Hostname: page-component-848d4c4894-mwx4w Total loading time: 0 Render date: 2024-06-28T00:02:58.645Z Has data issue: false hasContentIssue false

Risk factors affecting child cognitive development: a summary of nutrition, environment, and maternal–child interaction indicators for sub-Saharan Africa

Published online by Cambridge University Press:  11 September 2015

N. D. Ford
Affiliation:
Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA
A. D. Stein*
Affiliation:
Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA Hubert Department of Global Health, Emory University, Atlanta, GA, USA
*
*Address for correspondence: A. D. Stein, Emory University, 1518 Clifton Road NW, CNR 7007, Atlanta, GA 30322, USA. (Email aryeh.stein@emory.edu)

Abstract

An estimated 200 million children worldwide fail to meet their development potential due to poverty, poor health and unstimulating environments. Missing developmental milestones has lasting effects on adult human capital. Africa has a large burden of risk factors for poor child development. The objective of this paper is to identify scope for improvement at the country level in three domains – nutrition, environment, and mother–child interactions. We used nationally representative data from large-scale surveys, data repositories and country reports from 2000 to 2014. Overall, there was heterogeneity in performance across domains, suggesting that each country faces distinct challenges in addressing risk factors for poor child development. Data were lacking for many indicators, especially in the mother–child interaction domain. There is a clear need to improve routine collection of high-quality, country-level indicators relevant to child development to assess risk and track progress.

Type
Original Article
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Walker, SP, Wachs, TD, Gardner, JM, et al. Child development: risk factors for adverse outcomes in developing countries. Lancet. 2007; 369, 145157.Google Scholar
2. Walker, SP, Wachs, TD, Grantham-McGregor, S, et al. Inequality in early childhood: risk and protective factors for early child development. Lancet. 2011; 378, 13251338.CrossRefGoogle ScholarPubMed
3. UNICEF. Improving child nutrition: the achievable imperative for global progress, 2013.Google Scholar
4. Andersson, M, Karumbunathan, V, Zimmermann, MB. Global iodine status in 2011 and trends over the past decade. J Nutr. 2012; 142, 744750.Google Scholar
5. Roll Back Malaria Partnership. Eliminating Malaria: Learning From the Past, Looking Ahead. World Health Organization; 2011 Retrieved 15 January 2015 from http://www.rbm.who.int/ProgressImpactSeries/docs/report9-en.pdf Google Scholar
6. Grantham-McGregor, S, Cheung, YB, Cueto, S, et al. Developmental potential in the first 5 years for children in developing countries. Lancet. 2007; 369, 6070.CrossRefGoogle ScholarPubMed
7. Engle, PL, Black, MM, Behrman, JR, et al. Strategies to avoid the loss of developmental potential in more than 200 million children in the developing world. Lancet. 2007; 369, 229242.CrossRefGoogle ScholarPubMed
8. Engle, PL, Fernald, LCH, Alderman, H, et al. Strategies for reducing inequalities and improving developmental outcomes for young children in low-income and middle-income countries. Lancet. 2011; 378, 13391353.CrossRefGoogle ScholarPubMed
9. Lee, PA, Houk, CPW. Cognitive and psychosocial development concerns in children born small for gestational age. Pediatr Endocrinol Rev PER. 2012; 10, 209216.Google Scholar
