ◽  
Early Child ◽  
Middle Income Countries ◽  
Early Child Care

Abstract Objectives To examine associations between child care center attendance and child health, growth, and development in low-income and middle-income countries. Methods Searches were conducted in the following databases: PubMed, Embase, Cochrane Central Register of Controlled Trials, PsycInfo, and ERIC. Inclusionary criteria were comparison of child care center participation with a nonparticipation group, aged 0–3 years, publication 2000–2018, and an English translation. Exclusionary criteria were specialized groups, co-intervention, or studies focused exclusively on children over 3 years of age. Eleven studies met criteria: 7 from South America (Brazil), 2 from Africa (Nigeria), and 2 from Asia (Turkey and Nepal). Results Child care centers, often implemented to enable mothers to work, included private, nongovernmental, and public programs. Children of older, better-educated mothers tended to enroll in private centers, and children from low-income communities and backgrounds in public centers. Child care center participation was associated with discontinued breastfeeding and increased infections. In some cases, longer duration of child care attendance was associated with improved immunity and normal growth, especially for the youngest children. Child development findings were mixed. Policies guiding the programs varied across the countries where studies were conducted; most countries were underdeveloped. Conclusions Many LMIC are increasing their attention and support for early child care programs, often in support of maternal employment. By providing child care centers that are accessible, available, and affordable; that ensure safe and hygienic environments; and that include opportunities for age-appropriate activities and interactions with consistent and responsive caregivers, countries can promote young children's health, growth, and development. Policies, programs, and investments that support high-quality child care can not only support mothers in the work force, but also enhance the country's future by ensuring that young children receive the care and support needed to advance their development. Funding Sources RTI International. Partial funding from the National Institutes of Health - National Institute of Diabetes and Digestive and Kidney Diseases

scholarly journals Timing and determinants of age at menarche in low-income and middle-income countries

2020 ◽  
Vol 5 (12) ◽  
pp. e003689
Author(s):  
Tiziana Leone ◽  
Laura J Brown
Keyword(s):  
Life Course ◽  
Low Income ◽  
Fixed Effects ◽  
The Philippines ◽  
Life Course Perspective ◽  
Age At Menarche ◽  
Demographic And Health Surveys ◽  
Fertility Survey ◽  
Middle Income ◽  
Middle Income Countries

IntroductionUnderstanding the timing and determinants of age at menarche is key to determining potential linkages between onset of puberty and health outcomes from a life-course perspective. Yet, we have little information in low-income and middle-income countries (LMICs) mainly due to lack of data. The aim of this study was to analyse trends in the timing and the determinants of menarche in LMICs.MethodsUsing 16 World Fertility Survey and 28 Demographic and Health Surveys (DHS) from 27 countries, we analysed cohort trends and used fixed-effects models for DHS surveys to investigate sociodemographic and regional effects in the timing of age at menarche.ResultsTrends of the mean age at menarche across time within and between countries show a declining or stalling path. Results of the determinant modelling show the relationship with wealth changes over time although not consistently across countries. We see a shift from poorer women having earlier menarche in earlier surveys to richer women having earlier menarche in later surveys in Indonesia, the Philippines and Yemen, while in Egypt, the reverse pattern is evident.ConclusionsThere is a considerable gap in both literature and data on menarche. We see a trend which is declining rapidly (from 14.66 to 12.86 years for the 1932 and 2002 cohorts, respectively), possibly at a faster pace than high-income countries and with a strong link to socioeconomic status. This study calls for menarche questions to be included in more nationally representative surveys and greater use of existing data because of its impact on life-course health in fast-ageing settings. Further studies will need to investigate further the use of the age at menarche as an indicator of global health.

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