School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
Department of Social Statistics, Faculty of Social Sciences, University of Kelaniya, Sri Lanka.
Child Care Health Dev. 2024 Jan;50(1):e13171. doi: 10.1111/cch.13171. Epub 2023 Sep 27.
In South Asia, 89 million children under 5 are at risk of not reaching their developmental potential. Household socioeconomic position (SEP) is a determinant of early child development (ECD). However, synthesised evidence for the association between ECD and SEP in young children in South Asia is not available. Therefore, this review synthesises evidence on the relationship of household SEP with ECD in children under 36 months of age in South Asia.
PubMed, Cochrane Library, MEDLINE and Scopus were systematically searched to identify studies from South Asian countries that reported evidence on the association between SEP and ECD. Search terms included items related to motor, cognitive, language and socioemotional development. Study quality was assessed using the QualSyst tool, with three quality levels (high/medium/low), and a narrative review for each ECD outcome was constructed (PROSPERO registration: CRD42019131533).
Twelve of the 950 publications screened met the inclusion criteria (nine from India, two Nepal and one Bangladesh). The majority (n = 10, 83%) reported language development on its own or alongside another ECD outcome. Fewer articles assessed cognitive (n = 6, 50%), motor (n = 7, 58%) or socioemotional development (n = 3, 25%). Higher SEP was associated with better ECD for one third of the associations reported. One ECD outcome (socioemotional development) was negatively associated (with socioeconomic status) based on low quality evidence. Mother's education and family income were the major SEP constructs associated with ECD. One, four and seven studies were rated as having a low, medium and high risk of bias, respectively.
This review reveals the scarcity of evidence exploring associations between household SEP and ECD in children under 36 months in South Asia, especially outside of India. Enhancing evidence for associations between ECD and SEP is needed for evidence-based policy making to reduce developmental delays associated with a disadvantaged SEP in the South Asian region.
在南亚，有 8900 万 5 岁以下儿童面临无法充分发挥其发展潜力的风险。家庭社会经济地位（SEP）是早期儿童发展（ECD）的决定因素。然而，目前没有综合的证据表明南亚幼儿 ECD 和 SEP 之间存在关联。因此，本综述综合了南亚家庭 SEP 与 36 个月以下儿童 ECD 之间关系的证据。
系统检索了 PubMed、Cochrane 图书馆、MEDLINE 和 Scopus 中的文献，以确定来自南亚国家的报告 SEP 与 ECD 之间关联的研究。检索词包括与运动、认知、语言和社会情感发展相关的项目。使用 QualSyst 工具评估研究质量，分为三个质量水平（高/中/低），并为每个 ECD 结果构建了叙述性综述（PROSPERO 注册：CRD42019131533）。
筛选出的 950 篇文献中有 12 篇符合纳入标准（9 篇来自印度，2 篇来自尼泊尔，1 篇来自孟加拉国）。其中大多数（n=10，83%）单独报告了语言发展或与其他 ECD 结果一起报告。评估认知（n=6，50%）、运动（n=7，58%）或社会情感发展（n=3，25%）的文章较少。三分之一的报告表明，较高的 SEP 与更好的 ECD 相关。基于低质量证据，一个 ECD 结果（社会情感发展）与社会经济地位呈负相关。母亲的教育程度和家庭收入是与 ECD 相关的主要 SEP 结构。分别有 1、4 和 7 项研究的偏倚风险为低、中、高。
本综述揭示了南亚 36 个月以下儿童家庭 SEP 与 ECD 之间关联的证据稀缺，尤其是在印度以外地区。需要加强 ECD 和 SEP 之间关联的证据，以便为南亚地区制定基于证据的政策提供依据，以减少与社会经济地位不利相关的发育迟缓。
