Desigualdades en desarrollo infantil temprano entre prestadores públicos y privados de salud y factores asociados en la Región Metropolitana de Chile

Abstract

Early child development is a population determinant of physical, mental and social health. To know the base line situation prior to the implementation of “Chile grows with you” (Chile Crece Contigo) is key to its evaluation. Objective To compare early child development and associated factors at baseline in pre-school children from public and private health sectors. Patients and method The sample consisted of 1045 children aged 30-58 months, 52% male, and 671 from the public and 380 from the private sector of the metropolitan region in Chile were evaluated using Battelle Developmental Inventory-1 and a household interview of primary carer. Results Abnormal child development was found in 14.4% of children in the private sector compared to 30.4% in the public sector. There were no differences in adaptive area (26.3% vs 29.2%), but there were statistically significant differents in cognitive (8.8% vs 12.1%), social-personal (13.2% vs 32.5%), motor (19.2% vs 35.3%), and communication (19% vs 36.8%) development. The logistic regression showed that, independent of socioeconomic level, the risk factors are: Apgar < 7 (OR: 5.4; 95% CI: 1.24-23.84); having childhood chronic diseases (OR: 1.3; 95% CI: 1.11-1.42). Protective factor is: home with resources to learn and play (OR: 0.8; 95% CI: 0.76-0.89). Conclusion These results are another input about early child development situation and its importance for paediatric social policy.