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dc.contributor.authorMcCoy, Dana Charlesen_US
dc.contributor.authorPeet, Evan D.en_US
dc.contributor.authorEzzati, Majiden_US
dc.contributor.authorDanaei, Goodarzen_US
dc.contributor.authorBlack, Maureen M.en_US
dc.contributor.authorSudfeld, Christopher R.en_US
dc.contributor.authorFawzi, Wafaieen_US
dc.contributor.authorFink, Güntheren_US
dc.date.accessioned2016-07-14T19:17:29Z
dc.date.issued2016en_US
dc.identifier.citationMcCoy, Dana Charles, Evan D. Peet, Majid Ezzati, Goodarz Danaei, Maureen M. Black, Christopher R. Sudfeld, Wafaie Fawzi, and Günther Fink. 2016. “Early Childhood Developmental Status in Low- and Middle-Income Countries: National, Regional, and Global Prevalence Estimates Using Predictive Modeling.” PLoS Medicine 13 (6): e1002034. doi:10.1371/journal.pmed.1002034. http://dx.doi.org/10.1371/journal.pmed.1002034.en
dc.identifier.issn1549-1277en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:27662227
dc.description.abstractBackground: The development of cognitive and socioemotional skills early in life influences later health and well-being. Existing estimates of unmet developmental potential in low- and middle-income countries (LMICs) are based on either measures of physical growth or proxy measures such as poverty. In this paper we aim to directly estimate the number of children in LMICs who would be reported by their caregivers to show low cognitive and/or socioemotional development. Methods and Findings: The present paper uses Early Childhood Development Index (ECDI) data collected between 2005 and 2015 from 99,222 3- and 4-y-old children living in 35 LMICs as part of the Multiple Indicator Cluster Survey (MICS) and Demographic and Health Surveys (DHS) programs. First, we estimate the prevalence of low cognitive and/or socioemotional ECDI scores within our MICS/DHS sample. Next, we test a series of ordinary least squares regression models predicting low ECDI scores across our MICS/DHS sample countries based on country-level data from the Human Development Index (HDI) and the Nutrition Impact Model Study. We use cross-validation to select the model with the best predictive validity. We then apply this model to all LMICs to generate country-level estimates of the prevalence of low ECDI scores globally, as well as confidence intervals around these estimates. In the pooled MICS and DHS sample, 14.6% of children had low ECDI scores in the cognitive domain, 26.2% had low socioemotional scores, and 36.8% performed poorly in either or both domains. Country-level prevalence of low cognitive and/or socioemotional scores on the ECDI was best represented by a model using the HDI as a predictor. Applying this model to all LMICs, we estimate that 80.8 million children ages 3 and 4 y (95% CI 48.1 million, 113.6 million) in LMICs experienced low cognitive and/or socioemotional development in 2010, with the largest number of affected children in sub-Saharan Africa (29.4.1 million; 43.8% of children ages 3 and 4 y), followed by South Asia (27.7 million; 37.7%) and the East Asia and Pacific region (15.1 million; 25.9%). Positive associations were found between low development scores and stunting, poverty, male sex, rural residence, and lack of cognitive stimulation. Additional research using more detailed developmental assessments across a larger number of LMICs is needed to address the limitations of the present study. Conclusions: The number of children globally failing to reach their developmental potential remains large. Additional research is needed to identify the specific causes of poor developmental outcomes in diverse settings, as well as potential context-specific interventions that might promote children’s early cognitive and socioemotional well-being.en
dc.language.isoen_USen
dc.publisherPublic Library of Scienceen
dc.relation.isversionofdoi:10.1371/journal.pmed.1002034en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4896459/pdf/en
dash.licenseLAAen_US
dc.subjectPeople and Placesen
dc.subjectPopulation Groupingsen
dc.subjectAge Groupsen
dc.subjectChildrenen
dc.subjectFamiliesen
dc.subjectGeographical Locationsen
dc.subjectAsiaen
dc.subjectBiology and Life Sciencesen
dc.subjectBehavioren
dc.subjectMedicine and Health Sciencesen
dc.subjectPediatricsen
dc.subjectChild Healthen
dc.subjectPublic and Occupational Healthen
dc.subjectMathematical and Statistical Techniquesen
dc.subjectStatistical Methodsen
dc.subjectForecastingen
dc.subjectPhysical Sciencesen
dc.subjectMathematicsen
dc.subjectStatistics (Mathematics)en
dc.subjectNutritionen
dc.subjectAfricaen
dc.subjectNeuroscienceen
dc.subjectCognitive Scienceen
dc.subjectCognitionen
dc.titleEarly Childhood Developmental Status in Low- and Middle-Income Countries: National, Regional, and Global Prevalence Estimates Using Predictive Modelingen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalPLoS Medicineen
dash.depositing.authorMcCoy, Dana Charlesen_US
dc.date.available2016-07-14T19:17:29Z
dc.identifier.doi10.1371/journal.pmed.1002034*
dash.contributor.affiliatedDanaei, Goodarz
dash.contributor.affiliatedMcCoy, Dana
dash.contributor.affiliatedFink, Gunther
dash.contributor.affiliatedSudfeld, Christopher
dash.contributor.affiliatedFawzi, Wafaie
dc.identifier.orcid0000-0002-2908-600X


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