ArticleBMC public health2026
Social determinants of early childhood development in The Gambia: a multi-level analysis of household, maternal, and healthcare factors.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly childhood development is a critical determinant of lifelong health and well-being, yet evidence on its social and maternal determinants from West Africa remains limited. We examined the independent contributions of household, maternal, and healthcare factors to maternally reported suspected developmental concerns in children under two years in The Gambia.
methodsWe conducted a cross-sectional study of 504 mother-child dyads recruited through multi-stage probability sampling from urban and rural settlements in The Gambia (August-October 2021). The primary outcome was maternally reported suspected developmental concerns, assessed by a single binary question combining developmental and growth-related concerns. Cumulative maternal stress was measured using a 32-item binary checklist adapted from the Revised Prenatal Distress Questionnaire (Cronbach's α = 0.79). Hierarchical multivariable logistic regression examined factors at household (settlement type, education, income), maternal (age, stress, polygamy, intimate partner violence, anemia, hypertension), and healthcare (adequate antenatal care, ≥ 8 visits) levels with child age and sex retained as covariates. We formally tested for effect modification by settlement type using a product term.
resultsSuspected developmental concerns were reported for 69 children (13.7%). High cumulative maternal stress (≥ 6 stressors) was independently associated with the outcome (adjusted odds ratio [aOR] = 2.80, 95% confidence interval [CI]: 1.38-5.70, p = 0.004). Intimate partner violence during pregnancy showed a positive association of borderline significance (aOR = 2.06, 95% CI: 0.99-4.28, p = 0.054). Adequate antenatal care was not associated with the outcome (aOR = 0.81, 95% CI: 0.46-1.41, p = 0.452). The interaction between high stress and settlement type was not statistically significant (interaction p = 0.59); stratified estimates were of similar magnitude in urban (OR = 3.48) and rural (OR = 4.62) settings. Maternal-level factors substantially improved model fit (Δ pseudo-R² = 0.060) compared with household (R² = 0.027) or healthcare factors (ΔR² = 0.002).
conclusionCumulative maternal psychosocial stress was independently associated with maternally reported suspected developmental concerns in young Gambian children, with a similar association observed in urban and rural settings. Intimate partner violence during pregnancy showed a positive association of borderline statistical significance. The number of antenatal care visits alone was not associated with the outcome, suggesting that visit quantity may be insufficient without quality improvements that address maternal mental health. These findings, while cross-sectional and based on a single-item maternal-report outcome, support further investment in integrated maternal mental health services within antenatal care. Longitudinal studies using validated developmental assessments are needed to establish temporal relationships and causality.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.