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.
Keywords: Child development; Growth and development; Child, preschool; Nutritional status; Overweight and obesity; Health status disparities; Primary healthcare; Medical informatics applications; Community-based health assessment; Mexico
Background
Early childhood is a decisive stage for human development, during which nutrition, the family environment, and early stimulation directly influence both physical growth and developmental trajectories. In this context, growth refers to measurable physical changes such as weight and height gain, whereas development encompasses cognitive, motor, emotional, and social processes that evolve through early life. Although conceptually distinct, these dimensions are closely interconnected: inadequate nutrition may impair neurodevelopment, while insufficient stimulation can hinder both cognitive progress and overall well-being. For this reason, early childhood health strategies must ensure that both growth and developmental domains are systematically assessed and supported .
In Mexico, among the 12.4 million children under six years of age [1], nearly half live in poverty [2], making them highly vulnerable to undernutrition, overweight, and anemia. In this study, vulnerable communities refer to populations characterized by high levels of socioeconomic disadvantage, including poverty, limited access to health services, and residence in rural or peri-urban marginalized areas. National estimates report a prevalence of chronic undernutrition (stunting) of 12.8%, rising to nearly 20% in southern states such as Chiapas, Guerrero, and Oaxaca, as well as in rural or indigenous communities [3]. Overweight affects approximately 8% of children under five years of age [3], whereas anemia, directly linked to impaired neurodevelopment, affects approximately 9% of children aged 1 to 4 years, with the highest prevalence among infants under two and in impoverished households [4].
Developmental risk is also prevalent: one in five Mexican children aged 2–5 years fail to achieve age-appropriate developmental milestones [5]. Among the poorest households, up to four in ten children present delays in cognitive and socioemotional domains, often resulting from limited stimulation, inadequate play resources, and insufficiently supportive caregiving environments [6].
One of the main challenges of public health is the absence of integrated systems for the ongoing evaluation of nutritional and developmental conditions, particularly in marginalized areas. Health services remain fragmented, and information systems lack interoperability, limiting the capacity to generate actionable insights [7]. To address gaps in standardized early risk detection, the Carlos Slim Foundation developed Medición Integrada para la Detección Oportuna (MIDO), a digital health strategy that has an interoperable digital platform embedded within primary healthcare services, designed to standardize the assessment of child growth and developmental conditions (Fig. 1).
Fig. 1.
Care pathway and intervention components of the MIDO first childhood strategy
The digital platform was specifically designed to operate in resource-constrained environments with limited digital infrastructure. MIDO First Childhood includes both online and offline functionalities, allowing data to be entered locally in settings without stable internet connectivity. Information recorded offline is subsequently synchronized with the central database through secure batch uploads once network access becomes available. This hybrid architecture enables standardized data collection across geographically distant health centers and in mobile health outreach campaigns. It is particularly well-suited for underserved communities and settings with intermittent or limited internet connectivity.
The objective of this study is to describe the health, nutritional, and developmental profiles of children assessed through MIDO First Childhood between 2019 and 2024, with a focus on sex differences and implications for equity-oriented child health strategies.
Methods
Study design and population
We conducted a cross-sectional descriptive analysis of 18,197 children aged ≤ 5 years of age assessed through the MIDO First Childhood program between June 17, 2019, and December 31, 2024. The study population comprised all children with complete anthropometric and developmental assessments recorded in the digital platform during the study period.
Assessments were conducted as part of routine child health monitoring activities and opportunistic screening in primary healthcare units operated by the Ministry of Health. The dataset reflects routine service utilization rather than a population-based sample; therefore, the findings should not be interpreted as nationally representative estimates but rather as descriptive results from children accessing primary healthcare services in participating facilities.
The program was implemented across eight Mexican states (Coahuila, Durango, Guanajuato, Hidalgo, Mexico City, Mexico State, Querétaro, and Quintana Roo), encompassing both, rural and urban peripheral communities characterized by varying levels of socioeconomic disadvantage. Implementation intensity varied across states, and the geographic distribution of assessments reflects operational coverage rather than proportional state representation.
Data collection platform and instrumentation
MIDO First Childhood has a digital platform embedded within routine primary care services designed to standardize early risk detection and monitoring.
