MIDO first childhood: assessment of growth and development in early childhood among vulnerable Mexican communities

Abstract

Background: Early childhood health in Mexico is characterized by chronic undernutrition, excess weight, and risk of developmental delay, particularly among children living in socioeconomic vulnerability. Despite national statistics, integrated and standardized screening within routine primary healthcare remains limited. MIDO First Childhood is a digital health strategy that has an interoperable digital platform to support standardized assessment of child growth and development in primary healthcare settings. The objective of this study was to describe the health, nutritional, and developmental profiles of children assessed through MIDO First Childhood between 2019 and 2024. Methods: We conducted a cross-sectional descriptive analysis of 18,197 children aged five years or younger assessed through MIDO First Childhood in primary healthcare facilities across eight Mexican states. The first recorded assessment per child with complete anthropometric and developmental data was included. Variables comprised sociodemographic characteristics, perinatal and health-related factors, standardized anthropometric indicators based on the World Health Organization growth standards, and child development assessed using the validated Early Development Instrument screening tool. Sex differences were examined using chi-square and Student’s t tests. Results: The coexistence of undernutrition and excess weight observed in our sample is consistent with national statistics, describing the double burden of malnutrition among young children in Mexico. These findings highlight the complexity of nutritional challenges faced in vulnerable populations within primary healthcare settings: 8.4% presented stunting or severe stunting, while 7.9% were overweight or obese. Only 65.3% achieved age-appropriate development. This proportion dropped sharply to 46.1% in children aged 31–36 months. Significant sex disparities were observed: boys had a higher prevalence of stunting (9.5% vs. 7.1%, p < 0.001), obesity (3.1% vs. 2.6%, p = 0.002), and were significantly more likely to experience critical neonatal events (7.5% vs. 5.7%, p < 0.001). Conclusions: This analysis documents a substantial prevalence of nutritional and developmental risk among children assessed through MIDO First Childhood, particularly among boys and in younger age groups. The implementation of the digital health strategy and the use of a standardized digital platform facilitates systematic identification of growth and developmental risks within primary healthcare settings. These findings provide descriptive evidence relevant for early screening and ongoing monitoring efforts in socioeconomically vulnerable populations in Mexico.