Non-specialist delivery of the WHO Caregiver Skills Training Programme for children with developmental disabilities: stakeholder perspectives about acceptability and feasibility in rural Ethiopia

TY - JOUR

T1 - Non-specialist delivery of the WHO Caregiver Skills Training Programme for children with developmental disabilities

T2 - stakeholder perspectives about acceptability and feasibility in rural Ethiopia

AU - Zerihun, Tigist

AU - Kinfe, Mersha

AU - Koly, Kamrun Nahar

AU - Abdurahman, Rehana

AU - Girma, Fikirte

AU - WHO CST Team, null

AU - Hanlon, Charlotte

AU - de Vries, Petrus J.

AU - Hoekstra, Rosa

N1 - Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: The Ethiopian WHO CST study was funded by Autism Speaks (#9817) and by a grant (MR/P020844/1) from the Joint Global Health Trials scheme, funded by the Medical Research Council (MRC), Department of Health and Social Care (DHSC), the Foreign, Commonwealth & Development Office (FCDO) and the Wellcome Trust. C.H. is funded through the ASSET research programme, supported by the UK’s National Institute of Health and care Research (NIHR) (NIHR Global Health Research Unit on Health Systems Strengthening in Sub-Saharan Africa at King’s College London (16/136/54)) using UK aid from the UK Government. R.A.H. and C.H. also receive support from NIHR through grant NIHR200842 using UK aid from the UK Government. The views expressed in this publication are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care, England. C.H. also receives support from the Wellcome Trust (Grant 222154/Z20/Z). Publisher Copyright: © The Author(s) 2023.

PY - 2023/5/16

Y1 - 2023/5/16

N2 - Autism and other developmental disabilities (DD) are common in low- and middle-income countries. The World Health Organization (WHO) developed the Caregiver Skills Training (CST) programme to address the needs of families with children with DD globally. This study explored the acceptability and feasibility of the CST facilitated by non-specialists in rural Ethiopia, where contextual factors such as poverty, stigma and low literacy may affect CST delivery. In-depth interviews were conducted with caregivers (n=19) and four focus groups with non-specialist facilitators (n=8) in two rural pilot tests of the CST programme. Results suggested that participants experienced the CST programme as acceptable and relevant for their context but suggested some modifications to improve the programme. Caregivers’ accounts showed that facilitation by non-specialists was acceptable; facilitators emphasised the importance of supervision throughout the programme. Participants indicated that the home visit and group training modalities were acceptable and feasible. Facilitators indicated that some CST topics were difficult to explain to caregivers; the concept of formalised play between caregiver and child was particularly foreign to caregivers. Lack of available toys made it difficult to practise some of the CST exercises. These findings may have relevance to non-specialist delivery of the CST and other parent-mediated interventions in low-resource contexts.

AB - Autism and other developmental disabilities (DD) are common in low- and middle-income countries. The World Health Organization (WHO) developed the Caregiver Skills Training (CST) programme to address the needs of families with children with DD globally. This study explored the acceptability and feasibility of the CST facilitated by non-specialists in rural Ethiopia, where contextual factors such as poverty, stigma and low literacy may affect CST delivery. In-depth interviews were conducted with caregivers (n=19) and four focus groups with non-specialist facilitators (n=8) in two rural pilot tests of the CST programme. Results suggested that participants experienced the CST programme as acceptable and relevant for their context but suggested some modifications to improve the programme. Caregivers’ accounts showed that facilitation by non-specialists was acceptable; facilitators emphasised the importance of supervision throughout the programme. Participants indicated that the home visit and group training modalities were acceptable and feasible. Facilitators indicated that some CST topics were difficult to explain to caregivers; the concept of formalised play between caregiver and child was particularly foreign to caregivers. Lack of available toys made it difficult to practise some of the CST exercises. These findings may have relevance to non-specialist delivery of the CST and other parent-mediated interventions in low-resource contexts.

UR - http://www.scopus.com/inward/record.url?scp=85159846262&partnerID=8YFLogxK

U2 - 10.1177/13623613231162155

DO - 10.1177/13623613231162155

M3 - Article

SN - 1362-3613

JO - Autism

JF - Autism

ER -