The information was recorded using the MIDO First Childhood digital platform, which standardizes data entry through predefined electronic forms integrated into routine primary healthcare services in accordance with Mexican health regulations [8]. The platform incorporates structured fields capturing sociodemographic information (child’s age and sex, maternal education, and marital status), perinatal history (type of delivery, birth weight and length, number of pregnancies, and maternal complications during pregnancy), biological risk factors (prenatal healthcare attendance, prematurity, and neonatal hospitalization).
Nutritional status was assessed using standardized anthropometric indicators (weight-for-age and height-for-age) calculated according to the World Health Organization (WHO) Child Growth Standards [9]. Anthropometric measurements were performed by trained primary healthcare personnel as part of routine clinical practice. Although participating facilities used locally available weighing scales and length/height measuring devices, all personnel underwent standardized theoretical and practical training to ensure consistency in technique and data recording. Weight-for-age, height-for-age, and weight-for-length/height z-scores were automatically calculated within the MIDO First Childhood digital platform using embedded algorithms. The platform generates standardized nutritional classifications according to established WHO cut-off points.
Child development was evaluated using the Early Development Instrument (EDI), a screening tool that classifies children according to age into three categories: normal development, developmental lag, or risk of developmental delay [10]. The Mexican validated version of the EDI was used in this study. Validation studies conducted in Mexico have reported a sensitivity of approximately 0.81 and specificity of 0.61 for detecting developmental delay when compared with standardized diagnostic assessments [11]. The instrument was administered by trained primary healthcare personnel following official application guidelines, and the platform incorporates automated scoring algorithms to generate age-specific classifications.
The EDI was administered by trained personnel following the official national application guidelines. Staff received standardized training in the administration and scoring of the instrument [12]. The platform incorporates automated scoring algorithms that classify developmental status according to age-specific criteria established in the EDI manual [10].
The platform minimizes transcription errors by using predefined fields and automated risk classification algorithms based on established criteria. Data are stored in a centralized database and were extracted in anonymized format for secondary analysis.
MIDO First Childhood was developed by several study authors in collaboration with public health authorities and subsequently implemented within primary healthcare services. Ethical approval was obtained at the time of its integration into the public health system, and informed consent procedures were conducted according to institutional regulations. The present study constitutes a secondary cross-sectional analysis of anonymized data collected during routine implementation of the program.
Data cleaning and quality control
Data cleaning procedures included verification of internal consistency, exclusion of implausible anthropometric values according to WHO-recommended z-score ranges [13], and removal of duplicate records. Only the first recorded assessment per child during the study period was included in this cross-sectional analysis.
Because the dataset is derived from routine service utilization, potential sources of bias include selection bias, as only children attending participating facilities were assessed, and information bias related to caregiver-reported variables. To mitigate measurement variability, field personnel underwent standardized theoretical and practical training based on operational manuals and measurement protocols. The Carlos Slim Foundation provides structured training programs, including both in-person workshops and online courses delivered through its digital learning platforms [14]. These programs include theoretical instruction, practical demonstrations, and standardized guidelines for anthropometric measurement and EDI administration, aiming to promote consistency across participating facilities [14].
Statistical analysis
Quantitative variables were described using measures of central tendency and dispersion, whereas categorical variables were summarized using absolute and relative frequencies. Comparisons by sex were conducted using chi-square tests (for proportions), Student’s t tests (for means), and Wilcoxon rank-sum tests when appropriate. A p-value < 0.05 was considered statistically significant. Statistical analyses were performed using STATA version 17.
Results
Study population
During the study period (2019–2024), 19,170 children were identified. After applying eligibility criteria and excluding records with missing key information (maternal identifier, age ≥ 6 years, or incomplete anthropometric assessment), the final analytic sample comprised 18,197 children (Fig. 2). Of these, 52.9% were boys, and 47.1% were girls. Nearly half were infants under 6 months (48.7%), followed by children aged 12 months. (12.3%), and those aged 6–11 months of age (11.4%). Most assessments took place in the state of Guanajuato (80.9%), followed by Quintana Roo (4.9%), Hidalgo (4.7%), and Mexico City (3.3%) (Table 1).
Fig. 2.
Flow diagram of participant selection and exclusions for the analytic sample (2019–2024)
Table 1.
