Food Insecurity and Early Childhood Development among Children 24-59 Months in Nigeria: A Multilevel Mixed Effects Modelling of the Social Determinants of Health Inequities

Otobo Ujah, University of South Florida
Omojo Adaji, Sight Saver
Innocent Ujah, Federal University of Health Sciences
Russell Kirby, University of South Florida

Following the recent replacement of the original Early Childhood Development Index (ECDI) with the Early Development Index 2030 (ECDI2030), we investigated the association between household food insecurity (HFI) and early childhood development (ECD), accounting for socio-ecological determinants among children aged 24-59 months in Nigeria (N = 11,494). Data were drawn from the 2021 Multiple Indicator Cluster Survey in Nigeria. We measured ECD using the ECDI2030, across domains of learning, psychosocial well-being, and health. HFI was assessed using the Food Insecurity Experience Scale (FIES), categorized as none, moderate, and severe. We estimated the relationship between HFI and ECD using multilevel logistic regression models, with random intercepts, adjusting for child, maternal/household, and contextual level characteristics. Approximately 76% of children experienced HFI, and 46.4% of children were developmentally off track. The intercept-only model showed statistically significant variation in the prevalence of ECD status (t00 = 0.94, intraclass correlation = 0.21, p < 0.0001). Adjusting for confounders, HFI was not associated with ECD. However, multiple factors at the child, maternal/household, and broader contextual levels were associated with ECD. Results indicate the association between HFI and ECD in children aged 24-59 months in Nigeria remains inconclusive and is influenced by compositional and contextual factors.

Keywords: Multi-level modeling , Children, Adolescents, and Youth, Population, Shocks and Pandemics, Neighbourhood/contextual effect analysis

See paper.