Skip to main content
Top
Published in: BMC Public Health 1/2022

Open Access 01-12-2022 | Research

The impact of social determinants of health on early childhood development: a qualitative context analysis in Iran

Authors: Omolbanin Atashbahar, Ali Akbari Sari, Amirhossein Takian, Alireza Olyaeemanesh, Efat Mohamadi, Sayyed Hamed Barakati

Published in: BMC Public Health | Issue 1/2022

Login to get access

Abstract

Background

Social determinants have a significant impact on children’s development and their abilities and capacities, especially in early childhood. They can bring about inequity in living conditions of children and, as a result, lead to differences in various dimensions of development including the social, psychological, cognitive and emotional aspects. We aimed to identify and analyze the social determinants of Early Childhood Development (ECD) in Iran and provide policy implications to improve this social context.

Methods

In a qualitative study, data were collected through semi-structured interviews with 40 experts from October 2017 to June 2018. Based on Leichter’s (1979) framework and using the deductive approach, two independent researchers conducted the data analysis. We used MAXQDA.11 software for data management.

Results

We identified challenges related to ECD context in the form of 8 themes and 22 subthemes in 4 analytical categories relevant to the social determinants of ECD including: Structural factors (economic factors: 6 subthemes, political factors: 2 subthemes), Socio-cultural factors (the socio-cultural setting of society: 6 subthemes, the socio-cultural setting of family: 4 subthemes), Environmental or International factors (the role of international organizations: 1 subtheme, political sanctions: 1 subtheme), and Situational factors (genetic factors: 1 subtheme, the phenomenon of air pollution: 1 subtheme). We could identify 24 policy recommendations to improve the existing ECD context from the interviews and literature.

