Early detection of developmental delays in vulnerable children by community care workers using an mHealth tool

Abstract

Developmental delays are increasing worldwide, as a result of exposure to environmental risk factors, such as poverty. Early detection services are often inaccessible in low- and middle-income countries (LMIC) due to limited human resources and a lack of knowledge regarding development. This study investigated an mHealth screening programme with community care workers (CCWs) facilitating early detection of developmental delays in children from underserved communities. An exploratory research design that was both qualitative and quantitative in nature was applied. CCWs, employed by a community-based non-governmental organisation (NGO), were trained to administer the Parents’ Evaluation of Developmental Status (PEDS) smartphone application as part of home-based services offered to families affected by HIV/AIDS. After the training, they screened 138 children (mean=19.2 months, SD=11.1) in the community. Children who failed the screen were rescreened, and depending the outcome, were referred for diagnostic assessment. CCWs completed a questionnaire regarding their perceptions and experiences of community-based mHealth-assisted screening. The results indicated an overall referral rate of 69%. Older children (19-38 months old) had a significantly higher (p<0.05; Chi-Square) referral rate (57%; n=39) compared to those aged 0-18 months (40%; n=24). The high referral rate may be attributed to the at-risk population sampled. Average screening time was 12.5 minutes and on average ten children were screened per day. CCWs perceived mHealth screening as valuable in terms of utility, outcomes and contribution to developmental knowledge for community members and CCWs. Community-based services are a promising platform for the implementation of mHealth-assisted early developmental screening programmes for improved access to early detection and surveillance for vulnerable children and their families. CCWs indicated that they were motivated to promote increased developmental surveillance in their community.