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Longitudinal Implementation of a Neurodevelopmental Screening Program for Children Born to Mothers Living With HIV in
Megan S McHenry1,2, Eren Oyungu2,3, Amina Abubakar4
1Department of Pediatrics, Indiana University School of Medicine, Indianapolis, USA.
Insights
Neurodevelopmental (ND) screening for children with perinatal HIV exposure is feasible and sustainable. Implementing ND screening in child health programs can improve early detection of developmental delays.
Area of Science:
- Global Health
- Pediatrics
- Implementation Science
Background:
- Children with perinatal HIV exposure face higher risks of neurodevelopmental (ND) delays.
- Limited data exists on the practical implementation of ND screening for this vulnerable population.
Purpose of the Study:
- To evaluate the implementation of ND screening for children aged 18-36 months with perinatal HIV exposure.
- To assess implementation outcomes including acceptability, feasibility, fidelity, and sustainability.
Main Methods:
- A longitudinal study conducted at a Kenyan health clinic from September 2021 to August 2023.
- Utilized a 12-item general ND tool for screening children aged 18-36 months.
- Employed time-motion observations, clinic records, and semi-structured interviews to assess implementation outcomes.
Main Results:
- 80% (405/507) of eligible children were screened, with consistent rates over 24 months.
- Average screening time decreased to under 5 minutes.
- Key facilitators included staff collaboration and caregiver support, while time constraints and child temperament posed barriers.
Conclusions:
- ND screening demonstrated acceptability, feasibility, and sustainability in this cohort.
- Recommendations include integrating ND screening into national child health programs, investing in training and task-sharing, and enhancing referral systems.
Abstract:
BackgroundChildren with perinatal HIV exposure are at increased risk for neurodevelopmental (ND) delays, yet little is known about ND screening implementation for this population.MethodsThis longitudinal study evaluated ND screening implementation at a health clinic in Kenya, from 9/2021 to 8/2023. Children aged 18-36 months with perinatal HIV exposure were screened using a 12-item general ND tool. Implementation outcomes-acceptability, feasibility, fidelity, and sustainability-were assessed through time-motion observations, clinic records, and semi-structured interviews with caregivers and staff.ResultsOf 507 eligible children, 405 (80%) were screened. Screening rates were consistent over 24 months, with average time reduced to under 5 min. Facilitators included staff collaboration and caregiver support; barriers included time constraints and child temperament.ConclusionsND screening was acceptable, feasible, and sustainable. Policymakers should embed ND screening within national child health programs, invest in workforce training and task-sharing models, strengthen referral and follow-up systems, and ensure affordable access to services.
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