Factors associated with early identification of developmental delays and disabilities, and linkage to care among children under 5 years in Kabarole District, Western Uganda

Abstract

Children in rural and resource-constrained areas face challenges in accessing early diagnosis and care for developmental delays and disabilities, affecting about 4.3% of children aged 0–4 years. In Kabarole District, despite efforts like UNICEF's IDEC program, an estimated 9,349 children live with developmental delays and disabilities, and limited information exists on early identification and linkage to care for children under 5 years, hindering effective service planning. This study assessed the factors associated with early identification of developmental delays and disabilities, and linkage to care for children under five years with developmental delays and disabilities in Kabarole District, Western Uganda. Methodology: A cross-sectional design was employed, utilizing both quantitative and qualitative methods to meet distinct objectives. Data from 211 caregivers were analyzed using descriptive and modified Poisson regression in STATA 15. Qualitative data from 9 key informants and 12 caregivers were analyzed thematically using Atlas.ti v.8. The response rate was 100%, ensuring comprehensive data collection. The results revealed that 50.2% of caregivers identified and linked their children to care early. The prevalence of reporting of early identification and linkage to care among caregivers with prior knowledge of the disability was nearly twice higher than those who didn’t (aPR=1.98, CI: 1.37-2.87, p<0.001). A very good relationship with healthcare providers increased the prevalence of reporting of early identification and linkage to care (aPR=1.59; 95% CI: 0.97-2.62), though not statistically significant. The prevalence of reporting of early identification and linkage to care among caregivers who benefited from healthcare programs was 1.45 times higher (aPR = 1.45, 95% CI: 0.95-2.20). Qualitative findings emphasized strengthening health and social support systems, including postnatal care, regular checkups, screening tools, community awareness, peer and family support, and family welfare. The study concluded that early identification and intervention for children under 5 with developmental disabilities in Kabarole district are low. The key factors included knowledge, healthcare relationships, and access, highlighting the need for better awareness, training, screenings, access, and organizational collaboration.