{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T02:49:46Z","timestamp":1785466186258,"version":"3.56.0"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T00:00:00Z","timestamp":1709078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","award":["720-OAA-18C-00083"],"award-info":[{"award-number":["720-OAA-18C-00083"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","award":["720-OAA-18C-00083"],"award-info":[{"award-number":["720-OAA-18C-00083"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","award":["720-OAA-18C-00083"],"award-info":[{"award-number":["720-OAA-18C-00083"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-008034"],"award-info":[{"award-number":["INV-008034"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Anemia is a significant public health problem in many low- and middle-income countries (LMICs), with young children being especially vulnerable. Iron deficiency is a leading cause of anemia and prior studies have shown associations between low iron status\/iron deficiency anemia and poor child development outcomes. In LMICs, 43% of children under the age of five years are at risk of not meeting their developmental potential. However, few studies have examined associations between anemia status and early childhood development (ECD) in large population-based surveys. We examined the associations between severe or moderate anemia and ECD domains (literacy-numeracy, physical, social-emotional, and learning) and an overall ECD index among children age 36\u201359 months. Nine Demographic and Health Surveys (DHS) from phase VII of The DHS Program (DHS-7) that included the ECD module and hemoglobin testing in children under age five years were used. Bivariate and multivariate logistic regressions were run for each of the five outcomes. Multivariate models controlled for early learning\/interaction variables, child, maternal, and paternal characteristics, and socio-economic and household characteristics. Results showed almost no significant associations between anemia and ECD domains or the overall ECD index except for social-emotional development in Benin (<jats:italic>AOR<\/jats:italic> = 1.00 <jats:italic>p &lt;<\/jats:italic> 0.05) and physical development in Maldives (<jats:italic>AORs<\/jats:italic> = 0.97 <jats:italic>p &lt;<\/jats:italic> 0.05). Attendance at an early childhood education program was also significantly associated with the outcomes in many of the countries. Our findings reinforce the importance of the Nurturing Care Framework which describes a multi-sectoral approach to promote ECD in LMICs.<\/jats:p>","DOI":"10.1371\/journal.pone.0298967","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T18:29:26Z","timestamp":1709144966000},"page":"e0298967","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Is child anemia associated with early childhood development? A cross-sectional analysis of nine Demographic and Health Surveys"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4350-0403","authenticated-orcid":true,"given":"Rukundo K.","family":"Benedict","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8859-8144","authenticated-orcid":true,"given":"Thomas W.","family":"Pullum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Riese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Milner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,2,28]]},"reference":[{"issue":"9555","key":"pone.0298967.ref001","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/S0140-6736(07)60032-4","article-title":"Developmental potential in the first 5 years for children in developing countries","volume":"369","author":"S Grantham-McGregor","year":"2007","journal-title":"The Lancet"},{"issue":"10064","key":"pone.0298967.ref002","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/S0140-6736(16)31390-3","article-title":"Nurturing care: promoting early childhood development","volume":"389","author":"PR Britto","year":"2017","journal-title":"The Lancet"},{"issue":"10064","key":"pone.0298967.ref003","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/S0140-6736(16)31389-7","article-title":"Early childhood development coming of age: science through the life course","volume":"389","author":"MM Black","year":"2017","journal-title":"The Lancet"},{"issue":"12","key":"pone.0298967.ref004","doi-asserted-by":"crossref","first-page":"e916","DOI":"10.1016\/S2214-109X(16)30266-2","article-title":"Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level","volume":"4","author":"C Lu","year":"2016","journal-title":"The Lancet Global Health"},{"issue":"6","key":"pone.0298967.ref005","doi-asserted-by":"crossref","first-page":"e1002034","DOI":"10.1371\/journal.pmed.1002034","article-title":"Early Childhood Developmental Status in Low- and Middle-Income Countries: National, Regional, and Global 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