Are young children developmentally on-track in Learning, Psychosocial well-being and Health? Observations from China, Myanmar, Bangladesh and India

Abstract

Progress towards United Nations Sustainable Development Goal Target 4.2 is to be measured by determining the percentage of children who are developmentally ontrack in the areas of, learning, psychosocial well-being, and health (Indicator 4.2.1). UNICEF is currently developing a parent-report measure to obtain population level estimates of Indicator 4.2.1. This study complemented UNICEF’s efforts and developed a direct assessment tool to evaluate children’s development in four countries that together make up 35% of the world’s children under 5 years. Children’s scores on the direct assessment were compared to parent reports. Children, ranging in age from 3 to 5 years, from urban and rural areas in Bangladesh (n=239, 120 girls), China (n=240, 120 girls), India (n=239, 117 girls), and Myanmar (n=238, 119 girls) were directly assessed by “Developmentally on Track for 4.2.1 (DOT)”. The 28 items were each dichotomously scored (Learning: 15 items; α = 0.82; Psychosocial well-being: 9 items; α = 0.74; and Health: 4 items; α = 0.66). Parents responded to parallel items in individual interviews. The linear regression indicates a developmental trend in direct assessment scores with older children performing better than younger children in learning (β=0.98, t (940) =0.98, p < 0.001), psychosocial well-being (β=0.67, t (899) =3.67, p < 0.001) and health (β = 0.53,t (941)=5.74,p< 0.001). After controlling for age, urbanicity still predicted psychosocial well-being (β =0.98, t (899) =3.06, p=0.002). We defined ontrack as the total score being not more than 2 SDs below the mean from children at that month-of-age and found that the majority of the children were on-track (Bangladesh: 96.23%, China: 99.58%, India: 94.96%, Myanmar: 96.03%). Significant associations were found between direct assessment and parent report for the learning, psychosocial and health domains in all four countries (r=0.59, p<0.001; r=0.13 p<0.001; r=0.36, p <0.001, respectively). Implications of the findings are discussed.