Abstract
This research aimed to examine the current status of early childhood development,
including caregiving practices and the use of the Developmental Surveillance and Promotion
Manual (DSPM) among primary caregivers; and investigate selected factors influencing child
development. And to study the model of early childhood development (ECD) promotion
implemented by Sub-district Health Promoting Hospitals (SHPHs) under the transfer of
authority to local administrative organizations (LAOs); A mixed-methods approach, combining
quantitative and qualitative research, was employed.
For the quantitative research, the study population included 3,961 children aged
9 months to 5 years and 11 months 29 days, along with their primary caregivers (parents
or family members aged 20 years and above) across 12 health regions and Bangkok,
Thailand. Data were collected through structured interviews using a questionnaire
developed by the researchers. The questionnaire covered family and child information,
DSPM-based developmental promotion practices and caregiver satisfaction with the DSPM.
Data were analyzed using frequency distributions, percentages, means, and standard
deviations. The Chi-square test was used to explore associations between variables and
multiple logistic regression was employed to identify factors influencing developmental
outcomes.
For qualitative research, in-depth interviews were conducted with 53 participants,
including Provincial Administrative Organizations, public health division directors, provincial chief
medical officers or heads of health promotion (in provinces where SHPHs had not yet
been transferred to the PAO), district public health officers, SHPH directors or early
childhood development personnel, Village Health Volunteers (VHVs), childcare teachers
early childhood development centers, and families or caregivers of young children. Data
were analyzed using content analysis.
The findings indicated that parental education, adequacy of household income,
parental relationship status, exclusive breastfeeding during the first six months, enrollment
in early childhood development centers, and caregivers’ access to and use of the DSPM
were significantly associated with child development. Children in families with insufficient
income, who were not breastfed in the first six months, or whose caregivers had not received
or rarely used the DSPM, were more likely to experience suspected developmental delays.
The study also found that SHPHs, under the transfer to LAOs, often lacked clear strategic
direction in promoting early childhood development. Key challenges included insufficient
personnel, unclear budget allocation, unintegrated data systems, and relatively lower
prioritization of early childhood compared to other age groups.
The study recommends prioritizing investment in early childhood development,
promoting integrated collaboration at both policy and local levels, and developing a comprehensive
database to support young children and the personnel involved in their care.
