Construction and Examination of an Early Childhood Development Composite Index: Evidence from Iran's Multiple Indicator Demographic and Health Survey.

Background: Assessing children's early development can help health and social policymakers to improve children's well-being. This study aims to develop an early childhood composite index for measuring early childhood care and education among Iranian children considering each child's geographical area, socioeconomic status and gender. Methods: In this cross-sectional secondary study, the data come from Iran's Multiple Indicator Demographic and Health Survey 2010. Of the 9,345 eligible children whose information had been collected, 3,532 fulfilled the inclusion criterion of being 3 or 4 years old at the time of the interview. We examined a composite index and three subscales of early childhood development including "Quality of Care", "Early Childhood Care and Education", and "Overall Developmental Status". Factor analysis and latent class analysis were used for analyzing the data. Results: The results indicate that of the children in the sample, 47.3% were in the "low early child development" class, 6% were in the "middle early child development" class, and 46.7% were in the "high early child development" class. The means of the three subscales and the composite index were significantly different across geographical areas (P < 0.01) and between the socioeconomic classes (P < 0.0001), with children from poorer families having lower scores. The composite index was significantly higher for girls (M = 11.28, SD = 3.96) than boys (M = 10.99, SD = 3.87, P = 0.029). Conclusions: The study presents significant differences in childhood development based on geographical divisions, quartile classes and gender. We suggest that future research is needed to explore the robustness of findings in this study over time and diversity between and within various Iranian populations.