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Perspectives of paediatricians on developmental surveillance and screening in a low- to middle-income country: a
Alia Dani1, Meghety Gudeshian2, Gladys Honein-Abou Haidar3
1Pediatrics, American University of Beirut, Beirut, Lebanon.
Insights
Paediatricians in Lebanon show varied understanding and inconsistent practices in early childhood development surveillance and screening. National guidelines are needed to improve developmental support for children under five.
Area of Science:
- Pediatrics
- Global Health
- Developmental Psychology
Background:
- Early childhood development (ECD) is a critical global health issue.
- Paediatricians are key in promoting healthy development through surveillance and screening.
- Limited research exists on paediatrician perspectives in low-resource settings like Lebanon.
Purpose of the Study:
- To explore paediatricians' perspectives on current routine developmental surveillance (DS) and screening (DSc) practices for children under five in Lebanon.
Main Methods:
- Purpose and convenience sampling of paediatricians across all Lebanese governorates.
- Semi-structured interviews (face-to-face/online) conducted between 2018-2021.
- Thematic analysis of transcribed and translated interview data.
Main Results:
- Significant variation in understanding of DS and DSc concepts among paediatricians.
- Non-academic paediatricians focused mainly on physical development; academic paediatricians included cognitive and psychosocial aspects.
- Practice was influenced by paediatrician, parent, interaction, and system-level factors.
Conclusions:
- Developmental surveillance and screening practices in Lebanon are inconsistent and not systematically integrated.
- Need for increased awareness, standardized methods, and national guidelines for ECD.
- Further research in similar low-resource countries is needed for global efforts.
Introduction:
Early childhood development (ECD) is a critical global and public health issue. Worldwide, paediatricians serve as the primary point of contact between children and the healthcare system, playing a key role in promoting healthy development through routine developmental surveillance (DS) and screening (DSc). However, there is limited research on paediatricians' perspectives regarding this matter, particularly in low-resource communities and countries such as Lebanon. This study aimed to explore the paediatricians' perspectives on the current routine DS and DSc practices for children under 5 years of age.
Methods:
Paediatricians from all five Lebanese governorates were invited to participate using purpose and convenience sampling. A total of five academic and eleven non-academic paediatricians were included in the study. Semi-structured face-to-face or online interviews were conducted in Arabic between September 2018 and August 2021. Interviews were audio-recorded, then transcribed verbatim and translated into English and thematically analysed using Quirkos V.2.5.3 software.
Results:
The study revealed significant variation regarding the understanding of concepts of routine DS and DSc. Most non-academic paediatricians primarily focused on physical development, while academic paediatricians were more attuned to cognitive and psychosocial development, with variation in practice. Factors influencing the practice were multi-layered: paediatricians, parents, paediatrician-parent interaction and system level.
Conclusion:
DS and DSc practices in Lebanon are inconsistent, often incomplete and not systematically integrated into routine paediatric care. Efforts should be made to raise awareness about their importance, the appropriate methods for conducting them, and address the system-level factors by developing national guidelines for ECD. Data on paediatricians' practices in other similar low-resource countries or communities is needed to understand the common problems and have joint efforts to address them globally.
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