The age at which a child starts school can have profound effects on their health and development. While much research has been conducted in high-income countries (HICs), the effects of school-entry age remain understudied in low- and middle-income countries (LMICs). A recent scoping review by Liao et al. (2023) highlights the need for further investigation into this area. This blog will explore key findings from the review and offer insights for practitioners seeking to enhance educational outcomes and student well-being.
The Scope of the Research
The review conducted by Liao et al. (2023) systematically examined studies from LMICs focusing on the relative age for grade—whether children start school younger or older compared to their peers. The research identified eight studies from middle-income countries like Brazil, Mexico, Vietnam, and Türkiye, but none from low-income countries. These studies primarily explored neurodevelopmental and mental health outcomes, sexual and reproductive health, non-communicable diseases, and nutrition.
Key Findings
- Neurodevelopmental and Mental Health: Children who started school earlier were more likely to be diagnosed with attention deficit hyperactivity disorder (ADHD). The findings suggest that younger students may face developmental challenges due to their relative immaturity compared to older peers.
- Sexual and Reproductive Health: Early school entry was linked to earlier sexual debut, adolescent pregnancy, and marriage in countries like Vietnam and Mexico. This suggests that starting school younger may accelerate family formation processes.
- Non-Communicable Diseases and Nutrition: The evidence was mixed regarding nutritional outcomes. While some studies indicated increased risk factors for overweight among early starters, others found reduced stunting rates due to access to school meal programs.
Implications for Practitioners
Practitioners working in education and health sectors in LMICs can draw several lessons from this research:
- Tailored Interventions: Understanding the specific needs of young-for-grade students can help design interventions that mitigate potential disadvantages. For instance, providing additional support for ADHD symptoms or enhancing access to reproductive health education could be beneficial.
- Nutritional Programs: Leveraging school meal programs can address nutritional disparities among young-for-grade children. Ensuring these programs are accessible and effective can help improve health outcomes.
- Policy Advocacy: Engaging with policymakers to reconsider school-entry age policies could help align educational practices with developmental readiness, potentially reducing negative health impacts.
The Way Forward
The review underscores the need for more comprehensive research in LMICs to fully understand the implications of school-entry age on health outcomes. Practitioners are encouraged to participate in or advocate for further studies that explore diverse health domains beyond neurodevelopmental issues.
Moreover, qualitative research could provide deeper insights into the contextual factors affecting school-entry decisions and their long-term impacts on children's lives. By expanding the scope of research, practitioners can contribute to developing strategies that promote equitable educational opportunities and improved health outcomes for all students.
To read the original research paper, please follow this link: The effect of school-entry age on health is understudied in low- and middle-income countries: A scoping review and future directions for research.
