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Despite increasing demands, the uptake of parenting education programs in developing countries is limited. This study evaluated the effectiveness of a Learning Through Play (LTP) informed, illustration-based parent educational training program designed for low-literacy populations in Bangladesh to promote early childhood development. A quasi-experimental design was employed, involving parents of typically developing children and children with special needs aged 0–6 years. Results showed significant enhancements in parenting knowledge, skills, and attitudes in both groups, with larger effects on knowledge and attitudes among parents of special needs children. The findings underscore the potential of LTP Calendar-based educational training programs as cost-effective, culturally sensitive, and accessible strategies for enhancing positive parenting practices and child development outcomes in economically disadvantaged settings. Future research should focus on cultural sensitivity evaluation, sample size expansion, and long-term impact assessment to further validate and extend these findings. [ABSTRACT FROM AUTHOR]

This paper used longitudinal data from five studies conducted in Bangladesh, Bhutan, Cambodia, Ethiopia, and Rwanda to examine the links between family stimulation and early childhood development outcomes (N = 4904; Mage = 51.5; 49% girls). Results from random‐effects and more conservative child‐fixed effects models indicate that across these studies, family stimulation, measured by caregivers' engagement in nine activities (e.g., reading, playing, singing), predicted increments in children's early numeracy, literacy, social‐emotional, motor, and executive function skills (standardized associations ranged from 0.05 to 0.11 SD). Study‐specific models showed variability in the estimates, with null associations in two out of the five studies. These findings indicate the need for additional research on culturally specific ways in which caregivers may support early development and highlight the importance of promoting family stimulation to catalyze positive developmental trajectories in global contexts. Research Highlights: Research on the links between family stimulation and early childhood development in low‐and‐middle‐income countries (LMICs) is limited.We used longitudinal data from studies conducted in five LMICs to examine the links between family stimulation and early childhood development outcomes.Results suggest that family stimulation predicted increments in children's numeracy, literacy, social‐emotional, motor, and executive function skills.We found variability in the observed estimates, with null associations in two out of the five studies, suggesting the need for additional research in LMICs. [ABSTRACT FROM AUTHOR]

Background: Mass media can play critical roles in influencing parents' attitudes and practice toward the healthy upbringing of children. Objective: This study examined the association between the use of five types of mass media among mothers living in rural and urban areas and the early childhood development (ECD) of their children. Methods: We analysed nationally representative and internationally standardized Multiple Indicator Cluster Survey data collected in 2013 and 2019 in Bangladesh. The ECD was calculated using four domains of development: physical health, literacy-numeracy, learning and social-emotional. Mothers' use of newspapers/magazines, radio, television, internet and mobile phones was the study factor. We used Poisson regression with robust variance. The dataset included 27,091 children aged three or four years. Results: Almost 21% of the children were living in urban and 78% in rural areas. Mothers/caretakers of 30% of the children used none, 39% used one, 25% used two, and approximately 6% used three or more of the five types of media. Mobile phones and television were the dominant types of media, both in terms of the number of users and the frequency of use. Overall, 68.87% of the children were on track in terms of their ECD and 31.13% were not. A significantly larger proportion of urban children (74.23%) than rural children (67.47%) were on track in their ECD. The prevalence of children being on track of ECD increases by 4% (aPR 1.04; 95%CI: 1.01–1.06) for each additional media use among women who lived in urban areas and increases by 7% if women live in rural areas. In terms of the individual formats of media, using newspapers, television and internet was found to be significantly associated with the children in rural areas being on track in terms of their ECD. In the urban sample, only radio use was found to be significant. Conclusions: Targeted and well-designed child development campaigns that are delivered through popular media types are likely to help mothers to take better care of their children. [ABSTRACT FROM AUTHOR]

