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Child development in rural Ghana: Associations between cognitive/language milestones and indicators of nutrition and stimulation of children under two years of age

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Abstract

OBJECTIVES: Two studies aimed to assess the provision of nutrition and psychosocial stimulation in the home and to examine associations between mental development and nutrition and stimulation using a validated measure of development milestones.

METHODS: The first study consisted of secondary analyses on health and nutrition data from 1081 mother-child pairs (the children aged 0–12 months) and their households in Ghana’s Eastern Region. For the second study, the Ghana Milestones Measure, consisting of items assessing cognitive and language development, was used to assess child development in a subsample (N = 330) of Study 1 participants one year later (children 10–24 months of age). This measure was mother-reported and had been validated in a separate community in Ghana. Correlation and linear regression analyses were used to analyze the data.

RESULTS: Family assets and maternal education were identified as key factors of the family context. Both variables were positively associated with preventive health practices (r = 0.08 to 0.1 3, p < 0.0001 to 0.01), and dietary diversity (r = 0.15, p = 0.0001 to 0.0006), and negatively associated with maternal depressive symptoms (r = −0.19 to −0.12, p < 0.0001). Taller children had higher receptive (standardized beta = 0.16; p = 0.04) and expressive (0.21; 0.003) language, but not cognitive (0.15; 0.07) milestone scores, and psychosocial stimulation was positively associated with all three milestones (receptive = 0.1 3, p = 0.01; expressive = 0.21, p < 0.0001; and cognitive = 0.24, p < 0.0001).

CONCLUSION: Our study provides the first validated measure of children’s language and cognitive development in Ghana, finding associations with nutrition and stimulation. The Ghana Milestones Measure can be used to assess and help promote children’s mental development.

Résumé

OBJECTIFS: Deux études ont évalué la nutrition et la stimulation psychosociale en milieu familial et ont examiné les associations entre le développement mental d’une part, et la nutrition et la stimulation d’autre part, à l’aide d’un indicateur validé des étapes de développement.

MÉTHODE: Pour la première étude, des analyses secondaires des données de santé et de nutrition de 1 081 couples mère-enfant (les enfants étant âgés de 0 à 12 mois) et de leurs ménages ont été menées dans la Région orientale du Ghana. La seconde étude a fait appel au Ghana Milestones Measure, un indicateur d’évaluation du développement cognitif et de l’acquisition du langage, pour évaluer le développement des enfants dans un sous-échantillon (N = 330) des participants de l’étude 1 un an plus tard (les enfants étant âgés de 10 à 24 mois). Les éléments de l’indicateur ont été déclarés par les mères et validés dans une autre communauté du Ghana. Les données ont été analysées par corrélation et par régression linéaire.

RÉSULTATS: L’actif familial et l’instruction maternelle ont été jugés être les facteurs clés du milieu familial. Ces deux variables étaient associées positivement aux pratiques sanitaires préventives (r = 0,08 à 0,1 3, p < 0,0001 à 0,01 ) et à la diversité alimentaire (r = 0,15, p = 0,0001 à 0,0006), et associées négativement aux symptômes dépressifs maternels (r = −0,19 à −0,12, p < 0,0001). Le langage réceptif (coefficient normalisé [bêta] = 0,16; p = 0,04) et expressif (0,21; 0,003) des enfants de plus grande taille était plus développé, mais non leurs indices de développement cognitif (0,15; 0,07), et la stimulation psychosociale était associée positivement aux trois étapes (langage réceptif = 0,1 3, p = 0,01; langage expressif = 0,21, p < 0,0001; et développement cognitif = 0,24, p < 0,0001).

CONCLUSION: Notre étude, qui offre le premier indicateur validé du développement linguistique et cognitif des enfants au Ghana, établit des associations avec la nutrition et la stimulation. L’outil Ghana Milestones Measure peut être utilisé pour évaluer et contribuer à favoriser le développement mental des enfants.

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Authors and Affiliations

  1. Department of Psychology, McCill University, Montreal, QC, Canada

    Marilyn N. Ahun BA & Frances E. Aboud PhD

  2. Department of Social and Preventive Medicine, University of Montreal, Montreal, QC, 7101 Avenue du Parc, 3rd Floor, H3N 1X9, Canada

    Marilyn N. Ahun BA

  3. School of Public Health, University of Ghana, Accra, Ghana

    Richmond Aryeetey PhD & Esi Colecraft PhD

  4. School of Dietetics and Human Nutrition, McCill University, Sainte-Anne-de-Bellevue, QC, Canada

    Grace S. Marquis PhD

Authors
  1. Marilyn N. Ahun BA
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  2. Frances E. Aboud PhD
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  5. Grace S. Marquis PhD
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Corresponding author

Correspondence to Marilyn N. Ahun BA.

Additional information

Acknowledgements: The Government of Canada provides funding for this initiative through Global Affairs Canada. Additional funding was provided by McCill University and World Vision Canada. We thank Bridget Aidem of World Vision for providing nutrition survey items, Dr. Theresa Thompson-Colón for managing the data, Mr. Boateng Bannerman for his key role in field and data management, the Kintampo Health Research Centre (Ghana) for recruiting participants, the data collectors and all the mothers who participated in our study.

Conflict of Interest: None to declare.

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Ahun, M.N., Aboud, F.E., Aryeetey, R. et al. Child development in rural Ghana: Associations between cognitive/language milestones and indicators of nutrition and stimulation of children under two years of age. Can J Public Health 108, e578–e585 (2017). https://doi.org/10.17269/CJPH.108.5875

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  • DOI: https://doi.org/10.17269/CJPH.108.5875

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