Demographic characteristics of children and mothers (n = 18,197)
| Total n (%) | Boys n (%) | Girls n (%) | p value | |
|---|---|---|---|---|
| Total (n) | 18,197 | 9619 | 8578 | |
| Age | ||||
| < 6 months | 8863 (48.7) | 4470 (46.5) | 4393(51.2) | < 0.001 |
| 6–12 months | 2072(11.4) | 1076 (11.2) | 996(11.6) | |
| 1 year | 2244(12.3) | 1183(12.3) | 1061(12.4) | |
| 2 years | 1558(8.6) | 891(9.3) | 667(7.8) | |
| 3 years | 1635(9.0) | 934(9.7) | 701(8.2) | |
| 4 years | 1797(9.9) | 1047(10.9) | 750(8.7) | |
| 5 years | 28(0.1) | 18(0.2) | 10(0.1) | |
| State | ||||
| México City | 604(3.3) | 303(3.1) | 301(3.5) | 0.426 |
| Coahuila | 76(0.4) | 43(0.4) | 33(0.4) | |
| Durango | 343(1.9) | 180(1.9) | 163(1.9) | |
| Guanajuato | 14,724(80.9) | 7840(81.5) | 6884(80.2) | |
| Hidalgo | 863(4.7) | 446(4.6) | 417(4.9) | |
| México | 172(0.9) | 83(0.9) | 89(1.0) | |
| Querétaro | 515(2.8) | 269(2.8) | 246(2.9) | |
| Quintana Roo | 900 (4.9) | 455(4.7) | 445(5.2) | |
| Mother’s education (n = 12896) | ||||
| None | 131(1.0) | 68(1.0) | 63(1.0) | 0.345 |
| Primary | 1466(11.4) | 754(11.2) | 712(11.6) | |
| Secondary | 5924(45.9) | 3101(45.9) | 2823(45.9) | |
| High school/technical | 3,930(30.5) | 2099(31.1) | 1831(29.8) | |
| University or higher | 1445(11.2) | 728(10.8) | 717(11.7) | |
| Mother’s marital status (n = 11933) | ||||
| Single/divorced | 1427(12.0) | 749(11.9) | 678(12.0) | 0.970 |
| Married/cohabiting | 10,506(88.0) | 5520(88.1) | 4986(88.0) | |
Values expressed as n (%). p values were determined via the chi² test
Regarding maternal characteristics, more than half of the mothers had only a basic education (11.4% primary, 45.9% secondary education). Most were married or cohabited (88.0%).
Perinatal history and biological risk factors
Overall, 55.5% of the children were delivered vaginally and 43.2% by cesarean section, with cesarean births being more common among boys (p = 0.005). The average birth weight was 3,137 g for boys compared to 3,059 g for girls (p < 0.001), and the mean birth length was also greater among boys (49.6 cm vs. 49.4 cm, p < 0.001) (Table 2).
Table 2.
Perinatal history and biological risk factors by sex
| Total n(%) | Boys n(%) | Girls n(%) | p* | |
|---|---|---|---|---|
| Delivery Mode (n = 13072) | ||||
| Cesarean section | 5647 (43.2) | 3014 (43.8) | 2633 (42.5) | 0.005 |
| Assisted vaginal delivery | 194 (1.5) | 81 (1.2) | 113 (1.8) | |
| Spontaneous vaginal delivery | 7231 (55.3) | 3783 (55.0) | 3448 (55.7) | |
| Type of gestation (n = 13443) | ||||
| Twin | 163 (1.2) | 77 (1.1) | 86 (1.4) | 0.231 |
| Triplets or more | 13 (0.1) | 5 (0.1) | 8 (0.1) | |
| Singleton | 13,267 (98.7) | 6986 (98.8) | 6281 (98.5) | |
| Mean birth weight (g) mean (SD) (n = 18064) | 3100 (484) | 3137 (493) | 3059 (470) | < 0.000 |
| Mean birth length (cm) mean (SD) (n = 18197) | 49.5 (3.1) | 49.6 (3.3) | 49.4 (2.9) | < 0.000 |
| Maternal morbidity during pregnancy | ||||
| Type 2 diabetes (n = 10338) | 185 (1.8) | 83 (1.6) | 102 (2.0) | 0.174 |
| Gestational diabetes (n = 10430) | 541 (5.2) | 286 (5.3) | 255 (5.1) | 0.778 |
| Preeclampsia (n = 10332) | 629 (6.1) | 322 (6.0) | 307 (6.2) | 0.718 |
| Eclampsia (n = 10286) | 90 (0.9) | 50 (1.0) | 40 (0.8) | 0.747 |
| Hemorrhage (n = 10284) | 503 (4.9) | 260 (4.9) | 243 (4.9) | 0.982 |
| Urinary tract infection (n = 10510) | 2779 (26.4) | 1467 (26.9) | 1312 (25.9) | 0.442 |
| Placenta previa (n = 10286) | 69 (0.7) | 42 (0.8) | 27 (0.5) | 0.308 |
| Polyhydramnios (n = 10275) | 74 (0.7) | 34 (0.6) | 40 (0.8) | 0.593 |
| Oligohydramnios (n = 10290) | 154 (1.5) | 90 (1.7) | 64 (1.3) | 0.223 |
| Biological risk factors (n = 16520) | ||||
