(P24-047-24) Association Between Stunting and Developmental Delays in Children Under 6 Years of Age: Empirical Evidence From Lesotho

Objectives: Worldwide, over 250 million children under 5 years do not reach their developmental potential due to several causes, including malnutrition. In Lesotho, the prevalence of malnutrition remains high but data linking child malnutrition and development are limited. We aimed to assess the association of different forms of malnutrition with the risk for developmental delays among children 0-6 years old in Lesotho.

Methods: We used cross-sectional data on 428 children from a pilot on early identification of developmental delays conducted at ten health centers and preschools in Maseru and Mokhotlong districts. Data included age, sex, reported special health care needs, anthropometry (weight, length/height, and mid-upper arm circumference), risk for developmental delays using the Survey of Wellbeing in Young Children (ages 2-23 months), and functional difficulties using the Washington Group/UNICEF Child Functioning Module (ages 24-72 months). Stunting, wasting, and underweight were defined as z-scores < –2 for length/height for age, weight for length/height, and weight for age, respectively. We used odds ratios (OR) [95% confidence intervals] and chi-squared tests to compare malnutrition by risk for developmental delays.

Results: The mean age was 31.6±22.4 months, 51.6% were girls, and only 2.8% had reported special health care needs. The prevalence of stunting, wasting and underweight were 28.6%, 6.1%, and 13.4%, respectively. Risk for developmental delays was found in 22% of children 2-23 months old and functional difficulties in 6% of children 24-72 months old. Stunting was higher in children aged 0-23 months vs. ≥ 24 months (37.7% vs. 24.2%; p=0.005). Overall, stunting was associated with risk for developmental delays or functional difficulties (OR 1.97 [1.22-3.19]; p=0.005). For children aged 0-23 months, this association was present with borderline significance (OR 2.09 [0.97-4.49]; p=0.056). Underweight and wasting were not associated with risk for developmental delays.

Conclusions: Early identification of developmental delays and interventions that prevent stunting may contribute to improved child developmental outcomes in Lesotho. Integrating nutrition and early childhood development programming during the first 1,000 days is needed for greater impact on child outcomes.

Funding Sources: UNICEF-Lesotho Contract# 43339872