Background: The home learning environment (HLE), along with center-based early childhood education (ECE) programs, plays an essential role in promoting early childhood development (ECD). HLE can become more or less stimulating over time due to caregivers’ tendency to adapt HLE in response to preschoolers’ evolving developmental status, of which changes vary across household socioeconomic status (SES).This study aims to explore the trajectory of preschoolers’ HLE across diverse backgrounds and identify the sociodemographic characteristics that predict distinct HLE trajectories in Bangladesh.Leveraging longitudinal early years preschool program (EYPP) data from 2017 to 2019, this study employed a Group-based trajectory model (GBTM) and chi-square analysis to identify and characterize distinct HLE trajectories over time.The analysis revealed significant variation in HLE trajectories among preschoolers. However, the HLE disparity gradually diminished as caregivers’ home learning engagement increased over time. ECE experience and household SES emerged as crucial factors shaping HLE trajectories. ECE experience helped bridge the HLE gap between females and males and mediated the negative influence of low SES on HLE improvement. Gender disparities in HLE dynamics were observed, with highly educated mothers playing a critical role.The results highlight the evolving nature of HLE and the potential for increased caregiver engagement among disadvantaged groups, underscoring the need for tailored parenting programs for low-SES households. Additionally, the findings emphasize the positive influence of ECE on HLE, supporting Bangladesh’s two-year ECE extension plan and the need to enhance center-based ECE programs, particularly for low-SES preschoolers.Objective: The home learning environment (HLE), along with center-based early childhood education (ECE) programs, plays an essential role in promoting early childhood development (ECD). HLE can become more or less stimulating over time due to caregivers’ tendency to adapt HLE in response to preschoolers’ evolving developmental status, of which changes vary across household socioeconomic status (SES).This study aims to explore the trajectory of preschoolers’ HLE across diverse backgrounds and identify the sociodemographic characteristics that predict distinct HLE trajectories in Bangladesh.Leveraging longitudinal early years preschool program (EYPP) data from 2017 to 2019, this study employed a Group-based trajectory model (GBTM) and chi-square analysis to identify and characterize distinct HLE trajectories over time.The analysis revealed significant variation in HLE trajectories among preschoolers. However, the HLE disparity gradually diminished as caregivers’ home learning engagement increased over time. ECE experience and household SES emerged as crucial factors shaping HLE trajectories. ECE experience helped bridge the HLE gap between females and males and mediated the negative influence of low SES on HLE improvement. Gender disparities in HLE dynamics were observed, with highly educated mothers playing a critical role.The results highlight the evolving nature of HLE and the potential for increased caregiver engagement among disadvantaged groups, underscoring the need for tailored parenting programs for low-SES households. Additionally, the findings emphasize the positive influence of ECE on HLE, supporting Bangladesh’s two-year ECE extension plan and the need to enhance center-based ECE programs, particularly for low-SES preschoolers.Methods: The home learning environment (HLE), along with center-based early childhood education (ECE) programs, plays an essential role in promoting early childhood development (ECD). HLE can become more or less stimulating over time due to caregivers’ tendency to adapt HLE in response to preschoolers’ evolving developmental status, of which changes vary across household socioeconomic status (SES).This study aims to explore the trajectory of preschoolers’ HLE across diverse backgrounds and identify the sociodemographic characteristics that predict distinct HLE trajectories in Bangladesh.Leveraging longitudinal early years preschool program (EYPP) data from 2017 to 2019, this study employed a Group-based trajectory model (GBTM) and chi-square analysis to identify and characterize distinct HLE trajectories over time.The analysis revealed significant variation in HLE trajectories among preschoolers. However, the HLE disparity gradually diminished as caregivers’ home learning engagement increased over time. ECE experience and household SES emerged as crucial factors shaping HLE trajectories. ECE experience helped bridge the HLE gap between females and males and mediated the negative influence of low SES on HLE improvement. Gender disparities in HLE dynamics were observed, with highly educated mothers playing a critical role.The results highlight the evolving nature of HLE and the potential for increased caregiver engagement among disadvantaged groups, underscoring the need for tailored parenting programs for low-SES households. Additionally, the findings emphasize the positive influence of ECE on HLE, supporting Bangladesh’s two-year ECE extension plan and the need to enhance center-based ECE programs, particularly for low-SES preschoolers.Results: The home learning environment (HLE), along with center-based early childhood education (ECE) programs, plays an essential role in promoting early childhood development (ECD). HLE can become more or less stimulating over time due to caregivers’ tendency to adapt HLE in response to preschoolers’ evolving developmental status, of which changes vary across household socioeconomic status (SES).This study aims to explore the trajectory of preschoolers’ HLE across diverse backgrounds and identify the sociodemographic characteristics that predict distinct HLE trajectories in Bangladesh.Leveraging longitudinal early years preschool program (EYPP) data from 2017 to 2019, this study employed a Group-based trajectory model (GBTM) and chi-square analysis to identify and characterize distinct HLE trajectories over time.The analysis revealed significant variation in HLE trajectories among preschoolers. However, the HLE disparity gradually diminished as caregivers’ home learning engagement increased over time. ECE experience and household SES emerged as crucial factors shaping HLE trajectories. ECE experience helped bridge the HLE gap between females and males and mediated the negative influence of low SES on HLE improvement. Gender disparities in HLE dynamics were observed, with highly educated mothers playing a critical role.The results highlight the evolving nature of HLE and the potential for increased caregiver engagement among disadvantaged groups, underscoring the need for tailored parenting programs for low-SES households. Additionally, the findings emphasize the positive influence of ECE on HLE, supporting Bangladesh’s two-year ECE extension plan and the need to enhance center-based ECE programs, particularly for low-SES preschoolers.Conclusions: The home learning environment (HLE), along with center-based early childhood education (ECE) programs, plays an essential role in promoting early childhood development (ECD). HLE can become more or less stimulating over time due to caregivers’ tendency to adapt HLE in response to preschoolers’ evolving developmental status, of which changes vary across household socioeconomic status (SES).This study aims to explore the trajectory of preschoolers’ HLE across diverse backgrounds and identify the sociodemographic characteristics that predict distinct HLE trajectories in Bangladesh.Leveraging longitudinal early years preschool program (EYPP) data from 2017 to 2019, this study employed a Group-based trajectory model (GBTM) and chi-square analysis to identify and characterize distinct HLE trajectories over time.The analysis revealed significant variation in HLE trajectories among preschoolers. However, the HLE disparity gradually diminished as caregivers’ home learning engagement increased over time. ECE experience and household SES emerged as crucial factors shaping HLE trajectories. ECE experience helped bridge the HLE gap between females and males and mediated the negative influence of low SES on HLE improvement. Gender disparities in HLE dynamics were observed, with highly educated mothers playing a critical role.The results highlight the evolving nature of HLE and the potential for increased caregiver engagement among disadvantaged groups, underscoring the need for tailored parenting programs for low-SES households. Additionally, the findings emphasize the positive influence of ECE on HLE, supporting Bangladesh’s two-year ECE extension plan and the need to enhance center-based ECE programs, particularly for low-SES preschoolers. [ABSTRACT FROM AUTHOR]

