Early childhood development and associated factors among children aged 24-59 months in Tanzania: evidence from the 2022 Tanzania Demographic and Health Survey.

Background: Early childhood development is a key foundation for later health, learning, and productivity. However, evidence using the Early Childhood Development Index 2030 (ECDI2030) remains limited in Tanzania. This study assessed developmental status and associated factors among children aged 24-59 months in Tanzania. Methods: This was a cross-sectional analysis of nationally representative data from the 2022 Tanzania Demographic and Health Survey (2022 TDHS). The study included children aged 24-59 months living with their biological mothers during the study period. Developmental status was assessed using the UNICEF ECDI2030, with children classified as developmentally on track using age-specific recommended cut-off scores (24-29 months ≥7; 30-35 months ≥9; 36-41 months ≥11; 42-47 months ≥13; 48-59 months ≥15). Generalized linear models with Poisson distribution, log link, and robust variance estimation were used to assess factors associated with early childhood development. Adjusted prevalence ratios (aPRs) with 95% confidence intervals (CIs) were reported. Results: A total of 4,930 children with a mean age (±standard deviation) of 39.9 months (±10.0) were included for analysis. Overall, 47.0% of children were developmentally on track. The proportion declined with increasing age, from 57.6% among children aged 24-35 months to 35.8% among those aged 48-59 months. Female children had higher prevalence of being developmentally on track than males (aPR 1.15, 95% CI 1.07-1.23). Higher prevalence was observed among children of biological mothers aged 25-34 years (aPR 1.11, 95% CI 1.01-1.22) and 35-49 years (aPR 1.12, 95% CI 1.01-1.24), those whose biological mothers had primary (aPR 1.33, 95% CI 1.19-1.50) or secondary and higher education (aPR 1.43, 95% CI 1.25-1.65), children from rich households (aPR 1.18, 95% CI 1.06-1.31), and those whose biological mothers owned phones (non-smartphone: aPR 1.14, 95% CI 1.04-1.24); smartphones: aPR 1.27, 95% CI 1.12-1.44). Geographical disparities were observed, with higher prevalence in the Northern, Central, and Lake zones and Zanzibar, whereas lower prevalence was observed in the Western, Southern, and South West Highlands zones when compared with the Eastern zone. Conclusion: Nearly half of children aged 24-59 months were developmentally on track. Interventions addressing socioeconomic inequalities, caregiver education and geographical disparities are needed to improve early childhood development in Tanzania.