Factors associated with early childhood development: results from the Brazilian National Survey on Child Nutrition (ENANI-2019)
Introduction The full achievement of early childhood development (ECD) is a human right and adhering to the nurturing care framework may facilitate it.Objective To evaluate the association between distal and proximal variables and developmental quotient (DQ).Methods Data from 14 159 children <...
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BMJ Publishing Group
2025-02-01
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| Series: | BMJ Public Health |
| Online Access: | https://bmjpublichealth.bmj.com/content/3/1/e001516.full |
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| author | Gilberto Kac Nadya Helena Alves-Santos Dayana Rodrigues Farias Nathalia Cristina Freitas-Costa Raquel Scincaglia Paula Normando Inês Rugani Elisa Maria de Aquino Lacerda Sandra Crispim Alexandra Valeria Maria Brentani Claudia Regina Lindgren Alves |
| author_facet | Gilberto Kac Nadya Helena Alves-Santos Dayana Rodrigues Farias Nathalia Cristina Freitas-Costa Raquel Scincaglia Paula Normando Inês Rugani Elisa Maria de Aquino Lacerda Sandra Crispim Alexandra Valeria Maria Brentani Claudia Regina Lindgren Alves |
| author_sort | Gilberto Kac |
| collection | DOAJ |
| description | Introduction The full achievement of early childhood development (ECD) is a human right and adhering to the nurturing care framework may facilitate it.Objective To evaluate the association between distal and proximal variables and developmental quotient (DQ).Methods Data from 14 159 children <5 years were evaluated in the Brazilian National Survey on Child Nutrition. The Survey of Well-being of Young Children—Brazilian version milestones questionnaire was used to evaluate ECD. The developmental age was estimated using the graded response models. DQ was calculated by dividing developmental age by chronological age. The expected age milestones are attained when DQ=1. DQ predictors were defined considering distal and proximal levels/variables using a multiple linear regression model and a hierarchical approach.Results The DQ mean was significantly lower among children aged 36–59 months (0.91 (0.88 to 0.93)), boys (1.03 (1.01 to 1.06)) and those from the North region (0.98 (0.93 to 1.04)) compared with children aged 1–35 months (1.18 (1.15 to 1.22)), girls (1.11 (1.08 to 1.13)) and from the Southeast region (1.11 (1.07 to 1.16)). For children aged 1–35 months, DQ was inversely associated with emergency C-section (β=−0.08; p<0.01), consumption of ultra-processed food (β=−0.33; p<0.01), and positively associated with attendance at daycare/school (private: β=0.09; p=0.02 and No: β=0.12; p<0.01). For children aged 36–59 months, attendance to private daycare/school (β=0.08; p<0.01) was positively associated with DQ, and small for gestational age at birth (β=−0.05; p=0.01) and access to public health services (no-primary care) (β=−0.07; p<0.01) were inversely associated with DQ.Conclusions Adverse health, nutrition and learning factors predicted the ECD, demonstrating an inequitable environment for Brazilian children. These findings indicate a need for public policies to ensure social and health equity in early childhood. |
| format | Article |
| id | doaj-art-a9c7f45603c246df8a684cdecfb0d592 |
| institution | Kabale University |
| issn | 2753-4294 |
| language | English |
| publishDate | 2025-02-01 |
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| spelling | doaj-art-a9c7f45603c246df8a684cdecfb0d5922025-02-07T05:45:10ZengBMJ Publishing GroupBMJ Public Health2753-42942025-02-013110.1136/bmjph-2024-001516Factors associated with early childhood development: results from the Brazilian National Survey on Child Nutrition (ENANI-2019)Gilberto Kac0Nadya Helena Alves-Santos1Dayana Rodrigues Farias2Nathalia Cristina Freitas-Costa3Raquel Scincaglia4Paula Normando5Inês Rugani6Elisa Maria de Aquino Lacerda7Sandra Crispim8Alexandra Valeria Maria Brentani9Claudia Regina Lindgren Alves10Observatório de Epidemiologia Nutricional, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, BrazilInstituto de Estudos em Saúde e Biológicas, Universidade Federal