Situation and Needs for Developing a Developmental Surveillance and Promotion Model for Early Childhood with Suspected Developmental Delay at Bang Khan Mak Subdistrict Health Promoting Hospital, Lop Buri Province

Abstract

            Early childhood development provides a foundation for learning and later quality of life. Timely developmental screening and continuous follow-up are therefore essential for children with suspected developmental delay. This qualitative study aimed to explore the current situation, operational problems, and needs for developing a developmental surveillance and promotion model for young children with suspected developmental delay in the catchment area of Bang Khan Mak Subdistrict Health Promoting Hospital, Mueang Lop Buri District, Lop Buri Province. Nine informants were purposively selected, including public health personnel, representative of a local administrative organization, early childhood teacher, village health volunteer, and parents of children with suspected developmental delay.. Data were analyzed using content analysis. Four major themes were identified. First, the existing system had an established age-based screening process in which target lists were prepared monthly, appointments were communicated primarily through village health volunteers, and early childhood development centers contributed to identifying and observing children. Second, major barriers were related to caregivers’ knowledge, perception, and acceptance. Several caregivers did not understand the Developmental Surveillance and Promotion Manual (DSPM), did not accept screening results when a child failed a developmental item, and lacked skills for developmental stimulation. Third, continuity of care was disrupted after screening, particularly when children did not return for re-screening within one month or did not complete hospital referral, potentially delaying timely assistance. Fourth, informants expressed a need for a proactive network-based follow-up system and repeatedly proposed a “Mae Nom & Buddy” team to connect the subdistrict health promoting hospital with the local administrative organization, community leaders, early childhood development centers, village health volunteers, and parents. They also emphasized caregiver education and communication of screening results across the network. These findings indicate that the next phase of model development should emphasize case-based follow-up, caregiver capacity building, and coordinated referral and feedback mechanisms so that children with suspected developmental delay receive timely re-assessment, developmental stimulation, and referral.