1 research outputs found
Thailand's national universal developmental screening programme for young children: action research for improved follow-up
Introduction In low-income and middle-income
countries, it is estimated that one in every three
preschool-age children are failing to meet cognitive
or socioemotional developmental milestones. Thailand
has implemented a universal national developmental
screening programme (DSPM) for young children to
enable detection of developmental disorders and early
intervention that can improve child health outcomes.
DSPM implementation is being hampered by low
attendance at follow-up appointments when children fail
the initial screening.
Methods Action research, using qualitative methods
was conducted with 19 caregivers, 5 health workers and
1 chief at two Health Promotion Hospitals to explore the
factors affecting attendance at follow-up appointments.
Transcripts and notes were analysed using descriptive
content analysis. Findings were then discussed
with 48 health workers, managers, researchers and
policymakers.
Results The high workload of health workers during busy
vaccination clinics, and inadequate materials prevented
clear communication with caregivers about the screening,
how to stimulate child development and the screening
result. Caregivers, particularly grandparents, had a lack of
understanding about how to stimulate child development,
and did not fully understand failed screening results.
Caregivers felt blamed for not stimulating their child’s
development, and were either worried that their child was
severely disabled, or they did not believe the screening
result and therefore questioned its usefulness. This led to a
lack of attendance at follow-up appointments.
Conclusion Task-sharing, mobile health (mhealth),
community outreach and targeted interventions for
grandparent caregivers might increase awareness about
child development and screening, and allow health
workers more time to communicate effectively. Sharing
best practices, communication training and mentoring of
DSPM workers coupled with mhealth job aids could also
improve caregiver attendance at follow-up. Engagement of
caregivers in understanding the barriers to attendance at
follow-up and engagement of stakeholders in the design
and implementation of interventions is important to ensure
their effectiveness