Early detection and intervention for young children with early developmental disabilities in Western Uganda: a mixed-methods evaluation
Abstract Background Early support for children with developmental disabilities is crucial but frequently unavailable in low-resource settings. We conducted a mixed-methods evaluation to assess the feasibility, acceptability, and impact of a programme of early detection and intervention for young chi...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-03-01
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| Series: | BMC Pediatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12887-022-03184-7 |
| _version_ | 1828256850670256128 |
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| author | S. Sadoo R. Nalugya R. Lassman M. Kohli-Lynch G. Chariot H. G. Davies E. Katuutu M. Clee J. Seeley E. L. Webb R. Mutoni Vedastine F. Beckerlegge C. J. Tann |
| author_facet | S. Sadoo R. Nalugya R. Lassman M. Kohli-Lynch G. Chariot H. G. Davies E. Katuutu M. Clee J. Seeley E. L. Webb R. Mutoni Vedastine F. Beckerlegge C. J. Tann |
| author_sort | S. Sadoo |
| collection | DOAJ |
| description | Abstract Background Early support for children with developmental disabilities is crucial but frequently unavailable in low-resource settings. We conducted a mixed-methods evaluation to assess the feasibility, acceptability, and impact of a programme of early detection and intervention for young children with developmental disabilities in Western Uganda. Methods Early child development training for healthcare workers (HCWs) was implemented in three rural districts, and attendance was tracked. HCW knowledge and confidence were assessed pre-/post-intervention, and referral numbers tracked to evaluate impact. Facilitators were trained and mentored to deliver a participatory, group, early intervention programme (EIP) for young children with developmental disabilities and their families. Facilitators were tracked as they were identified, trained, and delivered the intervention, and attendance of families was tracked. Pre−/post-intervention assessments evaluated changes in family quality of life (PedsQL 2.0, Family Impact Module), and child nutritional outcomes. Focus group discussions with stakeholders also assessed feasibility, acceptability and impact. Results Overall, 93 HCWs from 45 healthcare facilities received training. In the pre−/post-evaluation, median knowledge and confidence scores increased significantly (from 4.0 to 7.0 and from 2.7 to 4.7, respectively (p < 0.001)). HCWs reported feeling empowered to refer and offer care for families with a young child with disability. Referral rates increased significantly from 148 to 251 per annum (70%; p = 0.03). Eleven EIP facilitators were trained, and all delivered the intervention; 84 families were enrolled, of which 78% attended at least 6 out of 10 modules. Amongst those with paired pre−/post-intervention data (n = 48), total family quality of life scores increased significantly (21%, p < 0.001). Improvements were seen across all domains of quality of life, with the largest impacts on emotional functioning and social functioning (p < 0.001). The programme was acceptable to caregivers and facilitators. Caregivers reported improved knowledge, family relationships, hope, emotional wellbeing, and reduced self-stigma. Conclusions A programme of early detection and intervention for children with early developmental disabilities and their families was feasible and acceptable in a rural community-based Ugandan setting. HCW training positively impacted knowledge, confidence, attitudes, and referral rates. Families enrolled to the EIP reported significant improvements in quality of life. Important programmatic barriers identified included geographical spread, poverty, gender inequality, and stigma. |
| first_indexed | 2024-04-13T02:34:17Z |
| format | Article |
| id | doaj.art-ca6c2a36498b410593fb2e49d49428fe |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-04-13T02:34:17Z |