Conclusion

With regard to the challenges related to the social determinants of ECD, such as increasing social harms, decreasing social capital, lack of public awareness, increasing socio-economic inequities, economic instability, which can lead to the abuse and neglect of children or unfair differences in their growth and development, the following policy-making options are proposed: focusing on equity from early years in policies and programs, creating integration between policies and programs from different sectors, prioritizing children in the welfare umbrella, empowering families, raising community awareness, and expanding services and support for families, specially the deprived families subject to special subsidies.
Appendix
Available only for authorised users
Literature
1.
go back to reference Avan BI, Kirkwood BR. Review of the theoretical frameworks for the study of child development within public health and epidemiology. J Epidemiol Community Health. 2010;64:388–93.PubMedCrossRef Avan BI, Kirkwood BR. Review of the theoretical frameworks for the study of child development within public health and epidemiology. J Epidemiol Community Health. 2010;64:388–93.PubMedCrossRef
2.
go back to reference Busolo B, Agembo W. Access and equity in early childhood education: challenges and opportunities. Baraton Interdiscip Res J. 2017;7:1–7. Busolo B, Agembo W. Access and equity in early childhood education: challenges and opportunities. Baraton Interdiscip Res J. 2017;7:1–7.
3.
go back to reference Heckman JJ, Cunha F. Investing in our young people. The National Institutes of Health and the Committee for Economic DevelopmentChicago: University of Chicago; 2006. http://jenni.uchicago.edu Heckman JJ, Cunha F. Investing in our young people. The National Institutes of Health and the Committee for Economic DevelopmentChicago: University of Chicago; 2006. http://​jenni.​uchicago.​edu
4.
go back to reference Woodhead M, Bolton L, Featherstone I, Robertson P. Early childhood development: delivering inter-sectoral policies, programmes and services in low-resource settings. In: The Health & Education Advice & Resource Team (HEART); 2014. Woodhead M, Bolton L, Featherstone I, Robertson P. Early childhood development: delivering inter-sectoral policies, programmes and services in low-resource settings. In: The Health & Education Advice & Resource Team (HEART); 2014.
5.
go back to reference McGregor SG, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B, et al. Developmental potential in the first 5 years for children in developing countries. Lancet. 2007;369:60–70.CrossRef McGregor SG, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B, et al. Developmental potential in the first 5 years for children in developing countries. Lancet. 2007;369:60–70.CrossRef
6.
go back to reference Bennett IM, Schott W, Krutikova S, Behrman JR. Maternal mental health and child growth and development in four low-income and middle-income countries. J Epidemiol Community Health. 2016;70:168–73.PubMedCrossRef Bennett IM, Schott W, Krutikova S, Behrman JR. Maternal mental health and child growth and development in four low-income and middle-income countries. J Epidemiol Community Health. 2016;70:168–73.PubMedCrossRef
7.
go back to reference Walker SP, Wachs TD, Gardner JM, Lozoff B, Wasserman GA, Pollitt E, et al. Child development: risk factors for adverse outcomes in developing countries. Lancet. 2007;369:145–57.PubMedCrossRef Walker SP, Wachs TD, Gardner JM, Lozoff B, Wasserman GA, Pollitt E, et al. Child development: risk factors for adverse outcomes in developing countries. Lancet. 2007;369:145–57.PubMedCrossRef
8.
go back to reference Walker SP, Wachs TD, Grantham-McGregor S, Black MM, Nelson CA, Huff man SL, et al. Inequality in early childhood: risk and protective factors for early child development. Lancet. 2011;378:1325–38.PubMedCrossRef Walker SP, Wachs TD, Grantham-McGregor S, Black MM, Nelson CA, Huff man SL, et al. Inequality in early childhood: risk and protective factors for early child development. Lancet. 2011;378:1325–38.PubMedCrossRef
9.
go back to reference Sacker A, J. Kelly Y. Ethnic differences in growth in early childhood: an investigation of two potential mechanisms. Eur J Pub Health. 2012;22(2):197–203.CrossRef Sacker A, J. Kelly Y. Ethnic differences in growth in early childhood: an investigation of two potential mechanisms. Eur J Pub Health. 2012;22(2):197–203.CrossRef
10.
go back to reference Schoon I, Jones E, Cheng H, Maughan B. Family hardship, family instability and cognitive development. J Epidemiol Community Health. 2012;66:716–22.PubMedCrossRef Schoon I, Jones E, Cheng H, Maughan B. Family hardship, family instability and cognitive development. J Epidemiol Community Health. 2012;66:716–22.PubMedCrossRef
