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Solid fuel use and early child development disparities in Ghana: analyses by gender and urbanicity

In Ghana, more than 77% of the population depends on biomass fuels for cooking. Previous studies show that solid fuel use (SFU) has adverse effects on pregnancy and child health outcomes. Yet, no previous study considered potential effects on early child development indicators (ECDI), nor how SFU ef...

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Autores principales: Nazif-Muñoz, José Ignacio, Spengler, John D., Arku, Raphael E., Oulhote, Youssef
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group US 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8075970/
https://www.ncbi.nlm.nih.gov/pubmed/32366880
http://dx.doi.org/10.1038/s41370-020-0224-4
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author Nazif-Muñoz, José Ignacio
Spengler, John D.
Arku, Raphael E.
Oulhote, Youssef
author_facet Nazif-Muñoz, José Ignacio
Spengler, John D.
Arku, Raphael E.
Oulhote, Youssef
author_sort Nazif-Muñoz, José Ignacio
collection PubMed
description In Ghana, more than 77% of the population depends on biomass fuels for cooking. Previous studies show that solid fuel use (SFU) has adverse effects on pregnancy and child health outcomes. Yet, no previous study considered potential effects on early child development indicators (ECDI), nor how SFU effects may vary by gender, and rural and urban areas. We investigated the associations of SFU with ECDI measures, and whether these associations exhibited sex and urban/rural differences. We used the 2011–2012 Ghana’s Multiple Indicator Cluster Surveys–UNICEF (N = 3326 children; 3–4 years). We derived a binary ECDI measure reflecting whether the child is developmentally on track or not from a caregiver-report of ten yes/no/do not know questions designed specifically to assess four domains of early child development: learning-cognition, literacy-numeracy, socio-emotional, and physical. We used multilevel Poisson regressions adjusting for neighborhood, household, mother, and child’s characteristics to estimate covariate-adjusted prevalence ratios (PRs) of the associations between SFU and ECDI and its four dimensions. We run stratified analyses and used z-score tests of differences to evaluate effect modification by sex and urbanicity. Overall, 85% of children were exposed to SFU and 28% of children were not developmentally on track. After adjustment for confounders, children exposed to SFU were more likely to be not developmentally on track in comparison with nonexposed children (PR = 1.16; 95% confidence interval, [95% CI]: 1.10,1.22). These associations were stronger in girls (PR = 1.36; 95% CI: 1.03,1.79) in comparison with boys (PR = 0.87; 95% CI: 0.73,1.04). No difference in associations was observed between urban and rural children. Overall, these associations were mainly driven by the literacy-numeracy dimension. In this study, we show that SFU was associated with developmental delays in Ghanaian girls. Policy efforts which tackle SFU should be mindful of gender disparities in susceptibility to indoor pollution.
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spelling pubmed-80759702021-05-06 Solid fuel use and early child development disparities in Ghana: analyses by gender and urbanicity Nazif-Muñoz, José Ignacio Spengler, John D. Arku, Raphael E. Oulhote, Youssef J Expo Sci Environ Epidemiol Article In Ghana, more than 77% of the population depends on biomass fuels for cooking. Previous studies show that solid fuel use (SFU) has adverse effects on pregnancy and child health outcomes. Yet, no previous study considered potential effects on early child development indicators (ECDI), nor how SFU effects may vary by gender, and rural and urban areas. We investigated the associations of SFU with ECDI measures, and whether these associations exhibited sex and urban/rural differences. We used the 2011–2012 Ghana’s Multiple Indicator Cluster Surveys–UNICEF (N = 3326 children; 3–4 years). We derived a binary ECDI measure reflecting whether the child is developmentally on track or not from a caregiver-report of ten yes/no/do not know questions designed specifically to assess four domains of early child development: learning-cognition, literacy-numeracy, socio-emotional, and physical. We used multilevel Poisson regressions adjusting for neighborhood, household, mother, and child’s characteristics to estimate covariate-adjusted prevalence ratios (PRs) of the associations between SFU and ECDI and its four dimensions. We run stratified analyses and used z-score tests of differences to evaluate effect modification by sex and urbanicity. Overall, 85% of children were exposed to SFU and 28% of children were not developmentally on track. After adjustment for confounders, children exposed to SFU were more likely to be not developmentally on track in comparison with nonexposed children (PR = 1.16; 95% confidence interval, [95% CI]: 1.10,1.22). These associations were stronger in girls (PR = 1.36; 95% CI: 1.03,1.79) in comparison with boys (PR = 0.87; 95% CI: 0.73,1.04). No difference in associations was observed between urban and rural children. Overall, these associations were mainly driven by the literacy-numeracy dimension. In this study, we show that SFU was associated with developmental delays in Ghanaian girls. Policy efforts which tackle SFU should be mindful of gender disparities in susceptibility to indoor pollution. Nature Publishing Group US 2020-05-04 2020 /pmc/articles/PMC8075970/ /pubmed/32366880 http://dx.doi.org/10.1038/s41370-020-0224-4 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Nazif-Muñoz, José Ignacio
Spengler, John D.
Arku, Raphael E.
Oulhote, Youssef
Solid fuel use and early child development disparities in Ghana: analyses by gender and urbanicity
title Solid fuel use and early child development disparities in Ghana: analyses by gender and urbanicity
title_full Solid fuel use and early child development disparities in Ghana: analyses by gender and urbanicity
title_fullStr Solid fuel use and early child development disparities in Ghana: analyses by gender and urbanicity
title_full_unstemmed Solid fuel use and early child development disparities in Ghana: analyses by gender and urbanicity
title_short Solid fuel use and early child development disparities in Ghana: analyses by gender and urbanicity
title_sort solid fuel use and early child development disparities in ghana: analyses by gender and urbanicity
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8075970/
https://www.ncbi.nlm.nih.gov/pubmed/32366880
http://dx.doi.org/10.1038/s41370-020-0224-4
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