Risk factors for early childhood disability in Bangladesh: Evidence from Multiple Indicator Cluster Survey 2019

Abstract

Introduction Early childhood is a vital part of human life because most of the brain developments occur in this particular period. Early childhood disability is a significant global public health burden, which can negatively impact the children’s quality of life and their overall productivity. It is also a major social and economic problem in Bangladesh. Therefore, it is very important to understand the associated factors for early childhood disability, which may help disability prevention, better management and policy formulation. The main objective of this study is to investigate the child, family, and community-level factors associated with early childhood disability in Bangladesh. Methods A cross sectional nationally representative data was derived from Multiple Indicator Cluster Survey (MICS), 2019. A total of 14,072 Bangladeshi children under five years of age were selected for this study. Various types of statistical analysis (simple, bivariate, multivariable) were performed. To assess the bivariate relationship between chosen categorical variables (independent) and early childhood disability (dependent), a chi-square test was used. The multivariable ordinal logistic regression was used to find out the association of disability with child, family, and community-level factors. Results The results show that 2.0% of the children have at least one disability and 0.8% have more disabilities. Several factors namely not attending in early childhood education [Odds Ratio (OR) = 0.65; 95% confidence interval (CI) = 0.13–1.17 Ρ = 0.01], having mother’s functional difficulty (OR = 1.23; 95% (CI) = 0.58–1.88 Ρ <0.001), unhappy mother’s life (OR = 0.85; 95% CI = 0.30–1.39 Ρ <0.001), parents without internet access (OR = 0.68; 95% CI = 0.06–1.29 Ρ = 0.03) and parents using mobile phone (OR = 0.52; 95% CI = 0.09–0.95 Ρ = 0.02) were found to be important for early childhood disability in Bangladesh. Conclusion Early childhood disability is still neglected in Bangladesh and further epidemiological studies are recommended. The findings of this study may help policy makers and relevant stakeholders to develop interventions for reducing the overall burden of early childhood disability.

Mother's functional difficulty is affecting the child functioning: Findings from a nationally representative MICS 2019 cross‐sectional survey in Bangladesh

“…In line with the previous study, 22 we found that gender was not significantly associated with the functional difficulties of under‐5 children. Several studies on adult functional difficulties, however, have identified gender as a potential cause of adult functional difficulty 37–39 .…”

“…Therefore, while the number of difficulties increased, the odds increased automatically. 32,33,36 In line with the previous study, 22 we found that gender was not significantly associated with the functional difficulties of under-5 children.…”

“…Though the factors for the two different age groups were almost similar, the prevalence differed a lot (nearly three times higher in the older age group) which was consistent with the findings from other cross‐sectional studies. 22 , 31 Furthermore, in line with previous studies, 19 , 22 we found that the mother's functional difficulties were significantly associated with both age groups, implying that if a mother has any functional difficulties, it is usually passed on to the child. Not going to an early childhood program and the geographical division also significantly impacted the functional difficulties of both groups of children.…”

“…However, the factor, area of residence, was not significant for 2–4 years old children. Saha and Khan 22 found a similar result. This indicates that while growing up, the environment around the children matters a lot.…”

“…A recent study on Bangladesh MICS showed that 0.8% of under‐5 children have multiple disabilities, while 2.0% have at least one functional difficulty. 22 They found that a mother's functional difficulty is a significant factor in 2–4‐year‐old children's functional difficulties. However, the authors did not investigate the functional difficulty of children aged 5–17 years.…”