Maribel Muñoz1,2, Adrianne Nelson3,2, Maureen Johnson1, Nancy Godoy1, Esther Serrano1, Engerid Chagua1, Jesica Valdivia1, Janeth Santacruz1, Milagros Wong1, Lenka Kolevic4, Betsy Kammerer5, Clemente Vega5, Martha Vibbert6, Shannon Lundy7, Sonya Shin1,8,9. 1. 1 Socios En Salud, Lima, Peru. 2. Ms. Munoz and Ms. Nelson are co-first authors of this paper. 3. 2 Harvard Medical School, Department of Global Health and Social Medicine, Boston, MA, USA. 4. 3 Infectious Disease, Instituto Nacional del Salud del Niño, Lima, Peru. 5. 4 Boston Children's Hospital, Boston, MA, USA. 6. 5 SPARK Center, Mattapan, MA, USA. 7. 6 University of California San Francisco Benioff Children's Hospital, San Francisco, CA, USA. 8. 7 Department of Infectious Disease, Brigham and Women's Hospital, Boston, MA, USA. 9. 8 Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA.
Abstract
BACKGROUND: In many resource-poor settings such as Peru, children affected by HIV have a high prevalence of neurodevelopmental delays (NDDs) and remain excluded from adequate treatment. METHODS: Community health workers (CHWs) administered NDD screening instruments to assess child development and associated caregiver and household factors in 14 HIV-affected parent-child dyads. Focus group discussion with caregivers was conducted to explore their needs and behaviors around early child stimulation and to assess their perceptions of the screening experience. RESULTS: Over 70% of the children had abnormal classification in at least 1 (out of 5) developmental domains according to Ages and States Questionnaire-provided cutoff scores. Caregiver depression and stress were associated with abnormal development as were some parenting behavior factors. Knowledge about child development was low. Caregivers felt testing and discussing results with a CHW were very insightful. Reported caregiver behavior differed between caregivers with HIV-infected children and those with uninfected children. CONCLUSION: Taken together, these exploratory quantitative data suggest that parenting behaviors associated with low child development scores may be modifiable and that community-based testing is well received and informative to these HIV-infected caregivers.
BACKGROUND: In many resource-poor settings such as Peru, children affected by HIV have a high prevalence of neurodevelopmental delays (NDDs) and remain excluded from adequate treatment. METHODS: Community health workers (CHWs) administered NDD screening instruments to assess child development and associated caregiver and household factors in 14 HIV-affected parent-child dyads. Focus group discussion with caregivers was conducted to explore their needs and behaviors around early child stimulation and to assess their perceptions of the screening experience. RESULTS: Over 70% of the children had abnormal classification in at least 1 (out of 5) developmental domains according to Ages and States Questionnaire-provided cutoff scores. Caregiver depression and stress were associated with abnormal development as were some parenting behavior factors. Knowledge about child development was low. Caregivers felt testing and discussing results with a CHW were very insightful. Reported caregiver behavior differed between caregivers with HIV-infectedchildren and those with uninfected children. CONCLUSION: Taken together, these exploratory quantitative data suggest that parenting behaviors associated with low child development scores may be modifiable and that community-based testing is well received and informative to these HIV-infected caregivers.
Entities:
Keywords:
child development; children affected by HIV; community health; community health workers; training