Parent reports of children’s emotional and behavioral problems in a low- and middle- income country (LMIC): An epidemiological study of Nepali schoolchildren

• Published in: PloS one 2021-08, Vol.16 (8), p.e0255596-e0255596
• Main Authors: Ma, Jasmine, Mahat, Pashupati, Brøndbo, Per Håkan, Handegård, Bjørn H, Kvernmo, Siv, Javo, Anne Cecilie
• Format: Article
• Language: English
• Subjects: Age groups; Behavior; Caste; Castes; Child & adolescent mental health; Child & adolescent psychiatry; Child welfare; Children; Cross cultural studies; Culture; Developing countries; Earth Sciences; Emotional behavior; Emotional problems of children; Emotions; Epidemiology; Ethnic groups; Ethnicity; Gender differences; Girls; Health aspects; Health sciences; Income; Low income groups; Measures; Medicine and Health Sciences; Mental disorders; Mental health; Minority & ethnic groups; Mountains; Norms; Parents; Parents & parenting; Pediatric research; People and Places; Population; Psychological aspects; Regions; Rural areas; Social Sciences; Statistics; Surveys; Systematic review; Tests; Urban areas; Variance analysis
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0255596

Background As epidemiological data on child mental health in low- and middle-income countries are limited, a large-scale survey was undertaken to estimate the prevalence and amount of child emotional and behavioral problems (EBP) in Nepal as reported by the parents. Methods 3820 schoolchildren aged 6-18 years were selected from 16 districts of the three geographical regions of Nepal, including rural, semi-urban and urban areas. We used the Nepali version of the Child Behavior Checklist (CBCL)/6-18 years as screening instrument. Comparisons of child problems between genders and between the seven largest castes and ethnic groups were carried out by analysis of variance. Prevalence was computed based on American norms. Results Adjusted prevalence of Total Problems was 18.3% (boys: 19.1%; girls:17.6%). The prevalence of internalizing problems was higher than externalizing problems. The mean scores of Total, Externalizing, and Internalizing problems were 29.7 (SD 25.6), 7.7 (SD 8.0), and 9.1 (SD 8.1), respectively. The Khas Kaami (Dalit) group scored the highest, and the indigenous Tharu group scored the lowest on all scales. In the Mountains and Middle Hills regions, problem scores were higher in the rural areas, whereas in the Tarai region, they were higher in the urban areas. Conclusion The prevalence and magnitude of emotional and behavioral problems in Nepali children were found to be high compared to findings in meta-analyses worldwide. Problem scores varied according to gender, castes /ethnic groups, and living areas. Our findings highlight the need for a stronger focus on child mental problems in a low-and middle-income country like Nepal.