Lin Kelly, M Kasuni Akalanka H, Thapa Subash, Allan Julaine, Buys Nicholas, Sun Jing
Rural Health Research Institute, Charles Sturt University, Orange, NSW, NSW2800, Australia.
School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, 4215, Australia.
BMC Public Health. 2025 Jul 3;25(1):2323. doi: 10.1186/s12889-025-23527-0.
The socioecological resilience (SER) model explains that individual, relational, and structural factors influence child development and mental health. Children in low-to middle-income countries (LMICs) are affected by multiple risk factors on different SER levels. This cross-sectional study aimed assess the influence of experience of child labour and poor caregiving practices on child development in LMICs using the SER model.
Data regarding child development, caregiving practices, and child labour collected through Multiple Indicator Cluster Surveys (MICS) by UNICEF were analysed. Differences in prevalence of developmental delays, mental illness, child labour, and poor caregiving practices were compared across countries and across different sociodemographic index (SDI) levels. Multi-level modelling was used to determine factors associated with developmental difficulties, and anxiety, and depression symptoms in children.
251,681 children were included in the analysis. Significant variations in child labour engagement existed across low to upper-middle SDI countries. Prevalence of anxiety (30.8%), depression (40.8%) and socio-emotional difficulties (mean score = 0.115) were highest in low SDI countries. Poor physical caregiving, engagement in child labour, and low maternal education was significantly associated with higher socio-emotional difficulties, anxiety, and depression.
To address the complex interplay between extreme poverty and adverse child health outcomes across low SDI countries, a multifaceted approach aimed at alleviating poverty, improving access to education, strengthening social protection systems, and promoting effective caregiving practices are required.
社会生态复原力（SER）模型解释了个体、关系和结构因素如何影响儿童发展和心理健康。低收入和中等收入国家（LMICs）的儿童受到不同SER水平上多种风险因素的影响。这项横断面研究旨在使用SER模型评估童工经历和不良养育方式对LMICs儿童发展的影响。
分析了联合国儿童基金会通过多指标类集调查（MICS）收集的有关儿童发展、养育方式和童工的数据。比较了不同国家和不同社会人口指数（SDI）水平上发育迟缓、精神疾病、童工和不良养育方式的患病率差异。采用多层次模型来确定与儿童发育困难、焦虑和抑郁症状相关的因素。
251,681名儿童纳入分析。从低SDI国家到中高SDI国家，童工参与情况存在显著差异。焦虑（30.8%）、抑郁（40.8%）和社会情感困难（平均得分=0.115）的患病率在低SDI国家最高。不良的身体照料、童工参与和母亲低教育水平与较高的社会情感困难、焦虑和抑郁显著相关。
为解决低SDI国家极端贫困与儿童不良健康结果之间的复杂相互作用，需要采取多方面的方法，旨在减轻贫困、改善教育机会、加强社会保护系统并促进有效的养育方式。