10. de Kieviet, JF, Zoetebier, L, van Elburg, RM, Vermeulen, RJ, Oosterlaan, J. Brain development of very preterm and very low-birthweight children in childhood and adolescence: a meta-analysis. Dev Med Child Neurol. 2012; 54, 313323.CrossRefGoogle ScholarPubMed
11. Gorman, KS, Pollitt, E. Relationship between weight and body proportionality at birth, growth during the first year of life, and cognitive development at 36, 48, and 60 months. Infant Behav Dev. 1992; 15, 279296.Google Scholar
12. Villar, J, Smeriglio, V, Martorell, R, Brown, CH, Klein, RE. Heterogeneous growth and mental development of intrauterine growth-retarded infants during the first 3 years of life. Pediatrics. 1984; 74, 783791.CrossRefGoogle ScholarPubMed
13. Liu, X, Sun, Z, Neiderhiser, JM, Uchiyama, M, Okawa, M. Low birth weight, developmental milestones, and behavioral problems in Chinese children and adolescents. Psychiatry Res. 2001; 101, 115129.Google Scholar
14. Zimmermann, MB. The effects of iodine deficiency in pregnancy and infancy. Paediatr Perinat Epidemiol. 2012; 26, 108117.Google Scholar
15. Haddow, JE, Palomaki, GE, Allan, WC, et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med. 1999; 341, 549555.Google Scholar
16. Bhutta, ZA, Ahmed, T, Black, RE, et al. What works? Interventions for maternal and child undernutrition and survival. Lancet. 2008; 371, 417440.CrossRefGoogle ScholarPubMed
17. Bhutta, ZA, Das, JK, Rizvi, A, et al. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet. 2013; 382, 452477.CrossRefGoogle ScholarPubMed
18. World Health Organization. Assessment of iodine deficiency disorders and monitoring their elimination. WHO. Retrieved 22 January 2015 from http://www.who.int/nutrition/publications/micronutrients/iodine_deficiency/9789241595827/en/ Google Scholar
19. Wu, T, Liu, GJ, Li, P, Clar, C. Iodised salt for preventing iodine deficiency disorders. Cochrane Database Syst Rev. 2002; 3, CD003204.Google Scholar
20. Aburto, NJ, Abudou, M, Candeias, V, Wu, T. Effect and Safety of Salt Iodization to Prevent Iodine Deficiency Disorders: A Systematic Review with Meta-Analyses. 2014. World Health Organization: Geneva. Retrieved 19 May 2015 from: http://apps.who.int/iris/bitstream/10665/148175/1/9789241508285_eng.pdf Google Scholar
21. Horwood, LJ, Fergusson, DM. Breastfeeding and later cognitive and academic outcomes. Pediatrics. 1998; 101, E9.Google Scholar
22. Jain, A, Concato, J, Leventhal, JM. How good is the evidence linking breastfeeding and intelligence? Pediatrics. 2002; 109, 10441053.Google Scholar
23. Daniels, MC, Adair, LS. Breast-feeding influences cognitive development in Filipino children. J Nutr. 2005; 135, 25892595.Google Scholar
24. Imdad, A, Yakoob, MY, Bhutta, ZA. Effect of breastfeeding promotion interventions on breastfeeding rates, with special focus on developing countries. BMC Public Health. 2011; 11(Suppl. 3), S24.CrossRefGoogle ScholarPubMed
25. Idro, R, Carter, JA, Fegan, G, Neville, BGR, Newton, CRJC. Risk factors for persisting neurological and cognitive impairments following cerebral malaria. Arch Dis Child. 2006; 91, 142148.CrossRefGoogle ScholarPubMed
26. Holding, PA, Stevenson, J, Peshu, N, Marsh, K. Cognitive sequelae of severe malaria with impaired consciousness. Trans R Soc Trop Med Hyg. 1999; 93, 529534.Google Scholar
27. Boivin, MJ. Effects of early cerebral malaria on cognitive ability in Senegalese children. J Dev Behav Pediatr JDBP. 2002; 23, 353364.Google Scholar
