The Practicality of conducting multi- domain disorders screening in preschools from low income communities in South Africa: A cross-sectional observational study
1
Audiology, University of KwaZulu-Natal, Durban, South Africa
2
Speech-Language Pathology, University of Massey, Auckland, New Zealand
3
Institute of Neurology, University College London (UCL),, London, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):A1476
ABSTRACT
BACKGROUND:
The lack of ongoing developmental surveillance in Africa hampers early detection of multidomain disorders related to vision, speech, language, and hearing impairments [1-2]. Early Childhood Development Centres (ECDC) could serve as community-based platforms for screening; however, practical implementation evidence in resource-limited settings remains scarce and warrants systematic investigation [3-4]. Setting: In Africa, multidomain developmental screening at ECDC is uncommon.
AIM:
This study examines the practical considerations influencing the implementation of a multi-domain developmental screening program within low-resource ECDCs in South Africa, based on cross-sectional observational data collected during screening.
METHODS:
A quantitative, descriptive, observational study was conducted across 30 public ECDCs in low-income areas of Durban, South Africa, including Phoenix, Inanda, Ntuzuma, and KwaMashu. Using proportional geographical sampling to identify ECDC for inclusion, census testing screened 731 children, and data on logistics, environmental factors, and screening outcomes were collected using a self-developed observational tool.
RESULTS:
While screening uptake was high, environmental and logistical challenges especially in rural sites posed barriers. Median screening times were efficient; however, high noise levels affected the accuracy of communication assessments. Findings support utilizing low-cost, portable tools combined with environmental modifications are necessary to improve early detection and equitable access to interventions.
CONCLUSIONS:
Multidomain screening is feasible in low-resource ECDCs. Sustainable implementation requires innovative service delivery models that address logistical, environmental, financial, and referral pathway challenges. Careful planning and adaptation are essential to scale screening within existing health and education systems. Contribution: Effective, scalable screening in resource-poor contexts depends on meticulous logistical planning and contextual adaptations, informing integration into public health and educational frameworks.
The lack of ongoing developmental surveillance in Africa hampers early detection of multidomain disorders related to vision, speech, language, and hearing impairments [1-2]. Early Childhood Development Centres (ECDC) could serve as community-based platforms for screening; however, practical implementation evidence in resource-limited settings remains scarce and warrants systematic investigation [3-4]. Setting: In Africa, multidomain developmental screening at ECDC is uncommon.
AIM:
This study examines the practical considerations influencing the implementation of a multi-domain developmental screening program within low-resource ECDCs in South Africa, based on cross-sectional observational data collected during screening.
METHODS:
A quantitative, descriptive, observational study was conducted across 30 public ECDCs in low-income areas of Durban, South Africa, including Phoenix, Inanda, Ntuzuma, and KwaMashu. Using proportional geographical sampling to identify ECDC for inclusion, census testing screened 731 children, and data on logistics, environmental factors, and screening outcomes were collected using a self-developed observational tool.
RESULTS:
While screening uptake was high, environmental and logistical challenges especially in rural sites posed barriers. Median screening times were efficient; however, high noise levels affected the accuracy of communication assessments. Findings support utilizing low-cost, portable tools combined with environmental modifications are necessary to improve early detection and equitable access to interventions.
CONCLUSIONS:
Multidomain screening is feasible in low-resource ECDCs. Sustainable implementation requires innovative service delivery models that address logistical, environmental, financial, and referral pathway challenges. Careful planning and adaptation are essential to scale screening within existing health and education systems. Contribution: Effective, scalable screening in resource-poor contexts depends on meticulous logistical planning and contextual adaptations, informing integration into public health and educational frameworks.
| eISSN: | 2654-1459 |
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