Combined screening of early childhood development, hearing, and vision by community health workers using mHealth tools in a low-income community

Abstract

LITERATURE : Children in low-income communities are at increased risk for developmental delays and sensory losses. Difficulties should be identified as early as possible to reduce the impact on development and later academic achievement. mHealth or mobile health involves the use of applications on a smartphone or technological device that give access to the validated screening tests. The tests can be carried out with the use of technology. mHealth screening tools can enable task-shifting, allowing community health workers to detect developmental delays and sensory losses. Combined screening approaches should be trialled to evaluate feasibility. AIM : This study aims to describe a combined (developmental and sensory – hearing and vision) mHealth-supported screening programme conducted by community healthcare workers at early childhood development centres in a low-income community. mHealth screening tools for development, hearing (pure tone audiometry), and visual acuity were used. METHOD : One community health worker conducted the combined screening programme with children aged four to six years (n=63). Early childhood development practitioners (n=5) assisted with the developmental screening. RESULTS : The referral rates were 30% (n=19) for development, 6% (n=4) for hearing and 5% (n=3) for vision. The total average screening time for the combined screening was 11.72 minutes (SD 3.45 minutes). Post screening, the community health worker and early childhood development practitioners completed a 7 questionnaire probing their perspectives on and experiences of the combined screening programme, which were mostly positive. DISCUSSION : The cumulative effect of risk factors raises the prevalence rate of developmental delays and sensory losses. In the context of frameworks such as the Nurturing Care Framework (NCF), this combined mHealth-supported screening programme, used by CHWs and ECD practitioners in a low-resourced setting with children in this age range, has the potential to become a standardised service. Evidence regarding technology and mHealth-supported tools in underserved communities has grown. The study also inherently investigates combining screening tools where impairments are closely related, to identify multiple impairments timeously. CONCLUSION : A combined mHealth-supported screening programme conducted by community health workers and early childhood development practitioners appears viable and can support the early detection of developmental delays and sensory losses in young children from low-income communities.