data collection. Moreover, given the nature of this phone survey, we were unable to capture the quality of ECE among children that were attending. Furthermore, given the periodic COVID-19related partial and full school closures in the years preceding the study (Nagesh et al., 2022), rates of ECE enrollment do not necessarily reflect consistent attendance (particularly as only about 7% of those attending had access to virtual ECE services). We used a proxy measure for income, which was average monthly mobile expenditure; however, this proxy may not accurately reflect income levels, loss of income in the recent past, or socioeconomic status. Similarly, the proxy measure for household size may not accurately map onto nuclear versus extended family structure or represent older-sibling effects. The study did not allow us to parse the roles of birth order, siblings and family structure directly, an area befitting future research, especially for effects on girls. Future research may also examine how attitudes towards child gender influence caregiving behaviors and child outcomes. Additionally, we did not have district- or village-level data to examine potential COVID-19 shocks at a more granular level. Statistical approaches allowed for associational inference only rather than causal conclusions, particularly in light of the above limitations regarding omitted variables and measurement and design constraints. Lastly, this analysis is crosssectional and therefore unable to explore how early investments and relationships may differentially be associated with future outcomes by child gender. Future studies could apply longitudinal designs to better understand the dynamic nature of these relationships.

# **Conclusion**

Our study examined the moderating role of child gender in the associations between parental distress, ECE enrollment, and psychosocial stimulation and ECD across two age cohorts. We found that higher parental distress had a negative association with ECD outcomes for very young children, with girls experiencing worse ECD outcomes than boys in the context of high levels of parental distress—although both boys and girls were sensitive to these distress levels. We also found that higher psychosocial stimulation had a strong, positive association with ECD across both age groups. This relationship was moderated by child gender among the youngest children, in which girls’ ECD outcomes were marginally lower than boys’ in instances of low stimulation. Finally, we found that ECE is strongly positively associated with ECD regardless of gender.

Our findings reaffirm the importance of investing in the psychosocial wellbeing of caregivers of young children and suggest that supports may be particularly beneficial for caregivers of girls in the earliest years in this context. This study also reinforces the need for early learning opportunities for young children under age 6. Results suggest that girls may especially benefit from efforts to raise parental awareness of the importance of stimulating environments. Taken together, our findings signal that investing in improved and scaled early learning opportunities, including nurturing and responsive interactions through stimulation and enrollment in high-quality ECE settings, can be promising strategies for fostering better ECD and later achievement outcomes in Pakistan for all children. Careful attention to child gender differences within this context may further enhance benefits, and further research on how to best support the wellbeing of female and male caregivers in their roles as providers of nurturing care to their young children is warranted.

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