Nutrition And Child Development By Ke Elizabeth Pdf 22 __FULL__
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Second, we used two-stage sampling to select the sample of children; however, this sampling approach likely affected the distribution of our sample as it eliminates socio-economic and gender differences. In future work, it would be useful to compare observed child development to the complete population of children in Zanzibar, as a first step to determine the representativeness of our study results. Third, we were unable to measure changes in the number or frequency of such activities over the three years of follow-up, and the interventions that have been delivered to the study population since the baseline survey. Fourth, several factors other than parental stimulation could be associated with child development. For example, maternal education and household wealth are associated with child nutrition and cognitive outcomes in this population [17]. Furthermore, while our measure of caregiver knowledge was an effective proxy for caregiver stimulation, we were not able to confirm that increased caregiver stimulation was leading to increased knowledge.
Zanzibari data suggest that more than a third of children under-five years old have low CREDI scores. The ECD gains seen here are comparable to the gains seen in other LMICs and smaller than in HICs, despite the fact that there is no national intervention for ECD in Zanzibar. This stresses that investments in ECD should continue to be prioritized, and further research examining the impact of interventions for ECD in LMICs is needed to inform implementation. These findings also suggest that, if we are to reach the SDG target of ECD by 2030, interventions should focus on strengthening the existing nutritional and health interventions, while providing the necessary psycho-social support for caregivers and children. This approach to reaching the SDG targets should be followed in other LMICs, where similar efforts will be needed to improve the lives of the children born today. In-country research is needed to inform policy and program implementation and to support efforts to understand the association between caregiver stimulation and ECD to inform better program design and implementation.
The CREDI achieved moderate to high test-retest reliability, and we found an association between CREDI scores and measures of language and cognitive domains in school-aged children. This tool can provide a rich assessment of child developmental status across domains, and can be used on a broad scale to assess ECD on the population level in low-resource settings.
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