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Diagnostic Accuracy of the Government of India Mother and Child Protection Card for Developmental Screening of Indian Children Aged 2–36 Months: A Hospital-based Mixed Method Study

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Abstract

Background

Universal developmental screening is recommended at 9, 18, 24 and 36 months. The Government of India Mother and Child Protection (MCP) card is an immunization record that is used to monitor child development, and identify children requiring further evaluation.

Objectives

To determine the diagnostic accuracy of the MCP card for developmental screening, and perform its item analysis.

Study design

Mixed-method study (prospective study of diagnostic accuracy and qualitative study).

Participants

Mother-child dyads of children between 2–36 months of age were recruited from the outpatient department or wards of a tertiary level children’s hospital from November, 2019 to October, 2021. Children with confirmed neurodevelopmental disorders/disability, and mothers with less than 6th standard education were excluded.

Intervention

Each mother was given a MCP card, and taught how to mark the items. This was followed by the researcher’s evaluation (index tool). The reference tool was a comprehensive clinical assessment (CCA) by the researcher and an expert. The CCA included clinical examination of hearing, vision, and neuro-development; and psychometric assessment of development and adaptive function. Each mother underwent an in-depth interview. Overall and group wise psychometric properties of diagnostic accuracy were computed. The interview transcripts were analyzed thematically.

Outcomes

The proportion of children with ‘fail’ and ‘delay’ by the evaluation of the researcher with the MCP card and the expert by the CCA, respectively.

Results

The study population included 213 children (40.4% females). Fifty-two (24.4%) children were identified as ‘Fail’ by the MCP card and 43 (20.2%) as ‘delay’ by the expert’s CCA. The overall sensitivity and specificity was 83.7% (95% CI 69.3–93.2) and 90.6% (95% CI 85.2–94.5), respectively. Acceptable diagnostic accuracy was found in the age-group 7–9 months, 13–18 months, and 25–36 months.

Conclusions

The MCP card may be used for developmental screening at 9, 18, and 36 months.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children’s Hospital, New Delhi, India

    Sharmila B. Mukherjee, S. Meghana, Suvasini Sharma & Dipti Kapoor

  2. Rashtriya Bal Swasthya Karyakram, Ministry of Health & Family Welfare, Government of India, New Delhi, India

    Arun Kumar Singh

  3. Department of Pediatrics, Kalawati Saran Children’s Hospital, New Delhi, 110 001, India

    Sharmila B. Mukherjee

Authors
  1. Sharmila B. Mukherjee
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  2. S. Meghana
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  3. Arun Kumar Singh
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  4. Suvasini Sharma
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  5. Dipti Kapoor
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Corresponding author

Correspondence to Sharmila B. Mukherjee.

Additional information

Ethics clearance

Institutional Ethics Committee, Lady Hardinge Medical College New Delhi; No. LHMC/IEC/Thesis/2019/95, dated Oct 28, 2019.

Contributors

SBM and AS conceptualized the study; SBM and SS planned the design of the study; SBM, SS, and DK were the neuro-developmental experts; SBM, MS, DK and SS were involved in collection and analysis of data; SBM and MS prepared the preliminary draft. All authors gave their intellectual inputs during critical revision, and approved the final manuscript.

Funding

None

Competing interests

None stated.

Note

Additional material related to this article is available at www.indianpediatrics.net

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Mukherjee, S.B., Meghana, S., Singh, A.K. et al. Diagnostic Accuracy of the Government of India Mother and Child Protection Card for Developmental Screening of Indian Children Aged 2–36 Months: A Hospital-based Mixed Method Study. Indian Pediatr 60, 187–192 (2023). https://doi.org/10.1007/s13312-023-2832-1

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  • DOI: https://doi.org/10.1007/s13312-023-2832-1

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