do Sul e Sudeste do Pará, Maraba, BrazilNutritional Epidemiology Observatory, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, BrazilNutritional Epidemiology Observatory, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, BrazilFaculty of Nutrition, Federal University of Goiás, Goiania, BrazilNutritional Epidemiology Observatory, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, BrazilInstitute of Nutrition, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, BrazilInstitute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, BrazilDepartment of Nutrition, Federal University of Paraná, Paraná, BrazilFaculty of Medicine, Department of Pediatrics, University of Sao Paulo, Sao Paulo, BrazilDepartment of Pediatrics, Federal University of Minas Gerais, Belo Horizonte, BrazilIntroduction The full achievement of early childhood development (ECD) is a human right and adhering to the nurturing care framework may facilitate it.Objective To evaluate the association between distal and proximal variables and developmental quotient (DQ).Methods Data from 14 159 children <5 years were evaluated in the Brazilian National Survey on Child Nutrition. The Survey of Well-being of Young Children—Brazilian version milestones questionnaire was used to evaluate ECD. The developmental age was estimated using the graded response models. DQ was calculated by dividing developmental age by chronological age. The expected age milestones are attained when DQ=1. DQ predictors were defined considering distal and proximal levels/variables using a multiple linear regression model and a hierarchical approach.Results The DQ mean was significantly lower among children aged 36–59 months (0.91 (0.88 to 0.93)), boys (1.03 (1.01 to 1.06)) and those from the North region (0.98 (0.93 to 1.04)) compared with children aged 1–35 months (1.18 (1.15 to 1.22)), girls (1.11 (1.08 to 1.13)) and from the Southeast region (1.11 (1.07 to 1.16)). For children aged 1–35 months, DQ was inversely associated with emergency C-section (β=−0.08; p<0.01), consumption of ultra-processed food (β=−0.33; p<0.01), and positively associated with attendance at daycare/school (private: β=0.09; p=0.02 and No: β=0.12; p<0.01). For children aged 36–59 months, attendance to private daycare/school (β=0.08; p<0.01) was positively associated with DQ, and small for gestational age at birth (β=−0.05; p=0.01) and access to public health services (no-primary care) (β=−0.07; p<0.01) were inversely associated with DQ.Conclusions Adverse health, nutrition and learning factors predicted the ECD, demonstrating an inequitable environment for Brazilian children. These findings indicate a need for public policies to ensure social and health equity in early childhood.https://bmjpublichealth.bmj.com/content/3/1/e001516.full |
| spellingShingle | Gilberto Kac Nadya Helena Alves-Santos Dayana Rodrigues Farias Nathalia Cristina Freitas-Costa Raquel Scincaglia Paula Normando Inês Rugani Elisa Maria de Aquino Lacerda Sandra Crispim Alexandra Valeria Maria Brentani Claudia Regina Lindgren Alves Factors associated with early childhood development: results from the Brazilian National Survey on Child Nutrition (ENANI-2019) BMJ Public Health |
| title | Factors associated with early childhood development: results from the Brazilian National Survey on Child Nutrition (ENANI-2019) |
| title_full | Factors associated with early childhood development: results from the Brazilian National Survey on Child Nutrition (ENANI-2019) |
| title_fullStr | Factors associated with early childhood development: results from the Brazilian National Survey on Child Nutrition (ENANI-2019) |
| title_full_unstemmed | Factors associated with early childhood development: results from the Brazilian National Survey on Child Nutrition (ENANI-2019) |
| title_short | Factors associated with early childhood development: results from the Brazilian National Survey on Child Nutrition (ENANI-2019) |
| title_sort | factors associated with early childhood development results from the brazilian national survey on child nutrition enani 2019 |
| url | https://bmjpublichealth.bmj.com/content/3/1/e001516.full |
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