New Perspectives in Science Education
Impact of early Child Emotional and Behavioural Disorders on later Educational Outcomes: A population-based cohort study in Ethiopia
Habtamu Mekonnen Kurmane, Jimma University and the University of South Africa (Ethiopia)
Girmay Medhin, Addis Ababa University (Ethiopia)
Mark Tomlinson, Stellenbosch University (South Africa)
Atalay Alem, Addis Ababa University (Ethiopia)
Martin Prince, Kings college (United Kingdom)
Charlotte Hanlon, Edinburgh University (United Kingdom)
Abstract
Abstract
Introduction: The relationship between child mental health and educational outcomes is well established in high-income countries. However, evidence from prospective, community-based studies in low-income settings remains limited. Although emotional and behavioural well-being is critical for later success, the impact of child emotional and behavioural disorders (EBD) on subsequent educational outcomes is still underexplored in sub-Saharan Africa.
Methods: We analysed data from the ongoing population-based cohort of 2,090 women and their children enrolled in the Child Outcomes in Relation to Maternal Mental Health in Ethiopia (C-MaMiE) study. Child EBD symptoms were assessed using the validated Amharic version of the parent-reported Strengths and Difficulties Questionnaire (SDQ) when children were aged 6–7 years (Time point 1, T1) and 7–8 years (T2). Educational outcomes included school drop-out (reported by mothers at T2) and school absenteeism and academic achievement (obtained from school records when children were aged 8–9 years, T3).
Results: After adjusting for potential confounders, higher SDQ total scores (Incidence Rate Ratio [IRR] = 1.01; 95% Confidence Interval [CI]: 1.01–1.02) and elevated scores (SDQ ≥14) (IRR = 1.36; 95% CI: 1.24–1.48) at T2 were significantly associated with subsequent school absenteeism. The emotional (IRR = 1.03; 95% CI: 1.01–1.04), hyperactivity (IRR = 1.03; 95% CI: 1.02–1.04), and peer problems (IRR = 1.02; 95% CI: 1.00–1.04) subscales were also significantly associated with absenteeism. Higher SDQ scores (SDQ ≥14) (β = –2.89; 95% CI: –5.73 to –0.06) and conduct problems subscale scores (β = –0.57; 95% CI: –1.02 to –0.12) were prospectively associated with lower academic achievement.
Conclusion: Child EBD symptoms were associated with increased school absenteeism and poorer academic achievement in this rural Ethiopian cohort. These findings highlight the importance of integrating child mental health interventions into educational strategies to improve school attendance and learning outcomes in low-resource settings. Addressing these issues is also a critical step toward fostering inclusiveness, ensuring that children with emotional and behavioral difficulties are not left behind in educational opportunities.
Keywords: child education, absenteeism, emotional and behavioural disorders, child mental health, cohort study, sub-Saharan Africa