Aim: Social determinants of health (SDH) have a critical role in child development. Yet these determinants are often overshadowed. This study examines the effect of composites of five SDH on early childhood development (ECD) of children of age 36-59 months., Methods: We used two 2013 and 2019 rounds of Multiple Indicator Cluster Survey Bangladesh data. The analytical sample included ECD data for 25 721 children. ECD was computed following United Nations International Children's Emergency Fund's psychometric approach. Three composite indices of SDH were developed to examine their gradient effects on ECD. Poisson regression with robust variance was used to examine the relationship between SDH indices and ECD. The concentration index was computed, and a concentration curve was developed to measure inequalities in being on track of ECD among children with various levels of SDH., Results: Almost 69% of children were on track in their ECD, a higher percentage in 2019 (74.85%) than in 2017 (65.37%). The prevalence of children on track in their ECD significantly rises per unit in the score of three SDH composites (adjusted prevalence ratios are 1.04 (95% confidence interval (CI): 1.03-1.04) for summative and standardised indexes and 1.49 (95% CI: 1.41-1.58) for weighted index). There is almost a linear positive relationship between the SDH composite and ECD. Significant concentration indexes suggest SDH-related inequalities in ECD., Conclusion: Children's early development can be hampered due to unfavourable SDH. Although ECD plays a vital role in creating and maintaining socio-economic and health inequalities through to adulthood, favourable SDH needs to be ensured during childhood., (© 2024 The Author(s). Journal of Paediatrics and Child Health published by John Wiley & Sons Australia, Ltd on behalf of Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)

Objective: Community day-care centers (or crèches) are gaining popularity; access to these centers can reduce cognitive gaps. This paper describes the sustained impact of enrollment in day-cares on cognitive gains. Methods: As part of a larger study, a census of all children was conducted in 2012–2013 to identify children between 9 and 17 months of age in rural Bangladesh. A sub-sample of children (n = ~1000) were assigned to receive either a day-care or playpen. Children from two sub-districts were randomly selected and assessed at 9–17 months of age for cognitive and behavioral domains using the Ages and Stages Questionnaire-III. The same children were then followed-up with after one year to see if the scores obtained by the children in the day-care intervention were different from those enrolled in the playpen intervention using a difference-in-difference estimator. Results: Children enrolled in the day-care intervention performed better (in communication, gross-motor, personal-social, and problem-solving domains) than children enrolled in the playpens when followed up with after a one-year period. Total scores were 0.31 (95% CI 0.141–0.472) higher (p value < 0.001) among children in the day-cares. Family care indicators as well as the child's and mother's weight were significantly associated with sustained and increased cognitive gains. Conclusion and relevance: The cognitive and psychosocial improvements seen with short-term exposure to structured ECD programs (day-care) were observed to be sustained over time with continued exposure. Home stimulation and parental involvement add to the long-term benefits of ECD. [ABSTRACT FROM AUTHOR]

