Missed Appointments at a Child Development Centre and Barriers to Access Special Needs Services for Children in Klang Valley, Malaysia: A Mixed Methods Study.

Fariza Fadzil,Azmi Mohd Tamil,Norazlin Kamal Nor,Idayu Badilla Idris,Juriza Ismail,Noor Ani Ahmad,Kamaliah Mohamad Noh,Rohana Ismail,Salimah Othman,Noraziani Khamis

doi:10.3390/ijerph19010325

Abstract

Attending appointments is vital for children with special needs, as such appointments involve long-term interdisciplinary care to ensure continuity of care and improve health and well-being. This study was performed to determine the prevalence of missed clinic appointments and identify the factors among those who have ever missed appointments and barriers of access to children’s special needs services at the Child Development Centre (CDC) at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Moreover, suggestions for improvement from the caregivers’ perspectives were explored. This is an explanatory sequential mixed methods study among caregivers of children with developmental disabilities aged up to 17 years old. Of 197 caregivers, 62 (31.5%) had missed clinic appointments. Forgetfulness was the most frequently cited reason. The bi-variable analysis showed significant differences in missed appointment rates by gender of caregivers and duration of follow-up. The final logistic regression model demonstrated that, when combined with the effect of being a male caregiver as an independent variable, follow-up duration of more than 6 years increased 2.67 times the risk of missing an appointment. Caregivers’ perceived barriers were transportation, caregiver, child and healthcare services factors. Policies and strategic plans should be focused on key findings from these factors to improve appointment adherence and accessibility to services for children with special needs.

Highlights

The World Health Organization (WHO) estimates that 15% of the global population has some form of disability, of whom 2 to 4% experience substantial difficulties in functioning [1]
The objective of this study is to determine the prevalence of missed clinic appointment and to identify its factors, and among those who ever missed appointments, we explore the barriers of access to children’s special needs services at the Child Development Centre in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) and suggestions for improvement from the caregivers’ perspectives
This study signifies an imperative step toward understanding missed appointments and factors associated with it, barriers of access to child development centres among children with developmental disabilities and suggestions for improvement from the caregivers’ perspectives

Summary

Introduction

The World Health Organization (WHO) estimates that 15% of the global population has some form of disability, of whom 2 to 4% experience substantial difficulties in functioning [1]. In Malaysia, the National Health and Morbidity Survey 2019 reported that 11.1% of adults and 4.7% of children were found to have disabilities [2]. The need for rehabilitation services has increased swiftly, with contributing factors including the advances in perinatal care (leading to increased survival rates among children with disabilities), variation.

Objectives

Methods

Results

Discussion

Conclusion