Developmental delay and associated factors among children aged 6-36 months in urban slums of Gondar city, Northwest Ethiopia. A thesis submitted to the institute of Public Health, College of Medicine and Health Sciences, and University of Gondar in partial fulfillment of the requirements for the degree of master of public health

Abstract

Background: Developmental delay is a delay in two or more of the developmental domains (gross and fine motor, speech and language, problem solving, social and personal). Various studies have estimated that 43% of children under five years of age living in low- and middle-income countries like Ethiopia are at risk of suboptimal development due to poverty and malnutrition. Objective: The aim of the study to assess developmental delay and its associated factors among children aged 6-36 months living in slum areas of Gondar City, Northwest Ethiopia. Methods: A community-based cross-sectional study was conducted from May 22–July 10, in slum areas of Gondar City. Systematic sampling was applied to select a total of 532 children aged 6–36 months along with their caregivers. The child’s developmental delay was assessed using standardized age and stage questionnaires (ASQ) version-3. Data was collected electronically using kobo tool box, exported to EXCL and final exported to SPSS version 25.0 for analysis. Anthropometric related data were analyzed using the WHO Anthro software and wealth index data were generated by principal component analysis. Bivariable Binary logistic regression was used to assess the association between dependent and each independent variable. All candidate variables for multivariable logistic regression model to control for confounders and identify factors associated with developmental delay. Adjusted odds ratio alongside 95Confidence intervals (CIs) were estimated tomeasure the strength of the association. Level of statistical significance was declared (p-value<0.05). Result: - The overall prevalence of developmental delay was 31.0% 95% CI (27.1%-35.1%).. Higher delays were observed in the personal-social (44.4%) domain, followed by problem solving (31.8%). Number of under-five children in households [AOR=7.27, 95%CI: 2.73-19.33], iron folic acid taken during pregnancy [AOR=2.22,95%CI: 1.59-5.04], birth interval [AOR=0.56, 95%CI: 0.333-0.96],shousehold dietary diversity [AOR=2.41, 95%CI: 1.42-4.09], stunting [AOR=3.08, 95%CI: 1.78-5.32], family size [AOR=1.96, 95%CI: 1.09-3.54] and child sex [AOR=2.18, 95%CI: 1.30-3.64] were statistically associated with developmental delay. Conclusion and recommendation: better to averse this high prevalence delay, work on focusing birth interval (spacing), family planning services, and offering iron during pregnancy. Give nutritional support program for children that living in slum areas. Better to give awareness for community about malnutrition children had risk of developmental delay.