Background There is still limited knowledge regarding the translation of early child development (ECD) knowledge into effective policies and large-scale programmes. A variety of frameworks that outline the key steps in scaling up exist, but we argue that taking a complex adaptive systems (CAS) approach assists in understanding the complex, dynamic processes that result in programmes being taken to scale. Objectives The objective of this study is to examine the process of scaling up four major country-level ECD programmes through the application of a CAS framework. Methods Nine key informants with a deep knowledge of how each ECD programme was established and brought to scale were interviewed via Skype or phone by using open-ended interviews. The interviews were tape recorded and then transcribed verbatim for subsequent coding by using CAS domains. The coding and integration of the results to identify unique and common CAS scaling up features across the case studies involved an iterative process of reaching consensus. Results The scaling up of all four programmes behaved as a CAS including as follows: (i) positive feedback loops (five themes) and negative feedback loops (two themes); (ii) scale-free networks (two themes); (iii) phase transitions (four themes); (iv) path dependence (two themes); and (v) emergent behaviour (six themes). Five additional themes were identified for sustainability, which was repeatedly mentioned as an important consideration when deciding how to scale up programmes. Conclusions CAS analysis is likely to improve our understanding of how effective ECD programmes become scaled up. Prospective CAS implementation research is needed to continue advancing the knowledge in the field. [ABSTRACT FROM AUTHOR]

Background: Knowing the relationship between the factors related to home environment and early childhood development (ECD) in Bangladeshi children aged 3 to 4  years would help to find out appropriate interventions for the children with lower ECD outcomes. Therefore, we aimed to understand the relationship between the home environment factors and ECD in rural Bangladeshi children aged 3 to 4  years., Methods: We used data from the Multiple Indicator Cluster Survey (MICS) 2019, and included 7,326 rural children aged 3 to 4  years. The ECD index (ECDI) included four domains: literacy-numeracy, learning, physical and socio-emotional development. If a child met at least three of these four domains, the child was indicated as developmentally "on track"., Results: The findings show that 27.4% of rural children missed to reach developmentally on-track while 72.2% of children did not attain the literacy-numeracy domain of ECD. The home environment factors including parental participation in children's activities, was found to be associated with ECD. For instance, reading books to child had 26% (aOR = 1.26, 95% CI = 1.08-1.48), and telling stories to child had 29% (aOR = 1.29, 95% CI = 1.09-1.53) more developmentally on-track in overall ECDI. Similar associations between home environment factors and specific ECD domains were also obtained. We also identified that children aged 4  years, girls, and children of mothers with higher socio-economic status (SES) were higher developmentally on-track than their counterparts., Conclusion: Home environment factors like reading books and telling stories to children were found to be significantly associated with ECD in rural areas of Bangladesh. Our study's findings would assist in implementing the essential public health intervention to enhance the ECD program especially in the rural Bangladeshi context., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Rahman, Tuli, Mondal, Sultana, Hossain, Kundu, Clara and Hossain.)

Background: Early child development is a crucial factor for children that controls health and well-being in later life., Aims: To determine the influence of sociodemographic factors on the Early Child Development Index (ECDI) among children aged < 5 years., Methods: The analysis was performed using cross-sectional survey data from 2019, 2017-2018 and 2018 Multiple Indicator Cluster Surveys from Bangladesh, Ghana and Costa Rica, respectively. We used the χ 2 test for bivariate analysis and binary logistic regression model for multivariate analysis for all 3 countries. All the statistical analyses were performed with IBM SPSS version 25 and R version 4.0.0., Results: Child age and sex, followed by maternal education level, economic status, child nutritional status, reading children's books, and maternal functional difficulties had the greatest effect on ECDI. Children aged 36-47 months had lower odds of development than those aged 48-59 months, and boys had lower odds of development than girls in Bangladesh, Costa Rica and Ghana. Urban children had lower odds of development than rural children in Costa Rica but higher odds in Ghana., Conclusion: We recommend that governments should take the necessary steps to enhance children's early development and well-being in all 3 countries by raising education, improving economic conditions and providing balanced nutrition., (Copyright © World Health Organization (WHO) 2021. Open Access. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).)

