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The determinants of compliance with an early intervention programme for high-risk babies in India
N de Souza1, V Sardessai, K Joshi
1Sethu Trust for Child Development and Family Guidance, 35 Defence Colony, Sangath, Alto Porvorim, Goa 403521, India. ndesouza@sancharnet.in
Insights
Early intervention programs improve outcomes for high-risk infants. Home-based programs and higher maternal education significantly boost treatment adherence in developing countries.
Area of Science:
- Pediatrics
- Public Health
- Developmental Psychology
Background:
- Early intervention is crucial for improving outcomes in infants with growth and developmental risks.
- Prolonged programs with frequent contact are typical but challenging in developing countries due to poverty, illiteracy, and poor communication.
Purpose of the Study:
- To analyze the compliance of a clinic-based early intervention program for high-risk infants in Goa, India.
- To identify socio-demographic, programmatic, and infant-related factors influencing treatment adherence.
Main Methods:
- A cohort of 152 neonates and their parents participated in a clinic-based early intervention program.
- Follow-up was conducted until the infants' first birthday.
- Compliance was assessed, and various influencing variables were examined.
Main Results:
- Moderate compliance was observed, with 59.2% of infants attending three or more sessions.
- Higher maternal education levels were significantly associated with better compliance.
- Closer proximity of the family's residence to the clinic also correlated with improved adherence.
Conclusions:
- Home-based early intervention programs demonstrate higher potential for reaching high-risk infants compared to center-based services.
- Maternal education plays a key role in convincing mothers of the benefits of early intervention.
- Recommendations for future practice and research emphasize the need for accessible, home-visiting models and further investigation into adherence factors.
Background:
Early intervention is known to improve outcomes for babies at risk for growth and developmental problems. Such programmes usually have a prolonged course and require frequent contacts with the service providers. As a consequence of poverty, illiteracy and lack of communication facilities in developing countries, treatment adherence can suffer.
Methods:
The present study is an analysis of a clinic-based early intervention programme for high-risk babies in a developing society in Goa, India. A sample of 152 neonates and their parents were offered an early intervention programme and followed up until their first birthday. The primary outcome under study was the uptake of the programme. Various socio-demographic, programmatic and infant-related variables that could affect compliance were examined.
Results:
Compliance with the intervention programme was only moderate, with 59.2% of infants brought for three or more sessions. Higher maternal educational levels and proximity of the place of residence of the family to the early intervention clinic were significantly associated with better compliance.
Conclusions:
Early intervention programmes that go into homes have a greater chance of reaching high-risk infants, compared with those provided at a distant centre. Better-educated mothers are more likely to be convinced about the benefits of such inputs. The authors conclude with recommendations for future practice and research.
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