Selecting an Early Child Development Assessment Tool in Rural Limpopo, South Africa

More than 200 million children under five fail to reach their cognitive potential due to poverty, poor health, poor nutrition and lack of care. Providing increased cognitive stimulation or learning opportunities to young children significantly increases cognitive and social-emotional competence later in life. An interdisciplinary team of students from the United States worked with the University of Venda and the Vhembe Health District in Limpopo to determine the acceptability and feasibility of a pediatric assessment tool and program to track child development in a rural health district in Limpopo, South Africa.  A total of 11 primary health nurses from the region in two focus groups were selected to learn and compare two child development assessment tools: the Cognitive Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS) and Ages and Stages Questionnaire (ASQ).  Data were analyzed using versus coding to compare between the two focus groups and between ASQ and CAT/CLAMS.  There were no major differences in the opinions between the two focus groups.  The major categories that emerged from the discussion were current practice, usability, resource management, cultural adaptation, patient and parent factors, and new knowledge.  The two tools were compared within these categories and the Ages and Stages program was most feasible for this population.  This study is the first to investigate any type of child developmental assessment in rural, sub-Saharan Africa, and is a small step to improving overall child health in this region through developmental tracking and parental education.