Child health clincs and inverse care laws: evidence from longitudinal study of 1878 pre-school children.

In a longitudinal study it was intended that 1878 children should receive periodic developmental examinations from the age of 6 weeks to 3 years. The children were divided into those with a high or low risk of developmental problems. Although clinic attendance rate of 85-89% were achieved in the catchment area 100% coverage was difficult because of population mobility and non-attendance at clinics. Children in families who moved away from the area were more difficult to trace and thus more likely to miss developmental examinations. This was a greater problem in the high-risk group. Altogether 683 home developmental examinations were carried out on 269 children who did not attend clinics. Thirty-five per cent of these children were in the high-risk group compared with 22% in the study population, and significantly more had developmental problems. Thus one possible way of reaching and helping such children is though home developmental examinations.