Ujah Otobo I, Adaji Omojo C, Ujah Innocent A O, Kirby Russell S
College of Public Health, University of South Florida, Tampa, Florida, United States of America.
Department of Obstetrics and Gynaecology, Federal University of Health Sciences, Otukpo, Nigeria.
PLoS One. 2025 Jan 13;20(1):e0316381. doi: 10.1371/journal.pone.0316381. eCollection 2025.
Food insecurity (FI) has been identified as a determinant of child development, yet evidence quantifying this association using the newly developed Early Childhood Development Index 2030 (ECDI2030) remains limited. Herein, we provide national estimates of early childhood development (ECD) risks using the ECDI2030 and examined to what extent FI was associated with ECD among children aged 24-59 months in Nigeria. This population based cross-sectional analyses used data from the UNICEF-supported 2021 Multiple Indicator Cluster Survey in Nigeria. The analytic sample comprised children aged 24-59 months (weighted N = 12,112). We measured early childhood development for each child using the ECDI2030, measured across three domains: learning, psychosocial well-being and health. Food insecurity was assessed using the Food Insecurity Experience Scale (FIES), categorized as none/mild, moderate and severe. We fitted mixed-effects multilevel logistic regression models, with random intercepts, to estimate the odds of association between FI status and ECD. A total of 11,494 children aged 24-59 months (mean ± SD age, 43.4 ± 9.9 months), including 5,797 boys (50.2%) and 5,697 girls (49.8%), were included in the study. Approximately 46.4% of children were developmentally off track and about 76% of children lived in food-insecure households. The intercept-only model indicated significant variation in ECD prevalence across communities (τ00 = 0.94, intraclass correlation = 0.22, p < 0.0001), suggesting nonignorable variability in ECD across communities. Adjusting for confounders, we observed no significant association between FI and ECD. However, increasing child's age and disability status appeared as significant risk factors for higher odds of children being developmentally off track. These findings highlight that while FI alone may not explain ECD, a combination of individual and contextual factors plays a crucial role. Future interventions addressing ECD in Nigeria should consider these multidimensional influences to promote optimal child development.
粮食不安全（FI）已被确定为儿童发育的一个决定因素，但使用新开发的2030年幼儿发展指数（ECDI2030）对这种关联进行量化的证据仍然有限。在此，我们使用ECDI2030提供了全国幼儿发展（ECD）风险估计，并研究了在尼日利亚24至59个月大的儿童中，FI与ECD的关联程度。这项基于人群的横断面分析使用了联合国儿童基金会支持的2021年尼日利亚多指标类集调查的数据。分析样本包括24至59个月大的儿童（加权N = 12,112）。我们使用ECDI2030对每个儿童的幼儿发展进行测量，该指数在三个领域进行测量：学习、心理社会福祉和健康。粮食不安全使用粮食不安全经历量表（FIES）进行评估，分为无/轻度、中度和重度。我们拟合了具有随机截距的混合效应多级逻辑回归模型，以估计FI状态与ECD之间的关联几率。共有11,494名24至59个月大的儿童（平均±标准差年龄，43.4±9.9个月），包括5,797名男孩（50.2%）和5,697名女孩（49.8%）被纳入研究。约46.4%的儿童发育偏离正轨，约76%的儿童生活在粮食不安全家庭中。仅截距模型表明，各社区的ECD患病率存在显著差异（τ00 = 0.94，组内相关系数 = 0.22，p < 0.0001），这表明各社区的ECD存在不可忽视的变异性。在对混杂因素进行调整后，我们未观察到FI与ECD之间存在显著关联。然而，儿童年龄的增加和残疾状况似乎是儿童发育偏离正轨几率较高的显著风险因素。这些发现突出表明，虽然仅FI可能无法解释ECD，但个体因素和背景因素的综合作用起着关键作用。尼日利亚未来针对ECD的干预措施应考虑这些多维度影响，以促进儿童的最佳发育。
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