DOI: 10.1101/19011064Nov 14, 2019Paper

Factors associated with risk of developmental delay in preschool children in a setting with high rates of malnutrition: a cross-sectional analysis of data from the IHOPE study, Madagascar

MedRxiv : the Preprint Server for Health Sciences
Ann C MillerLisy Ratsifandrihamanana


Background: Madagascar has one of the highest rates of stunting and at-risk child development in the world:50% of Malagasy children have moderate to severe stunting. In 2016, a new 10 year National Nutrition Action Plan (PNAN III), supported by the World Bank, was initiated to help address stunting and developmental delay. PIVOT, a health care NGO operating in collaboration with the MOH, conducts a longitudinal study, the IHOPE, to assess the population level impact of their collaborative health system strengthening activities on the rural district of Ifanadiana in southeastern Madagascar. We report factors associated with risk to developmental delay in children ages 3 and 4 years old in Ifanadiana district in 2016. Methods: The household survey data are from a cross-sectional analysis of a one wave of panel data in 2016, at the time of the initiation of PNAN III. Women ages 15 to 49 were interviewed, using the Multiple Indicator Cluster Survey (MICS) Early Child Development Indicator (ECDI) module, which includes questions for physical, socio-emotional, learning and literacy/numeracy domains. ECDI data were analyzed using standardized z scores for relative relationships. We assessed 2 outcomes: at risk for delayed development ...Continue Reading

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