Evaluation of Surveillance and Promotion of Early Childhood Development Program in Tambon Health Promoting Hospital in Phetchaburi Province

Abstract

Objective: To evaluate the performance, problems and obstacles of surveillance and promotion of early childhood development program in Phetchaburi Province. Materials and methods: This was a mixed-method, using the system theory, both quantitative and qualitative research. Quantitative data were collected by questionnaire from childs development service providers in 118 Tambon Health Promoting Hospitals’ and the service recipients in their catchment area. The sample size was 92 in each group, and the samples were randomly selected by stratified random sampling. Qualitative data were collected by in-depth interviews also from childs development service providers in Tambon Health Promoting Hospitals and service recipients in their catchment area. The sample size was 8 in each group. The data were collected from August to December 2017, and were analyzed by frequency, percentage, mean and content analysis.

Results:  1) Inputs; it was indicated that there were public communications to stakeholders and service recipients, enough numbers of staff, the system for recording data, and the screening plan which was separated from vaccination days, Service recipients received home visits from public health volunteers, and could access to the health centers nearby and had enough time to promote child’s development. However, there were some problems, such as the Early Childhood Developmental Surveillance and Development Toolkit and the manual were not sufficient, no workplace  for  developmental  assessment,  no  child  health  volunteer  specialist,  and  lacked  of cooperation from local agencies.  2) Processes; it was indicated that the service providers prepared data, materials, equipments, workplaces and contacted the parents before the screening including built relationships with children and parents’ contribution. Follow-up by home visits to stimulate and promote child development including children who were not assessed for screening by appointment. There were interpretation and summary of the results for the parents and the next appointment, and the data were record timely. Service recipients were found that most of them had read the child development manual, looked for the equipment and screened child development. The problems were those the ways they raised children were wrong, parents needed to be educated, such as choosing the right food for their children.  3) Results; it was indicated that service providers and servicerecipients were at moderate level of knowledge. ( = 6.71 and 5.68). Service providers were at moderate level of satisfaction. ( = 3.33), whereas service recipients were at high level of satisfaction. (= 3.96). The children with delayed development were successfully found at 21.0%, overall and were promoted to the standard development (88.8%). The problems were those service providers lacked of the knowledge about the goals, the developmental screening covered only 72.6% and the follow-up of children with suspected developmental delay was only 50.5%.