Elsevier

Early Human Development

Volume 84, Issue 9, September 2008, Pages 613-621
Early Human Development

Socioeconomic status, anthropometric status, and psychomotor development of Kenyan children from resource-limited settings: A path-analytic study

https://doi.org/10.1016/j.earlhumdev.2008.02.003Get rights and content

Abstract

Background

Sub-optimal physical growth has been suggested as a key pathway between the effect of environmental risk and developmental outcome.

Aim

To determine if anthropometric status mediates the relation between socioeconomic status and psychomotor development of young children in resource-limited settings.

Study design

A cross-sectional study design was used.

Subjects

A total of 204 (105 girls) children from two resource-limited communities in the Coast Province, Kenya. The mean age of these children was 29 months (SD = 3.43; range: 24–35 months).

Outcome measure

Psychomotor functioning was assessed using a locally developed and validated measure, the Kilifi Developmental Inventory.

Results

A significant association was found between anthropometric status (as measured by weight-for-age, height-for-age, mid-upper arm circumference, and head circumference) and psychomotor functioning and also between socioeconomic status and anthropometric status; no direct effects were found between socioeconomic status and developmental outcome. The models showed that weight, height and to a lesser extent mid-upper arm circumference mediate the relation between socioeconomic status and developmental outcome, while head circumference did not show the same effect.

Conclusion

Among children under 3 years living in poverty, anthropometric status shows a clear association with psychomotor development while socioeconomic status may only have an indirect association.

Section snippets

Study setting

The study took place at two sites. The first site was the Kenya Medical Research Institute, Centre for Geographic Medicine Research (Coast), Kilifi, Kenya. Kilifi is situated in a predominantly rural community. The majority of families depend upon subsistence farming with approximately (67%) of the population in the district living below the poverty line [21]. The majority of the population in Kilifi belong to the Mijikenda ethnic/linguistic group. Two Bantu languages are mostly spoken in the

Anthropometric status

Approximately 49% (N = 100) of the children were stunted, and 19.6% (N = 40) were underweight as measured by HAZ and WAZ scores below − 2 SD, respectively. Results indicate that rural children were more likely to be stunted (57%) than urban children (41.3%) were. A Pearson chi square test showed that this difference was significant (χ2(1, N = 204) =4.99, p = 0.03). The difference in percentage of children who were underweight was not significantly different for the urban and rural group (rural: 23%,

Discussion

Consistent with previous studies we found a relationship between SES indicators and HAZ, WAZ, and MUACZ [32], [33], [34], [35]. We also found that anthropometric status was significantly correlated with psychomotor performance which is consistent with earlier reports [36], [37], [38]. The psychomotor performance of children experiencing poor physical growth ranged from moderate delay for stunting, being underweight and MUACZ, to severe delay for those with poor head growth, as indicated by the

Acknowledgements

This paper is published with permission from the Director of KEMRI. Amina Abubakar and Penny Holding were supported by the NIMH Fogarty R21award (Grant MH72597-02). Professor Charles Newton is funded by the Wellcome Trust, UK (070114). The authors would like to thank B. Kabunda, R. Mapenzi, C. Mapenzi, P. Nzai, J. Maitha, M. Mwangome, E. Obiero, K. Rimba and G. Bomu for their role in the data collection, and K. Katana and P. Kadii for data entry. Our sincere gratitude goes to the families that

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