28. Sherr, L, Mueller, J, Varrall, R. A systematic review of cognitive development and child human immunodeficiency virus infection. Psychol Health Med. 2009; 14, 387404.Google Scholar
29. Sherr, L, Croome, N, Parra Castaneda, K, Bradshaw, K, Herrero Romero, R. Developmental challenges in HIV infected children – an updated systematic review. Child Youth Serv Rev. 2014; 45, 7489.Google Scholar
30. World Health Organization. Consolidated Guidelines on the use of Antiretroviral Drugs for Treating and Preventing HIV Infection. 2013. World Health Organization: Geneva. Retrieved 15 May 2015 from http://www.who.int/hiv/pub/guidelines/arv2013/download/en/ Google Scholar
31. De Cock, KM, Fowler, MG, Mercier, E, et al. Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice. JAMA. 2000; 283, 11751182.Google Scholar
32. Wachs, TD, Black, MM, Engle, PL. Maternal depression: a global threat to children’s health, development, and behavior and to human rights. Child Dev Perspect. 2009; 3, 5159.Google Scholar
33. Halbreich, U, Karkun, S. Cross-cultural and social diversity of prevalence of postpartum depression and depressive symptoms. J Affect Disord. 2006; 91, 97111.Google Scholar
34. Leahy-Warren, P, McCarthy, G. Postnatal depression: prevalence, mothers’ perspectives, and treatments. Arch Psychiatr Nurs. 2007; 21, 91100.Google Scholar
35. Magwaza, AS, Edwards, SD. An evaluation of an integrated parent-effectiveness training and children’s enrichment programme for disadvantaged families. South Afr J Psychol. 1991; 21, 2125.CrossRefGoogle Scholar
36. Kagitcibasi, C, Sunar, D, Bekman, S. Long-term effects of early intervention: Turkish low-income mothers and children. J Appl Dev Psychol. 2001; 22, 333361.Google Scholar
37. Eickmann, SH, Lima, ACV, Guerra, MQ, et al. Improved cognitive and motor development in a community-based intervention of psychosocial stimulation in northeast Brazil. Dev Med Child Neurol. 2003; 45, 536541.Google Scholar
38. UNICEF. The State of the World’s Children 2012. 2012. UNICEF: New York. Retrieved 18 May 2015 from http://www.unicef.org/sowc09/docs/SOWC09-FullReport-EN.pdf Google Scholar
39. World Health Organization, UNICEF, the World Bank. 2013 Joint child malnutrition estimates – Levels and trends. Global Database on Child Growth and Malnutrition, 2014. Retrieved 16 February 2015 from http://www.who.int/nutgrowthdb/estimates2013/en/ Google Scholar
40. Division of Malaria Control [Ministry of Public Health and Sanitation], Kenya National Bureau of Statistics, ICF Macro. 2010 Kenya Malaria Indicator Survey. 2011. DOMC, KNBS, and ICF Macro: Nairobi, Kenya. Retrieved 29 January 2015 from http://dhsprogram.com/pubs/pdf/MIS7/MIS7.pdf Google Scholar
41. Nriagu, J. Toxic metal pollution in Africa. Sci Total Environ. 1992; 121, 137.Google Scholar
42. Golow, A, Kwaansa-Ansah, E. Comparisons of lead and zinc levels in the hair of pupils from four towns in Jumasi municipal area of Ghana. Bull Environ Contam Toxicol. 1994; 53, 325331.Google Scholar
43. Advisory Committee on Childhood Lead Poisoning Prevention. Low Level Lead Exposure Harms Children: A Renewed Call for Primary Prevention. 2012. Centers for Disease Control and Prevention: Atlanta, GA. Retrieved 3 March 2015 from http://www.cdc.gov/nceh/lead/acclpp/final_document_030712.pdf Google Scholar
