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孟加拉国儿童早期发展状况及其相关因素:两项连续全国代表性调查的比较。

Early childhood developmental status and its associated factors in Bangladesh: a comparison of two consecutive nationally representative surveys.

机构信息

Department of Statistics, Shahjalal University of Science and Technology, 3114, Sylhet, Bangladesh.

Department of Neurosurgery, University of Florida College of Medicine, Gainesville, FL, USA.

出版信息

BMC Public Health. 2023 Apr 12;23(1):687. doi: 10.1186/s12889-023-15617-8.

Abstract

BACKGROUND

Inadequate cognitive and socio-emotional development in children leads to physical and mental illness. We aimed to investigate the status of early childhood development (ECD) and its associated factors. Additionally, aimed to compare the changes of significantly associated factors using two multiple indicator cluster surveys (MICS) in Bangladesh.

METHODS

We used data from the Multiple Indicator Cluster Surveys (MICS) 2012 and 2019 nationally representative surveys. A total of 17,494 children aged 36-59 months were included in the analysis. The outcome variable was ECD status: either developmentally on-track or not. We used bivariable analysis and crude and adjusted multivariable logistic models to assess the ECD status and its associated factors.

RESULTS

Comparing both MICS surveys, the overall and individual domains of ECD status improved from 2012 (65.46%) to 2019 (74.86%), and the indicators of child literacy-numeracy domain improved from 21.2 to 28.8%, physical domain improved from 92.2 to 98.4%, and social-emotional domain improved from 68.4 to 72.7%. The learning approach domain was 87.5% in 2012 and increased to 91.4% in 2019. According to the adjusted logistic model in both surveys (2012 and 2019), the age of 4 years had an adjusted odds ratio (AOR) of 1.61 and 1.78 times higher developmentally on track than the age of 3. Female children were 1.42 (in 2012) and 1.44 (in 2019) times more developmentally on track than males. Compared to mothers with only primary education, children raised by mothers with secondary or higher education were 1.77 and 1.50 times more on track in their development. Moreover, Children from affluent families had 1.32- and 1.26 times higher odds- on track than those from the poorest families. Families with books had 1.50 and 1.53 times higher developmentally on track than their counterparts.

CONCLUSION AND RECOMMENDATION

In summary, our study shows that the overall ECD status improved between MICS 2012 and MICS 2019. Important factors influence ECD status, including early childhood education programs, families' possession of children's books, mothers' educational level, and wealth index. The findings of our study will help making necessary public health-related initiatives in Bangladesh to improve ECD program.

摘要

背景

儿童认知和社会情感发展不足会导致身心疾病。本研究旨在调查儿童早期发展(ECD)的现状及其相关因素,并比较孟加拉国两次多指标类集调查(MICS)中显著相关因素的变化。

方法

我们使用了来自 2012 年和 2019 年全国代表性调查的多指标类集调查(MICS)数据。共纳入 17494 名 36-59 个月大的儿童。结局变量是 ECD 状况:发展正常或不正常。我们采用单变量分析和未校正及校正多变量逻辑回归模型来评估 ECD 状况及其相关因素。

结果

与两次 MICS 调查相比,总体和个别 ECD 状况领域从 2012 年(65.46%)提高到 2019 年(74.86%),儿童读写算数领域指标从 21.2%提高到 28.8%,身体领域从 92.2%提高到 98.4%,社会情感领域从 68.4%提高到 72.7%。学习方法领域在 2012 年为 87.5%,在 2019 年增加到 91.4%。根据两次调查(2012 年和 2019 年)的校正逻辑模型,4 岁儿童的发展正常轨道的校正优势比(AOR)比 3 岁儿童高 1.61 倍和 1.78 倍。女童的发展正常轨道的校正优势比(AOR)是男童的 1.42 倍(2012 年)和 1.44 倍(2019 年)。与只有小学教育的母亲相比,接受中学或以上教育的母亲养育的孩子在发展方面的正常轨道的校正优势比(AOR)分别高出 1.77 倍和 1.50 倍。此外,来自富裕家庭的孩子在发展方面的正常轨道的校正优势比(AOR)比最贫穷家庭的孩子高 1.32-1.26 倍。有儿童书籍的家庭在发展方面的正常轨道的校正优势比(AOR)比没有书籍的家庭高 1.50 倍和 1.53 倍。

结论和建议

总之,我们的研究表明,在 MICS 2012 年和 MICS 2019 年之间,整体 ECD 状况有所改善。重要因素影响 ECD 状况,包括儿童早期教育计划、家庭拥有儿童书籍、母亲教育水平和财富指数。本研究的结果将有助于在孟加拉国开展必要的与公共卫生相关的倡议,以改善 ECD 计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd4c/10099688/ef5eaf4c427f/12889_2023_15617_Fig1_HTML.jpg

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