| publishDate | 2022-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-ca6c2a36498b410593fb2e49d49428fe2022-12-22T03:06:27ZengBMCBMC Pediatrics1471-24312022-03-0122111410.1186/s12887-022-03184-7Early detection and intervention for young children with early developmental disabilities in Western Uganda: a mixed-methods evaluationS. Sadoo0R. Nalugya1R. Lassman2M. Kohli-Lynch3G. Chariot4H. G. Davies5E. Katuutu6M. Clee7J. Seeley8E. L. Webb9R. Mutoni Vedastine10F. Beckerlegge11C. J. Tann12London School of Hygiene and Tropical MedicineSpina bifida and Hydrocephalus association of UgandaKyaninga Child Development CentreLondon School of Hygiene and Tropical MedicineKyaninga Child Development CentreSt George’s University LondonFort Portal Regional Referral HospitalNeonatal Medicine, University College London Hospitals NHS TrustLondon School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineKyaninga Child Development CentreKyaninga Child Development CentreLondon School of Hygiene and Tropical MedicineAbstract Background Early support for children with developmental disabilities is crucial but frequently unavailable in low-resource settings. We conducted a mixed-methods evaluation to assess the feasibility, acceptability, and impact of a programme of early detection and intervention for young children with developmental disabilities in Western Uganda. Methods Early child development training for healthcare workers (HCWs) was implemented in three rural districts, and attendance was tracked. HCW knowledge and confidence were assessed pre-/post-intervention, and referral numbers tracked to evaluate impact. Facilitators were trained and mentored to deliver a participatory, group, early intervention programme (EIP) for young children with developmental disabilities and their families. Facilitators were tracked as they were identified, trained, and delivered the intervention, and attendance of families was tracked. Pre−/post-intervention assessments evaluated changes in family quality of life (PedsQL 2.0, Family Impact Module), and child nutritional outcomes. Focus group discussions with stakeholders also assessed feasibility, acceptability and impact. Results Overall, 93 HCWs from 45 healthcare facilities received training. In the pre−/post-evaluation, median knowledge and confidence scores increased significantly (from 4.0 to 7.0 and from 2.7 to 4.7, respectively (p < 0.001)). HCWs reported feeling empowered to refer and offer care for families with a young child with disability. Referral rates increased significantly from 148 to 251 per annum (70%; p = 0.03). Eleven EIP facilitators were trained, and all delivered the intervention; 84 families were enrolled, of which 78% attended at least 6 out of 10 modules. Amongst those with paired pre−/post-intervention data (n = 48), total family quality of life scores increased significantly (21%, p < 0.001). Improvements were seen across all domains of quality of life, with the largest impacts on emotional functioning and social functioning (p < 0.001). The programme was acceptable to caregivers and facilitators. Caregivers reported improved knowledge, family relationships, hope, emotional wellbeing, and reduced self-stigma. Conclusions A programme of early detection and intervention for children with early developmental disabilities and their families was feasible and acceptable in a rural community-based Ugandan setting. HCW training positively impacted knowledge, confidence, attitudes, and referral rates. Families enrolled to the EIP reported significant improvements in quality of life. Important programmatic barriers identified included geographical spread, poverty, gender inequality, and stigma.https://doi.org/10.1186/s12887-022-03184-7Developmental disabilityUgandaEarly detectionEarly intervention |
| spellingShingle | S. Sadoo R. Nalugya R. Lassman M. Kohli-Lynch G. Chariot H. G. Davies E. Katuutu M. Clee J. Seeley E. L. Webb R. Mutoni Vedastine F. Beckerlegge C. J. Tann Early detection and intervention for young children with early developmental disabilities in Western Uganda: a mixed-methods evaluation BMC Pediatrics Developmental disability Uganda Early detection Early intervention |
| title | Early detection and intervention for young children with early developmental disabilities in Western Uganda: a mixed-methods evaluation |
| title_full | Early detection and intervention for young children with early developmental disabilities in Western Uganda: a mixed-methods evaluation |
| title_fullStr | Early detection and intervention for young children with early developmental disabilities in Western Uganda: a mixed-methods evaluation |
| title_full_unstemmed | Early detection and intervention for young children with early developmental disabilities in Western Uganda: a mixed-methods evaluation |
| title_short | Early detection and intervention for young children with early developmental disabilities in Western Uganda: a mixed-methods evaluation |
| title_sort | early detection and intervention for young children with early developmental disabilities in western uganda a mixed methods evaluation |
| topic | Developmental disability Uganda Early detection Early intervention |
| url | https://doi.org/10.1186/s12887-022-03184-7 |
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