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Early Interventions for Infants at Risk for Developmental Impairment: The South Asian Perspective

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Abstract

Majority of under-five children with developmental disabilities live in low- and middle-income countries (LMIC). A considerable proportion of disabilities results from perinatal adversities. The neonatal and infant mortality rates in India, Bangladesh, and Sri Lanka have improved over the last two decades, implying survival of infants at risk for developmental impairments. The need to thrive beyond survival is a well-recognized concept and it is imperative to establish high-risk infant follow-up (HRIF) programmes to capture these infants within the first 1000 d of life. Many challenges are present within the LMICs to identify infants at risk and to ensure early intervention (EI) during the window of optimal neural plasticity. However, it is essential to acknowledge the strengths within such systems to understand the impact of these programmes and packages on the activity and participation of these infants and their families. The International Classification of Functioning, Health and Disability for Children and Youth (ICF-CY) version is a holistic framework that will enable the families, clinicians, and policymakers to measure the impact of these interventions. Though all three countries have national policies to reach for high-risk infants, there is lack of published evidence on the successful implementation of such strategies. Therefore, it is timely to establish universally accessible, culturally appropriate and sustainable HRIF programmes. It is also recommended to measure the outcomes of such programmes based on the ICF-CY to understand the impact on the activity and participation of children in South Asia.

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Author information

Authors and Affiliations

  1. Acting Community Pediatrician, Ministry of Health, Colombo, Sri Lanka

    Dilini Vipulaguna

  2. Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh

    Ismat Jahan

  3. Department of Pediatrics, All India Institute of Medical Sciences, Nagpur, Maharashtra, India

    Meenakshi Girish

  4. Department of Pediatrics, DEIC, Nodal Officer, Vani Vilas Hospital, Bangalore Medical College & Research Institute, Bangalore, Karnataka, India

    Gayathri Devi Chinnappa

  5. Department of Developmental Medicine Sagar Hospitals, Jayanagar, Bangalore, Karnataka, India

    Shashikala Gopalaswamy

  6. District Early Intervention Center (DEIC), Vanivilas Hospital, Bangalore Medical, College & Research Centre, Bengaluru, Karnataka, India

    Shashikala Gopalaswamy

  7. Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh

    Mohammod Shahidullah

  8. Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Sri Lanka Ayati National Centre for Children With Disabilities, North Colombo, Teaching Hospital, P O Box 6, Thalagolla Road, Ragama, 11010, Sri Lanka

    Samanmali P. Sumanasena

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  1. Dilini Vipulaguna
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  2. Ismat Jahan
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  3. Meenakshi Girish
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  4. Gayathri Devi Chinnappa
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  5. Shashikala Gopalaswamy
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  7. Samanmali P. Sumanasena
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Contributions

DV: Sri Lankan perspective, majority of literature review, preparation of figures, planning, and conceptualization; IJ, MS: Conceptualization, Bangaladeshi perspective, editing the manuscript, and literature review; MG, SG, GDC: Conceptualization, Indian perspective, editing the manuscript, and literature review; SPS: Sri Lankan perspective, preparation of the manuscript, literature review, planning, and conceptualization. SPS will act as the guarantor for this paper.

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Correspondence to Samanmali P. Sumanasena.

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Vipulaguna, D., Jahan, I., Girish, M. et al. Early Interventions for Infants at Risk for Developmental Impairment: The South Asian Perspective. Indian J Pediatr 89, 254–261 (2022). https://doi.org/10.1007/s12098-021-03871-w

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