Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level

Abstract

Summary Background A 2007 study published in The Lancet estimated that approximately 219 million children aged younger than 5 years were exposed to stunting or extreme poverty in 2004. We updated the 2004 estimates with the use of improved data and methods and generated estimates for 2010. Methods We used country-level prevalence of stunting in children younger than 5 years based on the 2006 Growth Standards proposed by WHO and poverty ratios from the World Bank to estimate children who were either stunted or lived in extreme poverty for 141 low-income and middle-income countries in 2004 and 2010. To avoid counting the same children twice, we excluded children jointly exposed to stunting and extreme poverty from children living in extreme poverty. To examine the robustness of estimates, we also used moderate poverty measures. Findings The 2007 study underestimated children at risk of poor development. The estimated number of children exposed to the two risk factors in low-income and middle-income countries decreased from 279·1 million (95% CI 250·4 million–307·4 million) in 2004 to 249·4 million (209·3 million–292·6 million) in 2010; prevalence of children at risk fell from 51% (95% CI 46–56) to 43% (36–51). The decline occurred in all income groups and regions with south Asia experiencing the largest drop. Sub-Saharan Africa had the highest prevalence in both years. These findings were robust to variations in poverty measures. Interpretation Progress has been made in reducing the number of children exposed to stunting or poverty between 2004 and 2010, but this is still not enough. Scaling up of effective interventions targeting the most vulnerable children is urgently needed. Funding National Institutes of Health, Bill & Melinda Gates Foundation, Hilton Foundation, and WHO.

Early childhood development coming of age: science through the life course

“…As a result, the estimated number of children in LMICs at risk of not reaching their developmental potential, calculated in 2004, was revised from 219 million to 279 million. 22 Between 2004 and 2010, the estimated number of children under 5 years in LMICs exposed to stunting or extreme poverty, and therefore at risk of not reaching their developmental potential, declined from 279.1 million (51% of children in 2004) to 249.4 million (43% of children in 2010) (table 1). 22 South Asia experienced the largest decline in both the number and prevalence of children at risk (from 110.9 million to 88.8 million, and from 65% to 53%, between 2004 and 2010).…”

“…22 Between 2004 and 2010, the estimated number of children under 5 years in LMICs exposed to stunting or extreme poverty, and therefore at risk of not reaching their developmental potential, declined from 279.1 million (51% of children in 2004) to 249.4 million (43% of children in 2010) (table 1). 22 South Asia experienced the largest decline in both the number and prevalence of children at risk (from 110.9 million to 88.8 million, and from 65% to 53%, between 2004 and 2010). Sub-Saharan Africa had the highest prevalence of children at risk of not reaching developmental potential (70% in 2004 and 66% in 2010).…”

Reporting guidelines for implementation research on nurturing care interventions designed to promote early childhood development

“…More than 250 million children fail to meet their cognitive developmental potential in the first 5 years of life . Meta‐analyses of interventions such as parenting, stimulation, and early childhood education have reported consistent medium‐to‐high effect sizes on early childhood development (ECD) and children's schooling outcomes .…”

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

“…Globally, it is estimated that approximately 250 million children under 5 years of age are at risk of not fulfilling their developmental potential 1. Inadequate stimulation, nutritional deficiencies, poor environmental conditions and maternal depression, among other co-occurring risk factors, have been found to compromise children’s early growth and development in low-income and middle-income countries (LMICs) 2 3.…”