Our Pediatric Care Project will create a health system to identify refugee children at risk of developmental delay. Early detection of developmental delay improves child & family well-being & contributes to life-long health. Working with physicians from Boston Children’s Hospital & the Happy Child Center, Ramallah, we will serve children in 3 West Bank camps with a total population of 40,000.

The center of this work are checkups, or well child exams. In them we screen for normal growth & development. In these screenings we can look for signs of developmental delay, such as language or speech delay, global delay, or autism. Through the screening process we will increase access for needy families to specialists who can then diagnose formally a condition & work towards long-term support. There is no magic pill or surgery for a developmental delay but rather an interdisciplinary approach towards improving support and life.

We aim to accompany new families who have just had a first child. Achieving a ratio close to 1 CHW to 20 families is our service goal. The project will start in the fall of 2024. We will follow children for 2 years, adding more newborns during the rollout period. Site locations will begin in the UN-run Aida camp & after it move to the UN-run Balata camp as well as to some locations in the Jordan Valley.

Early Childhood Development (ECD) in the West Bank faces care gaps. Only 47% of children experience development activities. There is also limited access to early learning and cognitive development, with only 34% of children aged 3-to-4 attending early childhood care and education. Per a 2015 World Bank report, children had gaps in exposure to developmental activity, specifically in cognitive development, such as reading books, telling stories, and ‘naming, counting, or drawing’. In all activities, including these as well as ‘taking outside’, singing songs, and playing, only 47% of children aged 0-to-4 had experienced 4% percent or more of the developmental activities, with 2% experiencing none. As of 2010, data only existed on these activities for children aged 3-to-4, leaving concern and uncertainty regarding ages 0-to-2.[1]

[1] https://www.worldbank.org/content/dam/Worldbank/document/mna/en/WestBankAndGaza_ecd_ch14.pdf.

The World Health Organization estimated that in 2019, 317 million children & young people were impacted by health conditions that supported the growth of a developmental disability. The diagnosis often came with stigma, marginalization & difficulties in accessing adequate care. Children with developmental delay were found to have a higher premature death rate & as adults experienced significant health problems. Access to a diagnosis & then to care was often found to be fragmented or unavailable. Source.

In Palestine (West Bank and Gaza) research-based data is still growing. One study found that parents of children with developmental delay face small & large barriers to care & support. Another report, by UNICEF State of Palestine, found that children with developmental delay & their care givers face marginalization, stigma, discrimination & challenges related to life under military occupation as barriers to care. Care givers were primarily mothers, usually lacking needed emotional support. They also found it difficult to access care for diagnosed children for a variety of reasons including inadequate transportation, high cost, poor communication & inadequate medical services. Community approaches to reducing stigma, expanding access & reducing barriers to care were thought to be effective towards expanding levels of care.