ABSTRACT:
In resource-constrained health facilities, the absence of dedicated screening for multidomain developmental disorders among children aged 0–5 underscores the need to identify alternative platforms for early detection, such as Early Childhood Development Centres (ECDCs) [1-3]. While ECDCs present a promising avenue for early intervention in socioeconomically disadvantaged communities, their potential role as hubs for screening and intervention remains insufficiently examined, particularly regarding the practical barriers to integration implementation methods of such programes in these contexts [3-6]. This study investigates the feasibility challenges of integrating multidomain developmental screening within the community infrastructure of ECDCs in eThekwini, KwaZulu-Natal. A quantitative, cross-sectional observational case study was conducted across 30 publicly funded ECDCs in low-income area. Multi-stage sampling was employed, integrating multiple sampling strategies to ensure comprehensive representation. Integration was assessed for workflow alignment (lowest, with overall means of 2.05 (SD = 1.39) and 2.11 (SD = 1.29) with 30%), scheduling compatibility (poor mean = 2.00, SD = 0.88), with 5%), documentation fit (moderate (mean = 3.05, SD = 1.65), with 42%), referral pathway compatibility, coordination (strength, with a mean score of 4.42 (SD = 0.61) and 95%) with ECDC practitioners, synergy with community resources, and feasibility of data sharing (mean = 4.53, SD = 0.61),95%) the similar. Overheads total R1,004,515, equating to R33,483.83 per ECDC and R1,374.17 per child. Transport is the largest cost driver (35.8%, R360,000; R12,000/ECDC, R492.48/child). A significant obstacle is the poor follow-up and tracking of children after initial screening. Multidomain developmental screening in resource constraint ECDC in the current service delivery method is not feasibile and requires ideological, methodological and financial shift to be contextually relavant.