RT Journal Article SR Electronic T1 Early childhood development and parental training interventions in rural China: a systematic review and meta-analysis JF BMJ Global Health JO BMJ Global Health FD BMJ Publishing Group Ltd SP e005578 DO 10.1136/bmjgh-2021-005578 VO 6 IS 8 A1 Dorien Emmers A1 Qi Jiang A1 Hao Xue A1 Yue Zhang A1 Yunting Zhang A1 Yingxue Zhao A1 Bin Liu A1 Sarah-Eve Dill A1 Yiwei Qian A1 Nele Warrinnier A1 Hannah Johnstone A1 Jianhua Cai A1 Xiaoli Wang A1 Lei Wang A1 Renfu Luo A1 Guirong Li A1 Jiajia Xu A1 Ming Liu A1 Yaqing Huang A1 Wenjie Shan A1 Zhihui Li A1 Yu Zhang A1 Sean Sylvia A1 Yue Ma A1 Alexis Medina A1 Scott Rozelle YR 2021 UL http://gh.bmj.com/content/6/8/e005578.abstract AB Introduction Inadequate care during early childhood can lead to long-term deficits in skills. Parenting programmes that encourage investment in young children are a promising tool for improving early development outcomes and long-term opportunities in low-income and middle-income regions, such as rural China.Methods We conducted a systematic review and a meta-analysis to investigate the prevalence of early developmental delays and stimulating parenting practices as well as the effect of parental training programmes on child development outcomes in rural China. We obtained data in English from EconPapers, PubMed, PsycARTICLES, Cochrane Library, Web of Science and Scopus (Elsevier) and in Chinese from China National Knowledge Infrastructure, Wanfang Data and VIP Information. We conducted frequentist meta-analyses of aggregate data and estimated random-effects meta-regressions. Certainty of evidence was rated according to the Grading of Recommendations Assessment, Development and Evaluation approach.Results We identified 19 observational studies on the prevalence of developmental delays and stimulating parenting practices for children under 5 years of age (n=19 762) and ten studies on the impact of parental training programmes on early child development (n=13 766). Children’s risk of cognitive, language and social-emotional delays in the rural study sites (covering 14 provinces mostly in Central and Western China) was 45%, 46%, and 36%, respectively. Parental training programmes had a positive impact on child cognition, language and social-emotional development.Conclusion There is evidence to suggest that early developmental delay and the absence of stimulating parenting practices (ie, reading, storytelling and singing with children) may be prevalent across rural, low-income and middle-income regions in Central and Western China. Results support the effectiveness of parental training programmes to improve early development by encouraging parental engagement.Trial registration number This study was registered with PROSPERO (CRD42020218852).Data are available on request. The Stata code and data permissible for sharing will be made available on request from DE (dorien.emmers@kuleuven.be).