Abstract
BackgroundThere is a growing global acknowledgement that improving child survival rates is no longer sufficient. Emphasis is shifting to the improvement of health and developmental trajectories in early childhood. Screening and measurement of these trajectories in low and middle income countries is difficult, however, as they currently rely on developmental tests standardised among populations of children growing up in resource rich environments.MethodsThis paper presents a comparison of one such tool adapted for use with children living in Southern Africa to children from the United States, Norway, Korea and Spain. The Ages and Stages Questionnaire version 3 (ASQ-3) was adapted and administered to 853 children living in South Africa and Zambia.ResultsChildren in southern Africa were found to perform significantly better than children from other countries early in life, especially in the domains of communication, gross motor and fine motor skills. By the age of five, children in southern Africa were performing significantly worse than their peers in the domains of fine motor and problem-solving.ConclusionThe results indicate the applicability of the ASQ-3 in southern Africa and point to the importance of early interventions to protect the early good development of African children in order to promote positive life trajectories.
Highlights
There is a growing global acknowledgement that improving child survival rates is no longer sufficient
Cronbach’s alpha and item-total correlations were calculated to examine the internal consistency of the ASQ-3 across the 21 ages
Many of the practices of African families that promote young children’s development were not recorded until the late 1950s. These practices were highlighted by psychologists and health practitioners working in Africa, who found that African children in their first year of life scored higher than American and European children when assessed on standardised tests of development [22, 23]
Summary
There is a growing global acknowledgement that improving child survival rates is no longer sufficient. Screening and measurement of these trajectories in low and middle income countries is difficult, as they currently rely on developmental tests standardised among populations of children growing up in resource rich environments. Child deaths have been halved [1], from an estimated global average under-5 mortality rate of 84.6 per 1000 live births in 1990, to an average of 44.0 per 1000 in 2013 [2]. 2013, rates fell consistently between 1.7 and 3.5% per year from 1970 to 2013 Despite these gains, it is estimated that more than 200 million children in low- and middleincome countries do not reach their developmental potential due to the impact of poverty and undernutrition on social, cognitive and physical development [3]. The 2011 WHO world report on disability found an estimated 1 in 20 children with disabilities globally in 2013 [4] and a near doubling of the prevalence of disability in lower income countries (18.0%) compared to higher income countries (11.8%); children (0–14 years)(4) bear the brunt [5]
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