Correlates and mediators of geo-ethnic inequalities in child development in Cambodia

Abstract

ABSTRACT The association between five indicators of inequality (geo-ethnicity, height-for-age, socioeconomic status (SES), gender, and preschool participation) and child development was examined among 1498 3- to 5-year olds from the Khmer and Phnong ethnic groups in Cambodia. Children were directly assessed using the East Asia-Pacific Early Child Development Scales (EAP-ECDS), and caregivers provided socio-demographic information. A series of multilevel regressions was run to examine associations between EAP-ECDS scores and each indicator of inequality. Structural equation models then examined whether geo-ethnic differences were mediated by other indicators of inequality. Results demonstrated significant differences between urban Khmer, rural Khmer and rural Phnong children. Increased height-for-age, higher SES background, gender (being a girl) and preschool participation all predicted higher developmental scores; and the combination of these indicators significantly mediated differences between rural and urban Khmer children, but not between Khmer and Phnong children. Findings suggest that Phnong children face substantial inequities in their early development that cannot be explained by other indicators of inequality. Appropriate nutritional and preschool interventions for rural children may be beneficial for reducing urban–rural disparities in the development of Khmer children.