| Attendance at two or fewer prenatal visits | 1412 (8.6) | 756 (8.7) | 656 (8.4) | 0.593 |
| Presence of cervicovaginitis, hemorrhage, hypertension, urinary tract infections, or other systemic conditions during pregnancy | 5241 (31.7) | 2777 (31.8) | 2464 (31.6) | 0.763 |
| Gestation < 34 weeks | 267 (1.6) | 160 (1.8) | 107 (1.4) | 0.019 |
| Birth weight ≤ 1500 g | 209 (1.3) | 108 (1.2) | 101 (1.3) | 0.738 |
| Apnea and nuchal cord at birth | 1092 (6.6) | 651 (7.5) | 441 (5.7) | < 0.001 |
| Neonatal intensive healthcare unit admission before one month of age with a duration > 4 days | 690 (4.2) | 405 (4.6) | 285 (3.7) | 0.002 |
| Maternal age < 16 years at delivery | 306 (1.8) | 150 (1.7) | 156 (2.0) | 0.178 |
*p values are based on chi-square tests or Student’s t tests for means
One-third of the pregnancies reported at least one complication. Urinary tract infection (26.4%) was the most common maternal condition, followed by preeclampsia (6.1%), gestational diabetes (5.2%), and pre-existing type 2 diabetes (1.8%). More than 6% of the newborns experienced critical events, including apnea or prolonged stay in a neonatal intensive healthcare unit (NICU); these events were significantly more common among boys (7.5% vs. 5.7%, p < 0.001, and 4.6% vs. 3.7%, p = 0.002, respectively). At least 31.7% of pregnancies involved maternal risk factors, such as cervicovaginitis, hemorrhage, hypertension, or systemic infections (Table 2).
Nutritional status
The anthropometric findings indicated a double burden of malnutrition. Based on weight-for-length/height indicators, 14.7% of the children showed some degree of undernutrition, while 7.9% were overweight or obese. Additionally, 15.9% had low weight-for-age, and 8.4% experienced stunting or severe stunting. Boys had a greater prevalence of nutritional issues, with significantly higher rates of stunting (9.5% vs. 7.1%, p < 0.001), severely low weight (1.4% vs. 1.0%, p = 0.001), and obesity (3.1% vs. 2.6%, p = 0.002) (Table 3).
Table 3.
Prevalence of weight-for-age and height-for-age classifications according to WHO standards, by sex. (n = 18,197)
| Total n(%) | Boys n(%) | Girls n(%) | p* | |
|---|---|---|---|---|
| Height-for-age | ||||
| Severe stunting | 471 (2.6) | 273 (2.8) | 198 (2.3) | < 0.000 |
| Stunting | 1052 (5.8) | 641 (6.7) | 411 (4.8) | |
| Normal height-for-age | 16,475 (90.5) | 8594 (89.3) | 7881 (91.9) | |
| Tall-for-age | 199 (1.1) | 111 (1.1) | 88 (1.0) | |
| Weight-for-age | ||||
| Severe underweight | 226 (1.2) | 137 (1.4) | 89 (1.0) | 0.001 |
| Underweight | 2900 (15.9) | 1556 (16.2) | 1344 (15.7) | |
| Normal weight-for-age | 12,351 (67.9) | 6425 (66.8) | 5926 (69.1) | |
| Overweight-for-age | 2720 (14.9) | 1501 (15.6) | 1219 (14.2) | |
| Weight-for-length/height | ||||
| Severe wasting | 206 (1.1) | 120 (1.2) | 86 (1.0) | 0.002 |
| Mild wasting | 1952 (10.7) | 1007 (10.5) | 945 (11.0) | |
| Moderate wasting | 522 (2.9) | 272 (2.8) | 250 (2.9) | |
| Normal weight-for-length/height | 14,079 (77.4) | 7389 (76.8) | 6690 (78.0) | |
| Overweight | 915 (5.0) | 528 (5.5) | 387 (4.5) | |
| Obesity | 523 (2.9) | 303 (3.1) | 220 (2.6) | |
*p values were obtained via the chi-square test for differences in proportions
Child development
The EDI test showed that only 65.3% of the children reached development levels appropriate for their age, while 15.0% experienced developmental delays, and 19.7% were at risk of delay (Table 4). The proportion of children classified as having normal development was lower among older age groups compared to younger infants: 80.5% of children demonstrated normal development at one month of age, but this proportion decreases to 46.1% among children at 31–36 months of age (Fig. 3).
