Associations between solid fuel use and early child development among 3 to 4 years old children in Bangladesh: Evidence from a nationally representative survey

Abstract

BackgroundHousehold Air Pollution (HAP) from solid fuel use (SFU) may have impacts on children’s health in low-resources countries. Despite these potential health effects, SFU is still highly prevalent in Bangladesh.ObjectiveThis study was conducted to assess the associations between SFU and early childhood development index (ECDI) among under-five children in Bangladesh and explore the potential effect modification by sex and urbanicity.Materials and methodsThis cross-sectional study used Bangladesh Multiple Indicator Cluster Survey (MICS) 2019 data, a nationally representative data collected by UNICEF from all 64 districts in Bangladesh. The ECDI consisted of ten different items across four developmental domains: literacy-numeracy, physical, social-emotional development, and learning skills in the early years of life (36 to 59 months). A total of 9,395 children aged 36 to 59 months were included in this analysis. We used multilevel Poisson regression models with a robust variance where SFU was a proxy indicator for HAP exposure.ResultsChildren exposed to SFU were 1.47 times more likely to be not developmentally on track (95% CI: 1.25, 1.73; <0.001) compared to children with no SFU exposure. Two sub-domains explained these associations, SFU was significantly associated with socio-emotional development (prevalence ratio [PR]: 1.17; 95% CI: 1.01, 1.36; p=0.035), and learning-cognitive development (PR: 1.90; 95% CI: 1.39, 2.60; p<0.001). Associations between SFU and ECDI were not significantly different (p-difference=0.210) between girls (PR: 1.64; 95% CI: 1.31, 2.07) and boys (PR: 1.37; 95% CI: 1.13, 1.65). Likewise, urbanicity did not modify the associations between SFU and ECDI outcomes.ConclusionBangladeshi children aged 36-59 months exposed to SFU exhibited delays in development compared to unexposed children. Public health policies should be designed to reduce HAP exposure to ensure better early childhood development in the low-resources country, where many children struggle to reach their full potential.

Effects of early childhood education on early childhood development in Bangladesh

“…The outcomes of this study indicate that a substantial proportion of children in Bangladesh, approximately 25%, are not on the expected developmental trajectory, amounting to roughly 1 million children when considering the country's average annual birth rate of 4 million. This estimate is consistent with findings from prior research conducted not only in Bangladesh but also in other LMICs [3,8,20]. The magnitude of this significant number highlights a considerable burden on the nation's resources and underscores the urgent need for targeted interventions.…”

“…These findings emphasize the critical importance of addressing the challenges associated with poor ECDI outcomes. Past studies consistently link such outcomes to adverse socio-economic and health conditions, encompassing lower parental education levels, disparities in wealth quintiles, instances of malnutrition, and the impact of parental migration [8,10,20].…”