Growth and Development Early Detection Toolkit, Enabling Mothers in Rural Areas to Monitor Child Development and Take Appropriate Measure to Ensure Healthy Grow

Problem

The first five years of life is crucial in child development to build a strong base for the child's quality of life. Thus, aside from physical growth, it’s important to regularly record and monitor developmental progress. Early detection and proper intervention of developmental disorder during this time can reduce the severity of the condition and help children adapt in school and social life. However in Indonesia developmental screening is not part of routine examination, especially in rural areas. Lack of professionals and the large population make it necessary to involve mothers and village health cadres in children development monitoring. Thus, cases at risk of developmental problems can be referred to health professional at the earliest, when it's easiest to rehabilitate.

Solution

Technically, a number of tools are available to monitor developmental progress, such as Frankenburg or Denver assessment, Bailey test, Munchner Developmental test. However, developing countries are lacking health professional to conduct such screening, and mostly neither affordable nor accessible for mothers from low income class with limited literacy. To enable rural mothers and health cadres to monitor their own child and take appropriate action, we develop Growth and Development Early Detection Toolkit (see picture). This toolkit consists of a pictorial developmental chart, interpretation guideline, and manual for follow-up intervention. We train health cadres to train mothers on how to use the toolkit, and ask for their feedback to improve material comprehensibility.

Example

We at Suryakanti establish a center for child development, which programs are: 1)Home Based Early Detection & Early Intervention Where professionals are lacking, mothers should be enabled to check basic developmental status. Growth and Development Early Detection Toolkit is a user-friendly home based screening tool. The developmental chart shows indicator skills of children maturity at specific age (based on Gesell and Muenchner test in 5 domain (gross motor; fine motor; perception/ adaptive behavior; speech and language; psychosocial) for 8 age groups). Upon delay in reaching developmental milestone, mothers can follow-up with proper stimulation or in serious case refer to healthcare facility. As growth and development is interrelated with health and nutrition, we advocate inclusion of the toolkit into Integrated Road to Health Card (KMS terpadu). This card is distributed in Public Integrated Health Post (Posyandu), allowing holistic health monitoring. 2)Child Development Clinic The clinic serves as reference point when development delay is detected. We provide therapy (occupational therapy, physiotherapy, speech therapy, etc.), rehabilitation aid equipments, and advance examination (EEG and audiometric test). 3)Special Education School For children with special need (e.g. autistic, mentally retarded, down syndrome, cerebral palsy) we provide special education aligned with national curricula. Unlike public special school, we don’t categorize their disability, but instead treat them as individuals with multiple ability and disability.

Marketplace

Our peers are among which the government (public health care provider, health department, education department) and international NGO (such as UNICEF and Plan International). Although for well-off urban population children development clinic is already mushrooming, rarely anyone is doing this kind of effort on the grass root level. Challenge appears as we have to share the market that help cross-subsidize our operation on the grass root.