Early childhood development status and associated factors among preschool children attending routine well clinics in Temeke Municipal, Dar es Salaam-Tanzania: a cross-sectional study.

Introduction: Early Childhood Development (ECD) is a social and public health concern especially in low- and middle-income countries whereby around 43% of children living in these countries are at risk of developmental delays. This may negatively affect their potential including reduced productivity in adulthood. Data from the 2022 Tanzania Demographic and Health Survey has shown that around 47.4% of children aged 24-59 months scored low in their early childhood scores. However, factors associated with low suboptimal ECD are not well understood. This study aimed to determine the magnitude and characteristics associated with low ECD scores among children aged 24-59 months attending RCH clinics in Temeke Municipal, Dar-es-salaam region.

Methods: the study was a facility-based cross-section study design involving Children aged 24 - 59 months attending RCH clinics in Temeke District, Dar-es-salaam, Tanzania. An interviewer-guided questionnaire was used to collect basic demographic information while ECD scores among participants were determined using a standardized ECD-I2030 tool. Data analysis was conducted using Statistical Package for Social Sciences (SPSS). The magnitude of children not on track was expressed in frequency and percentages. Factors associated with poor ECD were determined by using binary logistic regression analysis. The alpha level of 0.05 or less was considered statistically significant.

Results: a total of 422 children were enrolled in the study. Among participants, only 144(34.1%) were on track based on their childhood development scores while 278 (65.9%) were off track. Young age (AOR=0.149 (0.354-0.63); p-value=0.001), nutritional status (AOR=7.729(2.234-26.735); p value=0.010) and parents' employment status (AOR=3.730(1.937-7.184); p-value=0.001) were independently associated ECD scores.

Conclusion: most children enrolled in this study were off-track in their ECD scores which may limit the realization of their full potential. Young age, malnutrition and unemployed parents were significant factors associated with EDC delays. Therefore, targeted interventions aimed at ensuring food security and nutrition, economic empowerment of families through formal employment, and early positive parenting practices may improve ECDs among this age group.