Table 4.
Results of the EDI test by sex (n = 15,190)
| EDI test outcome | Total n(%) | Boys n(%) | Girls n(%) | p* |
|---|---|---|---|---|
| Normal development | 9,920 (65.3) | 4,936 (60.9) | 4,984 (70.3) | < 0.001 |
| Developmental delay | 2,282 (15.0) | 1,330 (16.4) | 952 (13.4) | |
| At risk of developmental delay | 2,988 (19.7) | 1,833 (22.6) | 1,155(16.3) |
*p values were obtained via the chi-square test for differences in proportions
Fig. 3.
Child development status by age group (n = 15,190). Legend: Classification on the basis of the EDI test. Normal development was highest during the first month of life (80.5%) and declined to 46.1% in children between 31–36 months of age. Developmental lag peaked at 27.5% in children between 25–30 months of age, whereas the risk of delay peaked at 41.9% in children between 31–36 months of age
Developmental lag was highest among children aged 25–30 months of age (27.5%), whereas the risk of developmental delay peaked among those aged 31–36 months of age (41.9%). Both indicators worsened with increasing age (Fig. 3).
Significant sex differences were observed (p < 0.001). Compared with boys, girls were more likely to achieve normal development (70.3% vs. 60.9%) and had a lower prevalence of developmental delay (16.3% vs. 22.6%) (Table 3). By 37–48 months of age, only 39.9% of the boys maintained normal development, compared with 59.8% of girls (Fig. 4).
Fig. 4.
Child development status by age group and sex (n = 15,190). Legend: Based on the EDI test. Compared with boys, girls consistently had a greater prevalence of normal development and a lower prevalence of developmental risk. By 37–48 months of age, only 39.9% of the boys maintained normal development, whereas 59.8% of the girls did
Discussion
This study provides a cross-sectional description of the initial growth and developmental conditions of children assessed through MIDO First Childhood, offering descriptive evidence that may inform understanding of early childhood health needs within the healthcare system.
The prevalence of low weight-for-age (15.9%) and stunting or severe stunting (8.4%) observed in our sample reflects the presence of chronic undernutrition in many communities. These findings are broadly consistent with national estimates from the National Health and Nutrition Survey (ENSANUT) 2022, which reported a 12.8% prevalence of stunting among Mexican children under five years of age [3]. The slightly higher prevalence of stunting identified in our study is expected, given that the MIDO strategy serves populations that tend to experience greater social, economic, and health vulnerabilities compared with the nationally representative ENSANUT sample.
ENSANUT data also indicate that progress in reducing chronic undernutrition has stalled since 2012. At the same time, excess weight in early childhood continues to rise: the combined prevalence of overweight and obesity has remained between 7% and 8% among children under five, illustrating the growing double burden of malnutrition in Mexico and emphasizing the need for context-specific, locally tailored interventions [3].
From a neurodevelopmental perspective, the EDI results revealed that approximately 35% of the children presented some degree of lag or risk of delay. Restricting the analysis to children aged 24–59 months, nearly half of the children assessed through the EDI presented lag or risk. This proportion contrasts with the 19.3% of children aged 24–59 months who were reported as not developmentally on track according to ENSANUT estimates based on the ECIDI-2030 [5]. Differences between these estimates may reflect variations in population characteristics, socioeconomic vulnerability, and the use of distinct developmental screening tools, rather than direct discrepancies in developmental status. The lower proportion of age-appropriate development observed among older age groups, from over 80% in the first months of life to below 50% at 31–36 months, this pattern underscores the relevance of early developmental screening in primary healthcare settings during the first 1,000 days of life, when the central nervous system is most adaptable to stimulation [5, 6].