44. The Partnership for Clean Fuels and Vehicles. An Overview of the Partnership for Clean Fuels and Vehicles (PCFV). United Nations Environment Programme; 2014. Retrieved 15 January 2015. http://www.unep.org/Transport/New/PCFV/pdf/PCFV-Brochure-April2014_combined.pdf Google Scholar
45. National AIDS Coordinating Agency Republic of Botswana, UNAIDS. Botswana 2013 global AIDS response report: progress report of the national response to the 2011 declaration of commitments on HIV and AIDS. Republic of Botswana: National AIDS Coordinating Agency; 2014 Mar. Retrieved 18 January 2015 from http://www.unaids.org/sites/default/files/en/dataanalysis/knowyourresponse/countryprogressreports/2014countries/BWA_narrative_report_2014.pdf Google Scholar
46. The Namibia Ministry of Health and Social Services (MoHSS), ICF International. The Namibia Demographic and Health Survey 2013. 2014. MoHSS and ICF International: Windhoek, Namibia, and Rockville, Maryland, USA. Retrieved 30 January 2015 from: http://dhsprogram.com/pubs/pdf/FR298/FR298.pdf Google Scholar
47. Sawyer, A, Ayers, S, Smith, H. Pre- and postnatal psychological wellbeing in Africa: a systematic review. J Affect Disord. 2010; 123, 1729.Google Scholar
48. Fatoye, FO, Oladimeji, BY, Adeyemi, AB. Difficult delivery and some selected factors as predictors of early postpartum psychological symptoms among Nigerian women. J Psychosom Res. 2006; 60, 299301.Google Scholar
49. Adewuya, AO, Ola, BO, Aloba, OO, Mapayi, BM, Okeniyi, JAO. Impact of postnatal depression on infants’ growth in Nigeria. J Affect Disord. 2008; 108, 191193.Google Scholar
50. Owoeye, AO, Aina, OF, Morakinyo, O. Risk factors of postpartum depression and EPDS scores in a group of Nigerian women. Trop Doct. 2006; 36, 100103.Google Scholar
51. Ukpong, DI, Owolabi, AT. Postpartum emotional distress: a controlled study of Nigerian women after caesarean childbirth. J Obstet Gynaecol J Inst Obstet Gynaecol. 2006; 26, 127129.Google Scholar
52. Lawrie, TA, Hofmeyr, GJ, de Jager, M, Berk, M. Validation of the edinburgh postnatal depression scale on a cohort of South African women. South Afr Med J Suid-Afr Tydskr Vir Geneeskd. 1998; 88, 13401344.Google Scholar
53. Cooper, PJ, Tomlinson, M, Swartz, L, et al. Post-partum depression and the mother-infant relationship in a South African peri-urban settlement. Br J Psychiatry J Ment Sci. 1999; 175, 554558.Google Scholar
54. Hanlon, C, Medhin, G, Alem, A, et al. Detecting perinatal common mental disorders in Ethiopia: validation of the self-reporting questionnaire and Edinburgh Postnatal Depression Scale. J Affect Disord. 2008; 108, 251262.CrossRefGoogle ScholarPubMed
55. Coleman, R, Morison, L, Paine, K, Powell, RA, Walraven, G. Women’s reproductive health and depression: a community survey in the Gambia, West Africa. Soc Psychiatry Psychiatr Epidemiol. 2006; 41, 720727.Google Scholar
56. Cox, JL. Postnatal depression: a comparison of African and Scottish women. Soc Psychiatry Sozialpsychiatrie Psychiatr Soc. 1983; 18, 2528.CrossRefGoogle ScholarPubMed
57. OECD. Health at a Glance: Europe 2012. 2012 OECD Publishing: Paris. Retrieved 19 May 2015 from http://www.oecd-ilibrary.org.proxy.library.emory.edu/social-issues-migration-health/health-at-a-glance-europe-2012_9789264183896-en Google Scholar
58. Ministry of Public Health and Sanitation (Republic of Tanzania). National Nutrition Action Plan (2012–2017). Ministry of Public Health and Sanitation; 2013. Retrieved 15 July 2015 from http://scalingupnutrition.org/wp-content/uploads/2013/10/Kenya-National-Nutrition-Action-Plan-2012-2017-final.pdf Google Scholar
