A Pilot Study of Early Intervention for Families With Children With or at Risk of an Intellectual Disability in Northern Malawi

Abstract

AbstractIn low‐income rural communities, access to early intervention and support services is restricted and resources needed to support children and families are limited. The aim of this study was to explore the role of local nonprofessional women, recruited as community home visitors (CHVs), to assist trained professionals in supporting parents with educating their child in their home environment. Structured questionnaires were developed and completed by interview. Three Portage staff, four trained CHVs, and a convenience sample of ten parents with children (aged <6 years) participated. An independent researcher conducted the interviews and parent interviews were assisted by a translator. Findings show that the CHVs are satisfied with the training received, are passionate about their job, and engaged parents with ease and as a friend. Challenges encountered include stigma, social exclusion of families, and a lack of community knowledge on how to help. Parents reported satisfaction with the support received, positive views of the home visits, varied progress in their child's development, increased involvement by fathers and siblings in the care of the child but continued lack of neighbor involvement, and some community pressure. Results show the centrality of using local women trained as home visitors in rural communities. Reciprocal respectful and trustful relationships can help to sustain parental compliance with an intervention program. The CHVs' presence in the village places them in a mediating role in efforts to integrate and destigmatize families and children with disabilities. More civic education and targeted anti‐stigma campaigns could provide a more inclusive and positive learning environment.