Supporting early childhood development during COVID-19 using telehealth: stakeholders’ perspectives

Timely assessment and intervention for developmental delays is a high priority in child healthcare, yet obtaining access to early developmental care services remains a challenge in low-and middle-income countries, such as South Africa, which has a shortage of healthcare professionals. The outbreak of COVID-19 in 2020 exacerbated these barriers, and alternative solutions for service delivery are needed. Telehealth holds potential as an innovative approach for the provision of early childhood developmental care services during the COVID-19 pandemic. The chapter aims to explore the feasibility of early developmental telehealth through stakeholders’ perspectives. To explore perspectives of tele-assessment, 30 caregivers of children (birth to 36 months) completed an online developmental assessment followed by an online questionnaire probing their perspectives thereof. Nineteen final-year student healthcare clinicians completed a survey on their initial experiences of tele-intervention, which was initiated mid-year during lockdown level 4. The perspectives of four caregivers and 10 student-clinicians were probed at the end of 2020 through synchronous online interviews. Almost all caregivers (96.7%, n=29) rated their overall tele-assessment experience as positive. The majority (66.7%, n=20) identified tele-assessment as a viable assessment mode; however, 53.8% (n=14) indicated that they would want face-to-face assessments to supplement tele-assessments. This suggests that families may prefer a hybrid approach to developmental assessment. Although they were initially apprehensive, caregivers and student-clinicians found tele-intervention to be a viable and positive approach to service delivery during the COVID-19 pandemic. Caregivers and student-clinicians faced similar technological challenges, but all experienced benefits from the telehealth services, including continued access to services during the pandemic. The tele-intervention framework successfully provided structure to online interventions. Telehealth, as part of the proposed hybrid service delivery model, provides caregivers access to developmental care, despite COVID-19 restrictions.