Early childhood development and its associated factors among children aged 36-59 months in Afghanistan: evidence from the national survey 2022-2023.

Background: Understanding the status of early childhood development (ECD) and its associated factors could serve as the basis for future policy efforts and interventions. Therefore, this study aimed to determine the status of ECD and its associated factors among children aged 36-59 months in Afghanistan.

Methods: We used data from the Afghanistan Multiple Indicator Cluster Survey 2022-2023 (MICS) to assess ECD status. The outcome variable was a binary measure, indicating whether a child was developmentally on track or not. To explore the associations between ECD status and various explanatory variables, we applied binary logistic regression models, presenting both univariate and multivariate analyses.

Results: Among the 13,866 children aged 36 to 59 months included in the analysis, 29.95% (95% CI: 29.19-30.72%) were found to be developmentally on track. The likelihood of being developmentally on track was higher in children whose mothers had secondary [adjusted odds ratio (AOR) 1.36 (95%CI 1.04-1.77)] and higher education [1.73 (1.08-2.76)], in children whose fathers had primary [1.32 (1.05-1.67)], secondary [1.40 (1.10-1.79) and higher education [1.60 (1.21-2.11)], and in children belonging to the higher household wealth status [1.46 (1.18-1.82)]. On the other hand, the likelihood of being developmentally on track was lower in children aged 48-59 months [0.35 (0.30-0.40)], in children living in rural areas [0.77 (0.62-0.96)], in children with stunting [0.77 (0.61-0.96)], and in underweight children [0.61 (0.52-0.72)].

Conclusion: Our findings indicate that 29.95% of children aged 36-59 months in Afghanistan are developmentally on track. Positive associations were found between ECD and higher parental education and household wealth status. However, living in rural areas, underweight and stunted growth were negatively associated with ECD. To improve early childhood development programs in Afghanistan, targeted interventions are needed to address the factors identified in this study.