# **Introduction**

The importance of children’s early development for subsequent educational attainment, economic productivity and lifelong health has been captured in a wide body of literature which explores the risk and protective factors associated with early child development (ECD) (Walker et al., 2011; McDonald et al., 2016; Donald et al., 2019). Risk factors often include poverty, lack of maternal education, and the health of the caregiver and child (Donald et al., 2019; McDonald et al., 2016). Protective factors often include enrollment in early childhood education (ECE), engaging and responsive interactions, and supportive social connections. These studies underscore the complex ways that risk and protective factors influence ECD. Fewer studies, however, have empirically examined the role that child gender plays within these relationships.

Studies examining differences in ECD by child gender at the country, regional, and global levels have typically found either no significant differences or small to moderate differences favoring girls (Lu et al., 2020; McCoy et al., 2016; Rey-Guerra et al., 2023). Early differences can last and manifest in differences in primary school performance, as was found in rural Indonesia (Nakajima et al., 2019). Associations of early risk and protective factors with ECD (Donald et al., 2019) and later outcomes for education and health (Stith et al., 2003; Hamil-Luker and O’Rand, 2007) vary by gender, with effects favoring boys or girls differently based on exposure type, outcomes, and geographic context. Therefore, investigating the relationship between child gender, exposure to risk and protective factors, and development in the early years may yield important insights about long-term gender inequities in human development outcomes.

Understanding these patterns is crucial for ensuring gender equitable outcomes for children from a life-course perspective, particularly in settings where this research remains limited. Untangling the relationships of ECD and child gender is complicated by numerous interrelated factors, including links to biological processes; social processes, such as gendered caregiving and peer norms and expectations; and even country-level measures of gender inequality (Rey-Guerra et al., 2023)—all of which vary across countries and sociocultural contexts.

In Pakistan, stark gender inequities persist in employment, education, and training (World Bank, 2023). As of 2018, only 23% of women participated in the labor force compared to 81% of men (World Bank, 2023). As of 2019, more girls aged 5-16 were out of school than boys (37% vs. 25%, respectively), and boys spent on average 1.4 more years in school than girls (World Bank, 2023). Although ECE enrollment is low for all children aged 3-5 years, with a national average enrollment rate of 19% as of 2020, across provinces enrollment rates are between 1 and 3 percentage points lower for girls (Tomlinson et al., 2023). A prior study examined associations between risk and protective factors with child development and school readiness outcomes in Pakistan, finding strong associations between better child outcomes and higher levels of psychosocial stimulation and lower levels of parental distress. However, relationships with gender remain unexplored (Hentschel et al., 2023) in part because of the complexity of the interconnections among ECD, risk and protective factors, and child gender. A study in rural Sindh examined gender differences in the associations of ECD outcomes with measures of brain activity and found that brain activity and verbal ability were positively related in 48-month-old girls but not boys. The authors present several possible explanations for this including biological, environmental, or sociocultural factors, but call for future research to examine these relationships (Tarullo et. al., 2017).

This study contributes to the existing evidence base by exploring whether child gender moderates the association between ECD outcomes and three risk and protective factors for which 2