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Background: Children, especially disadvantaged children in poor countries, were expected to be among the "biggest victims" of the Covid pandemic. Economic burdens, decreased nutritious foods, reduced medical care, school closures, and ill‐health or death of family members were predicted to increase child undernutrition and developmental delays, and diminish home child‐rearing quality. Methods: A planned nutrition intervention could not be implemented due to Covid restrictions. However, three surveys (pre‐Covid [December 2019], July 2021, and September 2021) in 280 Nepali households (309 parent‐dyads, 368 children, 6–66 months old) collected demographics, child anthropometry and development (Ages and Stages Questionnaire‐3 [ASQ‐3]), and home child‐rearing quality (caregiver engagement, learning resources, adult supervision [UNICEF's Multiple Indicator Cluster Survey]). Mixed‐effect regression models adjusted for household (wealth, maternal education) and child factors (age, gender) and survey round. Results: Height, mid‐upper‐arm circumference, and head circumference measurements improved over time. The total ASQ‐3 score did not change: Communication scores increased while fine motor and personal‐social scores declined. Girls' growth and development worsened more than boys. Caregiver engagement (especially mothers') generally declined, but learning resource availability increased. More children were left unsupervised at Round 2 than Round 1 or 3. Conclusions: In this sample, some aspects of child growth, development, and home child‐rearing quality improved while others declined. Better understanding of these changes in child well‐being and the family environment during the pandemic could provide insight on how to protect children during future crises. [ABSTRACT FROM AUTHOR]

Maternal depression has been associated with adverse child growth and development; less is known about its relation to children's diet. In a cross‐sectional study embedded at endline of a longitudinal community development intervention, mothers of 629 children (age 23–66 months) in rural Nepal responded to household and children's diet questionnaires and were screened for depression. Child anthropometry and development (Ages and Stages Questionnaire) were assessed. Regression models examined children's diet, growth and development, adjusting for household, child and maternal characteristics. The prevalence of maternal depression was 21%. Maternal depression was associated with 11% lower likelihood that the child consumed one additional food group [Poisson regression, adjusted relative risk (aRR) 0.89, 95% confidence intervals (95% CI 0.81, 0.99), p = 0.024] and 13% lower likelihood that the child consumed one additional animal source food (ASF) [aRR 0.87, (95% CI 0.76, 1.01), p = 0.061] compared with children of nondepressed mothers. However, maternal depression was not associated with either child anthropometry or development: these outcomes were strongly associated with better home child‐rearing quality. Stunting also related to child age and intervention group; child development related to mother's education and household wealth. This study suggests a correlation between maternal depression and child dietary diversity. This association could be due to unmeasured confounders, and therefore, further research is warranted. Understanding the relationship of depression to child outcomes—and the role of other potentially compensatory household factors—could help address some of the earliest, modifiable influences in a child's life and contribute to innovative approaches to improve child well‐being. [ABSTRACT FROM AUTHOR]

Developmental delays affect between 150 and 200 million children <5 years of age worldwide. Outside of diet supplement studies, relatively little is known about the relationships between diet quality and developmental status in resource‐poor settings. We examined associations between different aspects of dietary quality (dietary diversity score [DDS] and animal‐source food [ASF] consumption) and child development (assessed using the Ages and Stages Questionnaire‐3 [ASQ‐3]) among children whose families were enrolled in a community development intervention trial (implemented by Heifer Nepal) in western Nepal. Two sets of analyses were performed: (a) cross‐sectional Sample (N = 629) seen at the endline survey and (b) longitudinal sample (N = 269) with complete dietary records (six surveys over 48 months). In both samples, child development was significantly related to household wealth, maternal education, and especially home environmental quality. In the cross‐sectional sample, greater consumption of eggs (adjusted odds ratio [aOR] 0.80, p =.04) or dairy products (aOR 0.95, p =.05) over the previous 7 days significantly reduced odds of low total ASQ score, by logistic regression analysis. In the longitudinal sample, only egg consumption and cumulative DDS and ASF scores were associated with significantly reduced odds of low total ASQ score (aORs 0.59–0.89). In adjusted linear regression analysis, both cumulative DDS (β [CI]: 1.92 [0.4, 3.5]) and ASF scores (2.46 [0.3, 4.7]) were significantly associated with greater continuous total child development. Programmes targeting child development must address home environmental quality as well as long‐term diet quality. [ABSTRACT FROM AUTHOR]

Background: Many organizations seek to alleviate poverty in the developing world, often focusing their interventions on women. The role, status, and education of women are fundamentally important facets of development. Thus, understanding the interaction of women's educational level and the response to interventions is important. Therefore, we examined the impact of educational level of household adults on responses to a livestock-based community intervention. Methods: Six pair-matched communities in 3 districts of Nepal (Chitwan/Nawalparasi/Nuwakot), were randomly assigned to receive community development activities via women's self-help groups at baseline or 1 year later. At 6 intervals over 48 months, a 125- item questionnaire addressing family demographics and child health/nutrition was completed in each household, plus child growth monitoring. Results were analyzed in relation to the highest education attained by any woman in the household, the child's mother, men, or any other adult in the household. Results: Outcomes (wealth, water/toilet availability, child diet diversity and growth) all significantly related to adult education. However, notable differences were found comparing the impact of men's and women's education. Percent change in wealth score was significant only in households where women had primary or secondary education (respectively, p = .0009 and p < .0001). Increased soap use related only to women's education (p < .0001). When adjusted for group assignment, baseline income, wealth, and animal scores, higher women's education was significantly associated with increased household wealth (p < .0001), better child height-for-age z scores (HAZ, p = .005), and improved child diet diversity (p = .01). Higher mother's education predicted better child HAZ (primary, p = .01, secondary, p = .03) and diet diversity (primary, p = .05, secondary, p < .0001). Higher men's education was significantly associated with household wealth (p = .02) and child diet diversity (p = .04), but not HAZ; higher education of any household member was associated only with household wealth (p < .0001). Moreover, households where the mother's education was better than the best-educated man also were significantly more likely to have children with better HAZ and dietary diversity (p = .03, p < .0001). Thus, the educational level of women and mothers had the broadest impact on child outcome variables. Conclusions: Household characteristics vary among participants in most community development projects. Of these, adult education likely mediates response to the inputs provided by the intervention. Particularly in interventions directed towards women, better education may enhance the ability of households to put interventions into practice, thus improving wealth, hygiene, and child diet and growth indices. [ABSTRACT FROM AUTHOR]