Preschool type and child health outcomes in urban and rural Karnataka, India

This cross-sectional, community-based study compares health outcomes among children of four different preschool scenarios in urban and rural India (Bangalore). Maternal knowledge, attitudes and practices (KAP) toward acute diarrheal disease (ADD) and acute respiratory infections (ARI), and health outcomes of their 2 - 5 year-old children (two-week health recall) were collected using a pre-tested questionnaire. Anthropometric measurements of the children (weight, height, upper-arm circumference) were taken. From March through May of 2009, 125 urban and 130 rural mothers were interviewed by a local social worker and a community health worker, respectively, proceeding door-to-door through their communities.

Results were analyzed in terms of setting (urban vs. rural) as well as type of preschool the child attended: no preschool, government preschool (anganwadi), anganwadi receiving health check-ups from a medical college (SJMC), or “other” preschool. Mean composite child health scores were calculated based on the ADD and ARI health recall for the children (lower scores indicated better overall health): urban (10.2), rural (10.8); no preschool (11.1), anganwadi (9.9), SJMC (10.9), other (9.9). Underweight was most prevalent among children not attending preschool (44.4%) and least prevalent among those in other preschools (26.7%). Mean attitude scores were highest among mothers of anganwadis with health check-ups.

Children attending preschool, regardless of category, demonstrated better health outcomes than those not in preschool. Investigating this correlation further would inform policy and programs about the importance of promoting preschool attendance, especially among families not sending their children to preschool.