Services for the Elderly

Abstract

<h3>Abstract</h3> <h3>Background</h3> Household Air Pollution (HAP) from solid fuel use (SFU) may have impacts on children’s health in low-resources countries. Despite these potential health effects, SFU is still highly prevalent in Bangladesh. <h3>Objectives</h3> This study was conducted to assess the associations between SFU and early childhood development index (ECDI) among under-five children in Bangladesh and explore the potential effect modification by sex and urbanicity. <h3>Materials and methods</h3> This cross-sectional study used Bangladesh Multiple Indicator Cluster Survey (MICS) 2019, a nationally representative survey data collected by UNICEF from all 64 districts in Bangladesh. The ECDI consisted of ten different items across four developmental domains: literacy-numeracy, physical, social-emotional development, and learning skills in the early years of life (36 to 59 months). A total of 9,395 children aged 36 to 59 months were included in this analysis. We used multilevel Poisson regression models with a robust variance where SFU was a proxy indicator for HAP exposure. <h3>Results</h3> Children exposed to SFU were 1.47 times more likely to be not developmentally on track (95% CI: 1.25, 1.73; &lt;0.001<b>)</b> compared to children with no SFU exposure. Two sub-domains explained these associations, SFU was significantly associated with socio-emotional development (prevalence ratio [PR]: 1.17; 95% CI: 1.01, 1.36; p=0.035), and learning-cognitive development (PR: 1.90; 95% CI: 1.39, 2.60; p&lt;0.001). Associations between SFU and ECDI were not significantly different (p-difference=0.210) between girls (PR: 1.64; 95% CI: 1.31, 2.07) and boys (PR: 1.37; 95% CI: 1.13, 1.65). Likewise, urbanicity did not modify the associations between SFU and ECDI outcomes. <h3>Conclusion</h3> Bangladeshi children aged 36-59 months exposed to SFU exhibited delays in childhood development compared to unexposed children. Public health policies should promote a better early life environment for younger children to meet their developmental milestones by reducing the high burden of HAP exposure in low-resource settings where most disadvantaged kids struggle to reach their full developmental potentials.