Information on the association between stunting and child development is limited from low‐income settings including Bangladesh where 36% of children under‐ 5 are stunted. This study aimed to explore differences in early childhood development (ECD) between stunted (length‐for‐age z‐score [LAZ] < −2) and nonstunted (LAZ ≥ −2) children in Bangladesh. Children (n = 265) aged 6–24 months who participated in the MAL‐ED birth cohort study were evaluated by trained psychologists at 6, 15, and 24 months of age using the Bayley Scales of Infant and Toddler Development‐III; child length and weight were measured using standard procedures. ECD scores (z‐scores derived from cognitive, motor, language and socio‐emotional skills) were compared between stunted, underweight (weight‐for‐age z‐score < −2), and wasted (weight‐for‐length z‐score < −2) children, controlling for child age and sex and maternal age, education, body mass index (BMI), and depressive symptoms. Stunted children had significantly lower ECD scores than their nonstunted peers on cognitive (P =.049), motor (P <.001), language (P <.001) and social–emotional (P =.038) scales where boys had significantly lower fine motor skills compared with girls (P =.027). Mother's schooling and BMI were significant predictors of ECD. Similar to stunting, underweight children had developmental deficits in all domains (cognitive: P =.001; fine motor: P =.039, and P <.001 for both gross motor and total motor; expressive communication: P =.032; total language: P =.013; social–emotional development: P =.017). Wasted children had poor motor skills (P =.006 for the fine motor; P <.001 for both gross motor and total motor development) compared with the nonwasted peers. Early childhood stunting and underweight were associated with poor developmental outcomes in Bangladesh. [ABSTRACT FROM AUTHOR]

Supporting caregivers' mental wellbeing and ability to provide psychosocial stimulation may promote early childhood development. This paper describes the systematic approach of developing an integrated stimulation intervention, identifying the feasibility and challenges faced throughout the period. We developed an integrated curriculum by culturally adapting three interventions (Reach Up, Thinking Healthy, and general nutrition advice) and piloted this curriculum (Mar-April 2017) in courtyard groups sessions and individual home visits with pregnant women ( n = 11) and lactating mothers (of children <24 months) ( n = 29). We conducted qualitative interviews with the participants ( n = 8) and the community health workers who delivered the intervention ( n = 2). Most participants reported willingness to attend the sessions if extended for 1 year, and recommended additional visual cues and interactive role-play activities to make the sessions more engaging. Participants and community health workers found it difficult to understand the concept of "unhealthy thoughts" in the curriculum. This component was then revised to include a simplified behavior-focused story. Community health workers reported difficulty balancing the required content of the integrated curriculum but were able to manage after the contents were reduced. The revised intervention is likely feasible to deliver to a group of pregnant and lactating mothers in a low-resource setting.

Introduction: Lack of safe, stimulating and health-promoting environments for children under-5 hinders their physical, social and cognitive development, known as early childhood development (ECD). Improving ECD impacts on children, and can improve educational attainment for girls, who often care for younger siblings, and employment prospects for mothers. Developing and evaluating the impacts of ECD programmes within childcare needs to assess a range of social, health, educational and economic impacts, including women's empowerment.Children living in slums are at high risk of poor early development and holistic, sustainable interventions are needed to address ECD in these contexts. This study will be undertaken in Dhaka, Bangladesh, a city where over 8.5 million inhabitants live in slums. In collaboration with government, non-governmental organisations and communities, we are developing and testing a sustainable day-care model for low-income communities in Dhaka., Methodology and Analysis: A sequential mixed methods approach is being used in the study, with qualitative work exploring quantitative findings. Two hundred households with children under-5 will be surveyed to determine day-care needs and to assess ECD (parent-reported and direct assessment). The feasibility of four ECD measuring tools Caregiver-Reported Early Development Index, Measuring Early Learning Quality and Outcomes, The Early Human Capability Index and International Development and Early Learning Assessment will be assessed quantitatively and qualitatively. Qualitative methods will help understand demand and perceptions of day care while mothers work. Participatory action research will be used to develop a locally appropriate and potentially sustainable model of day care for under-5 children. A ward in the south of Dhaka has been selected for the study as this typifies communities with slum and non-slum households living next to each other, allowing us to explore potential for better-off household to subsidise day care for poorer households., Ethics and Dissemination: Findings will be published and inform decision makers at the national, regional and the local actors in order to embed the study into the policy and practice on childcare and ECD. Ethical approvals for this study were obtained from the School of Medicine Research Ethics Committee at the Faculty of Medicine and Health at the University of Leeds (ref: MREC16-106) and the Bangladesh Medical Research Council (ref: BMRCAIREC/20 I 6-20 I 9 I 250)., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY. Published by BMJ.)