The sociodemographic characteristics of the study population are consistent with known determinants of health inequalities. Although the analysis did not formally stratify outcomes by socioeconomic vulnerability, the observed patterns suggest the relevance of maternal education and access to health services in shaping early childhood outcomes.
Sex differences were also evident, with boys showing a greater incidence of adverse outcomes, including stunting, low birth weight, and neonatal complications. Similar findings have been reported in other marginalized contexts, such as Oaxaca, where boys exhibited poorer growth and developmental outcomes than girls [15]. These findings support the relevance of structured, data-informed approaches to early detection and monitoring in vulnerable populations.
One of the strengths of this study lies in the use of a centralized digital platform that enables standardized and consistent data collection across participating facilities. The training of health personnel further contributed to ensuring data quality and comparability. However, the cross-sectional design limits causal inference, and the absence of detailed family- and community-level data represents an area for future research.
The use of a structured digital platform for data collection allowed for standardized assessment of growth and development across multiple primary healthcare settings. The findings illustrate the potential utility of such systems for systematically identifying nutritional and developmental risks in vulnerable populations. However, the present analysis did not evaluate longitudinal follow-up, intervention effectiveness, or system-level impact.
Strengthening early detection strategies within routine primary healthcare may contribute to timelier referral and preventive action, particularly in socially disadvantaged communities. Future research should assess the long-term effects of structured screening models on developmental trajectories and health outcomes.
Conclusions
The results of this study underscore the importance of implementing integrated, digital, and equity-oriented systems such as MIDO First Childhood, which not only assess individual risks but also generate actionable intelligence for clinical decision-making and public health planning.
This model highlights the importance of structured early detection and systematic monitoring strategies in addressing health and developmental disparities. Its interoperability with broader health information systems and its ability to generate real-time, aggregated intelligence, position MIDO First Childhood as a valuable policy-enabling strategy for child health governance in Mexico.
Scaling up this approach could significantly contribute to achieving national and global goals in early childhood health, development, and nutrition, ensuring that no child is left behind in the pursuit of sustainable and inclusive human development.
Acknowledgements
We extend our sincere gratitude to all partner organizations involved in the implementation of MIDO First Childhood. We are especially grateful to the State Secretaries of Health, the Medical Mission Network, and Salud Integral México for their leadership and coordination. We would like to express our particular appreciation to the Lilly Global Health Partnership, whose support was instrumental in advancing this work. Finally, we thank the families who generously participated in the assessments their trust and time were essential to making this project possible.
Authors’ contributions
G. M.-S. & A. M. conceived the idea, analyzed the data, and drafted the original manuscript. D.-A. Á.-H., H. G.-R., L.-A. M.-J., R. S.-M., R. T.-C., J. F.-L. , R. M.-R. & R. G.-C. contributed to the conception and design of the work, oversaw the program implementation, and performed critical revision for intellectual content. D. C.-M. assisted in project design and critically reviewed the manuscript. All authors read and approved the final version of the manuscript. Each author takes responsibility for their own contributions and agrees to be accountable for the integrity and accuracy of all parts of the work, even those in which they were not directly involved.
Funding
The implementation of MIDO First Childhood was supported by The Carlos Slim Foundation as a part of its institutional public health efforts.
Data availability
The datasets generated and/or analyzed during the current study are not publicly available due to data protection regulations. However, anonymized data may be made available from the corresponding author upon reasonable request.
Declarations
Ethics approval and consent to participate
This study is a secondary analysis of de-identified operational data. According to the Mexican General Health Law on Health Research (Reglamento de la Ley General de Salud en Materia de Investigación para la Salud), this study is classified as “Risk-Free” (Category I), as it relies on retrospective documentary research where sensitive data is protected. Therefore, a specific IRB approval for this manuscript or individual informed consent for research was not required by national regulations. The use of the platform is governed by institutional collaboration agreements that strictly ensure data confidentiality.
The study adhered to the ethical principles of the Declaration of Helsinki, particularly regarding the protection of anonymity, confidentiality, and the responsible handling of health information.
Consent for publication
Not applicable. The study used anonymized, secondary data collected as part of routine health assessments.
Competing interests
The authors declare no competing interests.
Footnotes
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The datasets generated and/or analyzed during the current study are not publicly available due to data protection regulations. However, anonymized data may be made available from the corresponding author upon reasonable request.