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

ABSTRACT

Children in low-income communities are at risk for developmental delays and sensory losses. mHealth screening tools enable community health workers to detect developmental delays and sensory losses. This study aims to describe a combined (developmental and sensory – hearing and vision) mHealth-supported screening programme conducted by community healthcare workers with children aged four-six years (n = 63) at early childhood development centres in a low-income community. Early childhood development practitioners (n = 5) assisted with developmental screening. Referral rates were 30% (n = 19) for development, 6% (n = 4) for hearing and 5% (n = 3) for vision. The average screening time for combined screenings was 11.72 min (SD 3.45 min). Post screening questionnaires probing participants' perspectives and experiences of the combined screening were positive. A combined mHealth-supported screening programme conducted by community health workers and early childhood development practitioners appears viable, supporting early detection of developmental delays and sensory losses in children from low-income communities.

KEYWORDS:

• Developmental screening
• sensory screening
• community health workers
• ECD practitioners
• combined mHealth-supported screening
• low-income community

Acknowledgements

The authors thank all the children, caregivers, ECD practitioners and the CHW who participated in the previous study, as well as the hearX Group Foundation, for letting them access the data for further analysis.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Due to the nature of this research, participants of the screening project did not agree for their data to be shared publicly, so supporting data is not available due to ethical restrictions.

Additional information

Funding

This work was supported by National Research Foundation [grant number 120426].

Notes on contributors

Kirsty Fuchs

Kirsty Fuchs obtained her degree in Speech-Language Pathology in 2020 at the University of Pretoria. She is currently a Master of Speech-Language Pathology candidate. Her research is focused on training and empowering community health workers and ECD practitioners to conduct combined developmental and sensory screening using mHealth in their community. In 2022, she is currently completing her community service at Potchefstroom Hospital in the North West province.

Jeannie van der Linde

Prof. Jeannie van der Linde is the Head of the Speech-Language Pathology and Audiology Department at the University of Pretoria. Her research explores early childhood development and service delivery in underserved communities. Innovative solutions are being explored to improve service delivery in these communities. Her research focus originated from her master’s degree and PhD studies. In 2019, Prof. van der Linde was rated by the National Research Foundation (NRF), South Africa, as a Y2 scholar and was the recipient of the Exceptional Young Academic Achievers Award. A rising voice in her field, Prof. van der Linde has also won research awards from the NRF, the Andrew W. Mellon Foundation, and the Vice-Chancellor’s Academic Career Award. Additionally, she serves on the editorial board of the South African Journal of Communication Disorders.

Renata Eccles

Dr Renata Eccles recently completed her doctoral degree and is a senior lecturer in the Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa. Her research focuses on early intervention and innovative responses to developmental and academic challenges faced by young children in South Africa, including visual impairment, developmental delays, and literacy acquisition. She also has an interest in interprofessional education and collaboration in her teaching and research. She has partnerships with the University of Gavle (Sweden) and the African Interprofessional Education Network (AfrIPEN). She holds international certifications in parent/caregiver and early childhood practitioner coaching from Hanen (It Takes Two to Talk, More Than Words, and Learning Language and Loving It).

De Wet Swanepoel

De Wet Swanepoel is a professor in the Department of Speech-Language Pathology and Audiology, University of Pretoria and a senior research fellow at the Ear Science Institute Australia. Prof. Swanepoel’s research capitalizes on information and communication technologies to explore, develop and evaluate innovative solutions and service-delivery models for access to ear and hearing care. He has published more than 220 peer-reviewed articles, books, and book chapters and is funded by the NIH, the UK Academy of Medical Sciences and the National Research Foundation. He has received numerous national and international awards in recognition of his work and serves on various boards, committees and working groups including the World Health Organization. Prof. Swanepoel serves as Editor-in-Chief for the International Journal of Audiology and is a past president of the International Society of Audiology.

Marien Alet Graham

Prof. Marien Graham is a specialist in assessment, quality assurance, nonparametric statistics, and statistical quality control. She is an Associate Professor in the Department of Science, Mathematics and Technology Education, University of Pretoria, South Africa. She has contributed to many disciplines, such as education, healthcare, social issues, and agroforestry. Prof. Graham is a Y1-researcher with the National Research Foundation (NRF), South Africa. She is the co-author of Nonparametric Statistical Process Control, John Wiley & Sons (2019). She is also on the editorial advisory board of Scientific Studies and Research, Series Mathematics and Informatics, has been published in numerous accredited international peer-reviewed journals and has presented her research at several national and international conferences.

Maria du Toit

Dr Maria du Toit completed her PhD in 2020, continuing and building on the research done for her master’s degree by training and empowering community health workers to conduct developmental screening using mHealth in their community. She is currently a clinical lecturer at the University of Pretoria. In 2022, she started a postdoctoral fellowship, validating a contextually relevant developmental screening tool by implementing it on a larger scale for preschool children. In addition to this, she owns a private practice and provides speech-language therapy in her spare time not dedicated to research or coordinating student practicals.