11.
go back to reference Gialamas A, Mittinty MN, Sawyer MG, Zubrick SR, Lynch J. Social inequalities in childcare quality and their effects on children’s development at school entry: findings from the longitudinal study of Australian children. J Epidemiol Community Health. 2015;69:841–8.PubMedCrossRef Gialamas A, Mittinty MN, Sawyer MG, Zubrick SR, Lynch J. Social inequalities in childcare quality and their effects on children’s development at school entry: findings from the longitudinal study of Australian children. J Epidemiol Community Health. 2015;69:841–8.PubMedCrossRef
13.
go back to reference Engle P, Black M, Behrman J, Cabral de Mello M, Gertler P, Kapiriri L, et al. Strategies to avoid the loss of developmental potential in more than 200 million children in the developing world. Lancet. 2007;369:229–42.PubMedCrossRef Engle P, Black M, Behrman J, Cabral de Mello M, Gertler P, Kapiriri L, et al. Strategies to avoid the loss of developmental potential in more than 200 million children in the developing world. Lancet. 2007;369:229–42.PubMedCrossRef
14.
go back to reference Moore T, McDonald M, McHugh-Dillon H. Early childhood development and the social determinants of health inequities: a review of the evidence. Parkville: Centre for Community Child Health at the Murdoch Childrens Research Institute and the Royal Children’s Hospital; 2014. Moore T, McDonald M, McHugh-Dillon H. Early childhood development and the social determinants of health inequities: a review of the evidence. Parkville: Centre for Community Child Health at the Murdoch Childrens Research Institute and the Royal Children’s Hospital; 2014.
15.
go back to reference WHO Commission on Social Determinants of Health, World Health Organization. Closing the gap in a generation: health equity through action on the social determinants of health: Commission on Social Determinants of Health final report. World Health Organization; 2008. WHO Commission on Social Determinants of Health, World Health Organization. Closing the gap in a generation: health equity through action on the social determinants of health: Commission on Social Determinants of Health final report. World Health Organization; 2008.
16.
go back to reference Marmot M, Friel S, Bell R, Houwelin TA, Taylor S. Closing the gap in a generation: health equity through action on the social determinants of health. Lancet. 2008;372:1661–9.PubMedCrossRef Marmot M, Friel S, Bell R, Houwelin TA, Taylor S. Closing the gap in a generation: health equity through action on the social determinants of health. Lancet. 2008;372:1661–9.PubMedCrossRef
17.
go back to reference Leppo K, Ollila E, Pen˜a S, Wismar M, Cook S. Health in all policies: seizing opportunities, implementing policies. In: Ministry of social affairs and health, Finland; 2013. Leppo K, Ollila E, Pen˜a S, Wismar M, Cook S. Health in all policies: seizing opportunities, implementing policies. In: Ministry of social affairs and health, Finland; 2013.
18.
go back to reference National Secretariat of the integrated of early childhood development. National policy document on integrated early child development. Tehran: Ministry of Health and Medical Education, Ministry of education and welfare organization; 2013. (origin persian). National Secretariat of the integrated of early childhood development. National policy document on integrated early child development. Tehran: Ministry of Health and Medical Education, Ministry of education and welfare organization; 2013. (origin persian).
19.
go back to reference Vameghi R, Marandi A, Sajedi F, Soleymani F, Shahshahanipour S, Hatamizadeh N. Strategic analysis of the situation in Iran regarding the development of young children (analysis swot) and proposed strategies and activities. J Soc Welf. 2010;9(35):379–412 ( origin persian). Vameghi R, Marandi A, Sajedi F, Soleymani F, Shahshahanipour S, Hatamizadeh N. Strategic analysis of the situation in Iran regarding the development of young children (analysis swot) and proposed strategies and activities. J Soc Welf. 2010;9(35):379–412 ( origin persian).
20.
go back to reference Atashbahar O, Akbari Sari A, Takian A, Olyaeemanesh A, Mohamadi E, Barakat SH. Integrated early childhood development policy in Iran: a qualitative policy process analysis. BMC Public Health. 2021;21:649.PubMedPubMedCentralCrossRef Atashbahar O, Akbari Sari A, Takian A, Olyaeemanesh A, Mohamadi E, Barakat SH. Integrated early childhood development policy in Iran: a qualitative policy process analysis. BMC Public Health. 2021;21:649.PubMedPubMedCentralCrossRef
21.
