INTRODUCTION: Early intervention (EI) is critical for improving developmental outcomes among children at risk of developmental delays, yet implementation in low- and middle-income countries remains constrained. This study assessed healthcare provider practices, facilitators, and barriers to EI service delivery at the University Teaching Hospital of Kigali (CHUK).
METHODS: A facility-based cross-sectional study was conducted among 108 healthcare providers involved in pediatrics and rehabilitation services. Data were collected using structured questionnaires administered via Kobo Toolbox, capturing developmental screening practices, referral systems, facilitators, and perceived challenges. Descriptive statistics and chi-square tests were used to examine associations between provider characteristics and EI practices
RESULTS: Routine developmental monitoring was moderately implemented, with 49.1% of providers consistently assessing developmental milestones and 33.3% incorporating caregiver education. However, major gaps were identified in structured EI systems: 42.6% reported limited use of standardized screening tools, 64.8% lacked confidence in referral, and 66.7% reported absence of clear referral pathways. Key facilitators included multidisciplinary teamwork (60.2%), access to assistive devices (64.8%), and staff training or mentorship (50.9%). Major barriers included inadequate rehabilitation infrastructure (55.6%), limited outreach services (75.9%), insufficient trained personnel, and low caregiver awareness. No significant associations were observed between provider socio-demographic characteristics.
CONCLUSION: While foundational EI practices exist at CHUK, critical weaknesses in screening, referral systems, and service integration limit effective implementation. Strengthening standardized screening, referral pathways, provider capacity, and community outreach is essential to improve early identification and equitable access to EI services in Rwanda.
