Nutritional status and milestone development of children aged 3 to 5 years attending early childhood development centres at Chief Albert Luthuli Municipality

Abstract

Introduction: Nutritional status is vital for overall health and development in children. Anthropometry, reflecting health and nutritional status, predicts performance and survival. Children's development follows unique trajectories, with specific milestones achieved universally. This study explores the nutritional status and milestone development of preschoolers. Methods: A cross-sectional design was employed, clustering the Chief Albert Luthuli municipality into four circuits. Four Early Childhood Development (ECD) centers were randomly chosen from each cluster. Utilising Slovin’s formula, the sample size was determined, resulting in 353 participants. Participants were children attending ECD centers, while caregivers and ECD teachers were informants. Data were collected via a questionnaire and three 24-hour recalls assessing dietary diversity. Anthropometric measurements were taken using standard techniques, and developmental screening was conducted using the Developmental Assessment of Young Children-Second Edition (DAYC-2). Inferential statistics determined associations between nutritional status and milestone development. Results: Regarding household characteristics, the study found varying levels of access to resources such as land for food production and improved water sources. Notably, most households relied on electricity (94%) for cooking, while a portion of households still used wood (62%) as the primary cooking fuel, which has implications for indoor air quality and environmental sustainability. Across three visits, most children exhibited high dietary diversity scores (DDS) (63-77%). Commonly consumed food groups included meat and fish (72-78%), milk and dairy products (68-73%), with organ meat (5-8%) and eggs (6-13%) less frequent. The prevalence of stunting, underweight, and wasting varied, with stunting at 17.9%, underweight at 19.9%, and wasting at 23.2%. Approximately 8% showed suspected developmental delays, notably in physical fine motor skills (27%). Positive correlations were found between weight-for-height (wasting) and general development index (GDI) (p=0.00) as well as between DDS and GDI (p=0.00). Conclusion: The prevalence of malnutrition varied, with wasting being notably high. Physical fine motor skills showed lower scores in a significant proportion of children. However, most children met the expected milestones across developmental domains. Significant associations were observed between anthropometric indicators, DDS, and milestone development. These findings underscore the importance of addressing nutritional status and milestone development in preschool-aged children for their overall well-being and development.