Monday, April 21
Grant Miller: Managerial Incentives in Public Service Delivery
Hadley, C., A. Tegegn, F. Tessema, M. Asefa, and Sandro Galea. 2008. "Parental symptoms of common mental disorders and children's social, motor, and language development in sub-Saharan Africa." Annals of Human Biology, 35(3): 259-275.
Background: There is increasing interest in the social determinants of children's developmental outcomes in developing countries because of the links with schooling, behavioral, and employment outcomes. Yet, little is known about the impact of household and caretaker variables in influencing developmental outcomes in rural, developing country settings. Aim: The study examined the relative impact of individual and household variables and caretaker symptoms of common mental disorders on children's personal-social, fine and gross motor, and language development. Subjects and methods: A total of 431 children aged 3-24 months in a rural Ethiopian setting were studied. Children underwent a developmental assessment and parents independently provided information on household characteristics and were administered anxiety and depression symptom inventories. Results: In adjusted multivariable models, maternal symptoms of mental disorders were associated with both global development and most developmental sub-scales (p < 0.01) except language developmental; there was no consistent relation between paternal symptoms of mental disorders and child development. Nutritional stunting was generally a risk factor for lower developmental scores but few household-level variables were associated with child development. Conclusion: Child development in this setting is strongly associated with child age and maternal depression. If these findings are replicated elsewhere, they may suggest that interventions aimed at improving maternal depression may have an important role to play in efforts to improve child development and to mitigate the intergenerational transmission of poor health in sub-Saharan Africa.