Associations between poverty, maternal experience of intimate partner violence, and developmental delay among 12-23 month-old children in Nicaragua
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Background: As under-five mortality rates decrease in Nicaragua there is an increased urgency to understand the health of this young population, including factors that affect their developmental trajectories. Delays in early child development (ECD), including language, socio-emotional, motor and cognitive domains, can impact an individual's ability to thrive throughout the life course. ECD trajectories are influenced by numerous biologic, genetic, social and environmental factors. Poverty and maternal experience of intimate partner violence (IPV) are risks of particular interest in Nicaragua, as more than 40% of Nicaraguans live in poverty and an estimated 40% of Nicaraguan women have experienced IPV. This study aims to evaluate the associations between poverty, maternal experience of IPV and ECD outcomes. Methods: This study utilizes Nicaragua's 2006/2007 Demographic and Health Survey (DHS) data, which includes data from an early child development module. The study population consists of 1,115 children age 12-23 months. Logistic and ordered probit regressions were used to evaluate associations between predictors of interest and developmental delay, taking into account the sampling design. Findings: In 2006/2007, 41.8% of 12-23 month-old children in Nicaragua had some level of developmental delay, including 21.3% with delays in two or more domains. Poverty is positively associated with presence of any developmental delay and with severity of delay. Maternal experience of IPV is also associated with developmental delay and with severity of delay; this association does not vary by poverty status or child's sex. Discussion: This study reveals a high prevalence of detectable developmental delay among 12-23 month-old children in Nicaragua. Poverty and maternal experience of IPV are associated with presence and severity of developmental delay in children as young as 12-23 months old in Nicaragua. Early child development interventions are needed to address the current prevalence of delay among young children in Nicaragua. Interventions for impoverished communities or communities with high rates of IPV may be particularly important. Additional research is needed to further explore factors associated with ECD delay among young children in Nicaragua. Funding: There was no external funding for this project.
- Global health