go back to reference Rarani MA, Nosratabadi M, Moeeni M. Early childhood development in Iran and its provinces: Inequality versus average. Int J Health Plann Manage. 2018;33(4):1136–45.PubMedCrossRef Rarani MA, Nosratabadi M, Moeeni M. Early childhood development in Iran and its provinces: Inequality versus average. Int J Health Plann Manage. 2018;33(4):1136–45.PubMedCrossRef
22.
go back to reference Rashidian A, Khosravi A, Khabiri R, Khodayari-Moez E, Elahi E, Arab M, et al. Islamic Republic of Iran's multiple Indicator demographic and health survey (IrMIDHS) 2010. Tehran: Ministry of Health and Medical Education; 2012. (origin persian) Rashidian A, Khosravi A, Khabiri R, Khodayari-Moez E, Elahi E, Arab M, et al. Islamic Republic of Iran's multiple Indicator demographic and health survey (IrMIDHS) 2010. Tehran: Ministry of Health and Medical Education; 2012. (origin persian)
23.
go back to reference Rashidian A, Karimi-Shahanjarini A, Khosravi A, et al. Iran's multiple Indicator demographic and health survey - 2010: study protocol. Int J Prev Med. 2014;5(5):632–42.PubMedPubMedCentral Rashidian A, Karimi-Shahanjarini A, Khosravi A, et al. Iran's multiple Indicator demographic and health survey - 2010: study protocol. Int J Prev Med. 2014;5(5):632–42.PubMedPubMedCentral
24.
go back to reference Ministry of Health and Medical Education. national survey of anthropometric status, nutritional and growth and development indicators, and some indicators of health services evaluation in children Under five years. Tehran: Ministry of Health and Medical Education; 2018. (origin persian). Ministry of Health and Medical Education. national survey of anthropometric status, nutritional and growth and development indicators, and some indicators of health services evaluation in children Under five years. Tehran: Ministry of Health and Medical Education; 2018. (origin persian).
25.
go back to reference Hosseinpoor AR, Mohammad K, Majdzadeh R, Naghavi M, Abolhassani F, Sousa A, et al. Socioeconomic inequality in infant mortality in Iran and across its provinces. Bull World Health Organ. 2005;83:837–44.PubMedPubMedCentral Hosseinpoor AR, Mohammad K, Majdzadeh R, Naghavi M, Abolhassani F, Sousa A, et al. Socioeconomic inequality in infant mortality in Iran and across its provinces. Bull World Health Organ. 2005;83:837–44.PubMedPubMedCentral
26.
go back to reference Hosseinpoor AR, Van Doorslaer E, Speybroeck N, Naghavi M, Mohammad K, Majdzadeh R, et al. Decomposing socioeconomic inequality in infant mortality in Iran. Int J Epidemiol. 2006;35(5):1211–9.PubMedCrossRef Hosseinpoor AR, Van Doorslaer E, Speybroeck N, Naghavi M, Mohammad K, Majdzadeh R, et al. Decomposing socioeconomic inequality in infant mortality in Iran. Int J Epidemiol. 2006;35(5):1211–9.PubMedCrossRef
27.
28.
go back to reference Ministry of Health and Medical Education. Population and Health in the Islamic Republic of Iran: Iran Demographic and Health Survey (DHS) 2000. Tehran: Ministry of Health and Medical Education; 2000. (origin persian). Ministry of Health and Medical Education. Population and Health in the Islamic Republic of Iran: Iran Demographic and Health Survey (DHS) 2000. Tehran: Ministry of Health and Medical Education; 2000. (origin persian).
31.
go back to reference O'Brien GL, Sinnott SJ, Walshe V, Mulcahy M, Byrne S. Health policy triangle framework: narrative review of the recent literature. Health Policy Open. 2020;1:100016. O'Brien GL, Sinnott SJ, Walshe V, Mulcahy M, Byrne S. Health policy triangle framework: narrative review of the recent literature. Health Policy Open. 2020;1:100016.
32.
go back to reference Buse K, Mays N, Walt G. Making health policy. UK: McGraw-hill Education; 2012. Buse K, Mays N, Walt G. Making health policy. UK: McGraw-hill Education; 2012.
34.
go back to reference OECD (2014) PISA in focus – 2014/06 (June) does pre-primary education reach those who need it most? OECD (2014) PISA in focus – 2014/06 (June) does pre-primary education reach those who need it most?
35.
37.
go back to reference Abasian E, Mahmoudi V. Multidimensional poverty of families with children in Kerman province using the generational approach: 1983–2013. Soc Dev Quarterly. 2016;11(1):35–52 origin Persian. Abasian E, Mahmoudi V. Multidimensional poverty of families with children in Kerman province using the generational approach: 1983–2013. Soc Dev Quarterly. 2016;11(1):35–52 origin Persian.
38.
go back to reference Vameghi M, Dejman M, Rafiei H, Roshanfekr P. Urgent assessment of children’s street situation in Tehran: causes and risk of working children on the street. Quarterly Soc Stud Res Iran Univ Tehran. 2013;4(1):34–53. Vameghi M, Dejman M, Rafiei H, Roshanfekr P. Urgent assessment of children’s street situation in Tehran: causes and risk of working children on the street. Quarterly Soc Stud Res Iran Univ Tehran. 2013;4(1):34–53.
