Factors associated with early child development in Nepal – A further analysis of multiple indicator cluster survey 2019

Abstract

Introduction: Information on child development is limited in Nepal, where a large number of children suffer from the negative consequences of poverty, nutritional deficiencies, and inadequate learning opportunities. The study aims to determine the proportion of children developmentally on track and its associated factors among 2870 children under 5 years using data from Multiple Indicator Cluster Survey. Methods: We used bivariate analysis and multivariate logistic regression to determine the association among household and maternal variables and child characteristics with the Child Development Index. Results: The multivariate analysis showed that age, province, educational status, wealth index quintile, health insurance, stunting, and functional disability were associated with the Child Development Index (P < 0.05). The odds of child being developmentally on track at 4 years was more than two times (adjusted odds ratio [AOR] = 2; 95% confidence interval [CI]: 1.7–2.37) than of 3 years. Literate mothers had higher odds (AOR = 1.56 [95% CI: 1.29–1.89]) of child being developmentally on track compared to illiterate mothers. The odds of child being developmentally on track in the richest quintile was more than three times (AOR = 3.43 [95% CI: 2.39–4.91]) than child of the poorest quintile. With regard to stunting, there were higher odds of children who were not stunted (AOR = 1.35 [95% CI: 1.12–1.64]) being developmentally on track. Children who lack functional difficulty were more than six times (AOR = 6.7 [95% CI: 3.2–14.02]) on being developmentally on track. Children having health insurance were higher odds (AOR = 1.81 [95% CI: 1.04–3.15] P = 0.034) on being developmentally on track. Conclusion: The study found different factors such as age, province, educational status, wealth index quintile, health insurance, stunting, and functional disability associated with the Child Development Index providing insights to establish specific interventions based on socioeconomic barriers of household and health outcomes of children for ensuring child development.