59. Micronutrient Initiative. The Micronutrient Initiative in Africa. Micronutrient Initiative. 2015. Retrieved 2 March 2015 from http://www.micronutrient.org/english/view.asp?x=547.Google Scholar
60. Iodine Global Network. Global Iodine Nutrition Scorecard for 2012. Iodine Global Network; 2013. Retrieved 2 March 2015 from http://www.ign.org/cm_data/Scorecard_IGN_website_02_03_2015.pdf Google Scholar
61. Pearce, EN, Andersson, M, Zimmermann, MB. Global iodine nutrition: where do we stand in 2013? Thyroid. 2013; 23, 523528.Google Scholar
62. Cao, XY, Jiang, XM, Dou, ZH, et al. Timing of vulnerability of the brain to iodine deficiency in endemic cretinism. N Engl J Med. 1994; 331, 17391744.Google Scholar
63. Qian, M, Wang, D, Watkins, WE, et al. The effects of iodine on intelligence in children: a meta-analysis of studies conducted in China. Asia Pac J Clin Nutr. 2005; 14, 3242.Google Scholar
64. van den Wijngaart, A, Begin, F, Codling, K, Randall, P, Johnson, QW. Regulatory monitoring systems of fortified salt and wheat flour in selected ASEAN countries. Food Nutr Bull. 2013; 34, 102S111S.Google Scholar
65. United Nations Children’s Fund Micronutrient Initiative (UNICEF/MI) Vitamin and Mineral Deficiency. A Global Progress Report. Ottawa, 2004.Google Scholar
66. Nriagu, JO, Blankson, ML, Ocran, K. Childhood lead poisoning in Africa: a growing public health problem. Sci Total Environ. 1996; 181, 93100.Google Scholar
67. Lacey, M. Belatedly, Africa Is Converting to Lead-Free Gasoline. The New York Times, 31 October 2004. Retrieved 15 January 2015 from http://www.nytimes.com/2004/10/31/international/africa/31kenya.html Google Scholar
68. Nriagu, J, Oleru, NT, Cudjoe, C, Chine, A. Lead poisoning of children in Africa, III. Kaduna, Nigeria. Sci Total Environ. 1997; 197, 1319.Google Scholar
69. Nriagu, J, Jinabhai, CC, Naidoo, R, Coutsoudis, A. Lead poisoning of children in Africa, II. Kwazulu/Natal, South Africa. Sci Total Environ. 1997; 197, 111.Google Scholar
70. Ferrand, RA, Corbett, EL, Wood, R, et al. AIDS among older children and adolescents in Southern Africa: projecting the time course and magnitude of the epidemic. AIDS Lond Engl. 2009; 23, 20392046.Google Scholar
71. Ferrand, RA, Bandason, T, Musvaire, P, et al. Causes of acute hospitalization in adolescence: burden and spectrum of HIV-related morbidity in a country with an early-onset and severe HIV epidemic: a prospective survey. PLoS Med. 2010; 7, e1000178.Google Scholar
72. Walker, AS, Mulenga, V, Sinyinza, F, et al. Determinants of survival without antiretroviral therapy after infancy in HIV-1-infected Zambian children in the CHAP Trial. J Acquir Immune Defic Syndr. 2006; 42, 637645.CrossRefGoogle ScholarPubMed
73. Rice, ML, Zeldow, B, Siberry, GK, et al. Evaluation of risk for late language emergence after in utero antiretroviral drug exposure in HIV-exposed uninfected infants. Pediatr Infect Dis J. 2013; 32, e406e413.Google Scholar
74. Gadow, KD, Angelidou, K, Chernoff, M, et al. Longitudinal study of emerging mental health concerns in youth perinatally infected with HIV and peer comparisons. J Dev Behav Pediatr JDBP. 2012; 33, 456468.Google Scholar
75. Abiodun, OA. Postnatal depression in primary care populations in Nigeria. Gen Hosp Psychiatry. 2006; 28, 133136.Google Scholar
76. Tomlinson, M, Cooper, P, Murray, L. The mother-infant relationship and infant attachment in a South African peri-urban settlement. Child Dev. 2005; 76, 10441054.Google Scholar