39.
go back to reference Goldfeld S, Villanueva K, Lee JL, Robinson R., Moriarty A, Peel D et al. Foundational community factors (FCFs) for Early Childhood Development: A report on the Kids in Communities Study; 2017. Goldfeld S, Villanueva K, Lee JL, Robinson R., Moriarty A, Peel D et al. Foundational community factors (FCFs) for Early Childhood Development: A report on the Kids in Communities Study; 2017.
42.
go back to reference Kawachi I, Berkman LF. Neighborhoods and health. New York: Oxford University Press; 2003.CrossRef Kawachi I, Berkman LF. Neighborhoods and health. New York: Oxford University Press; 2003.CrossRef
43.
go back to reference Spencer N. Social, economic, and political determinants of child health. Pediatrics. 2003;112(3):704–6.PubMedCrossRef Spencer N. Social, economic, and political determinants of child health. Pediatrics. 2003;112(3):704–6.PubMedCrossRef
44.
go back to reference Vaida N. A study on various factors affecting growth during the first two years of life. Eur Sci J. 2003;8(29):16–37. Vaida N. A study on various factors affecting growth during the first two years of life. Eur Sci J. 2003;8(29):16–37.
46.
go back to reference Powers JR, McDermott LJ, Loxton DJ, Chojenta CL. A prospective study of prevalence and predictors of concurrent alcohol and tobacco use during pregnancy. Matern Child Health J. 2013;17:76–84.PubMedCrossRef Powers JR, McDermott LJ, Loxton DJ, Chojenta CL. A prospective study of prevalence and predictors of concurrent alcohol and tobacco use during pregnancy. Matern Child Health J. 2013;17:76–84.PubMedCrossRef
48.
go back to reference Keshavar Z, Abassi A-SMJ, Ebadi A, Alavi moghadam F, Salari E. Ethnic, cultures and reproductive behavior in North Khorasan. J North Khorasan Univ Med Sci. 2017;9(1):109–19 origin Persian.CrossRef Keshavar Z, Abassi A-SMJ, Ebadi A, Alavi moghadam F, Salari E. Ethnic, cultures and reproductive behavior in North Khorasan. J North Khorasan Univ Med Sci. 2017;9(1):109–19 origin Persian.CrossRef
49.
go back to reference Oveisi S, Eftekhare Ardabili H, Majdzadeh R, Mohammadkhani P, Jean AR, Loo J. Mothers’ attitudes toward corporal punishment of children in Qazvin- Iran. J Fam Violence. 2010;25(2):159–64.CrossRef Oveisi S, Eftekhare Ardabili H, Majdzadeh R, Mohammadkhani P, Jean AR, Loo J. Mothers’ attitudes toward corporal punishment of children in Qazvin- Iran. J Fam Violence. 2010;25(2):159–64.CrossRef
50.
go back to reference Maggi S, Irwin LG, Siddiqi A, Poureslami I, Hertzman E, Hertzman C. Knowledge network for early child development. Analytic and Strategic Review Paper: International Perspectives on Early Child Development. World Health Organization’s Commission on the Social Determinants of Health; Human Early Learning Partnership; 2005. p. 6–9. Maggi S, Irwin LG, Siddiqi A, Poureslami I, Hertzman E, Hertzman C. Knowledge network for early child development. Analytic and Strategic Review Paper: International Perspectives on Early Child Development. World Health Organization’s Commission on the Social Determinants of Health; Human Early Learning Partnership; 2005. p. 6–9.
53.
go back to reference Hesterman M. The effects of adverse childhood experiences on long-term brain development and health development and health. Aisthesis. 2021;12(1). Hesterman M. The effects of adverse childhood experiences on long-term brain development and health development and health. Aisthesis. 2021;12(1).
54.
go back to reference Hajnasiri H, Gheshlagh Ghanei R, Sayehmiri K, Moafi F, Farajzadeh M. Domestic violence among Iranian women: a systematic review and meta-analysis. Iran Red Crescent Med J. 2016;18(6):e34971 (origin Persian).PubMedPubMedCentralCrossRef Hajnasiri H, Gheshlagh Ghanei R, Sayehmiri K, Moafi F, Farajzadeh M. Domestic violence among Iranian women: a systematic review and meta-analysis. Iran Red Crescent Med J. 2016;18(6):e34971 (origin Persian).PubMedPubMedCentralCrossRef
56.
go back to reference Sokolowski MB, Boyce WT. Epigenetic embedding of early adversity and developmental risk. In: ENCYCLOPEDIA on Early Childhood Development (CEECD); 2017. Sokolowski MB, Boyce WT. Epigenetic embedding of early adversity and developmental risk. In: ENCYCLOPEDIA on Early Childhood Development (CEECD); 2017.
57.
Metadata
Title
The impact of social determinants of health on early childhood development: a qualitative context analysis in Iran
Authors
Omolbanin Atashbahar
Ali Akbari Sari
Amirhossein Takian
Alireza Olyaeemanesh
Efat Mohamadi
Sayyed Hamed Barakati
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2022
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-022-13571-5

Other articles of this Issue 1/2022

BMC Public Health 1/2022 Go to the issue